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Recent Traumatic Dislocations of the Shoulder in adults: Epidemiological, Therapeutic and Evolutionary Aspects

Open Journal of Orthopedics 2023年第7期13卷 267-274页

作者： Inza Bamba Achié Jean-Régis Akobe Kouamé Jean-Eric kouassi Serge Amos Ekra aya natacha adélaide kouassi Sédi Louess De Randolphe Akpro Ibrahim Soumahoro Zolopégué Marcel Soro Gbale Yannick Ble Koffi Léopold Krah Michel Kodo Traumatology and Orthopaedic Surgery Department of The University Hospital of Bouaké Alassane Ouattara University Bouaké C&ocircte d’Ivoire General Surgery Department of The University Hospital of Bouaké Alassane Ouattara University Bouaké C&ocircte d’Ivoire

Introduction: Shoulder dislocations represent about 50% of all joint dislocations. The objective was to describe the epidemiological, therapeutic and evolutionary aspects of traumatic shoulder dislocations in Bouaké. Methods: This retrospective and descriptive study was conducted between January 2017 and December 2019. It concerned patients over 15 years of age with a recent traumatic shoulder dislocation treated and followed in the department. The variables studied were epidemiological, therapeutic and evolutionary. The severity of the trauma was assessed according to the Injury Severity Score (ISS). Functional outcome was assessed according to the Constant score. Results: There were 49 patients (49 dislocations) out of 22,569 patients. The prevalence was 0.2%. The mean age was 32 years (17 - 62). There were 38 men (77.5%). The sex ratio was 3.4. Students predominated (n = 10;20.4%). The etiology was dominated by road traffic accidents (n = 19;38.8%). Anterior dislocation was the most common (n = 45;92%). The ISS score was minor (n = 46;93.8%). The mean time to reduction was 7 hours (4 - 16). Orthopaedic reduction using the Kocher technique predominated (n = 44;89.8%). The mean duration of external rotation immobilisation of the shoulder was 23 days (16 - 45). Recurrence occurred in 8 patients (21.6%). The functional outcome at a mean Constant follow-up of 15 months (8 - 20) was satisfactory (n = 44;89.8%). Conclusion: Traumatic dislocation of the shoulder represented 0.2%. Treatment was mainly orthopaedic. Recurrence was rare.

关键词： adult Shoulder Anterior Dislocation Traumatic Orthopaedic Treatment

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Predictive Factors of Functional Outcome of Open Fractures of the Foot at the Bouaké Hospital and University Center

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Open Journal of Orthopedics 2024年第11期14卷 510-523页

作者： Kouamé Innocent M’bra Achié Jean-Régis Akobe aya adélaide natacha kouassi Ibrahim Soumahoro Loukou Blaise Yao Bada Justin Léopold Niaoré Sery Koffi Léopold Krah Michel Kodo Orthopaedics-Traumatology Department of the University Hospital of Bouak Ivoiry Coast (Alassane Ouattara University) Bouak Ivoiry Coast

The study evaluated functional outcomes of foot open fractures, finding satisfactory results in 89.6% of cases. It identified associated lesions, more than two fractures, and lack of rehabilitation as predictors of po... 详细信息

关键词： AOFAS-Open Fracture-Foot-Functional Outcome

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Initial Treatment of Knee Dislocation at Yopougon Teaching Hospital/Abidjan, Ivory Coast

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Open Journal of Orthopedics 2016年第11期6卷 337-343页

作者： Traoré Alidou kouassi Kouamé Jean Eric kouassi aya adelaïde natacha Mbende Alban Slim Sie Essoh Jean Baptiste Bamba Insa Lambin Yves Trauma and Orthopaedics Department Yopougon Teaching Hospital Abidjan Ivory Coast Trauma and Orthopaedics Department Bouak&eacute Teaching Hospital Bouak&eacute Ivory Coast Neurosurgery Unit Yopougon Teaching Hospital Abidjan Ivory Coast

