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Trapezium fracture is a rare condition that goes undetected and exposes to long-term comorbidities : chronic pain and rhizartrosis. In presence of suggestive clinical presentation with a normal radiograph, CT scan should be considered. Therapeutic guidelines are not well established due to the lack of series reported in the literature.

Introduction: Traumatic knee dislocation is considered an orthopedic emergency. Knee dislocations are relatively infrequent injuries. This injury frequently occurs from high-energy impact trauma. Neurovascular injuries can result in debilitating consequences if the diagnosis and treatment are delayed. Associated complications include degenerative arthritis, permanent neurovascular injury, and amputation. The poorest prognosis is seen in patients with knee dislocation longer than 6-8 hours before reduction. History: The 25-year-old male patient presented with a history of a road traffic accident to the emergency department. The patient presented with swelling, pain, and deformity of the left knee and leg. Examination: On examination, the patient had tense swelling and tenderness of the left knee joint and leg. Visible deformity of the left knee joint is seen. The posterior tibial artery and dorsalispedis artery were not palpable. Active ankle and toe movements were absent. Investigations: Plain radiograph was taken at the emergency department of the left knee and leg. X-rays showed anterior dislocation of the knee joint. Treatment: After valid written informed consent, the dislocated left knee joint was reduced under sedation in the operation theatre and immobilized in the above knee plaster slab. Reduction of the knee joint was done within 4 hours of injury. Then the distal pulses were re-assessed. The posterior tibial and dorsalispedis artery was absent. Hence, MR Angiography of the left lower limb was done. It showed popliteal artery transection. So, the artery was explored and end-to-end vascular anastomosis was done. A knee-spanning external fixator was applied to the left lower limb. Fasciotomy was done for the tense leg compartments. After a week, the fasciotomy wounds were infected for which extensive debridement of the wounds was done and antibiotic beads were placed. Knee was mobilized with a gradual range of motion exercises and non-weight bearing mobilization with a foot drop splint. Gradually full weight-bearing ambulation was allowed. Conclusion: Knee dislocation is rare, albeit a serious and potentially limb-threatening condition. The prognosis of knee dislocations is variable and is heavily dependent on the time interval between trauma and initiation of management. Immediate, timely, and proper management can salvage the limb, and amputation is not the only solution. Keywords: Dislocation, Posterior tibial artery, Fasciotomy

Introduction: Compartment syndrome is a medical-surgical emergency. In fact, it is a "race against the clock" to reduce, as quickly as possible, the pressure inside a well-defined muscular compartment. Its development at the hand level as part of a crushing trauma is a rare localization and mainly affects the radial interosseous muscular compartment. The diagnosis of hand compartment syndrome is primarily clinical. Its classical clinical triad includes spontaneous pain, paralysis, and pain increase during passive extension. Any additional examination must not, in any sense, delay the patient's management. Ignoring this surgical emergency can cause permanent damage to the hand. Case report: In this article, we will discuss our experience with two cases who presented with hand compartment syndrome after suffering numerous metacarpal fractures as a result of trauma. The treatment included a discharge dermofasciotomy, metacarpal pinning, and close hand surveillance. Excellent outcomes were seen after three months, with complete functional recovery of hand mobility. Conclusion The compartment syndrome in the hand is a rare localization that affects the hand's functional prognosis. Its treatment consists of two key components: discharge aponeurotomy and bone stabilization. There should be no delay in surgical treatment for this syndrome.

Q1. How can this defective soft tissue be covered? Q2. What are the surgical requirements and postoperative instructions? Q3. What indicators are used to assess the sensitivity of the flap? Q4. How is the impact of this type of flap on the patient's daily life evaluated?

L´ostéome ostéoïde est une tumeur osseuse bénigne, mais douloureuse et dont le traitement consiste en l´exérèse chirurgicale totale. Les auteurs rapportent le cas d´un jeune patient présentant un ostéome ostéoïde de l´extrémité supérieure du radius avec une revue de la littérature.

