A. Miri

False aneurysm of the radial artery: Unusual complication of both-bone forearm fracture in children: A case report

False aneurysm or pseudo aneurysm of an artery in close proximity to fractured bone is a well-recognized entity, and fewer various cases, involving different sites have been reported in the literature. We report new case of a Moroccans patient who had 10-year-old boy presented with a right non displaced both-bone forearm fracture; the patient was placed in a long arm splint. After, six weeks, the cast was removed. And a pulsatile mass on the volar-radial aspect of the forearm was decouvred. The mass was non-tender and the patient had radial and ulnar pulse. An Ultrasound and brachial angiography showed a false aneurysm of distal radial and the radial artery was ligated.In conclusion, pseudoaneurysm of the radial artery can be associated with any bone fracture despite non displacing fractures related to the elasticity of the bone in this age and orthopedic surgeons should be aware of this potential complication.

Stiffness after neglected elbow trauma in children: a report of 57 cases

Neglected trauma of the elbow in the child is not rare, especially in countries where traditional treatment is still practiced. The authors report a study of 57 neglected elbow trauma in children and the complication of stiffness managed in the pediatric orthopedics department in Rabat, Morocco, between 1996 and 2002. Average patient age was 11 years, location predominated at the right elbow, and the average delay of consultation was 7 months after the trauma. Clinical examination found 36% of stiffness in bending, 29% in extension, and 35% mixed. Of these, 43% were judged very serious, 20% serious, and 37% moderate. Radiological finding showed 35 neglected elbow dislocations (61%), ten supracondylar humeral fractures (17%), and 12 posterior lesions difficult to determine. Abstention from surgery was recommended for 12 patients; 45 were operated on. The end result was 53% with minimal and moderate stiffness. The authors analyzed clinical and therapeutic aspects of all lesions, insisting on abstention from surgery according to the variable and unforeseen character of surgery results.RésuméLes traumatismes du coude négligés chez l’enfant sont loin d’être rares, surtout dans les pays où le traitement traditionnel est encore pratiqué. Les auteurs rapportent une série de 57 cas de traumatismes du coude négligés et compliqués de raideurs, colligée au service d’orthopédie pédiatrique de Rabat au Maroc entre 1996 et 2002. L’âge moyen des patients est de 11 ans, l’atteinte prédomine au niveau du coude droit, et le délai moyen de consultation est de 7 mois après le traumatisme. Le bilan clinique a objectivé 36% de raideurs en flexion, 29% de raideurs en extension et 35% de raideurs mixtes. 43% de ces raideurs sont jugées très graves, 20% graves et 37% jugées modérées. Le bilan radiologique a montré 35 luxations négligées du coude (61%), 10 fractures de la palette humérale (17%), et 12 lésions impossibles à déterminer a posteriori. Sur le plan thérapeutique, l’abstention thérapeutique a été préconisée chez 12 patients et 45 ont été opérés, le résultat global obtenu est de 53% de raideurs minimes et modérées. A travers cette série les auteurs analysent divers aspects cliniques et thérapeutiques de ces lésions, tout en insistant sur l’intérêt de l’abstention thérapeutique devant le caractère variable et imprévisible des résultats de la chirurgie.

La tuberculose musculaire isolée : Localisation inhabituelle du bacille de Koch

We report an exceptional case of tuberculosis in an 8-year-old girl. The focus of infection was situated in the anterior muscle compartment of the left thigh. Diagnosis was established on the basis of histological findings. A 12-month antituberculosis regimen was given. Outcome was good with no general or functional sequelae. Based on this case and data reported in the literature, we discuss the routes of dissemination of the Koch bacillus explaining this unusual sporadic localization.Resume Les auteurs rapportent le cas exceptionnel d’une tuberculose musculaire isolee interessant les muscles de la loge anterieure de la cuisse gauche chez une patiente âgee de huit ans. Le diagnostic a repose essentiellement sur l’histologie et l’enfant a ete mise sous traitement antituberculeux pendant 12 mois. L’evolution a ete bonne sans aucune sequelle fonctionnelle ou generale. A travers ce cas et une revue de la litterature, les auteurs revoient les modalites d’essaimage qui expliquent la survenue de cette localisation sporadique.