Highlights
Bilateral posterior hip dislocations are very rare injury, resulting from high energy trauma.
After elimination of vital emergencies and radiological assessment, reduction must be rapid within 6 h.
Post reduction CT-scan is essential to analyze the femoral head and the hip joint congruity.
In case of irreducibility or associated Pipkin’s fracture, an open approach is indicated.
The main complications are avascular necrosis, heterotopic ossification, and posttraumatic osteoarthritis.
Gamma nail closed osteosynthesis has surpassed several methods previously used in the treatment of fractures in the trochanteric region.
The objective of the research was to carry out an epidemiological study and to assess the evolutionary profile of patients with per-trochanteric fracture treated with gamma nail.
Materials and methods. In this retrospective study, we report the experience of the Traumatology-Orthopedics Service II of the Military Teaching Hospital Mohamed V-Rabat, in the treatment of per-trochanteric fractures by gamma nail in 100 cases, collected between January 2011 and March 2016.
Results. The average age of our patients was 68 years, with a male predominance of 67%. The most reported etiology (92% of cases) was simple drop. Stable fractures were the most common (81%), with a predominance of simple per-trochanteric fractures. The average response time was 24 hours, the average duration of the surgical procedure was 45 minutes. The rate of infectious complications was 1%; the rate of mechanical complications was 1%. The functional results were excellent and good in 95% of cases. The average consolidation time was 8 weeks.
Conclusions. Trochanteric fracture is a delayed emergency which is seen primarily in the elderly. The gamma nail represents one of the latest improvements in implants for the treatment of these fractures. We report a series of 100 cases of trochanteric fractures treated surgically by gamma nail. The functional results were very encouraging compared to those reported in the literature.
Pure open dislocation of the elbow remains a very rare entity, being associated with a complete rupture of the brachial artery make it more exceptional, the therapeutic strategy is very discussed. The vascular repair is essentially based on a venous graft which can be collected from different sites, the second challenge is to reduce and maintain the stability of the elbow.The course ofthis different operatory times represents the real challenge in front of that type of traumas. We report a case of a young man admitted in the emergency room with an open pure elbow dislocation with rupture of the brachial artery, treated by a venous graft and reparation of the elbow capsular with an elbow immobilization by an ulno-humeral pin and with a satisfactory evolution in a long term.
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