Biomedical subjects

T Fikry

Publications and source records attributed to T Fikry.

At least 19 recordsLinked to original sources

PubMed2005

[Total carpometacarpal dislocation. Case report].

Anterior carpometacarpal dislocation are rare injuries. The anterior type is exceptional. Mr A.T 18 years old, male, student, right-handed, without pathological medical history. He was admitted in emergency after a fall of a motorbike (unknown mechanism) for a closed left hand injury; examination revealed a total impaired mobility and an important swelling of the hand without vasculonervous disorders. X-ray revealed a pure anterior dislocation of the five carpometacarpal joints. The patient was operated on in emergency using both anterior and posterior approach, which allowed to reduce the dislocation. It was maintained by K-wires. An antebrachiopalmar cast was applied for six weeks. One year later, the result obtained was considered excellent.

Accidental Falls↗

PubMed2005

[Aseptic osteonecrosis of the femoral head in thalassemia minor: a case report].

We report a case of aseptic necrosis of the femoral head in a 14-year-old black adolescent with thalassemia minor disclosed by physical examination and blood tests. No other anomaly could be identified. Despite the very probably secondary nature of the aseptic osteonecrosis of the femoral head and the absence of any other etiology, it is highly difficult to demonstrate the causal effect of thalassemia minor. We reviewed the literature and discuss the pathogenesis of this association.

Adolescent↗

PubMed2004

[Hand trauma from table saw: best prevention].

OBJECTIVE: Trauma to the hand from a circular saw table is a common occurrence in developing countries. It tends to occur in young people, leading to psychologic- and socio-economic disability and loss. METHOD AND RESULTS: In this series of 834 patients. The mean age was 25 years. The left hand was involved in 88%. The authors report on the epidemiologic features of these lesions. These accidents are correlated with postprandial somnolence. The most frequent causes are absence of security systems and heterogeneity of the wood. DISCUSSION: The authors emphasize the importance of information for workers, using consciousness raising campaigns. They also stress the necessity of improvement of the conditions of work. Professional formation must be mandatory for young woodworkers and the laws concerning utilization of dangerous machines must be rigorously enforced, in order to lower the incidence of these accidents.

Accidents, Occupational↗

PubMed2004

[Cubital tunnel syndrome and heterotopic ossification. Eight case reports].

INTRODUCTION: The occurrence of cubital tunnel syndrome during heterotopic ossification is infrequent. Entrapment of the nerve requires early decompression whereas definitive elbow release is often delayed to reduce the risk of recurrence of periarticular ossification. The pathophysiology and treatment of these two conditions are discussed. METHOD: The authors report a retrospective study of eight men (average age 37 years), all with previous head injury. The nerve entrapment was severe in two cases, moderate in four and mild in two. The elbow was ankylosed with a mean flexion deformity of 96 degrees (77 degrees-123 degrees). Management consisted of early decompression and neurolysis with anterior transposition of the ulnar nerve. In four cases elbow release was postponed until maturation of the ossification. RESULTS: The neurolysis results were assessed according to the score of KLEIMAN modified by TEOH. They were excellent in two cases, good in five and bad in one. DISCUSSION: Entrapment of the ulnar nerve in the context of heterotopic ossification seems related to compression and tension on the ulnar nerve. The compression may be due to prolonged pressure of the medial edge of the elbow on the bed of the nerve, or to a periarticular bony bridge and the initial inflammatory reaction of the heterotopic ossification. Ulnar nerve tension seems to be due to prolonged flexion of the elbow joint and to movements of the shoulder and the wrist, on either side of the ankyrozed elbow. Treatment should be by early decompression of the nerve and we recommend, in addition, anterior transposition to reduce the tension on the nerve. The elbow release can be combined with the neurolysis or delayed according to the state of activity of the heterotopic ossification.

Adult↗

PubMed2003

[Ossifying parosteal lipoma of the rib: a case report].

Ossifying parosteal lipoma is an uncommon form of parosteal lipoma. We report an exceptional rib localization where hyperosteosis probably arose from contact between the lipoma and the periosteum. Foci of metaplastic cartilage undergoing chondral ossification within the adipose tissue suggest a possible mixed origin.

Adult↗

PubMed2003

[Lateral dislocation of the elbow: pathophysiological and therapeutic analysis].

Lateral dislocation of the elbow is exceptional, and its pure form even more so. We report a case of lateral dislocation of the elbow observed in a 65-year-old woman following a fall on the medial aspect of the elbow in the flexion position. Reduction could not be achieved because of the anconeus muscle interposition. Analysis of the mechanism involved and the displacements observed enabled to propose a reduction manoeuvre using gentle traction on the elbow with extension and progressive supination of the forearm, pushing the olecranon backward then pulling it medialy. This enabled avoiding incarceration of the nerve bundle or capsulo-ligamentary structures.

Accidental Falls↗

PubMed2001

[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↗

PubMed2000

[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↗

PubMed1998

[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↗

PubMed1998

[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↗

PubMed1998

[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↗

PubMed1997

[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↗

PubMed1996

Osteoid osteoma after a fracture of the distal radius.

We report a case of osteoid osteoma occurring at the site of a previous fracture of the radius treated by internal fixation with insertion of a rod. The fracture may have acted as a trigger for the formation of an osteoid osteoma.

Adult↗

PubMed1996

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↗

PubMed1993

[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↗

PubMed1993

[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↗

PubMed1993

[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↗

PubMed1993

[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↗