Biomedical subjects

M El Andaloussi

Publications and source records attributed to M El Andaloussi.

5 recordsLinked to original sources

PubMed2003

[Aneurismal bone cyst in children: 17 cases].

INTRODUCTION: The aneurismal bone cyst (KOA) represents 1.5 to 4% of benign osseous tumors. It affects the young patients and its etiopathogeny is still discussed. Numerous difficulties of diagnostic, therapeutic and specially evolution, characterize this pathology. MATERIAL AND METHODS: Our study reports 17 patients who were treated between 1976 and 2000. The average age was 8 years and delay of diagnostic was 11 months. It affected the long bones in 70%, the brief bones in 25% and the flat bones in 5%. In limbs, the pathological fracture was revealing in 47%, the painful lameness in 35% and tumefaction in 18% of cases. For two vertebral locations, pain was associated with a stiff neck for the cervical spine and there was a deformation with a medullar compression for the lumbar vertebral location. The radiological aspect was typical in 82% of cases. First biopsy in 13 cases allowed to confirm the KOA in eight cases; for five cases, a second biopsy was necessary to confirm diagnosis. In four cases, diagnosis was hold on typical radiographic aspect or on the hemorrhagic nature of the cyst. The surgery was realized in 15 cases (88%), with 13 eventrations and graft (three osteosynthesis) and two complete exeresis. The radiotherapy was performed for a hemorrhagic cyst located in cervical spine. Finally, a cast immobilization alone was realized for a location of the patella. RESULTS: A good result was observed in nine cases, the recurrence in three cases, degeneracy in one case and we deplore one death following a toxic shock. Degeneracy seems to be due to an initial misunderstanding of the osteosarcoma. Three patients could not be evaluated for the study. DISCUSSION: The KOA is a solitary bone dystrophy that can be primitive, or secondary to a sometimes-sly underlying hurt. The symptomatology is varied according to the location; modern imaging allows to better defining of the KOA aspects. Biopsy is indispensable for the diagnosis, but histological confirmation is not always certain. The best treatment must permit the "carcinologic" removal of the KOA. The reconstruction will be done by graft and osteosynthesis if necessary. The injection of ethibloc and the embolisation are indicated for the voluminous and very aggressive cysts. Radiotherapy, with its important morbidity, can be used for the inoperable cases. Unpredictable evolution remains threatened by the risk of local recurrence and later, by the risk of degeneracy.

Adolescent↗

PubMed2001

[Vertebral hydatidosis: three case reports].

PURPOSE OF THE STUDY: Vertebral hydatidosis, the most frequent localization of skeletal hydatidosis, has an ominous prognosis with the risk of progressive but permanent neurological damage. There is no consensus on appropriate management. Treatment is often unsuccessful with frequent recurrence. The purpose of this study was to assess our experience with this rare disease to identify diagnostic, therapeutic and prognostic features. MATERIAL AND METHODS: We reviewed the charts of three patients with vertebral hydatidosis treated at the department of orthopedics at the Casablanca children's hospital between January 1989 and January 1998. Diagnosis was made early in the first patients, allowing complete excision of the hydatid cyst. Follow-up was uneventful 10 years after surgery. The second patient presented after a long disease course and had definitive neurological complications despite treatment. The lesions were extensive in the third patient and cure could not be achieved although the patient remained asymptomatic. DISCUSSION: Vertebral hydatidosis is a severe disease causing frequent neurological complications. Surgical treatment, though difficult, is the only efficient option. Complete recovery can be achieved after surgical excision of lesions diagnosed early. Prevention is the best therapeutic strategy in endemic areas.

Adolescent↗

PubMed1990

[Treatment of the dislocated hip in older children].

Between 1976 and 1987, 85 cases of CDH occurring after walking age were followed in the department. Eighteen children aged 5 years or older were reviewed. In 11 children the dislocation was unilateral and in 7 bilateral; out of these 25 hips, 20 were high luxations and 5 occurred at a lower level. Two children, 6 and 13 years old, had a bilateral dislocation. Except for 2 children of 5 years of age who were treated conservatively, surgical treatment was indicated in the other 18 cases usually after tenotomy and derotation. In 13 hips, a surgical repositioning was performed, associated with femoral osteotomies, either shortening osteotomies (7) or derotation osteotomies (3). Pelvic osteotomies were indicated either immediately or later in 15 hips. A triple osteotomy was usually performed (11); a Salter (2) or a Chiari (2) has been rarely used. After a follow-up of 5 years, evaluation according to clinical and radiological criteria showed 14 good and 7 bad results. The latter 7 cases had either a dislocation or an eccentration. Reviewing these series, the authors describe the problems in the treatment of the dislocated hip in the older child: the indications, the therapeutic strategy for those dislocations and the decision for treatment of the bilateral high dislocation in the older child.

Age Factors↗

PubMed1984

[Atlanto-axial dislocations in children].

A series of 9 cases of atlanto-axial dislocation observed between 1976 and 1982 illustrates the wide range of etiologic factors as well as their possible implication. The findings were as follows: 3 congenital anomalies of the odontoid process, 2 luxations resulting from trauma, 1 spine infection, 2 Grisel syndromes, 1 psoriatic rheumatism. Among them 3 children had incomplete tetraplegia. Six patients were treated by posterior spine fusion either directly or after failure of conservative management. The authors emphasize the difficulty in relating the disorder to its real cause and discuss the various methods of treatment according to the etiology, whether reduction and stabilization are possible and according to the neural involvement and the date of onset of the disorders.

Adolescent↗

PubMed1981

[New approach to the management of caustic esophageal stricture in children (author's transl)].

The management of long segment esophageal stenosis following chemical burns in children remains a difficult problem although various kinds of treatment have been proposed. The surgical treatment, consisting in replacing the injured segment, is mutilating and always performed at some risks. On the other hand dilatations must be carried on over several years in order to produce results and are not compatible with normal life. Furthermore, they are often followed by complications. The authors have been led to develop a method which would both allow the conservation of the esophagus and avoid long term dilations. This procedure mainly consists in a lengthwise myotomy of the residual structure after 12 or 18 months retrograde dilatations so as to peel off the wall fibrosis. The technique is presented and discussed about 2 successfully treated cases with a 9 to 12 months follow up.

Burns, Chemical↗