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Resume La pathologie sportive de l’enfant et de l’adolescent a pris, ces dernieres annees, une importance considerable du fait de la pratique du sport a des âges de plus en plus jeunes et a des niveaux de plus en plus eleves. A cause de l’immaturite musculo-squelettique, des entites particulieres a l’enfant ont pu etre individualisees dont la plus frequente est representee par les arrachements apophysaires. D’autres entites, a savoir les arrachements diaphysaires, connues surtout chez l’adulte, peuvent se voir chez l’enfant. A travers deux observations pediatriques d’arrachements musculaires diaphysaires des muscles adducteurs, lesion rare et souvent meconnue, nous allons definir les caracteristiques cliniques, radiologiques et therapeutiques de cette lesion.

The aim of this study was to evaluate the results of two antibiotic therapy protocols for osteomyelitis with different durations of intravenous treatment. This was a prospective randomized study of children treated for acute hematogenous osteomyelitis. Patients in group 1 (G1) received 7 days of intravenous antibiotics, whereas patients in group 2 (G2) received 14 days. Treatment was deemed effective if there were no signs of chronic osteomyelitis at the last follow-up. Fifty-three patients were included in the study (G1=27, G2=26). After a mean follow-up of 11.5 months, none of the patients in either group showed signs of chronic osteomyelitis. In conclusion, a shortened treatment of 7 days of intravenous antibiotic therapy is as effective as a longer treatment.

Hidradenoma is a rare benign tumor that develops of the eccrine sweat glands. We report here two cases of benign giant hidradenoma with a clear cell variant in one case and nodular in the other. The tumor was localized on the forearm in a patient aged 6 years and in the foot in a 14-year-old child. An excisional biopsy was performed in both patients. Evolution was marked by a good outcome without recurrence. We try through this paper to review an uncommon tumor which his eccrine origin is controversial and which biological behavior was badly known.

Dysplasia epiphysealis hemimelica (DEH), also known as Trevor's disease, is a rare congenital skeletal developmental disorder in childhood. It is characterized by an asymmetric osteocartilaginous overgrowth arising from epiphyses or epiphyseal equivalents. Lesions have hemimelic topography, usually occur in the lower limbs, most commonly in the ankle and the knee and affect either the medial or lateral part of one epiphysis. Objective The purpose of this study is to describe the imaging features of DEH by reporting four cases. Materials and methods We present four cases of DEH in one female and three males aged between 7 and 15 years. Lower limb is involved in all cases and patients suffer from pain, limited function and deformity. Radiographs and CT findings were reviewed. All patients were treated by surgical excision. Results Plain X-ray revealed in all cases an irregular ossification arising from the affected epiphysis. The CT scan revealed an irregular fragmented osteocartilaginous mass involved from the epiphysis, with enlargement of epiphyses and intra-articular extension. Conclusion The early diagnosis and treatment of DEH is necessary in preventing articular function, CT assists in defining the anatomic relationship between the mass and its parent epiphysis and in evaluating the condition of the articular cartilage and soft tissue. The distinct clinical and radiographic features should enable to differentiate the osteochondroma and the DHE.

Thirty-one hips in 27 young girls, treated for developmental dysplasia of the hip in the authors' institute since 2003, showed persistent radiographic evidence of residual acetabular dysplasia. These hips were registered as candidates for pelvic osteotomy. A prospective study was conducted and these hips were evaluated by magnetic resonance imaging (MRI); the average age of the patients was 5 years. MRI measurement of acetabular angle and acetabular head index in 2 different landmarks (bone and cartilage) was performed. The results were correlated with plain radiographic film evolution. MRI studies revealed sufficient cartilaginous acetabular coverage in 27 hips, cartilaginous acetabular dysplasia in 2 hips, and short acetabulum in 2 others. The 27 hips with thick cartilage of the acetabular roof were subsequently followed up by plain radiographs. The average follow-up period was 2.1 years. The authors observed a spontaneous progressive ossification of the cartilaginous acetabular roof in all the 27 cases. In 4 cases, the correction of the acetabular angle was complete. They concluded that MRI promotes more accurate selection of patients for pelvic osteotomy and aids in the choice of the most appropriate type of osteotomy. Clinical imaging examples are presented and need to be further evaluated.

Resume Nous rapportons une serie de 26 cas d’osteomyelite du calcaneum, afin d’etudier les particularites cliniques et paracliniques de cette localisation rare. Le tableau clinique n’etait pas specifique. La temperature n’etait superieure a 38,5 °C que dans 45 % des cas. La symptomatologie etait celle d’un syndrome douloureux et febrile de l’arriere-pied avec une impotence fonctionnelle du membre. La douleur etait a distance du calcaneum, ce qui a fait errer le diagnostic dans six cas. Le syndrome inflammatoire biologique n’etait pas constant. Une leucocytose superieure a 10 000 par millilitre n’a ete notee que dans 61 % des cas. Le diagnostic de l’osteomyelite du calcaneum a ete retenu sur la radiographie standard, en montrant une geode au niveau de calcaneum dans 12 cas, sur l’echographie, realisee chez 19 malades et qui a montre six decollements sous-periostes au niveau de calcaneum, trois collections au niveau de l’arriere-pied et quatre epaississements des parties molles. La scintigraphie osseuse, realisee dans un cas, a montre une hyperfixation en regard du calcaneum. L’IRM, realisee chez un patient, a pu mettre en evidence une anomalie de signal au niveau de calcaneum sous forme d’un hypersignal T2 et hyposignal T1, avec la presence d’un abces sous-perioste. L’enquete bacteriologique etait positive dans 53 % des cas. Le traitement etait medical dans tous les cas, 23 enfants ont du subir un acte chirurgical. Nos resultats ont ete etudies avec un recul moyen de deux ans avec des extremes de un an a sept ans. Dix-neuf malades (73 %) n’ont garde aucune sequelle. Sept malades (27 %) ont presente des mauvais resultats avec limitation importante de la mobilite au niveau de l’arriere-pied et une ankylose de la cheville. On a note sept passages a la chronicite avec fistules, dont une reste productive au dernier recul. Les mauvais resultats ont ete observes chez des patients traites tardivement avec un delai moyen de consultation de 17 jours. Six mauvais resultats sur sept associent des arthrites a l’atteinte du calcaneum (atteinte de la sous-talienne et la tibiotarsienene dans deux cas et atteinte de la sous-talienne dans quatre cas).

