Evaluation des patients opérés d'une fracture fémorale proximale dans le cadre du programme Fragility Fracture durant la période de confinement belge

Introduction :The management of SARS-CoV-2 infection has completely reformed the medical sector. Between March 14 and May 17 2020, only urgent surgical operations remained, including the management of proximal femoral fractures. The aim of our study is to best qualify this population of surgical patients by evaluating some clinical and epidemiological characteristics and assessing the infection rate. Material and Methods :This is a retrospective, descriptive and mono-centric cohort study, which identifies all Fragility Fracture program patients who had surgery for a proximal femoral fracture between March 14, 2020 and May 17, 2020 in the CHU Tivoli. Overall we defined the population and analyzed clinical and biological characteristics of patients suspected of or suffering from COVID-19, but also patients who developed the infection during hospitalization, compared to patients considered healthy. Finally, we described our deceased cases. Results :We treated 18 proximal femoral fractures during this period. Eight patients were operated following the COVID-19 precautions. Six patients tested positive, 3 on admission and 3 who become infected during their time in hospital. There were no physiological or biological differences between patients on admission. The mortality rate for positive patients was 33%. Conclusion :Unlike other studies, our incidence of proximal femoral fractures did not decrease during this time. These fractures occur in patients with early stage COVID-19, however the mortality rate remains high.SCOPUS: ar.jDecretOANoAutActifinfo:eu-repo/semantics/publishe

Case report: unusual posteromedial capsular lesion with posterior lateral meniscus root tear in two patients with constitutional genu recurvatum presenting after an acute ACL injury

Abstract Ramp lesions of the medial meniscus and posterior lateral meniscus root tears (LMPRT) can be present simultaneously in up to 8% of patients undergoing anterior cruciate ligament (ACL) reconstruction. The prevalence of these complex and highly unstable meniscal tears increases exponentially with the severity of the injury. The posteromedial capsule (PMC) has often been disregarded in the past when discussing ligamentous and meniscal injuries, but the recent interest in ramp lesions has drawn surgeons’ attention to the posteromedial structures of the ACL injured knee. While the meniscocapsular junction is commonly repaired in unstable ramp lesions, in the current literature there is no report regarding proximal PMC lesions, be they in isolation or associated with complex meniscal injuries. We report here two cases of proximal posteromedial capsular lesions associated with medial meniscus instability and posterior lateral root tears after ACL injury. The first case involves a meniscus ramp lesion associated with a proximal PMC tear and a posteromedial fluid collection in the muscle plane on magnetic resonance in a 22‐year‐old male soccer player. The second case involves a 21‐year‐old female soccer player who presented with a PMC lesion after hyperextension/valgus knee injury. The capsular lesions were repaired to restore capsular tension and improve medial meniscus posterior horn stability

Arthrite septìque du genou causée par un germe inhabituel: à proposďun cas

Introduction: Osteo-articular infections witPi Streptococcus canis are rare. To our l<nowledge, only one case of septic osteoartiiritis witii S. canis is reported in the scientific literature. Clinical case: We report the case of a 55-year-old patient who presented with left gonalgia without trauma. He was bitten on the leg by his dog a few days earlier. The biological inflammatory syndrome was moderately significant. The complementary explorations allowed to set the diagnosis of septic osteoarthritis. Discussion: Streptococcus canis is mostly known in the veterinary area and only represents 1 % of the streptococcal infections in humans. This germ is mainly responsible of soft tissue infections but can also affect other areas. Conclusion: Septic arthritis with S. canis is a rare condition and is a therapeutic and diagnostic emergency. The puncture is essential before starting the antibiotherapy.SCOPUS: ar.jDecretOANoAutActifinfo:eu-repo/semantics/publishe

A systematic approach to managing complications after proximal tibial osteotomies of the knee

Abstract Proximal tibial osteotomy (PTO) is an effective procedure for active and young adult patients with symptomatic unicompartmental osteoarthritis and malalignment. They were considered technically demanding and prone to various complications related to the surgical technique, biomechanical or biological origin. Among the most important are hinge fractures and delayed or non‐healing, neurovascular complications, loss of correction, implant‐related problems, patellofemoral complaints, biological complications and changes in limb length. Being aware of these problems can help minimizing their prevalence and improve the results of the procedure. The aim of this narrative review is to discuss the potential complications that may occur during and after proximal tibial osteotomies, their origin and ways to prevent them