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)

Abstract The incidence of spinal cord injuries is the lowest of all major trauma, with devastating impact on the individual affected. The immediate treatment, though it remains mainly supportive, in many situations will determine the outcome and the cost of health care. Standards of care are unfortunately still lacking, this is mainly due to the existing controversies and lack of effective treatment of the injured cord. The author discusses here some of the controversial points based on literature review and personal observation. arabic 14 English 75
Nabil A. Alageli(10-2021)

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)