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Open Journal of Orthopedics 2022年第11期12卷 442-449页

作者： Diallo Mamadou Moustapha Lamah Leopold Barry Alhassane camara nouhou mangue Diallo Alpha Mamadou Fellah Department of Orthopedic Traumatological Surgery of the Donka National Hospital Conakry Guinea

Carpo-metacarpal dislocations are rare hand injuries. They are misdiagnosed due to their non-specific clinical signs. The authors report on their experience in the management of carpometacarpal dislocations in a specialized hand surgery center. Our study included patients received and treated in the department for a carpometacarpal dislocation. Dislocation fractures of Bennett and Rolando were excluded. The postoperative functional evaluation took place after 18 months by the DASH score. Twelve patients participated: one case of neuro-algodystrophy and one pin infection. The mean DASH functional outcome score was 1.10 at 18 months. Since carpometacarpal dislocations are rare and easily misdiagnosed, the surgeon should assume the possibility of them in patients with high-energy trauma, and imaging studies should be carefully evaluated. Pinning is an effective treatment option that provides good long-term functional results.

关键词： Dislocation Fracture Carpo-Metacarpal Joints

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

Evaluation of the Surgical Treatment of Patella Fractures in 17 Cases in the Orthopedic-Traumatology Department of the University Hospital Center of Donka, Republic of Guinea

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Open Journal of Orthopedics 2023年第9期13卷 391-396页

作者： Abdoulaye camara Abdoul Karim Balde nouhou Mangué camara Léopold Lamah Mamadou Moustapha Diallo Alhassane Barry Fatoumata camara Ibrahima Marie camara Service d’Orthopédie-Traumatologie du Centre Hospitalier Universitaire de Donka Conakry Republic of Guinea

Objectives: To determine the epidemiological, therapeutic and evolutionary aspects. Methodology: This was a retrospective study, from January 1, 2016 to December 31, 2018, on the files of patients aged 16 and over, admitted for patella fractures, treated surgically and followed up in our service. Results: The study involved 17 patients including 15 men (88.24%) and 02 women (11.76%) with an average age of 36.65 years. Workers were the most represented (29.42%);AVP were the leading cause of these fractures (52.94%). The fractures were open in 70.58% of cases. Associated lesions were dominated by femur fractures in 29.42%. Duparc type II was the most encountered bone lesion with 47.06% of cases. All our patients benefited from regional anesthesia. Bracing was the most used surgical treatment in 58.83%;the anterior approach was performed in all our patients. Four (04) cases of knee stiffness, two (02) postoperative infections and skin necrosis complicated the short and medium term consequences. After a two-year follow-up, radiologically one case of pseudarthrosis and one case of patellofemoral osteoarthritis were noted. According to the Bosman score, we found 17.65% excellent, 47.06% good and 35.29% poor functional results. Conclusion: Patella fractures are relatively rare. Treatment is primarily surgical for transverse and/or displaced fractures;Bracing is the osteosynthesis technique of choice. However, knee stiffness, pseudarthrosis and patellofemoral osteoarthritis are not uncommon.

关键词： Fractures Patella Bracing Patellofemoral Osteoarthritis

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