Nacim Soal

A B S T R A C T Carpometacarpal (CMC) fracture–dislocations of the fifth ray are common. For chronic injuries, Dubert proposed combining resection arthroplasty of the base of the fifth metacarpal (M5) with synostosis with the fourth metacarpal (M4). Our aim was to evaluate the results of this procedure. Between 1994 and 2014, 7 men and 1 woman with an average age of 36 years (range, 27 to 45) were operated on. The right hand was involved in 6 of the 8 cases. All patients had symptomatic osteoarthritis secondary to isolated articular malunion and subluxation of the 5th CMC joint. Fusion was obtained right away in all 8 cases. Six patients were evaluated with a mean follow-up of 93 months (range, 7 to 249). At the final assessment, all patients reported a significant decrease in pain. The mean pain assessed by a visual analog scale (VAS) was 0.6/10 (range, 0 to 5). Range of motion in flexion–extension of the M4-M5 block ranged from 108 to 208. Grip strength remained reduced by 15% to 70%. All patients except one were satisfied with the outcome. The technique described by Dubert is an effective method to relieve pain. By fusing together M5 and M4, it preserves the length of the fifth ray and a certain adaptability of the palm when gripping. However, it can be used only when the CMC joint of the 4th ray is healthy. This stabilized arthroplasty is an effective and reliable technique for the treatment of symptomatic osteoarthritis secondary to CMC fracture–dislocation of M5 Full text : Results of the Dubert procedure for chronic painful fracture

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on the Algerian orthopedic surgery residency programs. Medical education has been negatively impacted. From an educational standpoint, teaching conferences for residents have been suspended. Grand rounds and in-person meetings have also been cancelled to comply with social distancing recommendations. Objective: The purpose of this study was to assess the impact of the COVID-19 pandemic on the orthopedic surgery residents’ education, clinical practice, and well-being. Materials and methods: An online cross-sectional survey was shared with orthopedic surgery residents of 6 teaching hospitals in Algiers (Algeria). Results: We received 58 responses (response rate: 24.57%). Fifty-four percent of the residents have been deployed on COVID-19 screening’ duties. Nearly 97% of the trainees reported that the COVID-19 pandemic had negatively impacted their surgical training. Most participants referred inadequate supply in personal protective equipment and indicated that the orthopedic surgery-training program should include a session about personal protective equipment every year. Among all the subjects, 54 (93%) perceived an increase in stress levels during the COVID-19 crisis and 90% were concerned about transmitting infection to their family members. Conclusions: The COVID-19 pandemic has had a significant impact on the Algerian orthopedic surgery residency programs. The changes in the orthopedic activities have negatively impacted the residents’ learning, especially surgical training and affected their well-being. Adapted measures must be taken to face this unprecedented challenge and ensure the continuity of training for our residents. Key words: Orthopedic surgery, Education, Residents, COVID-1 Full text : Impact_of_COVID_19_on_orthopedic_surgery_residency.2 (1)

Introduction:A combination of bilateral scaphoid and distal radius fractures is extremely rare. It may occur as a result of high-energy trauma and can be neglected. The current paper described a case study of this rarely combined fracture. Case Report:A 22-year-old female was admitted to the emergency department following a fall while exercising which resulted in severe pain in both wrists without any neurovascular deficit. X-ray imaging showed bilateral combined fractures of the scaphoid and distal radius. To fix the fractures, the patient underwent closed reduction and internal fixation with Kirschner wires along with immobilization for 3 months. The radius and scaphoid fractures were united within approximately 6 and 10 weeks, respectively. Conclusion: Combined bilateral scaphoid and distal radius fractures are extremely rare resulting from high-energy trauma. The associated fractures require a precise diagnosis and appropriate therapeutic management. Keywords:distal radius, scaphoid, fracture, bilateral, reduction Full text :  Article JOCR