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Cardio-Renal Syndrome: Epidemiological Aspect in the Medicine Department of Tombouctou Hospital

World Journal of Cardiovascular Diseases 2022年第2期12卷 123-132页

作者： Bassirima Traore Samba Sidibé Souleymane Mariko Karamoko Kantako Massama Konaté kalifa diallo Nouhoum diallo Mariam Sako Abdoul Karim Sacko Youssouf Kassambara Ichaka Menta Souleymane Coulibaly Department of Medicine Tombouctou Hospital Tombouctou Mali Cardiology Department of the Point G University Hospital Bamako Mali Cardiology Department Mali Hospital Bamako Mali Cardiology Department CHU Gabriel TOURE Bamako Mali

Introduction: Cardio-renal syndrome is a pathophysiological disorder of the heart and kidneys in which chronic or acute dysfunction of one can lead to chronic or acute dysfunction of the other. The objective of this study was to determine the prevalence of cardio-renal syndrome in the Medical Department of the Tombouctou Hospital in Mali. Methods: It is about a descriptive transversal study carried out over 18 months, from January 01st, 2020 to June 30th, 2021 and relating to the analysis of 75 files of patients hospitalized for heart failure and with impaired renal function. Results: The frequency of cardio-renal syndrome was 6.4% with a predominance of men (sex ratio: 2). Hypertension was the most widely described risk factor (50.6%). The history was dominated by chronic heart failure (14.6%) and diabetes (6.6%). The average age was 58 with extremes of 18 and 90. The main aetiologies were dilated cardiomyopathy (46.6%) and ischemic heart disease (20%). Symptoms were dominated by dyspnea (90.6%) and edema of the lower limbs and face (74.6%) accompanied by cough (74.6%). Anemia was noted in 15 patients (20%). The mean clearance (MDRD) was at 32 ml/min. Doppler echocardiography found left ventricular dilation (66.6%), lower left ventricular systolic fraction (64%) and kinetic abnormalities (20%). The kidney ultrasound performed in 9 patients returned to normal in 8 cases and in 1 patient the kidneys were small. Eight deaths (10.6%) were noted. Conclusion: Cardio-renal syndrome is a common feature in which mixed failure is observed in the unfavorable course of heart disease and nephropathy. Its prevalence is unfortunately under evaluated in cardiological settings in Africa and particularly in Mali, hence the interest of a more advanced study.

关键词： Cardio-Renal Syndrome Epidemiology Tombouctou Hospital

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Epidemiology and Management of Heart Failure in the Medicine Department of Tombouctou Hospital

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World Journal of Cardiovascular Diseases 2023年第3期13卷 105-113页

作者： Bassirima Traoré Souleymane Mariko Samba Sidibé Karamoko Kantako Mariam Sako Massama Konaté Nouhoum diallo Abdoul Karim Sacko kalifa diallo Youssouf Kassambara Djibril Kassogue Oumar Ongoiba Oumar Sanogo Ichaka Menta Souleymane Coulibaly Department of Medicine Tombouctou Hospital Tombouctou Mali Department of Cardiology Point G University Hospital Bamako Mali Department of Cardiology Mali Hospital Bamako Mali Department of Cardiology CHU Gabriel TOURE Bamako Mali

Introduction: Heart failure is a complex syndrome and very frequently observed and secondary to the outcome of many advanced heart diseases. It is made up of a set of symptoms that reflect the tissue and visceral consequences of heart failure. The objective was to determine the hospital prevalence and to describe the management of heart failure in the medical department of Tombouctou hospital in Mali. Methods: This is a descriptive cross-sectional study with retrospective data collection, carried out over 24 months and involving the analysis of 266 records of patients hospitalized for heart failure. Results: The frequency of heart failure was 17.6% with a female predominance. The average age was 48 years with extremes of 16 and 90 years. Cardiovascular risk factors were dominated by high blood pressure with 38%. Global heart failure was the mode of discovery in 72.2% of cases. The etiologies were dominated by hypertensive dilated cardiomyopathy in 36.8% and peripartum cardiomyopathy in 32% of cases. The majority of our patients benefited from diuretic treatment, i.e. 95.9% frequency;with a favorable evolution in 96.2% of cases. We recorded 10 deaths, i.e. a lethality of 3.7%. We report some difficulties encountered during our security study because Tombouctou is a war zone and the lack of a technical platform for biology such as (BNP or NT-proBNP). Conclusion: Heart failure is a real public health problem. Its prevalence is increasing due to the aging of the population and especially the poor management of arterial hypertension in our context.

