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Severe Musculoskeletal Injuries in Children during Play

Open Journal of Orthopedics 2022年第11期12卷 393-399页

作者： Soumahoro Ibrahim Akobé Achié Jean Régis krah koffi léopold Kouassi Kouamé Jean-Eric Bénié Adoubs Célestin Kouassi Aya Adelaïde Natacha Ochou Jr Pierre Germain Digbeu Ogou Kevin Elie Traoré Ibrahim Traoré Abdoul Massandjé Norah Soro Zolopégué Marcel Blé Gbalé Yannick Akpro Sédy louess De Randolphe Kodo Michel Orthopaedics-Traumatology Department of the University Hospital of Bouaké (Cô te d’Ivoire)/Alassane Ouattara University Bouake Ivoiry Coast Paediatric Surgery Unit of the CHU of Bouaké (Cô te d’Ivoire)/Alassane Ouattara University Bouake Ivoiry Coast

Introduction: Musculoskeletal injuries are common in children but rarely severe. Their treatment varies according to the type of injury observed. The aim was to describe the epidemiological and therapeutic aspects of severe musculoskeletal injuries in children during play. Patients and Methods: This was a retrospective descriptive study conducted in the Orthopaedic-Traumatology Department and the Paediatric Surgery Unit of the University Hospital of Bouaké between January 2018 and December 2020. It concerned patients less than 16 years of age hospitalised for more than 24 hours for a musculoskeletal trauma following a gambling accident. The variables studied were epidemiological and therapeutic. Results: A total of 53 patients were collected. The frequency was 2.9%. The mean age was 9 ± 3.99 years. There were 38 (71.7%) boys and 15 (28.3%) girls. The sex ratio was 2.5. The patients were attending school in 79.3% (n = 42). The circumstances of occurrence were dominated by falls during play accidents (n = 35;66%). Football was observed in 93.5% (n = 49). The thoracic limb (n = 35;66%) was the preferred site of these injuries. The injuries were closed (86.7%) with a predominance of forearm fractures (n = 22;41.6%). The average hospital stay was 2.8 ± 1.4 days. Most of the patients were treated orthopedically (n = 37;69.9%). The evolution was favourable without complications. Conclusion: Musculoskeletal injuries during play were infrequent (2.9%). The circumstances were dominated by falls during play. The injuries were mainly closed fractures, most of which were treated orthopedically.

关键词： Children Fractures Musculoskeletal Trauma Orthopaedic Treatment

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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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Osteoarticular lesions of the Shoulder Girdle by Hippopotamus Bite: Highly Septic lesion

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Open Journal of Orthopedics 2024年第2期14卷 114-121页

作者： Jr Pierre Germain Ochou Achié Jean Régis Akobe Yao Aboh Ganyn Robert Arnaud Assere Kouamé Jean-Eric Kouassi Adelaïde Aya Natacha Kouassi Ibrahim Soumahoro Zolopégué Marcel Soro Sédi loues De Randolphe Akpro Gbalé Yannick Blé Kouamé Innocent M’bra loukou Blaise Yao Bada Juste léopold NiaoréSery koffi léopold krah Michel Kodo Department of Orthopaedic and Traumatological Surgery Bouaké University Hospital Bouaké Ivory Coast Raoul Follereau Institute Manikro Centre Bouaké Ivory Coast

Hippopotamus bites are rare in medical consultations, despite several studies exposing their aggressive character. A case of a hippopotamus bite on the shoulder of a fisherman has been reported. In addition to the osteoarticular aspect representing a therapeutic problem, the infectious aspect was marked by sepsis, with a death in less than 48 hours. Based on this observation, a protocol for the initial management of large animal bites was submitted.

关键词： Bite Hippopotamus Septic Shock

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Madelung’s Deformity: Reverse Wedge Osteotomy of the Distal Radius Associate Ulnar Wedge Osteotomy: A Case Report

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Open Journal of Orthopedics 2018年第2期8卷 33-38页

作者： Kouassi Kouamé Jean Eric Sery Bada Justin leopoeld Niaoré Yao loukou Blaise M’bra Kouame Innocent krah koffi léopold Kouassi Aya Adelaide Nathacha Assere Yao Aboh Ganyn Robert Arnaud Kodo Michel Traumatology and Orthopedics Surgery of the University Hospital of Bouake Bouake Cote d’Ivoire

