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A Lamine

Publications and source records attributed to A Lamine.

15 recordsLinked to original sources

[Chondrosarcoma of the hand. Diagnostic and therapeutic discussion (three case reports)].

Chondrosarcoma of the hand is very rare. We report three observations which enable us to make a review of its pathology. There were two men and one woman aged 72, 38 and 63 years respectively. Localisation was phalangeal in two cases and metacarpal in one case. Two cases were central and one peripheral. Radiographs were characterised by the presence of lytic areas with intralesional calcifications and soft tissue extension. Histological diagnosis was made by biopsy in two cases and after amputation of the finger for lesional spread in one case. Treatment consisted of amputation of the finger in two cases. In the case of metacarpal localisation, wide resection of two rays was followed by recurrence after ten months which required amputation of the hand. We agree with other authors who believe that chondrosarcoma in the hand is due to malignant change in a pre-existing chondroma. Conservative treatment is difficult due to the small size of the hand which allows easy spread of the tumour from compartment to compartment.

Adult↗

[Solitary osteochondroma of the limbs. Clinical review of 76 cases and pathogenic hypothesis].

The authors report a retrospective study of 76 solitary osteochondromas of the appendicular skeleton treated between 1981 and 1995. The ages of the patients ranged from 13 to 55 years with a mean of 21 years. The male/female-ratio was 1.37. Tumefaction with or without associated pain was the reason for consultation in 68 cases (89%). In 62 cases the osteochondroma was localized in the distal part of the femur or the proximal part of the tibia. All lesions were surgically resected; the resection was complete in all cases. Six patients were lost to follow-up; the other 70 were seen on a regular basis over a time period ranging from 1 to 12 years. The result from surgical treatment was assessed based on pain, joint motion, cosmetic consequences, nerve compression and recurrence of osteochondroma. The results were good in 68 cases and fair in two cases. Based on a review of previous experimental studies, the authors suggest a hypothesis to explain the rotation of a fragment of the growth plate which is needed for the development of osteochondroma. This rotation occurs as a result of the mechanical action from the periosteum under tension.

Adolescent↗

Tuberculous osteitis in limbs. Twenty five case-reports.

Tuberculous osteitis is a rare condition that can be difficult to differentiate from bone tumor on X-ray films. The purpose of this retrospective study was to analyse the epidemiologic, diagnostic and therapeutic aspects of this disorder. Data from 25 patients (13 men; 12 women; mean age = 37) were collected between 1984 and 1993. The source of contagion was traced in 32% of the cases and 24% of patients were known as tuberculous. Patients searched medical attention because of pain in 84% of cases. The greater trochanter was involved in more than 50% of cases. The definite diagnosis was obtained by examination of a surgical biopsy and the anti-bacillary treatment led to recovery in all cases. This study highlights that tuberculosis must be considered when investigating a bone lacuna, all the more so when the greater trochanter is involved, in a country where tuberculosis is endemic.

Adolescent↗

[Isolated tuberculosis of popliteal cyst. Apropos of a case].

INTRODUCTION: Isolated localization of tuberculosis in the popliteal cyst is an exceptional affection. CASE REPORT: Mr. M.L., 18-year-old black moroccan, was admitted for a painful swelling of the left popliteal cyst, general state alteration and left thoracic pain. Clinical examination found a 5 cm on 3 cm oval tumefaction at the supero-medial part of the left popliteal hollow. No articular effusion was noted. Left knee X ray was normal, while ultrasound examination showed a modified popliteal cyst. Chest X ray showed a pleural effusion. Tuberculine skin test was positive (18 mm). A subtotal resection of the cyst was performed, evacuating 10 ml of thick pus. The histologic examination of the cyst confirmed its tuberculosis origin. In addition the left pleural biopsy confirmed the diagnosis of tuberculosis as well. The antibacillar treatment based on rifampicine, INH and pyrazinamide was given during 6 months. The evolution was favorable at 2 years of follow-up. DISCUSSION: Knee popliteal cyst is frequently an expression of an inflammatory or traumatic affection. The communication between the articular synovium and the serosa bursa of the lateral gastrocnemius is found in 50 per cent of cases, allowing an association of both localizations of tuberculosis. Hamabuchi described for the first time an isolated popliteal cyst tuberculosis in 1990. This case is similar to Hamabuchi's observation. Clinical and radiographical examinations were normal thus excluding a possible dissemination from the knee joint.