关键词： Heart Failure Epidemiology Etiology Treatment Tombouctou Hospital

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Surgical Management of Unstable Superior Femoral Epiphysiolysis with Great Displacement

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Open Journal of Orthopedics 2023年第4期13卷 173-181页

作者： kalifa Coulibaly Cheick Oumar Sanogo Mahamdou diallo Abdoul Kadri Moussa Laye Toure Soumana Traore Aboubacar diallo Sory Ibrahim Tambassi Souleymane diallo Ousmane Traoré Orthopaedic Trauma Department Kati University Hospital Koulikoro Mali Orthopaedic Trauma Department Gabriel Touré University Hospital Bamako Mali Orthopedic Trauma Department Sikasso Regional Hospital Sikasso Mali

Introduction: Superior femoral epiphysiolysis (SFE) is a most progressive but sometimes abrupt displacement of the femoral head relative to the superior femoral metaphysis through the cervicocerebral growth plate of the femur. The displacement of the femoral head is most often downward and backward. It is a typical pathology of the pubescent adolescent, most often overweight. It occurs on average at the age of 12 years in girls and 14 years in boys. Unstable forms with large displacements have a high risk of femoral head necrosis and chondrolysis. Although in situ fixation is the generally accepted treatment for minor SFE, the treatment of more severe cases remains controversial. When the extent of the displacement makes it impossible to pass a screw between the femoral neck and the femoral head, the only option is to reduce the displacement. This reduction must be gentle, progressive and limited to the minimum necessary for osteosynthesis. Objective: The aim of the work was to evaluate the results of the technique of progressive reduction of epiphyseal displacement by transtibial traction followed by percutaneous fixation of the femoral head by screw. Patients and Method: This was a retrospective descriptive study over a 10-years period from January 1, 2013 to December 31, 2022. It focused on the surgical treatment of unstable upper femoral epiphysiolysis with large displacement in the orthopaedic trauma department of the University Hospital of Kati. All patients operated on in our department for large displacement SFE were included in this study. Cases of secondary large displacement upper femoral epiphysiolysis and patients who had already undergone surgery on the proximal femur were excluded. Continuous progressive traction on the Boppe splint through a pin under the anterior tibial tuberosity was performed for 15 days in all patients. The hip was flexed to 45° and the knee to 35°. Fixation was performed with one or two screws. No contralateral preventive fixation was performed. Minimum follow-up was one year

关键词： Epiphysiolysis Unstable Femoral Head Continuous Traction

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Lesional and Therapeutic Aspects of Tibial Plateau Fractures at the BSS University Hospital Center in Kati

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Surgical Science 2022年第10期13卷 471-479页

作者： Coulibaly kalifa Sanogo Cheick Oumar Tambassi Sory Ibrahim diallo Aboubacar Traoré Soumana Touré Laye Moussa Abdoul Kadri diallo Mahamadou diallo Cheickh Tidiane Keïta Mohamed Orthopaedic Trauma Department of the Kati University Hospital Koulikoro Mali Orthopaedic Trauma Department Sikasso Hospital Sikasso Mali Orthopedic Trauma Department of Gabriel Touré University Hospital Bamako Mali

Introduction: Tibial plateau fractures are solutions of continuity of the epiphyseal-metaphyseal block of the upper end of the tibia of which at least one line enters the joint. They threaten the stability and mobility of the knee and can compromise walking and standing. These fractures are on the increase, especially affecting young and active subjects. Orthopedic treatment is a rare indication apart from non-displaced or slightly displaced forms. Surgical treatment is required in displaced forms, particularly in depression fractures. The aim of this work was to report the lesional and therapeutic aspects of tibial plateau fractures in our department. Patients and Method: Patients and method: This was a retrospective study over 36 months from January 2019 to December 2021. Included in this study were patients treated for a tibial plateau fracture in our department and followed up for at least 10 months. The epidemiological and clinical data analyzed were age, sex, affected side, etiology, mechanism of injury, pathological anatomy and associated lesions. The fractures were classified according to the classification of Duparc and Ficat. The slightly or non-displaced forms were treated orthopedically while the displaced forms were treated surgically. The minimum follow-up was 10 months. The results were evaluated by the anatomical criteria according to Mazas and Duparc and functional according to Merle d’Aubigné. Results: The authors collected 71 cases of tibial plateau fractures. They accounted for 4.0% of all limb fractures, 5.8% of lower limb fractures and 33.8% of knee fractures in our service. The male sex was the most represented at 78.9% with a sex ratio of 3.7. The age group of [20 - 40] years was the most affected, i.e., 53.5%. The average age was 41 years with extremes of 17 and 82 years. The left side was affected (n = 47) and the right side (n = 24). Road traffic accident was the main cause. The mechanism of injury was mainly represented by lateral and sagittal compressions. Lateral unituberosity and bi

