ABSTRACT We reviewed 48 consecutive patients with type II (32) and type III (16), odontoid peg fractures. The clinical & radiological outcomes were assessed over an average period of follow up of 6.8 years. Union rate was determined and we discussed several factors that may affect it. Patients were treated conservatively with initial bed rest with or without cervical skeletal traction followed by bracing for an average of 9 weeks. Results: Bony union was established in 25 of 32 (78%) type II fractures. Of 7 cases with no bony union 4 were stable probably with fibrous union. 3 remained unstable. In 13 of 16 (83%) type III fractures bony union was established. 2 of the 3 with no bony union were considered stable. Osseous non-union was higher in patients with displacement of >5mm, but there is no correlation between union and age, gender or angulation of the fracture in both types. Conclusion: non-surgical management of odontoid fractures remain a viable option in the management of these fractures arabic 9 English 60
Nabil A. Alageli(1-2017)

Aim: The aim of the study was to assess the success and possible complications of closed reduction (CR) treatment of developmental hip dysplasia (DHD) in late‑diagnosed children and explores its relation to the acetabular index (AI) measurement prior to treatment. Patients and Methods: Twenty‑three consecutive patients with dislocated hips, 16 unilateral and 7 bilateral (30 hips), were retrospectively included in the study. They were admitted to the specialist pediatric orthopedic unit of the University Hospital (Tripoli Medical Center) in Tripoli, Libya. There were 21 females and 2 males with an average age at diagnosis of 17 months (range from 14 to 31 months). Their average follow‑up period was 3 years (2–5 years), and none of them received treatment prior to diagnosis. All patients received prior inpatient skin traction for at least 2 weeks followed by CR with soft tissue release (adductor tenotomy), hip spica applied and maintained for an average of 3 months. Patients who had a failure of reduction or resubluxation at follow‑up went for open reduction and a reconstruction procedure. Results: CR was successful in 27 hips (90%), failed in 3 (10%) other, the average age of the successful reduction group was 20.5 months, while that of the open reduction group, it was 23 months (Р = 0.25). The average AI of the CR group was 39.0°, while that of the open reduction group, it was 42.7° (Р = 0.15); 6.7% of patients with an AI of 40° had a failure of CR of the hip (Р = 0.46). No complications of treatment were recorded at follow‑up. Conclusion: Staged CR of DHD in older children in the hands of experienced specialists is still a valid means of their treatment, especially in developing countries with limited resources. There is a relatively higher failure rate of CR, the older the child is and the higher the AI. arabic 11 English 78
Nabil Alageli, Majdi Alakkari(4-2021)

Introduction: the risk of venous thromboembolism (VTE) after Spinal injuries was largely realised but the true incidence of which is still variable and unclear. Abstract Patients & method: We retrospectively reviewed the charts of 374 consecutive patients who sustained traumatic spinal injury and admitted acutely to a comprehensive care spinal injuries centre. 159 patients had spinal trauma with spinal cord injury (SCI) and 215 were neurologically intact. The majority of these patients were treated non-surgically and received the same thromboprophylactic regimen started within a median of 2 days post injury. The incidence of clinical VTE (deep Vein thrombosis DVT & Pulmonary Embolism PE) was determined and some risk factors discussed. Results: Among the neurologically intact group one patient developed clinical PE (0.5%). Out of 159 patients with SCI, 23 developed clinically evident VTE (14.5%), 15 had DVT (11.9%), 4 PE (5%) and 4 had both DVT & PE). There was no fatality. Complete SCI lesions were associated with higher incidence of VTE compared to incomplete lesions, 17.6 % & 11% respectively (p
Nabil Alageli, Aheed Osman(7-2021)