The place of the modified palmer technique for articular calcaneal fractures

Surgical treatment of displaced articular fractures of the calcaneus is currently recommended by most authors. Different surgical procedures are described in literature. The purpose of this study is to evaluate the functional and anatomic results of articular fractures of the calcaneus surgically treated with the modified Palmer method and precise the place, the conditions, and the advantages of this technique for articular fractures of the calcaneus. This is a retrospective study assessing the outcomes of surgical treatment of articular calcaneal fractures surgically treated using the modified Palmer technique. Twenty-two patients underwent this surgery for 6 years. All patients have diabetes and/or smoking history, and physical examination revealed a severe swelling within the hindfoot. Sanders classification Type II was found in 6 cases, whereas 18 cases fell below Type III. The mean preoperative Bohler angle was about 2.7°. An extended lateral approach was performed, and the void caused by elevating the intra-articular surface was filled by an iliac crest graft firmly impacted in all cases. Additional limited fixation was performed in 71 of patients. On follow-up, the functional and anatomic results were analyzed, respectively, by Kitaoka and Babin's quotations, and the radiological assessment was based on Bohler angle. No cutaneous or infectious complications were observed after surgery. The mean postoperative Bohler angle was 21.9°, and it was 19.8° at the last follow-up with a significant difference. At follow-up, the mean functional Kitaoka score was 75; it was considered as excellent in four cases, good in ten, fair in eight, and poor in two patients. The modified Palmer technique is a simple surgical procedure to treat intra-articular calcaneal fractures. It provides encouraging results. This method is recommended in the case of Sander's II and III calcaneal fracture for patients with a high risk of cutaneous complications to avoid infection and cutaneous complications

Place des gestes associés à l’ostéotomie de Scarf dans le traitement de l’hallux valgus

Devant la multiplicité des techniques proposées pour le traitement de l'hallux valgus, nous proposons d'évaluer l'ostéotomie Scarf associée ou non à une ostéotomie phalangienne et/ou une ostéotomie Weil. Il s'agit d'une étude rétrospective de 29 patients, dont un cas bilatéral, opérés entre 2011 et 2016 par une ostéotomie de Scarf du premier rayon avec un geste associé dans 80% des cas. Les résultats ont été analysés selon la satisfaction des patients, l'indice de Groulier et les mesures radiologiques. Le score global de Groulier donnait une bonne évaluation objective du résultat prenant en compte les données radiologiques et anatomiques qui influencent le résultat final en cas d'insuffisance de correction. Le recul moyen était de 3 ans et 5 mois. Une diminution significative du valgus phalangien (de 34,17% à 16,1%), du métatarsus varus (de 15,13% à 9,93%) et de l'angle articulaire distal métatarsien (de 17,63% à 12,73%) étaient retrouvés. Les patients sont satisfaits et très satisfaits dans 83% des cas. Les complications sont dominées par l'hypo-correction dans 13,3% des cas et nous n'avons noté aucun cas de pseudarthrose ou de nécrose de la tête de M1. Nos résultats sont comparables à ceux de la littérature. Nous insistons sur le caractère surtout fonctionnel de la chirurgie de l'hallux valgus qu'il convient d'intégrer dans une correction globale de l'avant-pied. L'ostéotomie de Scarf nécessite une technique rigoureuse, elle est fiable par ses résultats et présente comme limite les grosses déformations surtout de l'angle articulaire distal métatarsien

Avulsion of the Lesser Trochanter Following a Shot Put Sport Session

Avulsion of the lesser trochanter is an uncommon injury. In children and adolescents it usually occurs as a sports injury via traumatic avulsion of the psoas major tendon. In adults, isolated fractures of the lesser trochanter are most commonly pathological due to metastatic tumor invasion of the proximal femur. This case report documents how a 14-year-old boy, who presented with an avulsion of the lesser trochanter of the proximal femur following a seemingly atraumatic shot put session at a track and field event, was diagnosed and successfully treated with a conservative approach

Avulsion of the Lesser Trochanter Following a Shot Put Sport Session

Avulsion of the lesser trochanter is an uncommon injury. In children and adolescents it usually occurs as a sports injury via traumatic avulsion of the psoas major tendon. In adults, isolated fractures of the lesser trochanter are most commonly pathological due to metastatic tumor invasion of the proximal femur. This case report documents how a 14-year-old boy, who presented with an avulsion of the lesser trochanter of the proximal femur following a seemingly atraumatic shot put session at a track and field event, was diagnosed and successfully treated with a conservative approach

Avulsion of the Lesser Trochanter Following a Shot Put Sport Session

Avulsion of the lesser trochanter is an uncommon injury. In children and adolescents it usually occursas a sports injury via traumatic avulsion of the psoas major tendon. In adults, isolated fractures of thelesser trochanter are most commonly pathological due to metastatic tumor invasion of the proximalfemur. This case report documents how a 14-year-old boy, who presented with an avulsion of thelesser trochanter of the proximal femur following a seemingly atraumatic shot put session at a trackand field event, was diagnosed and successfully treated with a conservative approach