关键词： Fractures Tibial Plateau Pathology Osteosynthesis

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Double Arthrodesis, Postero-Medial Release and Posterior Tibial Transfer in One Step in Paralytic Inveterate Equine Varus Foot

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Surgical Science 2023年第2期14卷 122-130页

作者： kalifa Coulibaly Cheick Oumar Sanogo Sory Ibrahim Tambassi Aboubacar diallo Soumana Traore Laye Toure Orthopaedic Trauma Department Kati University Hospital Koulikoro Mali Orthopedic Trauma Department Sikasso Regional Hospital Sikasso Mali

Introduction: Varus equine foot deformity is common in developing countries. The management of these deformities is surgical in adults. Several surgical techniques have been described with more or less satisfactory results. To our knowledge, no study has been performed on the simultaneous association of double arthrodesis, posteromedial release, and posterior tibial transfer in a single operation in inveterate paralytic varus equines feet. The purpose of this work was to evaluate the results obtained. Patients and Method: This was a retrospective descriptive study from January 01, 2018 to December 31, 2021. It concerned inveterate paralytic varus equines feet operated on by the simultaneous association in a single operative time of double arthrodesis of the foot, posteromedial release of the back foot and transfer of the posterior tibial muscle to the lateral cuneiform. We identified seven patients with a mean age of 22.1 years with extremes of 11 years and 36 years. There were three males and four females. The cause of the deformity was neurological in all cases. All patients had painful walking discomfort and shoeing difficulties. The average time to management was 13.3 years with extremes of 4 and 25 years. The chronology of the interventional steps was posteromedial release, arthrodesis, and transfer of the posterior tibial muscle to the lateral cuneiform. The average postoperative follow-up was 21.7 months with extremes of 6 and 48 months. The parameters studied were the duration of the procedure, complications related to the procedure, muscle strength at the last recoil, consolidation of the arthrodesis, residual pain, patient activity, gait perimeter, stepping, ankle mobility, residual deformity, footwear, protrusion of the transferred tendon, and the possibility of walking on the heel. Final results were graded according to the Angus and Cowell criteria. Results: No intraoperative complications were noted. An early superficial infection of the surgical site was noted. It was treated with local care and he

关键词： Arthrodesis Foot Ankle Posterior Tibial Muscle Equine Varus

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Blount Method in the Management of Supracondylar Fractures of the Humerus in Children

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Surgical Science 2023年第5期14卷 331-337页

作者： Cheick Oumar Sanogo Mamadou Hawa Daffe kalifa Coulibaly Aboubacar diallo Soumana Traore Sory Ibrahim Tambassi Mohamed Berthe Mahamadou diallo Souleymane diallo Ibrahim Abdou Maiga Kassim Daouda Berete Alhassane Barry Department of Orthopedic Traumatology University Hospital Center Pr Bocar Sidy SALL Kati Mali Department of Orthopedic Traumatology Gabriel Toure University Hospital Center Bamako Mali Department of Orthopedic Traumatology National Hospital Donka Guinea

Supracondylar fractures of the humerus are the most common traumatic elbow injury in children. Several techniques are described in their support. Blount’s method is one of the widely used orthopedic means. The objective of our study was to evaluate the results of supracondylar fractures of the humerus treated by this method in our department. This was a descriptive, longitudinal study with the prospective collection over a period of 12 months from May 2018 to April 2019. It focused on children aged 0 to 15 years treated in the Orthopedic Traumatology Department of the CHU of Kati for a supracondylar fracture of the humerus in extension. A minimum follow-up period of 6 months was necessary for inclusion. 12 patients were collected. The sociodemographic, anatomopathologic, therapeutic and evolutionary aspects were studied. The results were evaluated according to Flynn’s criteria. The male sex was predominant with a ratio of 2. The average age was 5.5 years. The average admission time was 12.5 hours. Domestic accidents were the main etiology (66.66%) and Type II fracture was the most frequent with 58.33%. The duration of immobilization was 42 days for 11 patients. Complications were 1 case of secondary displacement and 1 case of 12˚ flexion deficit. The average Baumann angle was 72˚. The result was satisfactory for all our patients. Supracondylar fractures of the humerus are common in children, especially boys. The method of Blount when it is well carried out by respecting the indications gives good results.

