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Background: We report a retrospective study of 47 total prosthesis of hip put in place among the young adult of less than fifty years in the service of Traumatology and Orthopedics at the Wing IV of the CHU Ibn Rochd of Casablanca, over a period from January 2008 to March 2014, with an average rate of decline of 42 months. Results: The deliberate group of 43 patients (47 hips including 4 bilateral) consisted of 26 women, either 60, 47% and 17 men, either 39, 53%. The average age of our patients was 36 years. In our series, the predominant etiology has been conducted for the indication of the hip replacement was the aseptic osteonecrosis of the femoral head which has represented 31.91%. With regards to the choice of implants, 85% of PTH were non-cemented, the cemented PTH has been used in 15% of cases. The Friction Torque metal/polyethylene was used in all cases. The functional outcome was appreciated by the rating of Merle of Aubigne before and after arthroplasty. The average rate of decline of 42 months, and the results were generally satisfactory. They were excellent in 27.78% of cases, very good in 19.44% of cases and good in 44.44% of cases. The results on the Pain were remarkable: the rating of the pain going 2.8 in pre-operative at 5.6 at the latest decline. The results on the walking and mobility were also good. It was noted as a complication: 4 cases of prosthetic dislocation, 1 case of aseptic descellement bipolar, 2 cases of early sepsis on hardware, 3 cases of paralysis of the sciatic external popliteal and 4 cases of periprothetiques ossification. In total, 5 total prosthesis of hip were occasions. The young age does not seem to be an obstacle to the prosthetic surgery. Conclusion: However, a major question remains concerning the distant future of these prostheses in young active subjects, because they will be submitted for many years in a job which can cause the descellement of prosthetic parts.

Radiocarpal dislocation is a particular entity, infrequent, representing only 0.2% of all dislocationsas evidenced by the scarcity of publications, which mainly affects young patients, and most often the result of violent trauma. We reported a case of a 35-year-old male patient who sustained dorsal radiocarpal dislocation after a fall from a high place, with fracture of the radial and ulnar styloid process in both wrists, associated to a tiered trauma of the right upperlimb. He was treated with closed reduction and immobilized by cast for the bilateral radiocarpal dislocation, and treated surgically for the tiered trauma of the upperlimb. The evaluation at 3 months showed favorable results. This case is one of the few similar cases reported because it is an uncommon pathology and it is even less frequent because the injury involves both wrists and the upperlimb.

The management of nonunions with significant loss of bone remains a very difficult challenge for orthopedic surgeons. Several techniques have been developed, for some with difficult realization, and without convincing result for others. Our study involved ...

The authors report a rare case of a young man of 20 who presented following an accident of the public highway a protrusive neglected fracture dislocation of the hip without impaired function. This is an observation describing frequent lesion entity in our ...

The authors report eight cases of neglected dislocations of the elbow. The fracture-dislocations were included in our series. All patients benefited from a surgical reduction. In five cases, an internal fixation by K-wires was necessary. All patients benefited from physical therapy after removal of osteosynthesis material. After a mean follow-up of 20 months, we noted 50% of satisfactory functional results according to Mayo Elbow Performance Score. Neglected dislocations of elbow remain a rather frequent entity in developing countries. Its main cause is the negligence of patients and the recourse to traditional treatment. The prognosis of this injury remains reserved.

The authors report a case of a young man of 38 years who presented a rupture of the distal biceps tendon, which occurred following the wearing of a heavy load. This is an observation describing a rare nosology, operated by anterior transversal approach to the elbow with tendon rehabilitation through anchors at the radial tuberosity. The radioclinical evolution was satisfactory.

Background: It is recommended that the management of open lower-leg fractures should occur within six hours to avoid complications affecting both prognosis and functionality. This study aimed to evaluate the time taken for each step of management, identify causes of delay, and propose solutions to reduce the rate of complications. Patients and methods: This was a prospective study involving 153 patients treated from January 2011 to December 2012. Standardized data collection forms documented the times taken for each management step from the accident until surgical intervention. Results: For patients admitted directly to our institution, median time to surgical debridement from arrival was 5 hours. Median time for bone fixation was 24 hours. External fixation was used in 119 patients. There were several causes of delay; lack of financial resources was the most common. Certain causes of delay were significantly correlated with time to debridement. However, although 86.7% of patients who developed an infection had a time from injury to debridement greater than six hours, there was no statistically significant association between infection and delay beyond six hours (p = 0.403). Conclusion: By identifying causes of treatment delay, we hope to be able to avoid complications, and therefore reduce the socio- economic impact of these important surgical emergencies.

Le lymphome non hodgkinien (LNHK) extra-ganglionnaire primitif est rare et sa localisation intramusculaire primitive est exceptionnelle puisqu'elle est observée chez moins de 0,5% des patients. Ils touchent généralement des hommes dont l'âge moyen est de 70 ans. Le traitement standard associe l'exérèse chirurgicale, la chimiothérapie et la radiothérapie. Nous rapportons un cas d'un jeune patient de 31 ans qui s'est présenté pour un syndrome pseudotumorale musculaire au niveau de la jambe droite dont l'examen anatomopathologique avait conclu un lymphome malin non hodgkinien à grandes cellules B intramusculaire. Le patient a été traité par chimiothérapie exclusive avec une rémission complète.