Ankle dislocation without fracture is an extremely rare injury, requires high-energy trauma, up to 1995, only 73 cases were reported in the literature and 154 cases up to 2017. It is therefore a post-traumatic ankle disease growing in parallel with the increase in road-traffic accidents requiring the study of incriminated factors such as hypoplasia of the medial malleolus.The authors report the case of a young patient, a football player, who presented with a pure, closed dislocation of his ankle following a road-traffic accident. Management consisted of immediate reduction, followed by immobilization in plaster for 1 month, CLINICAL DISCUSSION: The short, medium and long term clinical and radiological results are excellent with no evidence of ankle instability or osteoarthritis.Ankle dislocation without associated fracture is an extremely rare injury. The posteromedial dislocation represents the most described variety in the literature. Early management, short-term immobilization, adapted and early rehabilitation seem to be associated with good long-term functional results.

Sclerosing Epithelioid Fibrosarcoma (SEF) is a rare form of soft tissue sarcoma. It is characterized by a slow evolution, with local recurrences and late metastases that are mainly pulmonary and pleural in about 50% of cases. The treatment is based on the surgery which must be as wide as possible. The efficacy of adjuvant therapy in the control of SEF is not yet demonstrated. Chemotherapy is used in recurrences, some have also proposed radiotherapy. Long-term follow-up of patients with SEF is therefore essential.

Carpal antelunar dislocations are much rarer than posterior dislocations. Their frequencies are between 3 and 6% of carpal perilunar dislocations. Out of 23 cases of carpal antelunar dislocations listed in the literature, there are only 11trans-scapho antelunar dislocations. Carpal antelunar dislocation and Fenton syndrome are two exceptional entities in the literature. In the case of Fenton syndrome, the head of the capitatum is described with a rotation of 90° to 180°. The association of these two entities remains anecdotal (3 cases described). The anterior approach of carpal antelunar fracture-dislocation was recently honored. This approach offers the benefit of better control of associated intracarpal fractures. In our case, the fracture of the capitatum forced us to a dorsal approach. This approach allowed the reduction and osteosynthesis of the scaphoid satisfactorily. At 3 months, the patient has very good clinical and radiological results.

Maxillofacial trauma is defined by the structures located between the capillary line upward and the tip of the chin downward. Our study is retrospective, covering 112 cases of extensive facial fractures over a period of two years from October 2016 to October 2018. Soft tissue lesions are excluded from our study. The goal is to define the epidemiological profile of facial fracture victims in Oujda and to adapt therapeutic modalities to local contexts. The incidence was highest in the 21 to 30 age group (36.6%). There were 7.6 men for a woman. The most common etiologies were in descending order; traffic accidents (60%), assaults (29%), sports accidents (6%). The frequency of these traumas increased in summer, especially in July-August. Mandible and nasal bone were the most affected (48.21% and 21.42%). In 16.96% of cases, it was a polytrauma. Head trauma was associated in 7.14% of cases.

Introduction : The odontogenic myxoma is a rare benign tumor of the maxilla, whose clinical and radiological manifestations are variable and nonspecific and can be confused with other radiolucent lesions. Its origin would be the embryonic mesenchyme of the dental follicle.Case report : We report the case of odontogenic myxoma of the right maxilla, discovered by chance in a 25 year old patient. Clinically, the patient had painless, firm on palpation, swelling of the right maxilla, impeding chewing and speech. Facial CT-scan showed an expansive osteolytic process blowing the right maxilla off. A biopsy was in favor of an odontogenic myxoma. The diagnosis was based on clinical, radiological and especially anatomopathological arguments.Conclusion : The local aggressiveness of the odontogenic myxoma and its high rate of recurrence justify a radical treatment beyond the lesion’s boundaries and thus imply a postoperative repair.

La rupture spontanée du muscle long extenseur du pouce (EPL) du tendon au niveau du poignet est rare et principalement rapportés après fracture du radius distal à tubercule de Lister, dans la synovite, ténosynovite ou la polyarthrite rhumatoïde. Nous rapportons 5 cas de rupture spontanée du tendon long extenseur du pouce, traités par une greffe ou un transfert tendineux.

Les fractures du scaphoide carpien sont de diagnostic et de traitement difficiles. Les auteurs rapportent les resultats du traitement de ces fractures par le vissage percutane par la vis de Herbert. Les resultats etaient interessants vu la rapidite de consolidation et la qualite du resultat fonctionnel.

