Latest Articles
ABSTRACT
The incidence of fractures of the upper extremity of the femur continues to increase as the population ages. Dynamic hip screw (DHS) is the treatment of choice for stable fractures. We report the case of an 80-year-old man with no notable pathological history presenting with a pertrochanteric fracture. Intraoperatively, the cephalic screw migrated unexpectedly into the pelvis. Several attempts were made to remove it, but the screw had penetrated deep into the pelvis, making removal impossible through the femoral neck. An emergency abdominal CT scan was performed showing that the screw had penetrated into the bladder. The urological surgeon was called in to remove the screw via a medial abdominal approach, which was fnally removed without any further complications. Intravesical migration of a DHS screw is a rare complication. Compliance with the DHS surgical technique, especially in very old osteoporotic patients, can avoid this complication.
ABSTRACT
Scaphoid dislocation is an uncommon entity of the carpal injuries that has been rarely reported in the literature. We report a case of a 41-year-old right-handed male who presented with a partial palmar scaphoid dislocation following a motor vehicle accident. Closed reduction was successfully performed and an immobilization by a short arm thumb cast has been maintained for 6 weeks. The last follow-up X-rays showed no evidence of redislocation, malunion or avascular necrosis. Our patient returned to his daily activities without any limitations. This case report emphasizes the importance of early diagnosis and orthopedic treatment for improved prognosis.
Original Research Article
ABSTRACT
Soft-tissue sarcomas (STS) are a rare, and comprise a relatively heterogeneous group of malignant tumors arising from mesenchymal tissue. STS can affect any age group. In order to provide patients suffering from STS, with a functional extremity without local tumor relapse, treatment decisions must involve a multidisciplinary team decision-making approach. We conducted a retrospective, descriptive study, of 43 cases of soft tissue sarcoma, collected between January 2013 and December 2018, in the department of Radiation-Oncology of the Oncology and hematology hospital of Mohammed VI University Teaching Hospital. With this study we aimed to report the epidemiological, clinical, histological, therapeutic and evolutionary characteristics of soft tissue sarcomas in the Radiation-Oncology department, and to define the factors influencing patient survival in order to improve the quality of care. The items collected were: epidemiological, clinical, histological, radiological, and therapeutic. Univariate and then multivariate analyzes were performed looking for factors influencing 2-year survival. During the study period, we collected 43 cases, 22 Men and 21 Women, the average age was 45.23 years (Extreme = 11-78 years). The tumor was deep in 73% percent of the cases, and the lower limbs were the most affected (65%) especially in the thigh. The predominant histological type was Liposarcoma in 16 cases (37.20%). The tumor stage was localized in 35 cases (81.39%), metastatic in 8 cases (18.60%). Thirty-five tumors were treated with surgery, including 31 cases (88.57%) of conservative surgery and 4 cases (11.42%) of radical surgery. Radiotherapy was performed in 33 patients, and chemotherapy in 24 patients. Follow-up monitoring has detected 5 cases (28%) of local recurrence, and 13 other cases (72%) of distant metastases. In univariate analysis the prognostic factors were age (p = 0.03) and tumor stage (p = 0.09). In our study, radiation therapy is an integral part of the ......
ABSTRACT
Osteomyelitis is an hemategenous infection that mainly affects the long bones. The location at the level of the hand is exceptional and can cause the problem of differential diagnosis with other injuries especially local such as phlegmon. We report the case of a 12-year-old girl who consults for a tumefaction of the right hand with local signs of inflammation and a temperature of 39° evolving for 5 days following a mild trauma. Laboratory tests showed white blood cells at 11,400 and a CRP at 34. The X-ray of the hand was without abnormalities. On ultrasound, no collection was observed. The scan of the hand done two days after admission shows a broken subperiosteal abscess. Surgical exploration by a palmar approach showed a ruptured subperiosteal abscess in the soft parts opposite the third metacarpal bone and allowed drainage. Bacteriological examination isolated a staphylococcus aureus. The outcome under suitable antibioc therapy was favorable. At the follow-up of one year, the child has a good function of his hand. Osteomyelitic metacarpal localization is rare. It must suspected especially in the case of painful inflammatory swelling of the hand with repercussion on the general condition. The treatment is surgical. Evolution is most often favorable. A short metacarpal is feared if there is a damage of the growth plate.
