Search

Les fractures trochantériennes se définissent par un trait de fracture siégeant en totalité ou en partie dans la région trochantérienne, surviennent surtout chez Le sujet âgé à cause de l’ostéoporose et de l’atrophie musculaire. Le pronostic fonctionnel et vital est aussi engagé, ce qui justifie les indications chirurgicales urgentes pour permettre le lever précoce. Le clou gamma long troisième génération représente le dernier perfectionnement du traitement des fractures trochantériennes selon les principes de l’enclouage centromédullaire à foyer fermé. Nous avons procédé à l’étude rétrospective des dossiers de 53 patients traités pour fracture sous-trochantérienne ou trochantéro-diaphysaire par clou Gamma long troisième 3eme génération. L’objectif de notre étude a été d’évaluer la supériorité de ce matériel d’ostéosynthèse pour le traitement de ce type de fractures par rapport aux autres méthodes d’ostéosynthèse. Les patients ont été évalués sur le plan clinique, radiologique et fonctionnel avec un recul moyen de 06 mois. En adoptant la cotation de Postel et Merle d’Aubigné, les résultats fonctionnels étaient excellents et bons dans 81,2 % des cas. Le clou Gamma long troisième génération reste de choix pour le traitement des fractures sous-trochantériennes et trochantéro-diaphysaires du a la stabilité de ce montage qui permet une réhabilitation rapide des patients, tout en réduisant les pertes sanguines et le risque infectieux., Journal Marocain des Sciences Médicales, Vol. 22, No 1

Introduction and importance Epiphyseal detachement of distal radius are frequent, the richness of the vascular supply at this level favors rapid consolidation, but with the possibility of long-term complications which vary according to the classification of Salter and Harris. In the literature they are dominated by the epiphysiodesis, however, Pseudarthrosis of the growth plate is exceptional. Through this case presentation, we will explain contributing factors of its occurrence and its care management. Case presentation We report a case of a pseudarthrosis of distal radial growth plate (GP) due to an epiphyseal detachement type I of Salter and Harris in a 16-years-old patient who presented with a right wrist trauma at the age of 8, treated by a traditional immobilization (Moroccan Jbira) and who kept a painful deformity of the right wrist in hand ulnar boot. Face and profile radiography of the right wrist found a pseudarthrosis of distal radial growth plate, the patient had surgery to attach pseudarthrosis spot using a Blount clip, and at the same time, creating a partial epiphysiodesis in the lateral side, resulting in the correction of the wrist malalignment. After 5 years, we had a consolidation of the pseudarthrosis spot, without modification of angular deviation. Clinical discussion GP's traumas care management is based on an urgent and anatomical reduction because it is a very fragile area and is more affected by mechanical stress, however in our context Patients consult usually after late complications such as deformations and functional abnormalities. Blount clip was our surgical team choice because it is the best way of osteosynthesis in our case, it allows a solid fixation thanks to its biomechanical characteristics. Pseudarthrosis of distal radial growth plate is exceptional in the literature that's why we cannot compare our results. Conclusion This complication would have been prevented with initial adequate care management, prevention about avoiding traditional traitements.

Le syndrome du canal carpien représente l'un des motifs de consultation les plus fréquents en chirurgie de la main, son incidence annuelle est de 300 par 100.000 habitants et 80.000 interventions chirurgicales pour le syndrome du canal carpien sont réalisées chaque année en France. Dans la plupart des cas, le syndrome du canal carpien est idiopathique survenant sans qu'aucune cause puisse être identifiée, cependant en dehors de ces formes l'intrication de plusieurs mécanismes peuvent expliquer la relation cause à effet de cette pathologie. A travers cette observation nous allons essayer de mettre la lumière sur une association exceptionnelle d'un syndrome du canal carpien secondaire à une variété anatomique rare du nerf médian.

This study aimed to investigate the effectiveness of a suggested program for tackling letter writing deficiencies among the 11th graders in the Middle Governorate. The sample of the study consisted of (68) 11th graders, (34) each group. The experimental group contained (17) male students and (17) female students; and the same for the control group. The researcher used a pre-test and a post-test, the pre-test showed the equitation of the experimental group and the control group. Moreover, it located the deficiencies that the students counterpart. The suggested program was based on the "writing process approach" and was applied on the experimental groups in (12) lesson sessions along (6) weeks. The results of the post-test showed the statistically significant differences between the control group (male and female11th graders) and the experimental group (male and female 11th graders) in letter writing performance after applying the suggested program. The results of the post test showed that the experimental group achieved a better performance which was computed as statistically differences in T-test values between the experimental group and the control group. In the layout domain (3.866** significant at 0.01), the punctuation domain (3.754** significant at 0.01), the sentences domain (2.541* significant at 0.05), the language domain (3.103** significant at 0.01), and the total post-test scores (3.637** significant at 0.01). The statically differences in the results proved to be in favor of the experimental group. These results agree with many researchers whose studies were built on suggested programs based on the stages of the writing process like: Cumber Worth and Hunt (1998), Mark (1998), Mark (2001), Doyle (2001), Kowalewski (2002), Hopkins (2002), and Baroudy (2008). The researcher recommended that the suggested program should be used for tackling the letter writing deficiencies among the 11th graders due to the proved effectiveness of the application of the program of the participating students.