Calcification post-traumatique du muscle ilio-psoas. À propos d’un cas et revue de la littérature

Post-traumatic iliopsoas calcifications are extremely rare affections. We report the case of a patient who presented a right hip discomfort after a wakeboard accident. A thick calcification of the right iliopsoas was visible on standard X-rays. Surgery was performed by the removal of the calcification associated to a non-steroidal anti-inflammatory treatment. The result after six months was excellent. The patient has resumed his sports activities at the same level without discomfort and no recurrence of the ossification.     

Fracture-avulsion de l’insertion tibiale du ligament croisé postérieur chez un enfant. À propos d’un cas et revue de la littérature

The isolated lesion of the posterior cruciate ligament (PCL) and in particular the tibial avulsion is a rarely reported entity on immature skeleton. We report a case of isolated avulsion fracture of the tibial insertion of PCL in a young athlete of 14 years old, treated surgically with good functional results 2 years later.     

Fracture ouverte de la clavicule et traitement par fixateur externe. À propos d’un cas et revue de la littérature

Introduction

Clavicular fractures are treated by orthopedic means or by surgery with internal fixation. Most open fractures are also treated surgically but the use of external fixator remains exceptional.

Clinical case

It is about a 23-year-old patient presenting secondary punctiform cutaneous opening within the framework of clavicule fracture. The fracture had remained exposed for more than 24 hours. After trimming of the wound and reduction, the stabilization of its fracture was carried out by an external fixator Percy Fx^®. The patient directly began rehabilitation for his upper limb. No infection was noted. On the third month, the callous was solid enough to allow hardware removal simple sedation.

Discussion

The cutaneous opening of the clavicule fractures is rare and represents less than one case over 1000. The open fractures in polytrauma patients are accompanied by other direct vascular, nervous even pulmonary complications. In the case of open fracture, surgery is indicated either by intramedullary nailing or with plate and screw fixation. However, the use of an external fixator is recommended by certain authors. The stabilization of this fracture was carried out by an external fixator whose flexibility, light character and radiotransparency, facilitated the follow up.

Conclusion

Although the installation of an external fixator remains exceptional for the treatment of an open clavicule fracture, this method could be under certain conditions an alternative technique to osteosynthesis.     

Rupture post-traumatique négligée du retinaculum extensorum à la cheville. À propos d’un cas et revue de la littérature

Post-traumatic ruptures of the retinaculum extensorum (RE) to the ankle is rare and behind a tendinous luxation, of a rope effect, tiredness and weakening or loss of strength. We report the observation of a patient aged 35 practicing full contact for 20 years, victim of a sports accident two years before upon a foot kick in the kicking bag during a training session bringing about a rupture of the RE at the ankle. Imagery (echography and MRI) made sure the clinical exam and to call for the diagnosis of the rupture of the lower band of the retinaculum with subluxation of the tendons of the tibialis anterior and of the extensor hellucis longus. The take in charge consisted of a local plasty of the RE. On the relapse (6 months), the patient is satisfied with the outcome and taking back to his initial sports activity. Through our observation and a review of the literature, we attempt to review the anatomy of the RE to the ankle and to analyze the causes and the consequences of its rupture as well as the usefulness of the imagery in analyzing its anatomic structure. The rupture of the RE is a rare affection mainly affecting sports persons. They can be unseen and may compromise the sports career of athletes. A meticulous clinical exam and targeting imagery as well as an adequate take in charge allow avoiding this unwanted evolution.     

Ostéochondrites disséquantes rares du genou chez l’enfant. À propos d’un cas tibial et d’ un cas rotulien et revue de la littérature

Osteochondritis dissecans is a rare condition and often involves the medial femoral condyle. We are here reporting two uncommon localizations in children involving the lateral portion of the tibial plateau in one and the patella in the other. They were two fourteen-year-old boys with respectively 4 and 3 months history of a right knee pain and locking. No previous trauma had been noted. X-ray studies and MR images provided definitive diagnosis. However, in the tibial localization, osteochondritis was associated to a damaged lateral discoid menisci and in the patellar localization, the osteochondral fragment was detached in the joint. Regularization of the lateral menisci and removal of a loose body were respectively performed under arthroscopy in the two knees. Literature is reviewed with an emphasis particularly on pathogenesis of these rare localizations.     

