ABSTRACT
Background: Laminectomy and discectomy are established surgical treatments for Prolapsed intervertebral disc (PIVD), aiming to decompress neural structures. However, routine addition of pedicle screw fixation in the absence of overt spinal instability remains a subject of ongoing debate. This study aimed to evaluate and compare functional outcomes in patients presenting with PIVD treated by laminectomy and discectomy without or with concomitant pedicle screw fixation. Materials and Methods: This comparative study was conducted in the Department of Orthopaedics, for a period of 18 months, which included 96 patients divided into two treatment groups of laminectomy and discectomy: (a) Without pedicle screw fixation, and (b) With pedicle screw fixation. Patients were followed up at 1, 3, and 6 months for post-operative functional outcome of patients, as assessed by the VAS scores for low back pain and leg pain, Oswestry Low Back Pain Disability Questionnaire, JOA scores, Roland-Morris Low Back Pain and Disability Questionnaire, and muscle power grading. Results: There was statistically significant improvement in the NPRS scores from baseline to 6-month follow-up period in both the study groups (p<0.001). Additionally, there was improvement in other outcome parameters in both study groups from pre-operative to 6-month follow-up, but the difference was not statistically significant (p>0.05). Conclusion: The study concluded that routine application of pedicle screw fixation may not be essential for this specific patient demographic, potentially enabling a less invasive surgical approach.

ABSTRACT
Comminuted fractures of the distal femur are a therapeutic challenge due to their anatomical complexity and frequent association with bone fragility, especially in elderly patients. The introduction of locked condylar plates has brought significant progress in the surgical management of these lesions. These plates offer superior angular stability, particularly useful in the presence of multiple fragments or osteoporosis. This retrospective study was conducted at the Ibn Sina University Hospital in Rabat, including 32 patients operated for comminuted distal femur fractures (AO/OTA types C2 and C3) between January 2018 and December 2023. All cases were treated using locked condylar plates, with early rehabilitation and a minimum follow-up of 12 months. Bone union was achieved on average at 14.6 weeks. The mean functional outcome (Knee Society Score) at 12 months was 82.7. Complications were rare: two cases of stiffness requiring arthrolysis, one case of superficial infection managed medically, and no cases of nonunion. These results confirm the efficacy and reliability of locked condylar plates in stabilizing complex comminuted fractures of the distal femur.

ABSTRACT
Scaphoid fractures are difficult to diagnose and treat. The authors report the results of treating these fractures with percutaneous screw fixation using the Herbert screw. The results were interesting given the rapid consolidation and the quality of the functional outcome.

ABSTRACT
Fractures of the upper end of the humerus pose a therapeutic problem, particularly for complex fractures with 3 and 4 fragments. The objective of this study is to determine the epidemiological-clinical characteristics of complex fractures of the upper end of the humerus in adults and to assess the functional and radiological outcomes of our series. This series consists of 15 cases collected at the orthopedics department of CHU Ibn Sina between 2021 and 2015. We recorded the epidemiological data of the patients and the circumstances of the trauma. The treatment was primarily surgical, either plate synthesis or nail fixation. The reduction was evaluated based on postoperative X-rays. At follow-up, functional results were assessed using the Constant score. Our series includes 8 men and 7 women, with an average age of 57 years; traffic accidents were noted in 48% of cases, and 4-fragment fractures were found in 76%.des cas. Plate osteosynthesis was used in 40% of cases and anterograde nailing was performed in 40% of cases. The average Constant score was 65.24 with extremes ranging from 35 to 88. We noted consolidation of fractures without malunion in 68%. In complex fractures of the proximal humerus, appropriately indicated osteosynthesis based on the patient and the fracture, along with early postoperative rehabilitation, results in acceptable functional outcomes.

ABSTRACT
The femoral offset is the most important prognostic element in hip arthroplasty. Its restoration is crucial. Any change in the native value of the offset affects the quality of clinical function of the hip. The aim of our study was to evaluate the clinical function of the hip based on the value of the femoral offset after arthroplasty. This is a retrospective study conducted between 2010 and 2013, involving 27 patients who underwent total hip arthroplasty. Patients who had previous surgical procedures on the same hip or on the contralateral hip were excluded. Measurements were taken from standard hip radiographs in approximately 15° internal rotation, with magnification at 100%. Clinical results were assessed using the WOMAC score, which averaged 15.2 points, and the Merle d'Aubigné-Postel score, with an average of 15 points. Two other tests were also evaluated in our study, the step and hop tests were used. The best functional results were obtained in patients who had a lateralization of the femoral stem with an increased offset.

ABSTRACT
Low-velocity tibial plateau fractures are not very comminuted and classically involve the lateral tibial plateau. The aim of this study was to present the anatomical and functional results of surgical treatment of external tibial plateau fractures classified as Schatzker types I, II and III. This was a cross-sectional study with prospective data collection, involving 33 patients. Functional results were assessed by the Lysholm score, and anatomical results by the Duparc and Cavagna criteria. The mean age of patients was 44.7 years, with a predominance of males (sex ratio 3 (25H/8F)). Road traffic accidents were the most frequent etiology, occurring in 28 patients (84.8%). Schatzker type I fractures were the most frequent, with 14 cases (42.4%). Osteosynthesis with a screw plate was the most common method of fixation in 15 patients (45.5%), followed by percutaneous screw fixation under fluoroscopic control in 13 cases (39.4%). The mean follow-up was 44.09 months. The mean Lysholm score for functional results was 90.09/100. Osteosynthesis using screw plates and percutaneous screw fixation under fluoroscopic control remains an effective therapeutic approach with good results.

ABSTRACT
Background: Radial head subluxation, also known as “nursemaid’s elbow,” is a common injury in children under the age of six, typically caused by axial traction on the forearm. Its occurrence in adolescents is exceedingly rare, often leading to misdiagnosis. This case highlights an unusual presentation of recurrent elbow pain in an adolescent patient, ultimately confirmed as a missed radial head subluxation. Case Presentation: A 13-year-old adolescent presented to an outpatient clinic with recurrent episodes of right elbow pain and functional limitation after minor traction injuries, such as being pulled by the arm during play. The pain was described as acute, sharp, and associated with limited supination, but without swelling, bruising, or deformity. Initial evaluations elsewhere had diagnosed the condition as a soft tissue strain, and the patient had been treated with analgesics and rest without significant improvement. On examination, the elbow showed tenderness over the lateral aspect and restricted supination, but radiographs revealed no evidence of fracture or dislocation. A clinical diagnosis of radial head subluxation was considered despite the patient’s atypical age. Closed reduction was performed using the supination-flexion technique, producing an audible “click” and immediate pain relief. At follow-up, the patient remained asymptomatic, with no recurrence after initiation of a physiotherapy program focusing on strengthening and ergonomic education. Conclusion: This case emphasizes that radial head subluxation, although rare in adolescents, should remain a differential diagnosis for recurrent elbow pain following minor traction injuries. Awareness of this atypical presentation in outpatient practice can prevent unnecessary imaging, inappropriate management, and prolonged morbidity. Prompt recognition and simple reduction techniques remain highly effective, while physiotherapy plays a key role in preventing recurrence.