Upper Limb Fractures in Kinshasa: Therapeutic Approach in a Sub-Saharan African Country

作     者：Johnny Cizemba Luc Mokassa Bakumobatane Ezeckiel Kalunda Mutombo Maurice Kanunyangi Mukendi Roger Muamba Kabengele Daniel Mukadi Bamuleka Christian Dumontier Johnny Cizemba;Luc Mokassa Bakumobatane;Ezeckiel Kalunda Mutombo;Maurice Kanunyangi Mukendi;Roger Muamba Kabengele;Daniel Mukadi Bamuleka;Christian Dumontier

作者机构：Department of Surgery University clinics of Kinshasa Kinshasa Democratic Republic of the Congo Upper Limb Surgery Department Water Clinics Guadeloupe France 

出 版 物：《Open Journal of Orthopedics》 (矫形学期刊（英文）)

年 卷 期：2023年第13卷第10期

页      面：405-420页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Fracture Upper Limb Treatment Controversy 

摘      要：Background: The upper limb fractures management is the subject of considerable controversy in the literature. Data on the treatment of these fractures in Africa are scarce. Most publications come from so-called northern countries (especially Europe and the USA) and their conclusions cannot be applied in Africa, where other factors must be taken into account. Objective: The aim of this study was to determine trends in the management of upper limb fractures in Kinshasa. Methods: The descriptive, cross-sectional, multicenter study reviewed the records of adult patients managed for upper limb fractures between January 2009 and December 2018 in 6 hospitals in the 4 districts that make up the city of Kinshasa. The results will be presented in the form of frequency, percentage, median and extremes. The data were processed anonymously in accordance with the Helsinki declarations. Results: We listed 852 upper limb fractures out of 844 patients. Upper limb fractures showed a very high rate of humerus fractures n = 350 (41.0%) followed by radius fractures n = 22.9% (n = 193). The four seats most important were the humeral diaphysis n = 292 (34.3%);the distal radius n = 115 (13.5%);the radial and ulnar shafts n = 79 (9.3%) and n = 74 (8.7%) respectively. The management of the latter was mainly surgical n = 538 (63.1%) against n = 314 (36.8%) for no-operative treatment. Surgical treatment showed a slight predominance in women aged ≤ 55 years n = 168 (51.8%) and it remained dominant on the almost all foci except the distal radius. Surgical practice has shown surprisingly a very high rate of plate use n = 232 (43.1%) overall broken bones. The external fixator was the most used material on the humeral diaphysis n = 140 (66.1%). Conclusion: Upper limb fractures care is certainly controversial, but today several recommendations based on clinical and imaging data must be taken into account in the choice of therapy if a satisfactory functional result is to be hoped for. Knowledge of ou