Emergency management of type IIIB open tibial fractures.

We present our therapeutic strategy for the treatment of type IIIB open tibial fractures. It involves emergency internal stabilisation of the bone by locked intra-medullary nailing when appropriate and skin cover using either a pedicled or free muscle flap. Where there is bone loss, a cancellous iliac graft is performed at the same time.

[Recent, closed trapezio-metacarpal luxation, treated by pinning.Apropos of 7 cases with a median follow-up of 8 years].

Seven cases of acute and closed traumatic dislocation of the trapezio-metacarpal joint treated by percutaneous pinning adapted by Wiggins are reported with an average follow-up of eight years. Seven patients (five men and two women) aged 18 to 62 were treated. The injury was due to a road traffic accident in four cases.

[Traumatic isolated palmar dislocation of the distal radio-ulnar joint. Apropos of a case].

Purpose Of The Study: The authors report a rare case of an isolated palmar dislocation of the distal radio-ulnar joint (DRU). Diagnosis was easily established in emergency even though this lesion is usually unknown in 50 per cent of cases, according to literature.

Case Report: A surgical approach was necessary because of irreducibility of the lesion: ulna and radius were hitched with no other anatomical interposition.

[Trapezometacarpal osteoarthritis: review of 27 cases treated by using silicone implant arthroplasty].

The results of 27 silicone implant arthroplasties using in the treatment of trapezo-metacarpal osteoarthritis are analysed with 3 years follow-up : 56 % of the patients are satisfied with the operation ; 46 % are disappointed or displeased. Bad results are in relation to synovitis (4 cases), dislocation of the implant (2 cases), algodystrophy (4 cases). In total, in 4 cases, a excision of the implant was necessary.

Reconstruction of a complex defect of the dorsum of the hand.

A 37-year-old right-handed male truck driver was admitted with a severe injury of the dorsum of his right hand following a traffic accident. He had a large combined defect involving skin, tendons and bone. A complex reconstruction was performed using a large iliac crest allograft, a tendon graft and a free serratus anterior flap in one stage, 8 hours after the injury.