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Chinese Journal of Traumatology 2015年第4期18卷 232-234页

作者： Anani Abalo Sena Amouzou Kouami Amakoutou assang dossim Service de Traumatologie Orthopedie CHU Sylvanus Olympio Lomb Togo

Double fracture-dislocations of the thumb are rare. Only a single case report of a simultaneous extraarticular fracture of the base of the first metacarpal and dislocation of the metacarpophalangeal joint has been previously reported. We report the second case report of this injury in a 20-year-old man. The patient had an excellent outcome after treatment.

关键词： Carpometacarpal joints Metacarpophalangeal joint Extraarticular fracture Thumb

Internal Fixation of Gunshot Induced Fractures in Civilians: Anatomic and Functional Results of a Standard Protocol at an Urban Trauma Center

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Open Journal of Orthopedics 2016年第3期6卷 63-70页

作者： Anani Abalo Atsi Walla Gamal Ayouba Yaovi Yannick Dellanh Kosivi Fortey assang dossim Department of Orthopaedics Tokoin Teaching Hospital Lomé Togo

Introduction: Despite extensive experience with civilian gunshot fractures or wounds, no consensus exists on a standard protocol to manage these injuries. Many authors recommended immediate debridement, but the optimal timing of internal fixation and the use of antibiotic have not been determined. The purpose of this paper is to present and discuss our experience. Material and methods: In January 2007, a treatment protocol was put in place for the evaluation and management of fractured extremities resulting from civilian gunshot wounds. Sixty-three patients with 64 fractures had been managed by this protocol for gunshot fractures between January 2005 and January 2012. There were 56 male and seven female. Their mean age was 33.1 years (range: 17 - 61 years). Thirteen patients (20.6%) were able to provide a description of the weapon. Only 15 patients had entry and exit wounds. The mean follow-up period was 27 (range, 20 - 58) months. The main factors assessed were the surgical site infection, the fracture union and the functional status. Results: Out of the 63 patients, 14 patients developed a wound infection (five superficial and seven deep infections). Wound infection was significantly associated with associated injuries (p = 0.0388), fractures sites requiring fixation (p = 0.024), the fracture pattern (p = 0.0412), operative modalities (p = 0.0400). There were nine cases (14.1%) of fracture non-union. The mean time to union was 15 weeks (range: 5 - 32 weeks). Five patients developed chronics osteomyelitis. The average SMFA score for all of the patients was 23.8 (range: 0 - 56.3). The mean dysfunctional and bother indexes were 18.3 (range: 0 - 52.7) and 22.6 (range: 0 - 66.1), respectively. The SMFA total score and dysfunction index had a significant correlation based on presence or absence of associated injuries (p < 0.0001). But bother index did not show the same correlation (p = 0.452). The average length of hospital stay was 11.3 days (range: 3 - 64). Conclusion

关键词： Fracture Gunshot Fracture Internal Fixation Wound Infection Surgical Treatment

Sagittal Unicondylar Fracture of the Femur on Nail of Küntscher

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Open Journal of Orthopedics 2017年第7期7卷 192-197页

作者： Tchatchuang Paul Urich Tambekou Batarabadja Bakriga Noufanangue Kombate Atchi Walla Anani Abalo assang Michel dossim Department of Orthopaedics Tokoin Teaching Hospital Lomé Togo Afagna Hospital Afagnan Togo

Unicondylar fractures of the femur on osteosynthesis equipment are a particular entity in terms of the lesion mechanisms and therapeutic difficulties. We report this case because of its exceptional nature and discuss the mechanism of occurrence. It was a lateral sagittal unicondylar fracture of the femur on a nail of Küntscher that had been laid for medio-diaphyseal fracture. The causal mechanism was direct. A double screwing on each side of the nail after an open reduction followed by an early rehabilitation was carried out. Consolidation was obtained at 3 months and the nail removed at 18 months with a good functional knee result. Anatomical reduction and fixation allowing early rehabilitation represent a guarantee for a good long-term result.

关键词： Fracture Unicondylar Femur Nail of Küntscher Surgical Treatment

Predictors of Nonunion in Humerus Shaft Fractures in Adults in Lomé(Togo)

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Open Journal of Orthopedics 2015年第11期5卷 361-368页

作者： Atchi Walla Gamal Ayouba Dadja Essoya Landoh Batarabadja Bakriga Tchaa Towoezim Anani Abalo assang Michel dossim Service de Chirurgie Orthopédique et Traumatologique CHU Sylvanus Olympio Lomé Togo Service de Chirurgie Générale du Centre Hospitalier de Kpalimé Kpalimé Togo Division de l’Epidémiologie Ministère de la Santé Lomé Togo

