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Solitary Osteogenic Exostosis of the Femur Revealed by Recurring Acute Distal Thigh Pain: About a Case

Open Journal of Pediatrics 2024年第4期14卷 719-726页

作者： Thierno Saïdou barry Mohamed lamine Sadou Sacko ba.la.keita.sory sidimé Moussa Condé Daniel Agbo-Panzo Pediatric Surgery Department Donka National Hospital (HND) of the University Hospital of Conakry Gamal Abdel Nasser University of Conakry (UGANC) of Guinea Conakry Guinea Orthopedic and Trauma Surgery Department Donka National Hospital (HND) of the Conakry University Hospital Conakry Guinea

Introduction: Solitary exostoses are the most common benign tumors of the fertile metaphyses of the long bones of children. Their radiological diagnosis of metaphyseal bone growth must be confirmed on pathological examination. These tumors can remain asymptomatic for a long time and reveal themselves during a particularly vascular complication. The objective of this study was to describe the epidemiological, diagnostic, therapeutic and evolutionary aspects of these tumors. Patient and Observation: We report the case of a 15-year-old adolescent girl, with no particular pathological history, received in the pediatric surgery department of the Donka National Hospital (HND) of the Conakry University Hospital for recurrent acute painful swelling of the lower third of the left thigh in an afebrile context accompanied by lameness and stopping school for a few days (2 - 3 days). The symptoms appear to have evolved over the past 3 years and after physical activities. It regresses with rest, analgesics and non-steroidal anti-inflammatory drugs. The notion of trauma and sickle cell disease was not reported in the patient's clinical history. It is the persistence of the symptomatology which motivates the said consultation. On palpation, a small hard mass is noted at the expense of the internal metaphysis of the left distal femur. Deep palpation of this area causes a tingling sensation and during rapid mobilization of the knee. The remainder of the orthopedic examination was unremarkable. Standard x-ray of the femur shows a bony growth with a pointed tip from the distal metaphysis of the left femur. On surgical exploration, we noted a wedge-shaped exostosis oriented towards the vastus medialis muscle. Histological examination of the surgical specimen confirms osteogenic exostosis. There is no recurrence after 2 years. Conclusion: The distal femoral metaphysis is the most common location of solitary osteochondromas in children. Their definitive diagnosis requires the histology of

关键词： Osteogenic Exostosis Osteochondromas Fertile Long Bone Metaphyses Child

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Epdemiology and Treatment of Pseudarthrosis of Long Bones in the Servce D Orthopedics-Traumatology of the University Hospital of Donka

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Open Journal of Orthopedics 2024年第3期14卷 133-138页

作者： Camara Nouhou Mangué Diallo Mamadou Moustapha Moustapha Alhassane Diallo Alpha Mamadou Fela sidimé sory Camara Abdoulaye Kolié Germain lamah Léopold Service d’Orthopédie-Traumatologie Centre Hospitalier Universitaire de Donka Conakry Republic of Guinea

Introduction: Pseudarthrosis (PSA) of the diaphysis of long bones still remains a current problem, despite improvements in the treatment of these fractures. Our study aims to study the epidemiological and therapeutic aspects of PSA of the diaphysis of long bones. Method: This retrospective work concerns 30 cases of non-union of the diaphysis of long bones treated in the orthopedic and trauma surgery department at Donka National Hospital, during a period of 18 months from January 1, 2019 to June 30, 2020. Results: We recruited 30 patients, 80% of whom were male, with an average age of 39.9 years. Public road accidents (AVP) represented the main cause of fractures of the diaphysis of long bones 87%, they were open in 25 cases or 83%. The fractures were located in the middle 1/3 of the diaphysis of the long bones in 50% of cases. Treatment of initial fractures was traditional in 21 cases, orthopedic in 2 cases and surgical in 7 cases. It was aseptic nonunion in 28 cases (93%) and septic nonunion in 2 cases. They were hypertrophic in 7 cases, slightly hypertrophic in 5 cases, oligotrophic in 11 cases, atrophic in 6 cases and with bone defect in 1 case. The treatment was based on osteosynthesis including 16 cases of screwed “PV” plate: 7 cases of centromedullary “ECM” nailing, 2 cases of external fixator, 1 case of broaching and 4 cases of Plastering. The results according to ASAMI criteria on an anatomical level were excellent in 19 cases, good in 3 cases and poor in 3 cases, with a union rate of 76%. And 5 patients undergoing consolidation. Conclusion: based on the literature data and the experience of our department, the true treatment of PSA requires correct management of the initial fracture without forgetting the interest in preventing AVP which appears to be an element essential, making it possible to reduce the incidence of fractures of the diaphysis.

关键词： Pseudarthrosis Aseptic-Septic-Diaphysis Long Bones Screwed Plate Intramedullary Nailing Bone Graft Osteo-Muscular Decortication

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Total Hip Replacement: Short- and Medium-Term Morbidity and Mortality in the Department of Orthopedic Traumatology of Donka University Hospital, Guinea-Conakry

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Open Journal of Orthopedics 2022年第12期12卷 493-502页

作者： lamah Leopold Diallo Mamadou Moustapha sidimé sory Diallo Ibrahima Gallé barry Alhassane lamah Philip bah Mohamed lamine Camara Nouhou Mangué Diallo Amadou Mamadou Fela Sané André Department of Orthopedics and Traumatology of the Donka University Hospital Conakry Guinea Orthopedic Traumatology Department of the Ignace Deen University Hospital Conakry Guinea Orthopedic Traumatology Service of the Aristide le Dantec University Hospital in Dakar Dakar Senegal

Introduction: Total hip prostheses are a reliable means of treating hip disorders. It is indicated when pain and reduced mobility of the hip become incompatible with the patient’s daily activities. In low-income countries, the risk factors for hip disease are numerous, but the means for its management, such as total hip prostheses, are not. The aim of this work was to determine the morbi-mortality of total hip prostheses in the short and medium term in our department and to review the literature. Patients and Method: This was a prospective and descriptive study over a period of 9 years. It involved 50 THPs performed on 45 patients. Patients who had received a THP and were followed up for at least two years were included. We excluded patients who were lost to follow-up. The Moore-type posterolateral minimally invasive approach was used. Complications were investigated from the immediate postoperative period and in the medium term. The final functional results were evaluated according to the Postel Merle d’Aubigné score. Results: We performed 50 THPs out of 750 procedures, i.e. , 6.6%. The indications were: primary coxarthrosis 60%, necrosis of the femoral head 26%, post-infectious balloon hip 4%, and pseudarthrosis of the femoral neck 10%. The average time to the consultation was 2.4 years with extremes of 1 and 5 years. According to the terrain, sickle cell disease represented 18%, tuberculosis 12%. Postoperative complications were lameness 12%, dislocation 6%, suppuration 6%, death 4%, peri-prosthetic fracture 8%, loosening 2%, peri-articular ossification 2%, and paralysis of the external popliteal nerve 2%. Conclusion: Whoever performs a THP is obliged to monitor the patient as long as he/she is alive. Complications are possible at any time and can negatively change the assigned goal and force the surgeon to be expensive and sometimes inconclusive secondary interventions.

关键词： THP Morbi-Mortality Short- Medium- Term

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