关键词： Supracondylar Humerus Fracture Children Blount Method

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Surgical Management of Recent Traumatic Epiphyseal Fractures-Detachments of the Distal Femur at Gabriel TouréUniversity Hospital

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Surgical Science 2023年第2期14卷 61-71页

作者： Mahamadou diallo Abdoul Kadri Moussa Layes Toure kalifa Coulibaly Mamadou Bassirou Traoré Cheick Oumar Sanogo Terna Traoré Mamadou diallo Amadou Maiga Adégné Togo Service d’Orthopédie-Traumatologie CHU Gabriel Touré Bamako Mali Service d’Orthopédie-Traumatologie Etablissement Hospitalier Publique Sikasso Sikasso Mali Service d’orthopédie traumatologie CHU de Kati Kati Mali Service de Neurochirurgie CHU Gabriel Touré Bamako Mali Service de chirurgie générale CHU Gabriel Touré Bamako Mali

Traumatic epiphyseal detachment fractures of the distal end of the femur are a rare lesion whose severity is linked to disabling sequelae such as limb length inequality or most often axial deviation. In this report, surgical treatment aims to reconstruct the anatomy of the distal femur, to avoid secondary displacements and to allow early mobilization of the knee. Surgery carried out mainly by the technique of plugging in or screwing, opened or better still closed, can be a source of complications including migration of pins, infections, knee stiffness, and growth disorders. The aim of this work was to describe their epidemiological, anatomo-clinical, therapeutic and evolutionary aspects in the Department of Orthopedics-Traumatology at the CHU Gabriel TOURE. It was a retrospective study over 30 months from July 2019 to December 2021. In fact, it concerned 42 patients with traumatic epiphyseal detachment of the distal femur occurring within 21 days or less, on a healthy knee with cartilage fertile treated surgically and followed in the department. However, the diagnosis of traumatic epiphyseal detachment of the distal femur was retained thanks to the clinical examination and supplemented by radiographic images of the knee from the front and from the side. The treatment was surgical. The functional results were evaluated according to the functional criteria of the Eastern Orthopedic Traumatology Society (SOTEST). Forty-two patients included 32 boys and 10 girls of average age of 12 years with extremes of 8 years and 16 years. The lesions were classified according to the Salter Harris classification. We noted 24% type I (n = 10), type II 71% (n = 30), type III 2% (n = 1), type IV 2% (n = 1). Union was achieved in all patients within an average of 6 weeks with extremes of 4 and 12 weeks. The functional result was considered good in 20% of cases and very good in 80%. Traumatic epiphyseal detachment fractures of the distal end of the femur are a rare lesion whose severity is linked to disabling sequelae such as limb len

关键词： Epiphyseal Detachment Distal Femur Treatment Surgical

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Management of Spinal Injuries Secondary to Rockfall in Traditional Mines

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Surgical Science 2023年第2期14卷 104-110页

作者： Coulibaly kalifa Traoré Youssouf Tambassi Sory Ibrahim Sanogo Cheick Oumar diallo Aboubacar Traoré Soumana Traoré Issa Djerma Issa Orthopedic Trauma Department of Kati University Hospital Koulikoro Mali Neurosurgery Department of the University Hospital of Kati Koulikoro Mali

Introduction: Spinal injuries represent the whole of the mechanisms responsible for vertebral, disco-ligamentary and spinal cord injuries. Spinal cord injury is life-threatening and is responsible for functional consequences that make the subsequent socio-economic integration of victims difficult. In developing countries, spinal injuries in traditional gold mining are becoming more and more frequent. Purpose: The purpose of this study was to describe the anatomopathological aspects and the results of surgical treatment of spinal injuries secondary to traditional mine collapses at the University Hospital of Kati. Patients and Methods: This was a prospective, descriptive study over 18 months, from November 2017 to May 2019. Included in this study were patients operated on for spinal trauma secondary to rockfall in traditional mines. The neurological status was assessed in each patient since admission to the department using the Fränkel score. Decompression by laminectomy combined with titanium device placement was preferred in lumbar, thoracic and thoraco-lumbar surgery. We performed an anterior cervical spine approach with SENEGAS plate placement in cervical injuries. Motor physiotherapy was associated whenever recovery was not complete. At a minimum follow-up of 6 months, all our patients were re-evaluated by the Fränkel score. Results: The mean age was 31 years with extremes of 10 and 49 years. The majority of patients were men, 95%. Twenty patients underwent surgery. According to the spinal segments, the cervical spine was affected in 05 cases, the thoracic spine in 08 cases and the lumbar spine in 17 cases. The neurological examination revealed tetraplegia (n = 5), paraplegia (n = 12) and paraparesis (n = 3). According to the types of lesions, we collected 12 cases of fractures, 4 cases of fracture-luxations and 04 cases of pure luxations. According to the site, the fracture was uni-articular (n = 3), corporal (n = 15) and transverse apophyseal (n = 1). According to the type of line, the fracture was s