Adolescent↗

[Multifocal bone tuberculosis: apropos of a case].

INTRODUCTION: Tuberculosis of bone is rare (10 to 20 per cent of all skeletal tuberculosis). The multifocal form is exceptional even in endemic countries of tuberculosis. It constitutes less than 5 per cent of all osseous tuberculosis. CASE REPORT: O.H. 34 year-old, Moroccan woman of black race not vaccinated against tuberculosis, with a contagion, complained for a year from scapular pain and weight loss. She noticed that two masses had appeared six months ago. The patient was feverish (38 degrees). The physical exam showed a non inflammatory mass 10 cm wide located in front of the left sacroiliac joint and seeming to be a cold abscess. The radiologic assessment showed a lytic image of the humerus upper extremity, the right iliopubis branch, the left ischium and the left iliac wing. The surgical biopsy of the humerus showed an evolutive caseo-follicular tuberculosis. The nuclear scan of bone found two other localizations in the fourth lumbar vertebra and the ninth left rib. We concluded to a multifocal bone tuberculosis with seven localizations: The upper extremity of both humerus Right pubis Left ischium Left iliac wing 4th lumbar vertebra 9th left rib. The treatment consisted in a specific antibiotic therapy for 6 months associated to the evacuation of the cold abscess. DISCUSSION: Multifocal bone tuberculosis is more frequent in young adults of black race. The beginning of the disease is progressive and the fistulas are the main reason of consultation. The radiologic lesions are not specific and have a geodic shape rimmed with an osteocondensation. Multifocal bone tuberculosis in black african predominate in flat bones. Otherwise in the white race it is located in the long bones extremities. The diagnosis of certitude is based on histologic findings of the peripheric bone lesion. The specific antibiotic therapy leads to the recovery if given early. Short protocols (9 or 6 months) are recently more used with success.

Adult↗

[Triquetro-lunar instability. The role of the radio-styloidian index].

Based on a series of 13 isolated triquetro-lunar instabilities, the authors underline the excess of the radio styloidian index measured radiologically. They found a significant difference (p < 0.001) when comparing this series with a group of 100 normal wrists. A similar comparative study of 13 triquetro-lunar instabilities secondary to perilunar dislocations and of a series of 16 hyperlax wrists did not reveal any significant difference. The same applies to a similar parallel study of the ulnar variance index measurements when comparing the various groups with the control group. After reviewing the mechanism of lesions, and disorders of the wrist's axial forces, caused by changes in the ulnar lengths, ulnar styloid overshooting is designated as a risk factor for isolated triquetro-lunar instabilities. Finally, the authors insist on the necessity of proper reduction of radial low end fractures and detachments, and on the shortening of the long ulna, as a "complementary" procedure when treating isolated triquetro-lunar instabilities.

Adolescent↗

[Associated median-ulnar nerve injuries at the level of the wrist. Apropos of 17 cases].

A study of a homogeneous series of 17 complete associated wounds of the median and ulnar nerves at the level of the wrist, was conducted. They were always associated with tendinous and arterial injuries. Repair in emergency has consisted in an epiperineural suture under optic enlargement, tendinous suture and arterial suture. 29.4 per cent of patients had good results. Elements of bad prognosis were contusion, repaired but non functional arteries, and total and simultaneous character of the two nerves section.

Adolescent↗

[Association of monomelic melorheostosis and synovial chondromatosis of the knee].

Melorheostosis is a rare affection, of obscure etiopathogenesis, corresponding to osteosclerosis with running hyperostosis. We report the observation of melorheostosis of a lower limb occurring to an 18-year old patient who consulted for tumefaction of the lower limb with an aching and stiffened knee. The radiography allowed the diagnosis by showing an aspect characterized by a running like of a candle accompanied by osteochondromatosis of the knee and the calcification of soft tissues. The synovectomy of the knee brought about indolence and the lesions seem to stabilise after a 3 years follow-up. The synovial osteochondromatosis seems to be an integral part of the disease. The characteristics of melorheostosis are studied according to the data of the literature.

