This is a retrospective study of 30 cases of first metacarpal fractures in adults collected in our service from March 2015 to March 2018. The average age was 31 years with a male predominance (80%). The etiologies were dominated by domestic accidents (50%). The mechanism of injury was direct in all patients. Imaging confirmed the diagnosis and allowed the classification. Surgery concerned types Rolando (40%), Bennett (30%), extra-articular (20%) and diaphyseal (10%), it consisted of pinning according Iselin 07 cases (70%), ascending pin according Kapandji 02 cases (20%) and direct screw 01 case (10%). Immobilisation after surgery was systematic in all patients (100%) for six weeks. Functional rehabilitation began early in all cases (100%). Bone healing was achieved in 06 to 08 weeks in 100% of cases. A complication was observed in 03 patients (10%), it was a malunion. Our results have been very satisfactory in 90% of cases.
Divergent fracture-dislocation of the ankle is a rare injury; it is due to a high-energy accident with axial forces that dislocate the astragalus at the tibiofibular junction with injury of the syndesmosis. It is most often associated with a fracture of the fibula, and sometimes with a fracture of both the fibula and tibia. We report 2 cases, their mechanisms, their treatments, their short-term results and review of the literature.
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