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Biomedical subjects

A Harfaoui

Publications and source records attributed to A Harfaoui.

10 recordsLinked to original sources

[Anterior luxation of the elbow. A case report].

We report in this work a case of anterior pur dislocation of elbow in a patient of 45 years, with antecedent of elbow trauma in childhood, occurred after a direct trauma on bent elbow. The diagnosis is obvious and represented by a pseudarthrosis of the epitrochlea. The treatment consisted of a reduction practiced immediately of the dislocation and contention by a posterior plaster for two weeks. The consequences are good without recidivism with a latenesis over one and half year.

Biomechanical Phenomena↗

[Epiphyseal detachment of the upper end of the tibia].

In this study, we report 3 cases of fractures involving separation of the upper end of the tibia in young adolescent. These are fairly rare injuries that usually treated by plaster immobilisation. Our aim, through this work is to show the uncommon characteristic of this injuries, possibility of local complications and the difficult of choice of treatment: conservative or surgical treatment.

Adolescent↗

[Antelunar dislocation of the wrist. Apropos of 3 cases].

Volar perilunar dislocation of the carpus is rare. We report three cases here. The patients were 18, 23 and 31 years of age. The etiology was a traffic accident in all cases and palmar hyperflexion of the wrist was noted in all three. Palmar dislocation was associated with a scaphoid fracture in two cases. In the third case, there was an associated fracture of the radial styloid and capitate. The patients were operated on after a delay of 48 h in two cases and four weeks in one. The dorsal approach was used in two cases and the palmar approach in the other. Reduction, fracture osteosynthesis and intracarpal temporary arthrodesis were the main lines of treatment. The functional result evaluated after a minimum of eight months' follow-up was good in two cases, and acceptable in one (Green and O'Brien score). Volar perilunar dislocation is often associated with fracture of a carpal bone, mainly the scaphoid. It occurs in young men, after a violent injury. Polytrauma is often associated. Closed reduction is attempted first but open reduction is often needed because of instability of the lesion. The functional result is good if the treatment restores carpal bone congruence.

Adolescent↗

[Metaphysis fracture of the distal radius: Kapandji's or Py's pinning?].

The authors report a prospective and randomized study comparing two pinning techniques for fractures of the distal radius. The series compared 42 patients treated by Kapandji's intrafocal pinning (Group I) and 46 patients treated by Py's isoelastic pinning (Group II). Secondary displacement was observed in 7 patients in group I and in 2 patients in Group II. Secondary displacement of K-wire was observed in 6 patients in group I and in no patient in group II. Functional results were analysed according to jakim's criteria. A significant difference was observed between the two groups, for global scores, objectives scores and radiological scores, with better results for Py's pinning. No significant difference was observed for subjective scores advantages of Py's pinning were: stability of isoelastic wires preventing posterior comminution and no need for radioscopic control. Kapandji's pinning is proposed in cases of lower and unstable fractures in teenagers without focal comminution and in T fractures. In the other cases of metaphyseal fractures with posterior displacement, Py's pinning could be proposed.

Bone Nails↗

[Local digital anesthesia using lidocaine with or without bicarbonate. A comparative randomized study].

PURPOSE OF THE STUDY: Local anesthesia with lidocaine is widely used in surgery of the extremities, particularly for fingers. Injection causes pain. In order to minimize this discomfort, addition of bicarbonate has been used by many authors. Results were however contradictory in relation with the difference of approaches. Our study is based on a randomized comparative series with and without lidocaine alcalinization. MATERIAL AND METHODS: Sixty patients presenting multidigital trauma concerning at least two fingers. For each patient, one finger was anesthetized by lidocaine 2 per cent alone and one by lidocaine 2 per cent plus bicarbonate 8.4 per cent respectively in proportion of 4/5 and 1/5. We compared the intensity of pain during injection by a scale ranging from 0 to 10. RESULTS: Significant difference was found between both groups (p < 0.001), alcalinization appearing to decrease discomfort during injection. DISCUSSION: Mechanism of pain decrease by alcalinization is unclear. It appears that intracellular passage of non ionic form of lidocaine is facilitated by alcalinization. This allows the decrease of latence of lidocaine and relieve pain more rapidly by pain receptors blockade. CONCLUSION: Diminution of pain during anesthetic injection has major advantage in out-patient surgery of extremities, in ligamentar testing of digital articulations and in steroid injection.

Adult↗

[Subungual exostoses. A retrospective study of a series of 28 cases].

Subungual exostosis represents an uncommon osteocartilaginous benign proliferation with a trend towards recurrence. The authors report on a retrospective series of 28 cases of subungual exostosis of the first toe with histologic confirmation. There were 20 male and 8 female patients, with a mean age of 18 years. A history of trauma or repetitive microtrauma was noted in 21 cases. Surgical treatment was performed using the most direct approach. The tumor was widely excised and the ungual apparatus was reconstructed under optic magnification. All patients were reviewed after 14 to 96 months. Tumor recurrence was observed in 4 cases, treated secondarily with success. No malignant transformation was seen.

Adolescent↗

[Primary muscular echinococcosis. Apropos of 2 cases].

We report 2 cases of primary muscular hydatosis of the thigh in a 30-year-woman and a 75-year-man. The clinical picture was a benign soft tissue tumor. The ultrasound and C.T. scan exams confirmed the diagnosis and showed precisely the intimacy of the lesion with the femoral vascular axe. Preoperative diagnosis of this affection is mandatory in order to prevent any rupture of the cyst so as to avoid anaphylactic shock and local recurrence. Percystectomy is the treatment of choice for this lesion.

Adult↗

[Carpal perilunar dislocation. Clinical study (apropos of 39 cases)].

Carpal perilunar dislocations are hidden lesions with uncertain outcome and treatment which is not yet standardized. This retrospective study including 39 cases of carpal perilunar dislocations helps clarify these issues. For fresh dislocations, the diagnosis was established in 66%. Surgical treatment was performed in 26 cases. Anatomic results showed nonunion, necrosis and residual instability. Function was always decreased and was worse in open forms or after orthopedic treatment. Scaphoid screwing results were better than those from pinning. Lateral wrist x rays must always be ordered in cases of wrist trauma to avoid delayed diagnosis. Surgical treatment must systematically use a palmar incision; it permits precise repair of bones and ligamentous lesions and reduces the risk of arthritis.

Adolescent↗