ABSTRACT
Background: Humeral shaft fractures (HSFs) represent 3% of the fractures of the locomotor apparatus, and the middle third of the shaft is the section most affected. In the majority of cases, it is treated using nonsurgical methods, but surgical indications in HSF cases are increasingly being adopted. They are most common in males between 21 and 30 years old and females between 60 and 80 years old. Objective: To compare the intramedullary nailing and plate fixation in adult humeral shaft fractures. Materials and Methods: This was a prospective comparative study carried out in the Department of Orthopedics, Jahurul Islam Medical College & Hospital, Bhagolpur, Bajitpur, Kishoregonj for 2 years based on the patient presentation at both emergency room and outpatient clinic department between June 2021 and March 2023 in which fifty adult patients with humeral shaft non-union were recruited. Coagulopathies, on drugs like steroids, anti-neoplastic that may interfere with healing and those with significant co-morbidities such as Diabetes Mellitus, Neoplasia were all excluded from the study. Results: The nailing group operated for 84.11±8.98 minutes, while the plating group took 115.66 ± 9.56 minutes. The result was statistically significant (P < 0.05). The nailing group lost 75.02 ± 9.57 mL of blood during surgery, significantly less than the plating group's 132.79 ± 8.64 mL (P < 0.05). Of the 25 patients in the plating group, nine (36%) had outstanding results and eight (32%) had good results. In the nailing group, 11 (44%) achieved great outcomes, and 9 (36%) had good results. The two groups did not differ statistically from one another. Conclusion: The nailing group required less operating time and had less blood loss than the plating group. There were no significant differences in functional outcomes between the intramedullary nailing and plating groups.

ABSTRACT
The fracture of the fifth metacarpal neck is common in hand, traumatology among the young and active population who is the most affected. In the case of an unmoved fracture or a minor displacement, simple immobilization followed by rehabilitation is sufficient, whereas fractures with swaying greater than 30° require surgical management. The L-shaped insertion of the ribs is a simple surgical technique with short hospitalization, obtaining a reduction and quality stability allowing immediate self-rehabilitation, with good anatomical and functional results.

ABSTRACT
This retrospective study concerns 40 cases of neglected rupture of the Achilles tendon listed in the Traumatology-Orthopedics department of the Avicenne Military Hospital in Marrakech over a period of 7 years, between 2017 and 2022. Our patients are 34 men and 6 women, the average age was 37 years (between 27 and 59 years). The average consultation time was 8 weeks. The causes of the delay in diagnosis are, on the one hand, the negligence of the patients (85%) and, on the other hand, the error of initial diagnosis and the traditional practice. The clinical examination was sufficient to make the diagnosis, although all patients received standard x-ray and ultrasound to eliminate other differential diagnosis. The treatment was surgical in all cases. Three surgical techniques were performed; V-Y plasty as described by Abraham, Bosworth plasty and the transfer with tendon of the flexor hallucis longus muscle. The long-term results were evaluated according to the score of AOFAS (American Orthopaedic Foot & Ankle Society) with a follow-up between a minimum of 2 years and a maximum of 7 years. The aim of our work is to describe the epidemiological, clinical and diagnostic profiles of patients and to evaluate the value of surgery in neglected ruptures of the Achilles tendon, by studying the indications of the different surgical techniques used.

ABSTRACT
Intramedullary nailing has increasingly become the standard surgical technique for treating diaphyseal fractures of long bones. Experimental and clinical studies have shown that reaming stimulates bone healing and promotes earlier fracture consolidation without significantly increasing the risk of local or systemic complications. However, its negative impact on endosteal blood flow is well-documented. Minimally reamed nailing offers a promising alternative, preserving the osteogenic benefits of reaming while minimizing its harmful effects on endosteal circulation. This study presents a series of 140 cases of patients with diaphyseal fractures of the lower limbs, all treated with minimally reamed intramedullary nailing.

ABSTRACT
Dorsal dislocations of the metacarpophalangeal joint of the thumb are rare. Complex dorsal dislocations are defined by the entrapment of the sesamoid bones and the soft tissue, such as the volar plate, behind the phalanx at the level of the metacarpal neck. These cases often necessitate open reduction. We present the case of a 22-year-old male patient who was admitted to our institution with a dorsal metacarpophalangeal dislocation of the thumb. Surgical reduction was required following the failure of closed reduction attempts.

ABSTRACT
Background: Failed Back Surgery Syndrome poses a significant challenge due to persistent pain following spinal surgery, greatly affecting patient quality of life and healthcare resources. Objective: This study aims to evaluate the effectiveness of revision spine surgery in FBSS patients, identifying key predictors for improved clinical outcomes. Method: A prospective study was conducted at a tertiary-level hospital in Bangladesh, involving 98 FBSS patients undergoing revision spine surgery from June 2020 to June 2023. Outcome measures included pain reduction (Visual Analog Scale), functional improvement (Oswestry Disability Index), and patient-reported quality of life. Result: Six months post-surgery, 74% of patients experienced clinically significant pain reduction (>50% on VAS), while 63% showed notable functional improvement with a reduction in ODI scores of over 40%. Quality of life improved for 68% of patients, with 25% reporting a complete return to daily activities. Among surgical types, decompression led to a 58% improvement in mobility, while fusion procedures resulted in a 70% pain reduction. However, 12% of patients reported little to no improvement, and 5% experienced worsened symptoms, underscoring the variability in outcomes. Predictive success factors included shorter intervals between surgeries and lower initial pain levels (p < 0.05). Overall, revision surgery was beneficial for the majority, but not all patients achieved desired outcomes. Conclusion: Revision spine surgery in FBSS patients can lead to significant improvements, though outcomes vary. Identifying predictive factors is essential to guide surgical planning and enhance patient selection.

ABSTRACT
Joint fractures of the base of the fifth metacarpal are rare injuries but they can cause serious complications if poorly managed, such as weak grip strength and wrist extension, decreased range of motion, osteoarthritis, tendon rupture, and carpal instability. We focus on two entities, Bennett and Rolando fractures regarding their mechanisms and tendency to instability. Their treatment remains a controversial subject. Through a series of 13 joint fractures of the base of the fifth metacarpal collected between December 2022 and June 2023 treated in the Orthopedic Department of Ibn Sina Hospital in Rabat, and a review of the literature, we review the data on anatomy, biomechanics, pathophysiology, diagnostic and therapeutic means and the prognosis of Bennett fractures by showing the benefit of osteosynthesis by Iselin double intermetacarpal pinning