Madelung deformity is rare, accounting for 1.7% of congenital anomalies. The treatment is essentially surgical and several techniques have been described. We report the result of a case treated in an adult patient by ... 详细信息

关键词： Madelung Deformity Cuneiform Osteotomy Radius Ulna

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Major limb Amputation Secondary to locally Advanced Cutaneous Squamous Cell Carcinoma in Tropical Environments: Determinants

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Open Journal of Orthopedics 2018年第4期8卷 139-147页

作者： Kouassi Kouamé Jean Eric Yao loukou Blaise Sery Bada Justin leopold Niaoré M’bra Kouamé Innocent krah koffi léopold Kouassi Aya Adelaide Nathacha Assere Yao Aboh Ganyn Robert Arnaud Kodo Michel Trauma and Orthopedics Department Bouake Teaching Hospital Bouake Ivory Coast

Objective: To identify the determinants of secondary limb amputation in advanced squamous cell carcinoma. Material and Methods: This was a retrospective study carried out in the Orthopedic Traumatology Department of the Bouaké University Hospital in Côte d’Ivoire from January 2013 to December 2016. It involved ten patients with locally advanced skin squamous cell carcinoma, confirmed by histology and having amputated limbs. The parameters studied were: demographic data (gender, age), socio-economic conditions (occupation, place of residence), the risk factors involved, the use of topical self-medication and the use of traditional medicine, antecedents and comorbidities factors, lifestyle, clinical aspects (seat, size), extension assessment (X-ray), anatomo-pathological examination data, duration of evolution of squamous cell carcinoma, the function of the affected limb, the treatment performed, the evolutionary modalities and the equipment. Results: Between 2013 and 2016, ten patients underwent either upper or lower limb amputations following locally advanced squamous cell carcinoma. The average age was 34.1 years (19 - 64 years). There were 7 men (70%) and 3 women (30%) and all our patients were black (sub-Saharan Africa). The majority of our patients were farmers (70%). The risk factors for squamous cell carcinoma were neglected chronic wounds. All our patients recognized during the interrogation a large use of the topicals of traditional medicine for the treatment of the initial cutaneous lesions. In terms of lifestyle, five (50%) were smokers and alcoholics. The mean time to progression of squamous cell carcinoma was 5.9 years. lesions were localized preferentially to the pelvic limbs six (60%) cases and four (40%) to the limbs chest. The lesion was diagnosed late in all our patients. The size of the tumor in all our patients was greater than 5 cm and had a deep invasion (nerves, vessels and bone). The proximal ipsilateral ganglionic invasion was constant.

关键词： Amputation Squamous Cell Carcinoma Cutaneous Histology

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Optimal Classification of Minerals by Microscopic Image Analysis Based on Seven-State “Deep learning” Combined with Optimizers

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Open Journal of Applied Sciences 2024年第6期14卷 1550-1572页

作者： Kouadio krah Sie Ouattara Gbele Ouattara Alain Clement Joseph Vangah laboratoire de Gnie Civil Gosciences et Sciences Gographiques Institut National Polytechnique Houphout Boigny (INPHB) Yamoussoukro Cte dIvoire Institut National Polytechnique Houphout Boigny (INPHB) Ecole Doctorale Polytechnique (EDP) Yamoussoukro Cte dIvoire laboratoire des Sciences et Technologies de la Communication et de lInformation (lSTCI) Institut National Polytechnique Houphout Boigny (INP-HB) Yamoussoukro Cte dIvoire Ecole de Gomatique et du Territoire (EGT) Abidjan Cte dIvoire lARIS SFR MATHSTIC Universit dAngers Angers France Universit Virtuelle de Cte dIvoire Abidjan Cte dIvoire

The development of artificial intelligence (AI), particularly deep learning, has made it possible to accelerate and improve the processing of data collected in different fields (commerce, medicine, surveillance or security, agriculture, etc.). Most related works use open source consistent image databases. This is the case for ImageNet reference data such as coco data, IP102, CIFAR-10, STl-10 and many others with variability representatives. The consistency of its images contributes to the spectacular results observed in its fields with deep learning. The application of deep learning which is making its debut in geology does not, to our knowledge, include a database of microscopic images of thin sections of open source rock minerals. In this paper, we evaluate three optimizers under the AlexNet architecture to check whether our acquired mineral images have object features or patterns that are clear and distinct to be extracted by a neural network. These are thin sections of magmatic rocks (biotite and 2-mica granite, granodiorite, simple granite, dolerite, charnokite and gabbros, etc.) which served as support. We use two hyper-parameters: the number of epochs to perform complete rounds on the entire data set and the “learning rate” to indicate how quickly the weights in the network will be modified during optimization. Using Transfer learning, the three (3) optimizers all based on the gradient descent methods of Stochastic Momentum Gradient Descent (sgdm), Root Mean Square Propagation (RMSprop) algorithm and Adaptive Estimation of moment (Adam) achieved better performance. The recorded results indicate that the Momentum optimizer achieved the best scores respectively of 96.2% with a learning step set to 10−3 for a fixed choice of 350 epochs during this variation and 96, 7% over 300 epochs for the same value of the learning step. This performance is expected to provide excellent insight into image quality for future studies. Then they participate in the development of

