Successful implementation of Medical Education Faculty Development Project at Saint George University of Beirut in the immediate post triple blow to Beirut.

Background: The aim of this study is to explore the efficacy of the Faculty Development Program (FDP) implemented at the Saint George University of Beirut-Faculty of Medicine (SGUB FM) under exceptional circumstances as the triple blow to Beirut.

Methods: The Faculty Development, directed towards a cohort of 35 faculty members, is composed of two major components: methodology of teaching and techniques of assessment. The Kirkpatrick's assessment model, in combination with a specifically designed psychological questionnaire, were chosen to assess the effectiveness of the faculty development initiative.

Intra-articular Lateral Tibial Plateau Osteoid Osteoma: Case Report and Arthroscopic Management.

Osteoid osteoma occurs in various locations in the human body, mostly in the metaphysis and diaphysis of long bones. This article describes a rare case of osteoid osteoma occurring in an intra-articular location, specifically in the lateral tibial plateau of a 40-year-old female patient. The challenge of diagnosing such a pathology in an atypical location was tackled in this article as well as different management options.

Ipsilateral Simultaneous Low-Energy Multiple Upper Limb Fractures in an Elderly Patient: Case Report and Review of the Literature.

Traumatic injuries of the upper limb can result in variant fracture combination. This article discusses a rare injury combination including ipsilateral proximal and distal humerus fractures alongside a distal radius fracture. The mechanism of the fall is unknown, but the patient being old with such a complex injury, one can only assume that osteoporosis played a major role.

Intertrochanteric fractures treated by diaphyseal support arthroplasty with hook plate vs cerclage wires only: A retrospective cohort study.

Background: The treatment of unstable fractures of the intertrochanteric region of the hip in the elderly is controversial. Conventionally, internal fixation with intramedullary nail or a dynamic hip screw is the treatment of choice in intertrochanteric fractures. Nowadays, some authors encouraged the use hip arthroplasty for management of these fractures with good outcome.

Hip joint space width in an asymptomatic population: Computed tomography analysis according to femoroacetabular impingement morphologies.

Background: Although the association between femoroacetabular impingement (FAI) syndrome and hip osteoarthritis (OA) is well established, not all hips exhibiting cam or pincer morphologies (i.e. imaging findings of FAI syndrome) are symptomatic or arthritic.

The Ischial Spine in Developmental Hip Dysplasia: Unraveling the Role of Acetabular Retroversion in Periacetabular Osteotomy.

Purpose: Radiological diagnosis of acetabular retroversion (AR) is based on the presence of the crossover sign (COS), the posterior wall sign (PWS), and the prominence of the ischial spine sign (PRISS). The primary purpose of the study is to analyze the clinical significance of the PRISS in a sample of dysplastic hips requiring periacetabular osteotomy (PAO) and evaluate retroversion in symptomatic hip dysplasia.

Methods: In a previous paper, we reported the classic coxometric measurements of 178 patients with symptomatic hip dysplasia undergoing PAO where retroversion was noted in 42% of the cases and was not found to be a major factor in the appearance of symptoms.

Anterior inferior iliac spine avulsion fracture post hip arthroscopy for Femoroacetabular impingement.

FAI (Femoroacetabular Impingement) is an uncommon yet reported pathology of the hip joint, especially in the young athletic population. If left untreated, it predisposes for premature osteoarthritis of the hip. FAI treatment modalities consists of either open or arthroscopic surgery, the latter becoming the most adapted modality.

Sacral Anatomical Orientation in the Lebanese Population.

Introduction: PI is currently used as the gold standard measurement in spinopelvic anatomy. There is a need for a reliable method to calculate sacral anatomic orientation (SAO) independent of posture and to establish its association with PI, which was previously established in a single study (Peleg et al., 2007).

Nerve transfers in the upper extremity: A review.

Injury of the brachial plexus and peripheral nerve often result in significant upper extremity dysfunction and disability. Nerve transfers are replacing other techniques as the gold standard for brachial plexus and other proximal peripheral nerve injuries. These transfers require an intimate knowledge of nerve topography, a technically demanding Intraneural dissection and require extensive physical therapy for retraining.

Efficacy of the Combined Administration of Systemic and Intra-Articular Tranexamic Acid in Total Hip Arthroplasty Secondary to Femoral Neck Fracture: A Retrospective Study.

Background: Total hip arthroplasty (THA) is associated with substantial blood loss in the postoperative course. Tranexamic acid (TXA) is a potent antifibrinolytic agent, routinely administered by intravenous (IV) and topical (intra-articular, IA) route, which can possibly interrupt the cascade of events due to hemostatic irregularities close to the source of bleeding. However, scientific evidence of combined administration of TXA in THA secondary to a femoral neck fracture is still meagre.

Rectus abdominis free tissue transfer in lower extremity reconstruction: Long term follow up in 58 cases.

Unlabelled: This study evaluates the long-term results of rectus abdominis free-tissue transfer performed for lower extremity reconstruction.

Methods: Over a period of 8 years 58 were available for long term follow-up. Indications for reconstruction included acute wounds with soft tissue defects, diabetic foot ulcers, and chronic osteomyelitis.

Isolated Congenital Absence of Lumbosacral Facet Joint.