Adolescent↗

[An osteoid osteoma of the os capitatum].

We report a hyperalgic form of an osteoid osteoma of the capitatum, wich had evolved since 14 months. The diagnosis was done by roentgenography. Complete surgical excision of the lesion led to the cure.

Adult↗

[Preventive treatment of hemodynamic disorders during conventional spinal anesthesia].

The prevention of blood pressure fall during a conventional spinal anaesthesia effected with 20 mg (4 ml) of isobaric 0.5 p. 100 bupivacaine relies on the use of vascular filling and/or a vasoconstrictor. A randomized prospective study was performed to evaluate the comparative efficacy of these two treatments. 148 patients were included and divided into three groups. Group I (n = 50): 2.5 mg IV bolus of etilefrine followed by continuous infusion (0.35 mg.kg-1.h-1). Group II (n = 50): 30 ml.kg-1 infusion of saline isotonic solution for 90 min, with infusion rate according to blood pressure. Group III (n = 48) did not receive any preventive treatment. A blood pressure fall of more than 30% of the initial value was observed in 59 patients: 18% of the etilefrine group, 28% of the saline infusion group, 54% of the control group. This peculiar frequency of hypotension in the control group emphasizes the need of a preventive treatment. Haemodynamic changes were fewer and less important in the etilefrine group compared with the saline infusion group. No failure and a better tolerance in the vasoconstrictor group were also to be noticed. These clinical data suggest that etilefrine could meet satisfactorily the therapeutic requirements.

Anesthesia, Spinal↗

[Arthrolysis of the elbow--apropos of 70 cases].

This retrospective review covers 70 cases of elbow stiffness treated by arthrolysis. The average age was 27 years. Eighty percent had a posttraumatic origin; 53.6% were old dislocations. In 67.1% the range of movement was reduced for flexion and extension; 80% were severe to very severe cases. Physiotherapy was passive and active from the third postoperative day, except for the old dislocations, treated for 2 weeks by fixation of the radial condyle, because of instability. For 51.4% the range of movement was -30 degrees extension up to 130 degrees flexion, intra-operatively; for 21.4% it was a long-term result. The results were related to the damage to the joint space, the large number of old dislocations and insufficient rehabilitation.

Adolescent↗

[Idiopathic acro-osteolysis. Apropos of a case with carpal-tarsal onset].

This work reports an isolated case of idiopathic acro-osteolysis with a carpo-tarsian onset without associated nephropathy, diagnosed in a 16 year-old patient. It has raised problems of etiologic diagnosis, of classification and therapeutic behaviour in the presence of destructive lesions with an extensive and progressive evolution.

Adolescent↗

[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↗

[Primary hydatidosis of the peripheral muscles. 7 case reports].

The authors reviewed a series of 7 cases of isolated and primitive hydatid cyst in the peripheral muscles. The disease was mainly diagnosed in young (average age 29.3 years) women of rural origin (87.7%), who consulted for a soft tissue tumor, evolving over at least 6 months, without alteration of the general condition. In 5 of the 7 patients, the tumor was located in the thigh and in 3 cases in the adductors compartment. The diagnosis was highly suspect on sonography. The surgical treatment consisted in a complete resection of the hydatic cyst with surrounding muscle tissue in 6 of the 7 cases, and in a subtotal removal of the surrounding tissues in one case which had adhesions of the surrounding tissues with the femoral vessels. With a follow-up of 19 months, neither clinical nor serological examination showed any recurrence or new sites.

Adolescent↗

[Metacarpophalangeal luxation of the thumb. Apropos of 30 cases].

A retrospective study of a series of 30 cases of metacarpo-phalangeal luxation of thumb (18 dorsal and 12 palmar) showed the relatively high frequency of the palmar variety both in adults and children. Prognosis was better for dorsal than for palmar luxations, the latter being associated with other lesions; cutaneous, tendinous and/or bony, these constituting the severity factor.

Adolescent↗