La fracture simultanée de Bennett et du trapèze chez un pilote de karting (à propos d’un cas et revue de la littérature)

Simultaneous trapezium and Bennett's fractures is rare. The authors report an observation of a professional kart pilot analyzed in the light of the literature. This lesion is likely to compromise the function of thumb if the treatment is not adapted. Osteosynthesis by screw is the only guarantor of an anatomical and stable reduction of metacarpal-trapezium joint. The results of the cases published are encouraging but are not conclusive compared to the occurrence of the arthritis in the long-term follow-up.     

Les accidents musculo-squelettiques avec les consoles vidéos de nouvelle génération. À propos d’un cas et revue de la littérature

The rise of next generation consoles game, with their share of sport simulations, has caused appearance of new sport injuries. We present a case of a traumatic rupture of the calcaneal tendon, after a game of virtual sport. It concerned a non-athletic 40-year-old woman. The surgery was performed with a very good long-term result. Literature review demonstrated the extent of these pathologies, with a prevalence of musculoskeletal troubles.     

Luxation traumatique isolée de la tête radiale chez l’adulte : à propos d’un cas et revue de la littérature

The authors report a case of isolated dislocation of the head radial road at a patient of 34 years following an injury in pronation and extension of the left elbow in a match of handball. After reduction, as a matter of urgency, the patient is immobilized during 15 days by a brachio-ante-brachio palmaire plaster in 100°. At recession of one year, the clinical examination finds amplitudes comparable to the elbow controlatéral. Only 20 cases of dislocations of the head radial road at the adult were reported in 30 years, among which 13 of them were reduced without surgery and without recurrence. The mostly found mechanism is a hyperpronation, the typical clinical case is a complete blocking of the prono supination without important deficit of the flexion extension.     

Luxation traumatique négligée de la tête radiale chez l’adulte (à propos d’un cas et revue de la littérature)

The authors report the case of an isolated dislocation of the head radial road neglected during 2 months at a 28-year-old patient further to a fall on the right hand bends in extension and hyperpronation of the front arm. The treatment consisted of a bloody reduction of the head radial road by extern way of the elbow with one temporary embrochage pen radial road and a suture of the previous annular ligament by point's transosseux paletot with plastered brachio-antébrachiopalmaire fixed asset in 100° of flexion. For to remind the diagnostic and therapeutic difficulties of this pathology, we propose the study of an observation analyzed in the review of the literature.     

Kyste hydatique primitif de la cuisse révélé par une cruralgie. À propos d’un cas

Hydatid echinococcosis is preferentially localized in the liver. Muscular localization of hydatid cyst is an uncommon event. Symptoms are often discrete. Diagnosis is confirmed by the imaging: ultrasonography and/or magnetic resonance imaging, thus avoiding any untimely gesture. The treatment is surgical. The authors report a case of primary and isolated localization of a muscular hydatid cyst of the thigh in a sport woman revealed by cruralgia.     

Ostéomyélite du pubis chez un athlète : à propos d’un cas et revue de la littérature

Osteomyelitis of the pubis has rarely been described. We report a case of pubic osteomyelitis with Staphylococcus aureus at sub periosteal abscess occurred in a custodial football aged 17. It was presented in a table feverish pain in the groin with a left and a functional sensitivity of the symphysis pubis. The diagnosis was based on blood cultures, biology, ultrasound and MRI performed in emergency. The surgical treatment was strongly associated with antibiotic therapy adapted to the germ. The pathogenesis of this entity is probably the location of bacteraemia secondary to a bone redesigned by micro trauma. The treatment is based on prolonged antibiotic therapy. Surgical drainage is required for infections to rebel or medical treatment in case of abscess.     

Fracture de fatigue du sésamoïde tibial. Présentation d’un cas et revue de la littérature

Sesamoids are accessory peripheral bones around the metatarsophalangial joint of the first toe. They are almost constant although some rare congenital absences have been described. They work like a pulley and increase the traction power of muscles during the last stage of the step. Clinical diagnosis of stress fracture is often difficult to establish because different pathologies are usually intertwined. Sensitive elective palpation of the sesamoids, local tumefaction, painful passive metatarsophalangial extension and walk with supination of the forefoot lead to one of the following diagnoses: static or microtraumatic pathologies, osteonecrosis, microcrystalline arthropathy, rheumatoid arthritis, infections, developmental abnormalities, perisesamoidal soft tissue injuries, or even less common etiologies. Radiologic examinations (Guntz view) allow for a precise evaluation of the sesamoid bones. According to the suspected diagnosis, computed tomodensitometry, magnetic resonance or scintigraphy can be performed. The initial treatment is a conservative one; if it is not responsive, surgical treatment can be suggested but usually leads to muscular instability.     