Knee dislocation is a serious and rare injury. Its rarity and the variety of injuries that result from it mean that there is no adequate management that is universally accepted. The aim of this study was to evaluate our emergency care strategy for these injuries. Materials and methodology: This was a retrospective study conducted from January 1992 to December 2004 on nine cases of knee dislocation. It consisted of six men and three women. The average age of these subjects was 35, ranging from 15 to 50 years. The causes for these injuries included: public road accidents (n = 4), household accidents (n = 3), a sporting accident and a dislocation that occurred following a fight. The dislocations were anteromedial (n = 4), posterolateral (n = 2), posterior (n = 2) and anterior (n = 1). Associated injuries were sore joint (n = 2), contusion of the common peroneal nerve (n = 1) and vascular injury (n = 1). An angiography was performed on one patient for a vascular injury and an Elecmyography (EMG) for a common peroneal nerve injury. Closed reduction was used for eight patients and open reduction for one patient. Results: Five knees were stable with normal range of motion and some residual pain. Four patients had knee instability;two anterior, one anteroposterior and one lateral. In three of these patients, the CT arthrography/arthro-scan confirmed central pivot damage, with meniscal damage in two of them. The four patients were referred to a knee surgeon in a private practice. The post-operational effects were minimal in vascular injury. The EMG performed for the common peroneal nerve detected a nerve contusion. Conclusion: Our emergency care strategy remains closed reduction. This therapeutic management is consistent, at least in the first 15 days, with the literature.

关键词： Knee Dislocation Initial Management Instability

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Surgical Site Infections in Trauma and Orthopaedics at Bouaké Teaching Hospital (Côte d’Ivoire)

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Open Journal of Orthopedics 2024年第9期14卷 381-390页

作者： Loukou Blaise Yao Koffi Léopold Krah aya adelaïde natacha kouassi Kouamé Innocent M’bra Kouamé Jean-Eric kouassi Michel Kodo Department of Trauma and Orthopaedics Bouak Teaching Hospital Bouak Cte dIvoire

Background: Surgical site infections are serious healthcare problems. The aim was to describe the epidemiological, diagnostic, therapeutic, and prognostic aspects of surgical site infections in Trauma and Orthopaedics at Bouaké Teaching Hospital. Method: This retrospective, descriptive, and analytical study was conducted from January 2019 to December 31, 2021. The data studied included prevalence, initial lesions, type of surgical intervention, type of SSI, bacteria involved, treatment, and outcomes. Results: Forty-four (11%) of the 399 patients included in the study developed a surgical site infection. The mean age was 27 years, with 36 male and 8 female. Initial lesions were predominantly open fractures (n = 31;70%), with a mean delay of 48 hours for surgical management. Emergency interventions accounted for 70% (n = 31) of cases. The NNISS infection risk score was 1 in 80% (n = 35) of cases. Superficial infections (n = 34;77%) appeared early, on a mean 6 days postoperatively. Bacteriological analysis primarily identified Pseudomonas aeruginosa (n = 10;23%), sensitive to Imipenem and Chloramphenicol but resistant to Amoxicillin-clavulanic acid, Ceftriaxone, Gentamicin, and Ciprofloxacin. Multidrug-resistant bacteria were found in 89% (n = 8) of cases, with all bacteria resistant to Ceftriaxone. Surgical revision was performed in 10 patients (23%), primarily involving debridement with hardware retention (n = 7;70%). Chloramphenicol was the most commonly used antibiotic post-antibiogram (61%). Outcomes were favourable in 98% of cases. Identified risk factors included the type of lesion according to NRC classification, the delay in managing open fractures, and the NNISS score. Conclusion: The prevalence of surgical site infection was 11%, favoured by the delayed operation of open fractures.

关键词： Surgical Site Infection Open Fractures Pseudomonas aeruginosa Ceftriaxone

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Fractures of Patella: Prospective Analysis of a Series of 51 Cases

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Open Journal of Orthopedics 2024年第11期14卷 535-546页

作者： Pierre Germain Ochou Jr adélaïde aya natacha kouassi Achié Jean Régis Akobe Zolopegué Marcel Soro Ibrahim Soumahoro Koffi Léopold Krah Michel Kodo Surgical Department Regional Hospital of San-Pedro San-Pedro Ivoiry Coast Orthopeadics Traumatology Department University Hospital of Bouak (Alassane Ouattara University) Bouak Ivoiry Coast

