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Introduction – This study reports the authors' experience using the peroneus tertius for chronic lateral ankle instability. Material and methods – Twenty nine patients (30 ankles) were reviewed using a clinical and radiological evaluation. 14 patients practiced competition sports and 7 were recreational athletes. Mean follow-up was 32 months (range 7–84). The results were evaluated using the Karlsson scoring scale as a subjective evaluation of the final result given by each patient (scale between 1 and 10). Results – 86% of the patients practicing competition sports resumed their sporting activities at the same level. According to Karlsson scoring scale, functionnal results are: 22 excellent, 4 good, 3 fair, and 1 poor. 83% of the patients had no instability and 70% remained painless. At final follow up 83% of the patients showed good or excellent results. Discussion – This procedure provides a suitable graft and avoids sacrificing an active lateral stabilizer of the tibiotalar joint like Peroneus Brevis. Its indications are essentially restricted by anatomic conditions, i.e., the presence of the peroneus tertius tendon or its variable diameter. Conclusion – This procedure fulfils the requirements of an anatomical reconstruction procedure in ankle lateral instability. It does not require any specific surgical approach to the ankle so that the best suitable technique can be chosen according to the assessment of the ligamentous injuries and the anatomical variations of the patient.

There is a general consensus concerning the clinical and radiological approach to diagnosis and proper management strategy in patients with sciatalgia subsequent to disk herniation. Recurrent herniation is the most probable diagnosis when pain recurs the same territory long after surgery. Despite advances in computed tomographic and magnetic resonance imaging, it may be difficult to identify the real source of the pain in some patients. We report a patient with renal cell cancer who developed recurrent sciatic pain which did not respond to disk surgery. This case illustrates the need for an extensive work-up before implicating the spine as the cause of recurrent sciatalgia.

We studied the efficacy of papaine for treatment of herniated discs at a mean 10-year follow-up and compared results with other series and other treatments.From an initial group of 160 patients, 96 patients, 53 men and 43 women, mean age 39 years, were selected for evaluation. These patients had 46 L4L5 herniations and 50 L5S1 herniations. All 96 patients were operated in the same department and received the same dose of papaine under the same anesthesia conditions. All patients were followed regularly to 3 months postoperatively then were reviewed 3 to 17 years after surgery. Inquiries were made about return to work, pain, and activity. Physical examination and x-rays were obtained for all patients.There were no neurological complications in our series. Seventeen patients required a second procedure for sciatic pain. Most of the patients continued their normal occupational and social activities after papaine treatment, but many of them had chronic lumbar pain.Our results were comparable with series reporting a similar long follow-up. Surgery is more efficient than papaine but long-term results are equivalent.Chemopapaine treatment provided good long-term results in our patients, similar to surgery. Chemonucleolysis may be employed as first line treatment for young patients with non-excluded disc herniation with sciatic pain.

We report a case of an aneurysmal cyst localized in the patella of a 37-year-old man. The lesion was secondary to a chondroblastoma at six years follow-up after initial curettage and bone graft. It were no recurrence. Treatment of aneurysmal cysts depends on the degree of articular involvement. We made a detailed study of 11 cases of this rare localization of aneurysmal cysts reported in the literature.

Complications of extravasation of intravenous fluid are not rare in pediatric practice, and their local (skin necrosis) and regional (vasculo nervous) implications can be severe. Two cases are presented in order to discuss the different treatments options and to describe the subcutaneous aspiration technique, which can be immediately efficient if proposed in a short delay.

To suggest a mechanically satisfying method to stabilize the unfrequent distal diaphyso-metaphyseal fractures of the radius, when they are anteriorly displaced, avoiding the classical use of an anterior osteosynthesis by plate and screws.Ten cases of postero medial Elastic Stable Intramedullary Nailing are presented. Technically, a small postero medial approach with gentle retraction of extensors tendons is used. Then a hole is drilled through the postero medial metaphysis of the distal radius. A present wire is introduced intramedullary, directing its elastic forces in a postero lateral way, fighting against the displacement.The instability of this fracture often requires an osteosynthesis. Plating needs a larger incision and a direct control of the fracture (danger of injure of the growth plate, scar). Retrograd nailing through the proximal end of the bone can injure nerves. Then, postero medial Elastic Stable Intramedullary Nailing can be useful for stabilization of the diaphysometaphyseal fractures of the radius.