The induced membrane technique is an excellent option for bone defect reconstruction compared to other usual bone graft techniques. It helped us to manage large bone loss in various skeletal segments.
Introduction: Open limb fractures are frequent and severe. Very often they result from high velocity traffic accidents.
<p class="abstract"><span lang="EN-CA">We report a case of postoperative osteoarthritis infection caused by <em>P. acnes</em> after shoulder arthroscopy<em>, and review possible preventive action. </em>A right-handed 24-year-old man presented an anterior instability of the left shoulder. The patient underwent an anterior stabilization by the latarjet procedure. Stabilization failed, requiring a second and third surgery. The patient returned 10 months later for suspected septic arthritis of his left shoulder. An arthroscopy lavage with bacteriological and anatomo-pathological sampling was carried out. The bacteriological results revealed a positive <em>P. acnes</em> culture. The patient was treated using antibiotherapy for 12 weeks with a combination of clindamicin and moxifloxacin. C-reactive protein (CRP) was negative two months after the onset of antibiotherapy. <em>P. acnes</em> is a anaerobic, non-sporulated, gram-positive bacillus. This commensal germ is part of the normal cutaneous flora and causes acne, but has also been recognized as a causative pathogen in osteoarticular infections since the 1990s, as described by Coden<strong>.</strong> Treatment is achieved via surgical debridement and intravenous antibiotics. We insist on preventive action in the form of a preoperative patient preparation protocol. Previous literature has underlined the important role of chlorhexidine or alcoholic iodinated polyvidone in the prevention of these infections. As <em>P. acnes</em> is a commensal germ of the patient's skin, prophylaxis should be reinforced by the thorough preparation of the surgery and surgical site. Clindamycin antibioprophylaxy specific to this germ should be administered for this surgery. To my knowledge, there is no specific antibioprophylaxy for shoulder surgery to date</span><span lang="EN-IN">.</span></p>
Introduction: The purpose of this prospective study was to describe the clinic pathological varieties of fracture-dislocations of Lisfranc joint and outcome of treatment. Patients and Methods: This study was conducted on 21 cases of fracture-dislocations of the Lisfranc joint treated in our orthopedics trauma unit from 2010 to 2013. We selected middle foot pure dislocations or associated with Lisfranc joint bone fractures. Classification of Myerson was used to characterize the lesions. The results assessment criteria were clinical and radiological for foot and Massari score. Results: Fourteen (14) patients were male. The average age was 34.7 years. Five (5) clinic pathological forms were met by relying on the classification of Myerson; 4 cases of type A; 5 cases of type B1; B2, 6 cases; 4 cases of type C1 and 2 cases of type C2. There were eight cases of pure dislocation and 13 dislocations were associated with fractures (metatarsal in 11 patients, cuneiform in 5 patients, cuboid bone in 2 patients and enucleation fracture of the medial cuneiform in 2 patients). It was noted 10 cases of skin openings. Treatment consisted on open reduction in all patients and stabilization by pin complemented by a foot plaster for 6 weeks. Four (4) immediately arthrodeses were made. All patients were followed up 7 month to 4 years (mean, 30 month). According to the criteria of Massiri, treatment outcomes were excellent in 19% of cases, good in 28%, fair in 30% and poor in 23%. Conclusion: In our context, these lesions are often open and associated with fractures of Lisfranc joint skeleton and treated after a period more or less long and sometimes, we face lesions totally old. Immediately arthrodesis can be a lasting solution and should not be overlooked.
Background: The aim of this paper was to report the functional and clinical results of subcutaneous Achilles tendon rupture repairs through two surgical plasty techniques, with a mean follow-up of 2 years. Patients and methods:This study carries out a retrospective analysis of 27 patients presenting a subcutaneous rupture of Achilles tendon who enderwent surgical treatment between January 2012 and December 2016. Surgical treatment was carried out using the Chigot-Lynn technique for 19 patients and the Bosworth-Lynn technique for the remaining 8 patients. Functional and clinical results were evaluated according to McComis criteria and patient satisfaction. Results: Clinical measurement of the of ankle motion range revealed average flexion of 15 ° and an average extension of 40 °. Amyotrophy of the triceps surae muscle was found in all patients, with an average 2 cm. Residual pain was found in four patients. Average sick leave was 4 months. 8 patients had resumed sport at their previous level of training, 3 patients had returned to lower levels of sport, and one patient had abandoned their sporting activity. The results were considered highly satisfactory or satisfactory by 24 patients, good by two patients and poor by one patient. Conclusion: Chronic ruptures of the Achilles tendon remain a therapeutic challenge for the orthopaedic surgeon. Surgery with a reinforcement plasty must be proposed to patients who are active or have sports activities. Surgical repair reduce iterative ruptures and ensure the best functional recovery.
Unicondylar fractures of the femur on osteosynthesis equipment are a particular entity in terms of the lesion mechanisms and therapeutic difficulties. We report this case because of its exceptional nature and discuss the mechanism of occurrence. It was a lateral sagittal unicondylar fracture of the femur on a nail of Küntscher that had been laid for medio-diaphyseal fracture. The causal mechanism was direct. A double screwing on each side of the nail after an open reduction followed by an early rehabilitation was carried out. Consolidation was obtained at 3 months and the nail removed at 18 months with a good functional knee result. Anatomical reduction and fixation allowing early rehabilitation represent a guarantee for a good long-term result.
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