Thevenard's disease is a rare familial ulceromutilative acropathy, responsible for sensory peripheral neuropathy associated with dysautonomous syndrome. The delay in diagnosis and major comorbidities make this condition disabling. We report here a case of 3 sisters, with a history of parental consanguinity, received in Orthopedic and Traumatology Department for the management of a sensitive polyneuropathy, associated with pressure ulcers and ulcers arthropathies of the feet. Functionally, walking was possible without dodging lameness. The electromyogram was in favor of a sensory polyneuropathy of the four limbs. An artisan shoe footfeeding shoe has been proposed, in the face of delayed healing of the wound, associated with local care and sensorimotor rehabilitation. Thévenard's Disease is a rare nosological entity that requires multidisciplinary management.
Chase’s intervention expands the treatment objectives by indexing the middle finger, which will ensure the pollicidigital grip, retain strength and respect the aesthetic appearance of the hand. It is a frequently performed surgical intervention, which gives very good results for the patients concerned. This study relates our experience in the Traumatology and Orthopedics Department of the University Hospital Center Ibn Sina in Rabat in the treatment of refractory suppuration of the index finger.
The floating elbow represents an uncommon combination of lesions in traumatology. Few studies have described this lesion especially in adults. Over a period of 5 months, two floating elbows were reviewed retrospectively. Reduction and internal fixation using different implants were performed for our patients. Consolidation was obtained at the humerus at 4 months (3.5-4.5 months) on average, and 5 months (4-6 months) at forearm bones. According to the classification of Lange and Foster, our functional results were good in 100 %. Good functional prognosis of the upper limb requires rapid and adequate management of floating elbows. Internal fixation followed by early rehabilitation is recommended. The choice of surgical acts depends on the location of fractures. Our strategy gave satisfactory results.
Comminuted fractures of the distal radius are common. A retrospective study was conducted in the Department of Orthopaedic and Traumatology of Ibn Sina Hospital in Rabat on a period of two years between February 2021 and January 2023 involving 12 cases of comminuted fractures of the distal radius treated with external fixator distraction. The average age of our patients, all males, was 37 years old. The right side was affected in 66 % of cases. X-rays have objectified an articular fractures and/or comminuted without opening the skin. We adopted the Castaing classification to characterize fractures of the distal radius. The treatment consisted on an external fixation. Ablation of osteosynthesis material was done after 45 days, then reeducation was started. After a window of 13 months, our results were very satisfactory with good recovery of mobility of wrist and practice of normal activities.
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