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Metatarsophalangeal arthritis of the first ray of the foot, also known as hallux rigidus, is an invalidating cause of walking that is still underestimated. It is associated to a local deformation of the first ray with a limitation of the dorsal mobilization of the joint, affecting thus the propulsion of the foot. Several stages of the disease exist, and symptoms as well as the treatment will depend on the moment of the consultation. In this paper, we present the different clinical pictures and adapted treatments according to the stage of the disease, and we share our results of a new modality of surgery that conserves the articular mobility of the joint.L’arthrose métatarsophalangienne du premier rayon du pied, connue également sous le nom de « hallux rigidus », est une pathologie invalidante de la marche encore sous-estimée. Elle est associée à une déformation localisée du premier rayon et à une limitation de la flexion dorsale au niveau de l’articulation, affectant ainsi la propulsion. Plusieurs stades de cette maladie existent, et les symptômes ainsi que leurs traitements dépendront du moment de consultation. Dans cet article, nous présentons les différents symptômes et traitements de cette arthrose, adaptés selon le stade en partageant notre expérience avec les nouveautés technologiques conservatrices du mouvement articulaire et leur résultat à moyen terme.

Highlights • Subtalar dislocation is a rare injury with post reduction instability being even rarer. • Rarity is attributed to the presence of a strong ligament connecting the talus and the calcaneus. • They occur more frequently in men than in women and predominately affect people in their mid-30 s. • Our case highlighted the importance of the calcaneo-fibular ligament as a subtalar stabilizer. • Our case is unique in using a synthetic graft to reconstruct the calcaneofibular ligament., Background Traumatic dislocation of the subtalar joint is an infrequently occurring injury, first described by DuFaurest in 1811. They were later on classified by Broca as medial, lateral, posterior and anterior dislocations based on the direction of the dislocation. Case report We present a case of a 30 year old male who presented after a 5 m height fall and direct right foot trauma. Investigations done in the emergency department revealed a right subtalar lateral dislocation with associated calcaneal intraarticular displaced fracture. Open reduction internal fixation of the calcaneal fracture was decided alongside with reduction of the subtalar joint. Intraoperatively the subtalar reduction was totally unstable due to the deficiency of the lateral collateral ligament. A decision of reconstruction of the calcaneofibular ligament using a synthetic ligament was taken. This reconstruction resulted in an adequate intraoperative stability of the subtalar joint. On a 2 year follow up the patient was asymptomatic with no residual subtalar instability. Discussion These injuries must be suspected after high energy trauma or twisting forces in the foot. They occur more frequently in men than in women and predominately affect people in their mid-30 s. Our case is unique in that the reconstruction of the calcaneofibular ligament was done using a synthetic graft to stabilize an acute unstable subtalar joint dislocation. Conclusion Subtalar dislocation is a rare injury with post reduction instability being even rarer. Care has to be taken not to overlook the frequently associated bony injuries, due to their impact on treatment decision and prognosis.

Intramedullary nails have gained popularity for the treatment of intertrochanteric fractures. Cephalic screw cutout, non-union, nail breakage, intraoperative fractures, and peri-implant fractures are complications of these implants and have been well described. This case report describes an unusual complication in an 89-year-old woman presenting with a femoral neck fracture with an intramedullary nail in place without implant failure or non-union after having been successfully treated three years previously for an intertrochanteric fracture.

We report a case of plantar rupture of peroneus longus tendon with fracture of the os peroneum after a minor trauma. This is a rare pathology and several treatment optionshave been proposed in the literature. We describe a new way of treatment consisting in subperiosteal excision of the proximal fractured os peroneum and side-to-side repair with augmentation with the peroneus tertius if present

Brucellosis has become a rare entity in many industrialised countries, because of animal vaccination programs. We report a first case in the literature of Brucella abscess in the hip region observed in Switzerland in a subject without any clear risk factor, leading us to conclude that abscess formation can be a rare manifestation of brucellosis. Because it can present in many different forms and locations without having characteristic clinics, a high index of suspicion is needed for the diagnosis even if the patient is a healthy athlete with no clear way of obvious route for contamination, and this even more if all the common causes of athletic hip pain have been ruled out.

Acetabular osteolysis is problem affecting long-term survival of total hip prosthesis.a 71 year old man was operated in December 2005 with a total uncemented hip arthroplasty. Immediate evolution was favourable but at 4 months postoperatively he came with the complaints of left back pain irradiating in the left thigh. X-rays revealed the presence of a lytic lesion around the acetabulum with secondary dispalcement of the acetabular cup. Further investigations ruled out infection and confirmed the presence of multiple myeloma. The wear and shear particles of polyethylene or metal are the leading cause of reactive osteolysis in total hip arthroplasty, nevertheless multiple myeloma or metastatic lesions should be included in the differentail diagnosis.

Summary One of the most demanding steps of an intramedullary nailing is the distal locking. The aim of this study is to evaluate clinically and prospectively a new targeting guide. Twenty-five patients were treated consecutively in two different trauma centres (level one and one general hospital) by two different surgeons who were instructed on using the new device. Reduction of the fracture, intramedullary nailing and proximal locking are performed according to standard procedures. Then the new targeting device is used for distal locking. Evaluations are focused on the time it takes to perform the distal locking, the duration of the irradiation exposure and the duration of the complete procedure. In terms of duration, our results are comparable to those reported in the literature but this new device has more advantages than any other system. This new device is fully mechanical and is solidly linked to the patient. It can be used with any existing radioscopic equipment in any hospital. The guide is manually adjustable out of the X-ray field avoiding the surgeon being irradiated. The procedure is easy to learn and reproducible.