关键词： Classification Convolutional Neural Network Deep learning Optimizers Transfer learning Rock Mineral Images

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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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Ankle Arthrodesis in the Treatment of Neglected Ankle Fractures

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Open Journal of Orthopedics 2022年第4期12卷 123-130页

作者： M’bra Kouamé Innocent krah koffi leopold Kouassi Kouamé Jean-Eric Yao loukou Blaise Akobé Jean Regis Achie Ochou Pierre Germain Jr Sery Bada Justin léopold Kouassi Aya Adélaïde Michel Kodo Traumatology and Orthopedics Surgery of the University Hospital of Bouaké Bouaké C&ocirc te d’Ivoire

Introduction: Neglected ankle fractures are common in our regions. Patients first consult traditional healers and it is when the signs persist that they consult the surgeon for a swollen and painful ankle. Initially we always performed anatomical repairs with osteosynthesis, but the majority of patients still complained of pain and disability. We wondered whether a primary arthrodesis would not be indicated in old ankle fractures to avoid disabling pain for patients. We therefore performed a series of arthrodesis on neglected post-traumatic ankles. The objective of our study was to describe the results of arthrodesis on an old post-traumatic ankle and to propose a therapeutic indication in the face of any neglected ankle fracture. Material and Method: This was a prospective study over 8 years between December 2012 and November 2020, involving 36 cases of neglected ankle fractures treated by arthrodesis using Meary’s technique. We used AOFAS (American Orthopedic Foot and Ankle Score) preoperatively and postoperatively for an objective assessment. Results: The average follow-up was 4.2 years and our results were satisfactory (94.4%) with an average AOFAS score ranging from 27.8 preoperatively to 76.7 postoperatively. The fusion rate was 97.2%. Discussion: Arthrodesis appears here as an important alternative in the treatment of neglected ankle fractures with significant trophic disorders.

关键词： Arthrodesis Ankle Neglected Fracture Osteosynthesis Traditional Healers

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

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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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Clinical Case of Bilateral Rupture of the Patellar Tendon of the late Diagnosis

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Open Journal of Orthopedics 2017年第9期7卷 235-240页

作者： Koné Samba Dogba Eric Nguianbanda léandre Kouassi Adélaide ledion Anicet krah léopold Bana Abdoulaye Touré Stanislas Agoh Serge Service de Traumatologie Orthopédie CHU de Cocody Abidjan C&ocirc te d'Ivoire Service de Traumatologie Orthopédie Hô pital des Instructions des Armées (HIA-OBO) Libreville Gabon Service de Traumatologie Orthopédie CHU de Bouaké Bouaké C&ocirc te d'Ivoire

Defined as a continuity solution on the muscular-osseous-tendinous chain of the knee, ensuring the extension of the leg on the thigh, the traumatic rupture of the knee’s extensor apparatus is often reported in literature. They are dominated by patellar fractures. The patellar or quadricipital tendon damage is rare and even exceptional in a bilateral topography. The aim of this work was to highlight the clinical case of bilateral rupture of the patellar tendon of late diagnosis, occurring in an adult with a particular field. It was an adult, who presented a bilateral rupture of the knee extensor apparatus following a minimal traumatism. Anamnesis found a chronic kidney disease correctly follow-up. The diagnosis was delayed so was the surgical management (Krackow’s technique and protection by a metallic frame). At 8 months post surgery the functional result is acceptable. The bilateral rupture of the patellar tendon stays a rare pathologic entity, which always seems associated at a particular field. The diagnosis delay (and so did the care) is an important bad prognosis factor. Treatment of this old form (unknown) is exclusively surgical.

关键词： Knee Extensor Apparatus Bilateral late

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