关键词： Trauma Spine Traditional Gold Mining Mali

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Surgical Treatment of Recent Traumatic Epiphyseal Detachments of the Distal Femur in the Orthopedic and Traumatological Surgery Department of the CHU Bocar Sidy Sall de Kati: About 20 Cases

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Surgical Science 2023年第5期14卷 338-346页

作者： Souleymane diallo Sory Ibrahim Tambassi Kaly Tounkara Terna Traore kalifa Coulibaly Aboubacar diallo Soumana Traore Aboubacar Sidiki Sangaré Salif Kone Drissa Kaloga Bagayoko Cheick Oumar Sanogo Department of Orthopedics and Traumatology CHU Pr Bocar Sidy Sall of Kati Kati Mali Department of Orthopedics and Traumatology Etablissement Public Hospitalier Sikasso Sikasso Mali Department of Anesthesia and Intensive Care University Hospital of Luxembourg Bamako Mali

Introduction: To our knowledge, no scientific study has been conducted at the university hospital of Kati on recent traumatic epiphyseal detachment fractures of the distal femur. However, every day, children present in consultation for knee trauma. Conjugal plate fractures are by definition single to children. Any break in any solution of continuity of this plate is called an epiphyseal fracture or detachment. Objectives: To evaluate the results of surgical treatment of traumatic epiphyseal in detachments of the distal femur recent in children and adolescents. Patients and Method: This was a 13-month prospectively collected longitudinal descriptive study from September 1, 2016 to September 30, 2017. We identified and reviewed 20 medical records of recent traumatic epiphyseal detachments of the distal femur. The parameters studied were sociodemographic, lesion, surgical technique and evolutionary. Results: During the study period, the most affected group age was 12 to 17 years (85%) with an average of 14.65 ± 1.61 years (6 and 20 years). The victims were male (95%). The most frequent etiology was road traffic accident (95%), with a mean time to care of 26.42 ± 10.21 hours and Type II was frequently encountered (85%) with 35% of immediate complications. Cross-bracketing was the most commonly used surgical technique (85%). The result was good (65%). Conclusion: This study allowed us to observe a significant hospital incidence of epiphyseal detachment fractures of the distal femur. Cross pinning was the most commonly used surgical technique with fewer complications (35%) and a satisfactory result in 90% of cases.

关键词： Fractures Epiphyseal Detachments Distal End of Femur Pinning

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Olecranon Bone Tumor Complicated by Ulnar Nerve Paresis Revealing Tuberculous Osteitis—About a Case

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Surgical Science 2023年第3期14卷 192-196页

作者： Abdoul Kadri Moussa Mahamadou diallo kalifa Coulibaly Layes Touré Mamadou Bassirou Traoré Tata Touré Adegné Togo Orthopedic-Traumatology Department CHU Gabriel TOURE Bamako Mali Traumatology Orthopedic Department of The Hospital and University Center: CHU Kati Mali Department of Orthopedics-Traumatology Sikasso Regional Hospital Sikasso Mali General Surgery Department CHU Gabriel TOURE Bamako Mali

Introduction: The localization of bone tuberculosis at the level of the olecranon is rare and can pose a problem of differential diagnosis with a tumoral affection. Only the biopsy allows the diagnosis of certainty. The goal was to report our first case to do a review of the literature. Clinical Observation: This was a 64-year-old patient who consulted 2 years after the onset of symptoms for swelling and mechanical pain in the left elbow. On clinical examination there was a firm consistent mass measuring 6/4 cm in diameter, not very painful and hot on the posterior surface of the left elbow, accompanied by paresthesias in the territory of the ulnar nerve associated with partial functional impotence of the left forearm with little altered general condition. The X-rays of the left elbow showed extensive bone lysis of the olecranon with fracture of the base of the olecranon. The CT Scan of the elbow performed showed osteolysis of the olecranon with extensive bone reactions at the distal end of the humerus. The biopsy carried out with histological examination concluded with an aspect of tuberculous osteitis and the culture came back sterile. A curettage was performed associated with anti-tuberculosis treatment for 12 months as well as the placement of a posterior splint. The evolution at 9 months was unsatisfactory with persistence of paresis and stiffness of the elbow. Conclusion: Tuberculous osteitis of the olecranon can simulate a malignant tumor with non-specific signs of bone tuberculosis. Only the anatomopathological examination is definitive for the diagnosis. The treatment is multidisciplinary. Orthopedic evolution is difficult to predict.

关键词： Osteitis Tuberculosis Olecranon Evolution Mali

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