Background: To identify predictors of humerus shaft fractures nonunion in adults whatever the type of treatment performed. Patients and Methods: We conducted a retrospective study among patients who had a fracture of the humeral shaft moving towards healing or nonunion. Patients were treated in the orthopedic trauma unit of Sylvanus Olympio Teaching Hospital and two other private clinics in Lomé between January 2008 and June 2012. On the X-ray of each patient, we measured the angulation, the diastasis, and inter fragmentary contact. For each included patient, we looked for: age, sex, medical history, body mass index (BMI), according to the third location of the shaft fracture, the type of fracture according to AO classification and the type of opening according Tscherne classification. Results: During the study period, 184 patients with humeral shaft fracture were identified. Of these 108 were men. The mean age of patients was 37.3 years. The fractures were treated conservatively in 100 patients (54.3%), 78 treated surgically and six (3.3%) have discharged from hospital against medical advice for traditional treatment. The factors that were associated with nonunion of humerus shaft fractures in these patients were: the opening of the fracture (RR = 4.5;95% CI = [2.9;7.1]), the presence of immediately radial paralysis (RR = 5.6;95% CI = [3.7;8.5]), the existence of other associated lesions or fracture (RR = 1.8;95% CI = [1.1;3.1]), energy of the trauma (RR = 2.3;95% CI = [1.3;4.4]) and type III classification of Tscherne (RR = 0.3;95% CI = [0.2;0.6]). After multivariate analysis, factors that remained significantly associated with the failure of consolidation were: the existence of diastasis > 2 mm (OR = 7.6;95% CI = [2.2;25.6)), the Body Mass Index (BMI) > 25 (OR = 1.3;95% CI = [1.1 - 1.6]) and the existence of other bone lesion (OR = 4.3;95% CI = [1.4 - 18.9]). Conclusion: BMI greater than 25, the existence of an interfragmentary gap of more than 2 mm and existence

关键词： Humerus Shaft Fracture Nonunion Predisposing Factors

Case of Unusual Abscess Localization in Lumbar Pott’s Disease

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Open Journal of Orthopedics 2018年第11期8卷 418-422页

作者： Atchi Walla Anthony K. Beketi Ibrahim Tine Faré Gnandi-Piou Komi Amakoutou assang dossim Department of Orthopedics and Trauma Campusteaching Hospital Lomé Togo Department of Neurosurgery Sylvanus Olympioteaching Hospital Lomé Togo Department of Neurosurgery Dakar Teaching Principal Hospital Dakar Sénégal Department of Orthopedic Surgery and Trauma Kara Teaching Hospital Kara Togo

In Pott’s disease, cold abscesses usually sit and spread along the psoas muscle. This case concerned a 60 years old man who came to us with bilateral lomboradicular pain and a swelling of inguinal area and the anterior part of the left thigh. We found a 2 years long lasting story of low back pain complaint. Physical examination showed good general health status, stiffness of lumber spine, a left psoitis and no neurological deficit. CT scan going downward from the lumbar spine to the pelvic region and femoral limb with coronal reconstruction demonstrated a huge disco-vertebral destruction of L2-L3 with translation, and bilateral paramedian psoas abscess migrating subfascially toward Scarpa triangle and cleaving anteriorly mainly muscles of the left thigh. After 12 months medical treatment, the evolution has been favorable with clinical cure. The localization of the cold abscess in the left thigh anterior muscles compatment is uncommon. It is why we report this case.

关键词： Lumbar Pott’s Disease Thigh Abscess Developing Country

Fracture-Dislocations of Lisfranc Joint in Lomé(Togo)

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Open Journal of Orthopedics 2016年第1期6卷 16-21页

作者： Atchi Walla Anani Abalo Agbékponou Lagnéblé Sényo Tsolenyanu Tchaa Towoezim N. K. Kombaté Michel assang dossim Service de chirurgie orthopédique et traumatologique CHU Sylvanus Olympio Lomé Togo Service de chirurgie orthopédique et traumatologique de l’hopital Saint-Jean de Dieu d’Afagnan Afagnan Togo

Introduction: The purpose of this prospective study was to describe the clinic pathological varieties of fracture-dislocations of Lisfranc joint and outcome of treatment. Patients and Methods: This study was conducted on 21 cases of fracture-dislocations of the Lisfranc joint treated in our orthopedics trauma unit from 2010 to 2013. We selected middle foot pure dislocations or associated with Lisfranc joint bone fractures. Classification of Myerson was used to characterize the lesions. The results assessment criteria were clinical and radiological for foot and Massari score. Results: Fourteen (14) patients were male. The average age was 34.7 years. Five (5) clinic pathological forms were met by relying on the classification of Myerson;4 cases of type A;5 cases of type B1;B2, 6 cases;4 cases of type C1 and 2 cases of type C2. There were eight cases of pure dislocation and 13 dislocations were associated with fractures (metatarsal in 11 patients, cuneiform in 5 patients, cuboid bone in 2 patients and enucleation fracture of the medial cuneiform in 2 patients). It was noted 10 cases of skin openings. Treatment consisted on open reduction in all patients and stabilization by pin complemented by a foot plaster for 6 weeks. Four (4) immediately arthrodeses were made. All patients were followed up 7 month to 4 years (mean, 30 month). According to the criteria of Massiri, treatment outcomes were excellent in 19% of cases, good in 28%, fair in 30% and poor in 23%. Conclusion: In our context, these lesions are often open and associated with fractures of Lisfranc joint skeleton and treated after a period more or less long and sometimes, we face lesions totally old. Immediately arthrodesis can be a lasting solution and should not be overlooked.

