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

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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Obturator Dislocation of the Hip at Yopougon/Abidjan Teaching Hospital

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Open Journal of Orthopedics 2015年第10期5卷 319-325页

作者： Alidou Traoré Daouda Kanaté Soumaro Christel Mobiot-Aka Alban Slim Mbende Rebecca Eva Boka Mamadou Dosso Kader Sy Jean Baptiste Sie Essoh Insa Bamba yves lambin Trauma and Orthopaedic Surgery Unit Yopougon Teaching Hospital Abidjan Cote d’Ivoire Neurosurgery Unit Yopougon Teaching Hospital Abidjan Cote d’Ivoire

Obturator dislocation of the hip is caused by high-velocity accidents as evidenced by its frequent association with other traumatic injuries and, seldom found. Its main complication remains femoral head avascular necrosis. We report on four cases of obturator dislocation of the hip. The mean age of patients was 30 years, and all their injuries followed a road traffic accident. Associated lesions were a contralateral femur fracture in two cases and an osteochondral fracture in one case. Reduction of dislocations was achieved orthopedically under general anaesthesia and the average waiting time before reduction was 20 hours. One patient had an intra-articular incarcerated fragment visible on X-ray, and another patient showed signs of early coxarthrosis 15 months later. The average follow-up time was 24 months.

关键词： Dislocation Anterior Obturator Hip Adult

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Intramedullary Nailing of Type I and Type II Open Leg Fractures after 6 Hours at Yopougon Teaching Hospital

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Open Journal of Orthopedics 2016年第8期6卷 227-233页

作者： Traoré Alidou Mbende Alban Slim Sery Bada Justin Léopold Niaoré Mobiot-Aka Christelle Soumaro Kanaté Daouda Boka Eva Rebecca Sie Essoh Jean Baptiste Bamba Insa lambin yves Trauma and Orthopaedics Department Yopougon Teaching Hospital Abidjan Ivory Coast Neurosurgery Unit Yopougon Teaching Hospital Abidjan Ivory Coast

Emergency debridement has long been the standard of care for open fractures of the tibia as infection is an important complication. In developing countries, patients are admitted to teaching hospitals 6 to 24 hours after their initial trauma. We sought to evaluate outcomes of nailing and correlations between the risk of infection and the delay in surgery. Materials and methods: Medical files of 48 men and 15 women with a combined total of 63 open fractures of the leg during a 12-year period were reviewed. The mean age was 29 years. Thirty-four type I and 29 type II open fractures according to the classification of Cauchoix and Duparc were treated with Küntscher nail after excision/debridement. Preoperative CRP was performed in 27 patients and in 22 cases it was positive. Twenty-six fractures were treated within a period of 6 to 24 hours, and a further 37 was operated on beyond 24 hours. The average waiting time before surgery was 2 days. Results: The infection was present in 11 patients (17.5%). We failed to establish any correlation between the time of treatment and the occurrence of infection for both type I and type II fractures treated during the same intervals with p = 0.244 (p > 0.05). But we established a correlation between the type of open fracture and the occurrence of infection with p = 0.01 (p < 0.05). There were 10 cases of infection among 22 cases of positive preoperative CRP. We couldn’t find a correlation between the positive value of the preoperative CRP and the occurrence of infection. Seven cases of infection were treated with appropriate antibiotherapy and early revision surgery. Four others cases complicated to bone infection (n = 2) and septic nonunion (n = 2). The average time of hospitalization was 22 days. The average time for fracture healing was 7 months. Conclusion: The rule of six hours is hardly applicable in our contexts. Our study showed no correlation between the preoperative period and the occurrence of infection.

关键词： Intramedullary Nailing Open Fracture Leg Six Hours

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Unusual Posterior Traumatic Hip Dislocations at Yopougon/Abidjan Teaching Hospital

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Open Journal of Orthopedics 2016年第4期6卷 71-77页

作者： Alidou Traoré Leopold Koffi Krah Daouda Kanaté Soumaro Rebecca Eva Boka Christelle Mobiot-Aka Alban Slim Mbende Mamadou Dosso Kader Sy Jean Baptiste Sie Essoh Insa Bamba yves lambin Trauma and Orthopaedic Surgery Unit Yopougon Teaching Hospital Abidjan Ivory Coast Neurosurgery Unit Yopougon Teaching Hospital Abidjan Ivory Coast

Traumatic dislocation of the hip is quite rare and accounts for 2% - 5% of all dislocations. We report on a case of a bilateral posterior hip dislocation associated with symmetric acetabular fracture and two cases of infracotyloid dislocation. The report included 2 men and one woman. The mean age of patients was 33 years. All dislocations followed a road traffic accident. Non-operative closed reduction was achieved within 19 hours of admission. The average follow-up time was 15 months. The hips were stable, mobile, and painless;and there was no radiographic sign of avascular necrosis of the femoral head.

关键词： Hip Dislocation Posterior Infracotyloid Posterior Wall

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用ELISA定量检测有严重同种免疫的孕妇血清中的IgG抗-K(KEL1)及其亚类

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国外医学（输血及血液学分册） 2001年第2期24卷 170-171页

作者： Abdelah Ahaded yves Brossare Debbia Patrick lambin 王学刚邯郸市中心血站

K抗原(KEL1)是仅次于ABO和Rh血型系统的与溶血反应和新生儿溶血病(HDN)有关的最重要的抗原。K抗原的免疫是由于怀孕(流产、胎盘出血)和输血引起。在1/1000的孕妇血清中发现有抗-K,且其在血清中可持续存在多年。用抗-K凝集试剂很容易检... 详细信息

K抗原(KEL1)是仅次于ABO和Rh血型系统的与溶血反应和新生儿溶血病(HDN)有关的最重要的抗原。K抗原的免疫是由于怀孕(流产、胎盘出血)和输血引起。在1/1000的孕妇血清中发现有抗-K,且其在血清中可持续存在多年。用抗-K凝集试剂很容易检出红细胞表面(RBCs)的K抗原,用PCR检测胎儿羊水细胞的DNA可鉴定其分子基因型。K抗原最早出现在胎儿红细胞成熟早期即孕期第10周。由抗-K引起的HDN的产前早期诊断是重要的,因为有些胎儿在孕期第4个月就必须进行胎儿输血以避免死胎和胎儿水肿。由抗-K导致的HDN的严重程度与母亲血清中抗体效价的相关性各家报道不一。

关键词：孕妇 IgG抗-K ELISA 定量检测同种免疫

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