Introduction: The patella is a key component of the knee’s extensor system. Fractures of the patella can be treated using a variety of methods. The objective of this study was to describe the epidemiological, anatomical-clinical, therapeutic and evolutionary aspects. Methods: This was a prospective, observational, analytic study conducted from January 2018 to December 2021. It concerned all patients over 15 years of age treated surgically for a patella fracture. The variables to be studied were epidemiological, anatomo-clinical, therapeutic and evolutionary. Statistical analysis was performed using the Chi-square test and Fisher’s exact test. Results: It concerned 51 cases. There were 39 men and 12 women. The average age was 35.13 years. The fracture was caused in 78.5% of cases by a road traffic accident. The main fracture was transverse (49.1%). Tension band technique predominated (92.1%). Complications included superficial suppuration (n = 7) and irritation of the material (n = 7). Mean time to consolidation was 66.39 days. Bösman scores were Excellent (n = 23;45.10%). Some patients presented osteoarthritic knee symptoms (n = 14;27.45%), and no pseudarthrosis. Conclusion: Patella fractures are rare. Surgical treatment gives good results, and the choice of method depends essentially on the anatomo-clinical characteristics of the fracture. Kinesitherapy is an essential and important weapon in functional recovery.

关键词： Patella Fracture Haubanage Patellectomy Kinesitherapy

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Peri-Operative Morbidity and Mortality of Elderly Patients in Traumatology-Orthopedics in Bouaké

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Open Journal of Orthopedics 2024年第11期14卷 524-534页

作者： aya adélaïde natacha kouassi Achié Jean-Régis Akobe Loukou Blaise Yao Kouamé Innocent M’bra Zolopégué Marcel Soro Ibrahim Soumahoro Koffi Léopold Krah Michel Kodo Department of Trauma and Orthopaedics Bouak Teaching Hospital Bouak Cte dIvoire Surgery Department Alassane OUATTARA University Bouak Cte dIvoire

Introduction: Elderly subjects have physiological and clinical characteristics that make surgical management more complex and have a major impact on their prognosis. The primary objective of this study was to assess peri-operative hospital morbidity and mortality in the elderly. Secondary objectives were to identify factors predictive of death. Methods: This was a retrospective observational descriptive and analytical study carried out over 02 years, based on hospitalized patient records. It concerned patients aged 65 or over who had undergone surgery or for whom an indication for surgery had been given, all pathologies included. A total of 138 files were collected. The mean age was 74.15 years. Diabetes (n = 52;37.68%) and arterial hypertension (n = 38;27.54%) were the most common comorbidities. The reasons for hospitalization were mostly degenerative (n = 56;40.58%) and traumatic (n = 49;35.51%) pathologies. Preoperative delay, intraoperative and postoperative complications, hospital stay, evolution (mode of discharge), time of occurrence and presumed cause of death were studied. Univariate (p Results: The mean preoperative delay was 5.53 days (1 - 23). Intraoperative complications were mainly hemodynamic instability (n = 26, 18.8%). Postoperatively, the main complications were anemia (n = 62;48.44%) and glycemic imbalance (n = 28;21.86%). Average hospital stay was 13.4 days. Age (>75 years), the existence of comorbidities, degenerative pathologies, ASA score > 2, delay in treatment > 3 days, the occurrence of complications and the blood transfusion requirement were the independent predictors of the occurrence of death in the multifactorial analysis. Conclusion: Peri-operative morbidity in the elderly was influenced by age (>75 years), the existence of comorbidities, degenerative pathologies, ASA score > 2, time to treatment > 3 days, the occurrence of complications and the blood transfusion requirement.

关键词： Comorbidity Elderly Patient Mortality Surgery

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Honey Dressing of Cutaneous Wounds on Limbs in the Traumatology Orthopaedics Department of Bouaké University Hospital

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Open Journal of Orthopedics 2024年第9期14卷 411-420页

作者： Achié Jean-Régis Akobe aya adélaide natacha kouassi Ibrahim Soumahoro Zolopégué Marcel Soro Sedy Louess De Randolphe Akpro Bakary Traoré Almamy Kamate Axel Fabrice Essehin Yao Aboh Ganyn Robert Arnaud Assere Lanciné Kaba Kouamé Innocent M’bra Loukou Blaise Yao Bada Justin Léopold Niaoré Sery Koffi Léopold Krah Michel Kodo Orthopaedics-Traumatology Department of the University Hospital of Bouak Bouak Ivory Coast Plastic and Reconstructive Surgery Department of the University Hospital of Bouak Bouak Ivory Coast

The study evaluated the effectiveness of honey dressings in healing recent skin wounds with soft tissue loss on limbs. Conducted over a year with 60 patients, results showed a significant reduction in wound size and early healing, with complete recovery on average within 29 days. The study supports honey as a viable wound treatment.

