Cure du quintus varus supradductus à la manière de Lapidus à propos d’une série de 6 cas

Le quintus varus supraductus est une malformation, le plus souvent   congénitale, qui associe une hyperextension, un varus et une rotation externe du cinquième orteil venant chevaucher sur le quatrième. Lorsqu'il entraîne une gêne esthétique et/ou surtout douloureuse, il justifie une curechirurgicale correctrice. Six pieds chez 3 patients avec un âge moyen de 19 ans ont été opérés et revus avec un recul moyen de 11mois. Le but de notre étude est d'exposer les résultats d'une technique chirurgicale associant une plastie par un lambeau local, la ténotomie de l'extenseur du 5eme orteil suturé sur l'abducteur de cet orteil après l'avoir passé sous la 1ere phalange à la manière de Lapidus, arthrolyse de l'articulation métatarso-phalangienne et ostéotomie du 5eme métatarsien permettant de corriger cette  malformation. Les résultats sont qualifiés de très bons

Relationship between the magnitude of intraocular pressure during an episode of acute elevation and retinal damage four weeks later in rats

PURPOSE: To determine relationship between the magnitude of intraocular pressure (IOP) during a fixed-duration episode of acute elevation and the loss of retinal function and structure 4 weeks later in rats. METHODS: Unilateral elevation of IOP (105 minutes) was achieved manometrically in adult Brown Norway rats (9 groups; n = 4 to 8 each, 10-100 mm Hg and sham control). Full-field ERGs were recorded simultaneously from treated and control eyes 4 weeks after IOP elevation. Scotopic ERG stimuli were white flashes (-6.04 to 2.72 log cd.s.m(-2)). Photopic ERGs were recorded (1.22 to 2.72 log cd.s.m(-2)) after 15 min of light adaptation (150 cd/m(2)). Relative amplitude (treated/control, %) of ERG components versus IOP was described with a cummulative normal function. Retinal ganglion cell (RGC) layer density was determined post mortem by histology. RESULTS: All ERG components failed to recover completely normal amplitudes by 4 weeks after the insult if IOP was 70 mmHg or greater during the episode. There was no ERG recovery at all if IOP was 100 mmHg. Outer retinal (photoreceptor) function demonstrated the least sensitivity to prior acute IOP elevation. ERG components reflecting inner retinal function were correlated with post mortem RGC layer density. CONCLUSIONS: Retinal function recovers after IOP normalization, such that it requires a level of acute IOP elevation approximately 10 mmHg higher to cause a pattern of permanent dysfunction similar to that observed during the acute event. There is a 'threshold' for permanent retinal functional loss in the rat at an IOP between 60 and 70 mmHg if sustained for 105 minutes or more

The elbow tuberculosis: rare and exceptional localization

The tuberculosis of the elbow is an exceptional localization of the mycobacterium tuberculosis. This raises a diagnostic problem which is often tardy. This could therefore, have important consequences. We report 2 cases of chronic arthritis of the elbow, where the diagnosis was built on the anatomic-pathology investigation. In addition to the surgical synovectomy, the antibacillar treatment had stopped the infection. This led to stiffness of the elbow in one of these two patients. Through these observations, we discuss the rarity of this tuberculosis localization which must be treated promptly to avoid heavy consequences. Highland Medical Research Journal Vol. 4(1) 2006: 113-11

Ipsilateral fractures of tibia and femur or floating knee

Ipsilateral fractures of the femur and the tibia are relatively uncommon lesions, with critical consequences to the knee. We report a series of 18 ipsilateral fractures of the femur and the tibia treated at the Department of orthopaedics, CHU Hassan II of Fez, over an eight-year period (1996–2004). Various surgical procedures were used, in particular, intramedullary nailing. After an average follow-up of 2.5 years, we re-examined the 18 patients. The functional results were evaluated using the Schiedts’ criteria, and we had seven excellent results (38.9%), six good (33.4%), and five bad (27.8%). There was one major lesion of the popliteal artery that led to an emergency amputation, two cases of osteitis, one septic non-union, one case of late deep sepsis, one insignificant shortening of 2 cm, two cases of varus, three cases of stiffness, and one ankylosis of the knee. Through this work we will try to show the repercussions of this type of fracture of the knee and to evaluate our therapeutic choices