The purpose of this study is to evaluate the early results of the Ponseti method and the effectiveness of the Steenbek foot abduction brace. A total of 74 patients with 110 idiopathic clubfeet were included in this prospective study. The feet were evaluated according to the Dimeglio-Bensahel classification, the Catteral-Pirani classification and the functional classification of the Hospital for Joint Diseases. Ninety-eight feet (89%) had a good result after the casting period. All the feet evaluated after the period of full-time bracing and during the period of part-time bracing showed a good correction. The Ponseti method using the Steenbek foot abduction brace is effective in correcting idiopathic clubfeet.

Resume Nous rapportons une serie de 28 cas d’osteomyelite du col du femur afin de mettre en evidence les particularites cliniques et paracliniques de cette localisation. Le tableau clinique non specifique etait fait d’un syndrome douloureux de la hanche dans un contexte febrile. Le diagnostic de l’osteomyelite du col du femur a ete realise en se basant, sur l’imagerie (IRM et scintigraphie) dans trois cas avec une preuve bacteriologique dans deux cas, sur les constatations operatoires qui ont confirme l’atteinte du col dans 19 cas et sur les modifications de l’aspect radiologique du col dans six cas. Le traitement a ete medical dans tous les cas, 25 malades ont du subir un acte chirurgical. On a note cinq complications thromboemboliques et cinq cas d’evolution vers une pandiaphysite femorale. Nos resultats ont ete analyses avec un recul moyen de trois ans et demi. Sur le plan fonctionnel, la mobilite de la hanche etait complete dans 78 % des cas. On a observe quatre cas de raideur de la hanche et deux cas d’ankylose. Sur le plan anatomique, on a note deux cas de necrose cephalique partielle et deux cas de necrose totale de la tete et du col. L’analyse de nos resultats a montre que le pronostic de l’osteomyelite du col du femur est fonction du delai de prise en charge. Les malades traites tardivement presentent des mauvais resultats. L’evolution vers une pandiaphysite est un facteur pejoratif.

Resume But. – Le but de ce travail etait de rappeler qu’il existe de veritables paralysies du plexus brachial d’origine infectieuse osteoarticulaire. Observations. – Il s’agissait de trois nourrissons âges de moins de trois mois et d’un nouveau-ne de six jours qui ont presente une paralysie du plexus brachial dont la cause etait une osteoarthrite de l’epaule. Le diagnostic de l’osteoarthrite a ete fait sur des arguments cliniques, biologiques, d’imagerie et evolutifs. Dans un cas, le germe causal, un Enterobacter, a pu etre isole. Le diagnostic de la paralysie etait essentiellement clinique. Dans un cas, une electromyographie a mis en evidence la souffrance du plexus brachial. Le traitement a associe une antibiotherapie et des ponctions iteratives. La recuperation etait complete dans les quatre cas dans un delai de moins d’un mois. Commentaires. – L’infection osteoarticulaire de l’epaule est reconnue actuellement comme une cause de paralysie du plexus brachial. Une thrombophlebite septique du vaisseau nourricier des nerfs ou une compression extrinseque sont incriminees dans la genese de la paralysie. Le diagnostic et le traitement de l’infection doivent etre precoces.

Dirofilariasis is a zoonosis affecting dogs and cats. It was transmitted to man by mosquito bites. Human dirofilariasis is rare. We report a case of 4-year-old girl presented with a subcutaneous palmar nodule of the hand. Surgical excision shows a nodule encircling the forth flexor tendon. The histological examination established the diagnosis by the presence of an adult worm identified as Dirofilaria repens. Surgical excision was curative.

Background This research paper deals with the development of a medical robotized control system for supracondylar humeral fracture treatment. Concurrent access to shared resources and applying reconfiguration scenarios can jeopardize the safety of the system. Methods A new methodology is proposed in this paper, termed BROMETH, to guarantee the safety of such critical systems from their specification to their deployment, and passing through certification and implementation. The solution is applied to a real case study named Browser-based Reconfigurable Orthopedic Surgery (abbrev. BROS), a robotized platform dedicated to the treatment of supracondylar fractures, to illustrate the paper's contribution. This work starts from a medical issue, namely supracondylar humeral fracture treatment, to establish a new informatics solution, namely a new methodology to design safe reconfigurable medical robotic systems. Results The results of the experiments performed on real SCH fracture radiographies were quite satisfactory. Conclusions Clinical experiments can then be performed after deploying the system on real hardware.