关键词： Healing Honey Limbs Loss of Substances

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Triceps Brachii Tendon Reconstruction with V-Y Plasty: Indication and Functional Results of a Case at BouakéTeaching Hospital

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Open Journal of Orthopedics 2017年第12期7卷 396-399页

作者： Krah Koffi Léopold Sery Bada Léopold Kone Samba Digbeu Kévin Assere Arnaud kouassi aya natacha kouassi Eric M’Bra Innocent Yao Loukou Blaise Kodo Michel Traumatology and Orthopedics Surgery of the University Hospital of Bouaké Bouaké C&ocirc te d’Ivoire Traumatology and Orthopedics Surgery of the University Hospital of Abidjan Abidjan C&ocirc te d’Ivoire

Repair of an old lesion of the triceps brachii tendon is infrequent. A V-Y plasty was performed 4 years after the injury in an adult. Post traumatic osteoarthritis limits functional outcomes. The patient is satisfied.

关键词： Reconstruction Tendon Triceps Brachii

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Primary Abscess of the Psoas of the Child: About a Case Observed at the University Hospital Center of Bouake

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Open Journal of Pediatrics 2018年第2期8卷 154-157页

作者： Benie adoubs Celestin Asse Kouadio Vincent Irie Bi Gohi Serge Kakou Aka Gerard Lohourou Grah Franck Traore Ibrahim kouassi aya adelaide natacha Kpangni AhuaJean Bertrand Department of Pediatric Surgery University Hospital Center of BouakeBouakeIvory Coast Pediatric Department University Hospital Center of BouakeBouakeIvory Coast Anesthesia-Resuscitation Department University Hospital Center of BouakeBouakeIvory Coast Department of General and Digestive Surgery University Hospital Center of BouakeBouakeIvory Coast Department of Traumatology-Orthopedics University Hospital Center of BouakeBouakeIvory Coast

The primary abscess of the psoas of the child is a rare affection, the pathogenesis of which is still unexplained. The positive diagnosis of this condition is difficult and relies mainly on medical imaging. We report a case of primary psoas abscess in an immunocompetent child, whose diagnosis was facilitated by the provision of abdominal radiography without preparation and abdominal ultrasound. The evolution was favorable thanks to the combination of antibiotic therapy and surgery.

关键词： Primary Abscess of the Psoas Child Ultrasound Surgery

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Treatment of Neglected Elbow Dislocations by Z-Lengthening of the Triceps Brachii

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Open Journal of Orthopedics 2022年第4期12卷 142-152页

作者： M’Bra Kouamé Innocent kouassi Kouamé Jean-Eric Yao Loukou Blaise AkobéJean Regis Achie Sery Bada Justin Léopold kouassiaya adélaïde natacha Krah Koffi Leopold Michel Kodo Traumatology and Orthopedics Surgery of the University Hospital of Bouaké Bouaké C&ocirc te d’Ivoire

Introduction: Neglected elbow dislocations are much more common in developing and underdeveloped countries. The main reason for the delay in diagnosis is that patients initially seek treatment from traditional healers. These will immobilize the elbow in extension, which will lead to the retraction of the triceps muscle and collateral ligaments. Patients and Method: We carried out a prospective study over five years (2014-2019). The study involved patients with unreduced elbow dislocation older than 21 days. All patients with a dislocated fracture and those whose x-ray showed joint fusion were not included in the study. We collected 26 patients, 20 men and 6 women with an average age of 27.5 years (17 and 45 years). The average consultation time was 8.9 months (3 - 13). The approach was posterior about 8 cm above the olecranon and 2 cm below the olecranon, the ulnar nerve was identified and isolated. The triceps tendon was cut in a Z from its myotendin junction to the beak of the olecranon, and then lengthened. Results: The patients were reviewed after a mean follow-up of 24 months (12 - 36). The Mayo Clinic’s average elbow performance index was 77.1 (60 - 85), with 19 good and 6 average results. The mean flexion was 114°(100°- 135°) and the mean extension deficit was 31.15°(10°- 55°). The average range of motion was 82.5°(60°- 120°). We did not find a correlation between the duration of the lesion and functional recovery (p > 0.05). The Wilcoxon test showed that surgery significantly improved the overall range of motion of the elbow (p = 0.001). Discussion: Based on this study, open reduction with tendon lengthening should remain a treatment option regardless of the age and chronicity of the dislocation.

关键词： Elbow Dislocation Neglected Triceps Plasty Posterior Approach

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