Original Research Article
ABSTRACT
Introduction: Fractures of the neck and head of the radius in children are relatively uncommon, constituting 4% to 7% of elbow fractures and dislocations. A child with a fracture of the radial neck and proximal ulna with complete medial displacement of the radial shaft is presented and the classification of the injury is discussed. Objective: To assess the medial displacement of the radial shaft with fracture of the radial neck and proximal ulna. Materials & Methods: This was a retrospective study conducted at Dept. of Ortho-Surgery, Patuakhali Medical College Hospital, Patuakhali, Bangladesh from January 2018 to December 2021. Twelve patients who had displaced radial neck fractures (Judet type III and type IV) treated. Patients were assessed for functional outcome by Mayo elbow performance score (MEPS), the Tibone and Stoltz functional criteria, and for complications with the average follow-up of four years (range: six months to seven years). Inclusion criteria were Judet type III and type IV radial neck fractures, open physis of radial neck at the time of fracture, minimum follow up time of six months. Exclusion criteria were open fractures and Judet type I and type II radial neck fractures. Results: The mean age of the patients was 9.12±2.2 years (range: 4 to 14 years). Nine (75%) patients were males and three (25%) patients were females. The right side was the most commonly injured side (right at 68% and left at 32%). 60% cases were of Judet type III and IV 40% cases were of Judet type IV. The mean fracture angulation of the series was 56.5 degrees (range 33.2 degrees to 79.2 degrees). Five patients had isolated radial neck fractures and five patients had associated proximal ulna fractures and two patients had associated posterolateral elbow dislocation. Six cases required open reduction and K-wire fixation as closed and percutaneous pin leverage techniques did not achieve acceptable reduction. The mean follow-up of all patients was four years ............
Original Research Article
ABSTRACT
Musculoskeletal disorders (MSD) are a category of work-related diseases affecting the dentists. The aim of this work is to investigate among dentists from Constanta the prevalence and characteristics of MSD, their posture during working and the adoption of ergonomic standards. Methods: A sample of 280 dentists working in private practice in Constanta were invited to participate to this study. The response rate was 65% (n=182). The participants filled a 35-items questionnaire including personal data, working position, MSD characteristics and treatment. The level of significance was set at p<0.05. Results: 67% of the dentists reported the presence of MSD and 71% consider that symptoms are related to the dental activity. MSD were located mostly in cervical area and neck (41%), followed by lower back (24%). No statistical correlation was found between presence of MSD and body weight (p=0,7). A sitting position was always used by 27% of subjects, 46% are using both sitting and standing working postures. No statistical significant correlation was found among the presence of MSD pathology and the activity of the dentists during Covid-19 pandemic (p=0,8). Conclusion: A high percentage of dentists reported MSDs. The main location is the spine, the cervical and lower back area. It is concluded postural problems leading to neck and back reported from the dentists in Constanta are comparable to those from other countries. Adoption of correct posture, sport and stretching exercises could prevent or minimize the effect of static dental activity.
Original Research Article
ABSTRACT
Background: The incidence of nonunion of humerus has been as high as 15% of all humeral fractures. Majority of humeral shaft fractures were treated by conservative treatment using splints, hanging arm cast, braces compromising anatomical reduction in view of wide range of movement of shoulder and elbow joint. Methods: The prospective study was conducted at Dept. of Ortho-Surgery, Sheikh Sayera Khatun Medical College & Hospital, Gopalgonj, Bangladesh from January 2021 to June 2022. Total 20 patients with fracture shaft humerus, who were treated with locking compression plate from the period were study. All patients are admitted and subjected to clinical & radiological examination, necessary lab investigations are carried out for proposed surgery. Regular follow up will be carried out by clinical examination and with X-rays at interval of 6 weeks, 3 months than 6 months and study will be conducted on a minimum of 20 patients. Results: Total 20 patients with fracture shaft humerus, who were treated with locking compression plate from the period of study. The age group of the patients in our study ranged from 15 years to 65 years. Most of the patients belong to 21- 40 years. 65% with male predominance (70%), with type A3 as the commonest fracture (50%) involving the mid shaft (70%) of humerus, underwent open reduction and internal fixation using locking compression plate. Conclusion: The age of the patient ranged from 15 years to 65. Majority of the patients were males. (M: F = 14: 6). In our series, left humerus was involved in 50% cases, while right was involved in the other 50% of cases.