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Global uncertainties have prompted nations to adopt vigilant approaches to safeguard their citizens. Recent crises have compelled Western nations to undertake evacuations, ranging from peaceful scenarios to urgent military interventions. In April 2023, Sudan descended into civil war, prompting France to orchestrate a complex evacuation operation leveraging prepositioned forces in Djibouti. This retrospective observational study aims to analyze the surgical challenges encountered during Operation SAGITTAIRE (OS), focusing on human, technical, and logistical requirements for successful military interventions in multinational civilian populations. OS successfully evacuated 1017 individuals of 84 nationalities from Khartoum using road, sea, and air routes. Special forces teams, including the Surgical Life-saving Module (SLM), were mobilized alongside conventional military elements. The Joint Medical Surgical Center (JMSC) in Djibouti served as a permanent medical facility with comprehensive facilities and staff. Air Medical evacuations were performed for vicitms and surgical interventions were conducted, including damage control surgery, orthopedic procedures, and debridements. Five surgical evaluations and four surgical procedures were performed. The operation spanned 96 h without death. The SLM, deployed in Khartoum and within an aircraft, played a crucial role. OS highlighted the need for a comprehensive health support system. Challenges in assessing health needs led to the establishment of a substantial and adaptable system. The report emphasizes the importance of a comprehensive approach to support Non-combatant Evacuation Operations in French Doctrine. OS showcased the French Health Military Service's capabilities in deploying a comprehensive damage control chain in challenging environments. This fatality-free success underlines the effectiveness of coordinated resuscitation, damage control, and transportation. Evacuation operations in non-combatant settings during civil wars pose formidable challenges, requiring a modular and adaptable support concept. Coordination, communication, logistical preparation, and training are crucial elements for successful management of such operations. [ABSTRACT FROM AUTHOR]

Background The Latarjet procedure is considered to be a violation of the subscapularis muscle. This study evaluated the postoperative status of the subscapularis through isokinetic and magnetic resonance imaging analysis after splitting. We hypothesized that compared with a healthy contralateral shoulder, there would be satisfactory recovery of subscapularis strength at the cost of some fatigability and some mild fatty infiltration. Materials and methods This was a case-control retrospective study of patients who underwent a Latarjet procedure between January 2013 and January 2015. A total of 20 patients were reviewed at 1 year postoperatively. With the patient seated, strength testing of both shoulders was done (concentric, eccentric, and fatigability) with a dynamometer. Trophicity and fatty infiltration were analyzed by magnetic resonance imaging. Results Strength of the internal rotators (IRs) and external rotators (ERs) of the injured shoulder was significantly lower compared with the healthy shoulder in concentric testing at 180°/s and 60°/s (13% for IR and 20% for E, P  < .05) and in eccentric testing at 60°/s (19% for IR and 16% for ER, P  < .05). A peak torque ratio (ER/IR) of the operated-on shoulder was maintained. The difference in muscular endurance was significant ( P  < .001). There was no muscle atrophy and minimal or no fatty infiltration of the subscapularis in any patient. Conclusion At 1 year after the open Latarjet procedure, isokinetic testing showed a combined strength deficit in both internal and external rotation with a conserved muscle balance. Although no significant subscapularis fatty infiltration or atrophy was noted, there was a significant deficit in endurance compared with the healthy shoulder. [ABSTRACT FROM AUTHOR]