Le genu varum sur gonarthrose fémorotibiale interne est une pathologie en nette recrudescence dans notre pays, affectant spécialement les femmes âgées et hautement invalidante chez l'adulte jeune; Souvent, elle pose un problème d'indication et de choix thérapeutique d'ordre multifactoriel. L'ostéotomie tibiale de valgisation par ouverture interne est une technique de référence, bien connue depuis longtemps et d'efficacité validée à court, moyen et long terme, et constitue un outil thérapeutique de choix et d'apport marqué, notamment pour les sujets jeunes actifs avec gonarthrose débutante. Par ailleurs, cette technique peut voir ses indications s’élargir au dépend de l’âge et du stade évolutif. Le but de notre travail est d’évaluer les résultats anatomiques et fonctionnels de notre technique d'ostéotomie tibiale de valgisation avec comblement cimenté chez l'adulte jeune de plus de 40 ans et de préciser les facteurs pronostiques qui régissent ces résultats. Ce travail propose à travers une étude rétrospectivement menée à propos de 38 genoux opérés chez 28 patients de dresser un bilan épidémiologique, clinique, et radiologique afin d’évaluer les résultats anatomiques et fonctionnels immédiats et à distance avec un recul minimum de 2 ans, de l'ostéotomie tibiale de valgisation avec comblement cimenté. Les 28 cas ont été revus à un recul moyen de 3,7 ans avec des extrêmes entre 2 et 9 ans, l’âge moyen de nos malades était de 52 ans avec des extrêmes de 40 à 67 ans, le sexe féminin était prédominant (64%). Le genu varum était primitif dans 20 cas (71,4%), et secondaire dans 8 cas (28,5%). Les stades I et II d'Ahlback constituaient la majorité des cas de l'arthrose fémoro-tibiale (94,7%). La déviation angulaire globale moyenne était de 11,3° avec des extrêmes de 8,5° à 18°. Les résultats évalués selon le protocole du groupe Guépar étaient excellents et très bons dans 86% des cas, et moyens et mauvais dans 14% des cas. Les meilleurs résultats ont été notés avec un âge au moment de l'ostéotomie de 60 ans, une arthrose au stade I et II d'Ahlback et un varus initial moyen ne dépassant pas 15°. La normocorrection a permis d'obtenir de bons résultats. Les complications postopératoires étaient rares sans conséquence sur les résultats thérapeutiques.

Les auteurs rapportent une observation rare d'un jeune adolescent de 17 ans qui a présenté une fracture du processus coronoïde du coude survenue suite à un accident de sport. Il s'agit d'une observation décrivant un abord particulier par voie antérieure transversale permettant un contrôle direct et vissage en compression du fragment déplacé; l’évolution radio clinique était satisfaisante. Nous discuterons à la lumière de la littérature, notre attitude thérapeutique, et l’évolution de ce cadre nosologique à travers l'analyse de cette observation.

Objective Originally developed for the purpose of muscle strengthening, mainly for knee muscles, the isokinetic has gradually seen its scope expand to other joints, especially in muscle testing, becoming one of reference. Son methods applied to the pathology of the shoulder is relatively recent and, to date, the rules for implementing the tests and rehabilitation remain unclear. The aim of study is to define the contribution of the isokinetic evaluation in the management of shoulder tendon. Material/Patients and methods This is a descriptive and analytical prospective study, over one year on 30 patients with tendinitis of the rotator cuff of the shoulder compared to 15 subjects from the general population, collected in physical medicine and CHU Ibn Rushd reeducation of Casablanca, in whom was performed isokinetic evaluation of the shoulder to 60°/s and 120°/s. Results These 30 patients whose average age is 30 years [24–73 years], there was a female predominance (80%), the dominant shoulder was mostly achieved. Statistical tests have objectified a significant difference in muscle strength of the medial and lateral rotators between the two groups assessed and between healthy and shoulder injured shoulder in patients with tendinitis of the rotator cuff against it by did not notice a significant difference in muscle strength between the dominant and non-dominant shoulder in the group of the general population. Discussion/Conclusion A force deficit shoulder rotator muscles is a predictor of occurrence of tendinitis of the rotator cuff of the shoulder.

Les métastases osseuses isolées des cancers colorectaux sont très rares. Le squelette axial est habituellement le plus atteint. La localisation au niveau du radius est exceptionnelle. Nous rapportons l'observation d'une femme âgée de 60 ans avec une métastase du radius distal isolée métachrone d'un cancer du haut rectum opéré un an auparavant. La métastase a été découverte sur les examens d'imagerie et confirmée par biopsie. Une amputation a été réalisée suite à une progression de la maladie après une radiothérapie palliative. L'évolution était marquée par l'apparition de métastases pulmonaires et le décès est survenu dans un tableau de défaillance respiratoire.