A congenital absence of the lumbar facet joint is a rare reported condition. This is the case of a 32-year-old male patient presenting with severe low back pain radiating to his right lower limb. Physical examination revealed no motor deficits, but right lower limb numbness was reported over dorsum aspect of the right foot.

Calcaneus Metastasis from Follicular Thyroid Carcinoma 12 Years after Total Thyroidectomy.

We report the case of a sixty-eight-year-old female patient who presented for left ankle pain; X-rays and MRI showed a benign calcaneal cyst, found to be delayed distant metastasis from primary papillary thyroid carcinoma. Patient required surgical excision of the cyst. Results of histological examination showed metastatic papillary thyroid carcinoma.

Fatal Necrotizing Fasciitis following Open Reduction Internal Fixation in a Polytrauma Patient.

Necrotizing fasciitis is an uncommon and potentially fatal infection that can affect the epidermis, dermis, and more commonly the subcutaneous, fascia, and muscle layers. NF is usually caused by toxin-producing bacteria with a relatively fast progression associated with severe surrounding tissue destruction. Early diagnosis and management are crucial factors for survival.

Locked Central Fracture Dislocation of the Hip in a Child after Low-Energy Trauma.

We present the case of a 13-year-old boy who sustained a locked central fracture dislocation of the right acetabulum following a bicycle fall. Immediate external reduction maneuvers under general anesthesia were unsuccessful due to intrapelvic entrapment of the femoral head. Open reduction internal fixation was achieved 48 hours later.

Surgical Hip Dislocation for Management of Acetabular Osteochondroma in an Adult.

The purpose of this study is to report a rare case of acetabular osteochondroma with a unique clinical presentation occurring in an adult with normally developed hips. The distinctive size and location of the lesion required an open approach with surgical dislocation of the hip for complete resection.

Arthroscopic Resection of a Bilateral Calcaneonavicular Coalition in a Child.

Calcaneonavicular coalition is a congenital anomaly characterized by a connection between the calcaneus and the navicular. It can manifest as lateral foot pain, peroneal spastic flatfoot, and repeated ankle sprains. Surgery is required in the case of chronic pain and after failure of conservative treatment.

Arthroscopic excision of intra-articular hip osteoid osteoma: a report of 2 cases.

Intra-articular osteoid osteoma is uncommon accounting for approximately 12% of all osteoid osteomas. It presents diagnostic and therapeutic challenges since several traumatic or degenerative pathologies of the joint can be simulated with delay in the diagnosis. We report the clinical, radiographic, and histopathological findings in 2 cases of intra-articular osteoid osteoma of the femoral neck and of the acetabulum.

Literature review and clinical presentation of bilateral acetabular fractures secondary to seizure attacks.

Central acetabular fracture dislocation is usually caused by high-energy external trauma. However, 26 cases that occurred as a result of a seizure attack appeared in the literature from 1970 to 2007, with the seizure attacks themselves caused by many different factors. In this setting, the central acetabular fracture not caused by direct trauma might initially remain unnoticed leading to a delayed diagnosis.

False aneurysm of the external iliac artery caused by aseptic loosening and migration of a cemented cup.

A 79 year old woman with bilateral hip replacements presented with severe left thigh swelling, and life threatening hypovolemic shock. After adequate resuscitation, an angio CT scan of her pelvis showed a false aneurysm of the external iliac artery in proximity to a loose pegged cemented cup. A pelvic X-ray 6 years prior to presentation had revealed a medialized high riding pegged cemented cup with a loose cemented stem.

Arthroscopically assisted reconstruction and percutaneous screw fixation of a pilon tibial malunion.

We report a case of distal tibial fracture (AO 43-C3) originally treated with close reduction and ligamentotaxis, which was seen at our institution at 6 weeks with malunion of the medial malleolus. It was successfully treated with arthroscopy-assisted mobilization of the malunion with subsequent percutaneous reduction and fixation. Four months after surgery, with an American Orthopedic Foot and Ankle Society score of 100, the patient felt no pain when walking.

Phalangeal osteosonogrammetry age-related changes and assessment of a Lebanese reference population.

This study was aimed to assess age changes in quantitative ultrasonometry (QUS) of the phalanx in a sample of Lebanese women to determine a reference data for the Lebanese population. Velocity of ultrasound (amplitude-dependent speed of sound; AD-SOS) and the interpretation of the ultra sound signal (ultrasound bone profile index; UBPI) were measured in 211 women with a mean age of 50 years (range 20-79 years) using a DBM sonic Bone profiler device. Women were randomly selected and asked to participate in a nation-wide screening program.

Acetabular morphology in bladder exstrophy complex.

Little information is available concerning the acetabular morphology in adults with a history of bladder exstrophy. We documented the pelvic anatomy in adult patients with bladder exstrophy who never had prior surgery. We retrospectively reviewed 31 patients (62 hips) seen from 1976 to 2003 for urologic problems related to bladder exstrophy without adjunctive pelvic osteotomy.

Compressive intrapelvic synovial cysts: an early complication of an HA-coated cup.

Synovial cysts arising from the hip are not common but can develop in response to intraarticular derangement and increased intraarticular pressures. We present a case of a compressive intrapelvic synovial cyst 3 years after a total hip replacement with a hydroxyapatite-coated acetabular component. At surgery, cracking of the coating of the acetabular component was observed in the areas where the cup was not covered by host bone.