Traitement chirurgical d’une luxation palmaire carpo-métacarpienne à propos d’un cas

Les luxations carpo-métacarpiennes sont des lésions rares, les auteurs rapportent un cas de luxation carpo-métacarpienne palmaire du cinquième doigt, traité en urgence par réduction et stabilisation par embrochage à foyer fermé. Une immobilisation postopératoire par une attelle intrinsèque plus a été réalisée pendant six  semaines, avec une rééducation à partir de la quatrième semaine. Le résultat fonctionnel était satisfaisant.Key words: luxation , carpo-métacarpienne , embrochage

Rupture bilatérale du ligament croisé antérieur chez un joueur de ski traitée par une ligamentoplastie DIDT sous arthroscopie en un seul temps opératoire

We report the case of a 25-year-old patient who suffered a ski accident that causing a serious knees sprain. The patient underwent immobilization by plaster knees. After 12 rehabilitation sessions, good progress was noticed in terms of pain. However, the patient is unstable when walking and a positive Trillat Lachman sign at both knees is observed. MRI of Knees confirmed a bilateral rupture of the anterior cruciate ligament (figures A, B). We conducted a ligament ACL with the DIDT technique on both knees, beginning with the left- side. After the surgery, everything was normal. Xray controls (face and profile views) of both knees showed a good positioning of implants (figures C, D). Rehabilitation was undertaken the day following the surgery. Six months later, the patient was able to return to sport.Pan African Medical Journal 2016; 2

Syndrome de loge aiguë secondaire à une injection intraveineuse d’héroïne chez un patient toxicomane: à propos d’un cas

Il s'agit d'un patient âgé de 27 ans, connu toxicomane depuis 2008 qui a présenté un syndrome de loge aigu suite à une injection d'héroïne en intraveineuse au niveau du pli du coude du membre supérieur droit. Le patient a consulté aux urgences 6 heures après l'injection d'héroïne, l'examen clinique initial a trouvé une tuméfaction du membre supérieur droit, un oedème diffus au niveau du bras et de l'avant-bras droite et un trouble de sensibilité dans le territoire du nerf médian et cubital. Le reste de l'examen clinique était normal. Le patient est opéré au urgence, il a bénéficié d'une aponévrotomie de décharge par 2 incisions au niveau de la face antérieure du bras et l'avant-bras (A). Le changement de pansement est fait chaque 2 jours au bloc opératoire par un système à pression négative de VAC® (B,C). Après 5 semaines, l'évolution était bonne on a noté une disparition du syndrome de loge (D) avec récupération de la sensibilité dans le territoire du nerf médian et cubital.Pan African Medical Journal 2015; 2

Tumeur glomique de l’index à propos d’un cas

Glomus tumor is a benign tumor that develops from the neuromyoarterial glomus of dermo-epidermal tissue. Its typical location is the distal phalanx of the fingers. We report a case of a glomic tumour in a 42 year old patient having pain at the level of the ulnar side of the distal phalanx of the right index finger since 7 months. Pain was triggered by applying pressure to the finger and by cold exposure. Clinical examination showed a painful point at the ulnar side of the right index finger by exquisite pressure and a positive Hildeth test. Standard finger radiograph objectified a small rounded subungual notch, completed by a MRI which showed a small 2 mm lesion of the nail matrix of the right index finger, evoking a glomus tumor (A). The patient underwent biopsy excision of the tumor (B, C, D, E, F); anatomopathological results revealed the presence of a glomus tumor. Clinical outcome was favorable with disappearance of pain.Pan African Medical Journal 2016; 2

Migration d’une broche dans le canal médullaire cervical après une ostéosynthèse de l’articulation acromio-claviculaire

We report the case of a 49 year-old right-handed chef with left shoulder trauma occurred during a football game. The diagnosis was fracture of the distal quarter of clavicle. The patient underwent osteosynthesis using cerclage wire and splint . The patient suffered from pain and hypoesthesia with a deficit in C8-T1 interosseous territory; radiographs objectified pin migration to the cervical spine. It pierced left C7-T1 vertebral foramen contacting the medullary sheath with consequent threat to vital or functional prognosis. The patient underwent urgent removal of osteosynthesis material in the Department of Neurosurgery. The evolution was marked by the disappearance of neuralgia and an acceptable functional recovery. Osteosynthesis using cerclage wire and splint is a major surgical technique for fractures of the distal quarter of clavicle or acromioclavicular disjunctions. Its main complication remains pin migration. The Pan African Medical Journal 2016;2

Fracture du col fémoral révélatrice d’un ostéosarcome de la hanche traitée par une prothèse massive

A 22 years patient with no significant pathological history consulted for right hip pain and total right lower limbs functional disability without general health deterioration a week before his hospitalization. Clinical examination performed at the time of admission objectified pain on palpation and after right hip mobilization. Plain radiography (A) and CT scan of the hip (B) objectified a right femoral neck pathologic fracture. Right epiphyseal-metaphyseal cervico-cephalic osteosarcoma was confirmed histologically. An evaluation of the extent of loco-regional recurrence and distant metastasis did not show other locations or metastasis. The patient underwent seven cycles of neoadjuvant chemotherapy, oncologic resection of the tumor and reconstruction with massive hip prosthesis (C).Pan African Medical Journal 2016; 2

Luxation radio carpienne ouverte pure: à propos d’un cas

Radio carpal dislocation is rare, its frequency is 0.2%. The pure form is an exceptional entity. We provide a typical observation of this lesion. 32 years old patient, victim of a road traffic accident, admitted to the emergency. The examination of the left arm objectified a cross wound next to the palm side of the left wrist (A), the neuro vascular examination shows no damage. Radiography’s front and profile views of the left wrist, showed a pure left posterior radio carpal dislocation (B). The patient was operated 2 hours after the trauma, under locoregional anesthesia. After the reduction of the radiocarpal dislocation, the patient received a plug-lunar radio and radio-scaphoid then a transverse racking radio-ulnar . The radiography of control confirmed the reduction of the dislocation (C, D). The patient underwent wrist immobilization for 6 weeks, followed by a pin ablation (E) then sessions of reeducation. After a backward movement of 18 months, the evolution was good, with a normal mobility of the wrist.Keywords: Dislocation, pure, radio carpalPan African Medical Journal 2016; 2

Post-Merger Acquisition of LAFARGE HOLCIM MOROCCO

The purpose of this scientific researchpaper is to measure the financial significance of the well-known corporate process, ‘Mergers and Acquisition.’ This scientific paperaims to provide the reader the importance of the mergers and acquisition in the corporate world. Further, it will identify the reasons why companies decide to adopt the process of merging and acquisitioning. There are financial, managerial, and operational, cost to produce factors are interlinked with this process. Lafarge Cements and Holcim Morocco merged and it turned out to be beneficial for both organisation