Nous rapportons le cas d’une patiente de 45 ans sans antécédents médicaux particuliers, qui a présenté une atteinte inflammatoire du pied gauche, sans notion de traumatisme ni de fièvre, avec apparition secondaire d’une fistule cutanée purulente à la face externe du cou de pied. Les radiographies standards et la Tomodensitométrie de la cheville mettaient en évidence une ostéite calcanéenne avec atteinte articulaire subtalienne. Une biopsie chirurgicale associée à une excision des tissus inflammatoires et nécrotiques et l’ablation du trajet fistuleux, ont été réalisées. L’analyse histologique montrait une image de granulome épithélio-giganto-cellulaire avec une nécrose caséeuse et les prélèvements bactériologiques (retrouvaient Mycobacterium tuberculosis. Une chimiothérapie antituberculeuse a été administrée pendant 12 mois. À 24 mois, la patiente ne présentait pas de récidive mais une arthropathie dégénérative secondaire subtalienne. Il nous semble intéressant de rappeler que tout tableau clinique traînant ou toute lésion osseuse suspecte et de présentation atypique doit faire évoquer le diagnostic de tuberculose afin d’éviter des retards de diagnostic. Ceci permet une prise en charge thérapeutique précoce de la pathologie.

Introduction A travers ce travail, l’épidémiologie et la psychopathologie du suicide par précipitation seront rappelées, le rôle du chirurgien traumatologue dans la restauration physique et psychique sera démontré. Méthodes Nous rapportons une étude rétrospective de 15 suicidants par précipitation admis pour des traumatismes complexes de l’appareil locomoteur entre 2004 et 2007. Résultats Il s’agissait de primosuicidants, comprenant 10 femmes et 5 hommes. L’âge moyen des hommes est de 26,5 ans (24-34 ans) et celui des femmes de 40,7 ans (17-45 ans). Le bilan lésionnel des suicidants a retrouvé 14 fractures des membres inférieurs, 4 traumatisme du rachis avec compression médullaire dans 1 cas, une fracture du bassin; deux traumatismes du membre supérieur. Aucun de ces patients n’a présenté de lésions viscérales ni de traumatismes crâniofacial. 80% ( n = 12) des patients souffraient d’une affection psychiatrique avant leur passage à l’acte suicidaire : 8 pour une pathologie dépressive et 4 pour une schizophrénie. Chaque suicidant a subi au moins un acte chirurgical. Tous les patients avaient poursuivi la prise en charge psychiatrique en ambulatoire. Nos résultats fonctionnels étaient satisfaisants sans complications. Aucun des patients n’a récidivé. La pathologie suicidaire représente un problème de santé publique. Le suicide par précipitation représente 5 % de l’ensemble des modalités suicidaires. Les traumatismes occasionnés par ce mode suicidaire sont complexes et graves. Leur prise en charge nécessite une collaboration multidisciplinaire. Conclusion La réparation chirurgicale permet à la fois le rétablissement de la fonction et l’amélioration psychique du sujet prévenant contre une rechute dépressive ou une récidive suicidaire.

Introduction Isolated fracture of the trochlea is a rarely reported entity. To the best of our knowledge, only 15 cases have been published. We report the case of a patient with an isolated fracture of the trochlea and discuss through a literature review the underlying mechanisms and the clinical, radiological and therapeutic features of this lesion. This work will significantly advance our understanding of this particular fracture. Case presentation A 21-year-old Caucasian man received an elbow injury. An anteroposterior radiograph showed only an irregularity of the medial joint space, but a lateral radiograph showed an intra-articular half-moon-shaped fragment that had moved up and forward. A computed tomography scan confirmed an isolated fracture of his trochlea. Open reduction and internal fixation were performed with a good outcome. Conclusion An isolated fracture of the trochlea is rare. The mechanisms generating this fracture are complex. As with other front-line fractures of the distal end of the humerus, such as the capitulum, we recommend open reduction and internal fixation for displaced fractures, with excision of the small osteochondral fragments that do not permit any osteosynthetic repair.