关键词： Dislocation Fracture Lisfranc Joint Pinning

Epidemiology of Open Limb Fractures in a Country with Low-Income

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Open Journal of Orthopedics 2017年第11期7卷 356-361页

作者： Noufanangue Kanfitine Kombate Atchi Walla Kolima Akloa Komi Amakoutou Batarabadja Bakriga Gamal Ayouba Yaovi Yannick Dellanh Anani Abalo assang Michel dossim Department of Orthopaedic and Traumatology Surgery Saint-Jean de Dieu d’Afagnan Hospital Lomé Togo Department of Orthopaedic and Traumatology Surgery Sylvanus Olympio Teaching Hospital University of Lomé Lomé Togo

Introduction: Open limb fractures are frequent and severe. Very often they result from high velocity traffic accidents. The aim of this study was to identify the epidemiologic aspects of open limb fractures in order to improve prevention and care. Material and Methods: It was a retrospective study carried out in the Department of Orthopaedic and traumatology Surgery of Afagnan hospital. It concerned the files of patients admitted from January 1st to December 31st 2016. Patients of 15 years old and older who presented open limb fractures were included in the study. The study variables were: age, sex, occupation, trauma aetiology, injury mechanism, location and type of lesions. An X-ray (antero-posterior and lateral view) of the injured limb segment was done in all patients. Results: On 87 patients, 148 cases of fractures were collected. The mean age was 38.08 years with extremes of 15 and 82. There were 23 women (26.4%) and 64 men (73.6%). The most common etiology was traffic accidents (73.5%). Motorcycle accidents (58.3%);accidents involving motorcycle and car (19.4%). Accidents at work represented (16.1%). Lower limbs were more affected (77.1%). Open fractures classified Gustillo-Anderson type III were predominant with type IIIa (51.0%), IIIb (32.6%) and IIIc (16.3%). Conclusion: Open limb fractures are severe. They are mainly due to the increase of high-velocity traffic accidents. This explains the predominance of the young male population. Road safety and all actors’ behaviour change are essential for the reduction of traffic accident morbidity.

关键词： Open Fracture Limb Epidemiology

银行流动性创造和经济产出：对喀麦隆共和国的实际评估

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银行流动性创造和经济产出：对喀麦隆共和国的实际评估

作者： assang Abanda Kevin Evrard（凯文）东北财经大学

学位级别：硕士

本研究根据经验评估了喀麦隆的流动性创造及其对经济产出的影响。流动性创造是银行履行的最重要职能之一,包括为风险较高的非流动资产提供无风险流动负债。银行通过存款和贷款活动以及资产负债表外的担保和衍生工具转变资产负债表上的... 详细信息

本研究根据经验评估了喀麦隆的流动性创造及其对经济产出的影响。流动性创造是银行履行的最重要职能之一,包括为风险较高的非流动资产提供无风险流动负债。银行通过存款和贷款活动以及资产负债表外的担保和衍生工具转变资产负债表上的流动性。经济从流动性中获得的好处是它在储蓄和投资之间创造的渠道,因此支持生产活动。我们使用 Berger 和 Bouwman(2009)建议的 BB 方法和 Deep and Schaefer(2004)提出的LT差距来衡量商业银行在1998-2013年期间创造的流动性。BB方法提供绝对现金计价的流动性创造量,而LT差距是银行进行流动性转换的相对衡量指标。我们发现喀麦隆银行在相对稳定的趋势下创造了越来越大的流动性绝对数量,但也表现出高水平的流动性转型,这表明它们可能具有脆弱的资产负债表。此外,资产负债表中的流动性创造在国家银行业中最为重要,因为流动性的最大部分来自资产负债表内活动。我们发现流动性创造与经济产出之间存在统计学上显着的正相关关系。而这种关系主要是由资产负债表内的活动推动的,这种活动本身也与GDP具有统计上显着的正相关关系,而资产负债表外的流动性创造显示出微不足道的关系。我们的结果使用普通最小二乘法(OLS)和广义矩量法(GMM)是一致的。然而,我们没有找到证据作为回报,国内生产总值能够预测银行的流动性创造。本研究的结果将为政策制定者和银行监管机构提供流动性创造积极影响的证据,从而鼓励他们采取适当行动来优化其规模,从而产生更多的经济增长。

关键词： creation liquidity banks banking 流动负债 sector equity created 无风险银行监管机构