Luxation traumatique de l’appareil extenseur au dos de l’articulation métacarpophalangienne. À propos d’un cas et revue de la littérature

The authors report the case of a dislocation of the extensor tendon over the metacarpophalangeal joint of the long finger, resulting from posttraumatic rupture of the radial sagittal band. A surgical procedure was performed to improve functional rehabilitation. The outcome at six months was excellent and the patient returned to sports, without recurrence of extensor tendon instability.     

Rupture post-traumatique du tendon patellaire (à propos d’un cas et une revue de la littérature)

Subcutaneous ruptures of patellar tendon are exceptional but very disabling, the authors bring report a case of rupture at a sportsman further to a foul in a volleyball match, the treatment was surgical, made by joinings and reposition of the apparatus bungee cord by a cerclage wire during six weeks. The functional results were very satisfactory with a correct active extension after the rehabilitation. We try through this case and a review of the literature to underline the rarity of this entity, its predisposing factors, and the difficulty its therapeutic coverage as well as the interest of the premature rehabilitation post-operating, which conditions the functional recovery of the knee.     

Fracture-luxation radiocarpienne postérieure ouverte du poignet. À propos d’un cas

The radiocarpal fracture-dislocations are uncommon injuries, occurring at a high-energy trauma explains the frequency of associated lesions in patients with multiple trauma often. The frequency of skin involvement very varies, but is rare (few cases reported in the literature). A combination of median nerve and worsens the functional prognosis of the hand. The authors report the case of a radiocarpal fracture-dislocation of the right wrist, which was complicated by anterior cutaneous opening in a young footballer after a sports accident.     

Luxation traumatique isolée du tendon tibial postérieur (tendon tibialis posterior). Revue de la littérature et présentation d’un cas

The traumatic dislocation of the tibialis posterior tendon, without any other lesion, is rare. We present the case of a football player who had one. It may look like a medial ankle sprain. A cordlike structure passing over the medial malleolus and a painful recurrent snapping are pathognomonic. Ankle radiographs are useful to detect an associated fracture. Sonography and MRI are the most reliable exams to confirm the lesion. Surgery is the standard treatment, easy to perform at an early time.     

Fracture bilatérale simultanée de rotule. À propos d’un cas

Bilateral simultaneous fractures of the patella occured with interruption of the apparatus bungee cord, in a young man is a exceptional occurrence. A mechanism in two times, without subjacent etiology, contributes to accentuate the originality of this observation. The authors propose to describe the assumptions of the organic mechanism and the physical therapeutic. The goal is the functional recovery most optimal and the restitution of a military efficiency.     

Fracture–avulsion isolée du tubercule mineur de l’humérus: À propos d’un cas et revue de la littérature

Isolated avulsion fracture of lesser tuberosity of humeral head is not infrequent. Usually diagnosis is delay or unrecognized and symptomatology is poor. Analysis of X-ray is often difficult because the avulsed bony insertion overlay on humeral head. The mechanism of injury is an excessive contracture of subscapularis muscle during a forced external rotation. Long biceps's instability is the main associated injury. The treatement is a sling immobilization with internal rotation of humeral head for no displaced fracture. Surgical treatement must be recommended for other cases. Deltopectoral approach with screw and anchor fixation is classical but one case of arthroscopic treatement has been described. The best treatement of long biceps's associated instability is section.     

Ressaut distal du biceps fémoral : à propos de 2 cas et revue de la littérature

Snapping of the biceps femoris over the fibular head is an uncommon condition. Reported causes include an anomalous insertionof the tendon, trauma at the insertion site of the tendon, and an abnormality of the fibular head. This article reports two cases of a painful snapping biceps femoris tendon. Medical management resulted in a complete resolution of symtoms.     

Muscle soléaire accessoire. À propos d'un cas et revue de la littérature

The soleus accessory muscle is an anatomical congenital variation, responsible for a soft tissue mass posteromedial to the ankle that can be source of a functional disorder while physical activity. Differents hypothesis have been proposed to explain the physiopathology of the clinical picture. Magnetic resonance imaging is the most accurate investigation to establish the diagnosis. In case of an important functional limitation, especially in athletes, surgical excision is necessary. In the following we present the case of a 15 years old athlete and a review of the literature concerning this pathological entity.