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surgical Treatment of Osteonecrosis of the Femoral Head Using Minimally Invasive surgical Drilling and Cancellous grafting at Brazzaville University Hospital

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Open Journal of Orthopedics 2024年第2期14卷 122-132页

作者： Kevin Parfait Bienvenu Bouhelo-Pam Marius Monka Arnauld sledje Wilfrid Bilongo Bouyou reg.s Perry massouama Paul Yèlai Ikounga roger Bertrand sah Mbou Armand Moyikoua Department of Orthopaedic surgery and Traumatology University Hospital of Brazzaville Brazzaville Republic of the Congo Faculty of Health sciences Marien N’GOUABI University Brazzaville Republic of the Congo

Introduction: Osteonecrosis of the femoral head (ONTF) is a debilitating condition. several treatments have been proposed with controversial results. The aim of our study was to evaluate treatment by surgical drilling coupled with in situ cancellous grafting. Materials and methods: Our study was a case-control study conducted at Brazzaville University Hospital from 1st January 2018 to 31 December 2023. It compared two groups of patients with ONTF: non-operated (13 patients, 20 hips) and operated (22 patients, 35 hips). We used the visual digital scale (VDs) for pain assessment, the Merle D’Aubigne-Postel (MDP) scoring.system for clinical and functional assessment, and the evolution of necrosis. results: The group of non-operated patients had a mean age of 35.69 ± 3.4 years, no improvement in pain with an EVN above seven at the last recoil and a mean global MDP score falling from 12.7 before offloading to 10.13 at one year. The group of patients operated on had a mean age of 37.86 ± 7.02 years, a significant reduction in pain (p = 0.00004) and a significantly increased MDP score (p = 0.0034). A comparison of the two groups of patients showed significant stabilization of the necrotic lesions in the operated patients (p = 0.00067), with better satisfaction in the same group. Conclusion: surgical drilling combined with grafting in the treatment of early-stage ONTF has improved progress in our series. The technique is reproducible and less invasive. It has made it possible to delay unfavorable progression and, consequently, hip replacement surgery.

关键词： Hip Osteonecrosis of the Femoral Head Conservative Treatment surgical Drilling Bone grafting

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Neurolysis of the Median Nerve to the Carpal Canal by the Way Mini-Open: review of 68 Files at Brazzaville University Hospital

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surgical science 2017年第12期8卷 510-518页

作者： Massamba Miabaou Didace Boukassa Léon Lamini Norbert massouama rég.s Monka Marius Ondélé Ngatsé Bileckot richard Ntsiba Honoré Multipurpose surgery Department Brazzaville University Hospital Brazzaville Congo rheumatology Department CHU Brazzaville Brazzaville Congo Department of Traumatology-Orthopedics University Hospital of Brazzaville Brazzaville Congo Anesthesia-resuscitation Department University Hospital of Brazzaville Brazzaville Congo Functional rehabilitation Department Brazzaville University Hospital Brazzaville Congo

Objective: To evaluate the results of neurolysis of the median nerve to the carpal tunnel in patients operated by the mini-open technique. Methods: The prospective study included 68 patients (16 men and 52 women) aged 43 to 80 years (mean age: 64 years). Patients were evaluated in pre- and post-operative by a questionnaire. The mini open technique with cutaneous approach to the heel of the hand following the 4th ray was performed in all patients under local, locoregional or general anesthesia. results: The results were evaluated in 3 consultations, in the 1st, 3rd and 6th month. We obtained very good results in 54.4% of the cases (n = 37) and 30.9% (n = 21) of good results and 14.70% (n = 10) of poor results. No vascular, tendinous or neurological complications were noted. Two patients were reoperated for incomplete resection of the carpal ring ligament. The mini-open technique has achieved good results in all neurolysis despite the delay in surgical management. Conclusion: The results of the surgical treatment of the carpal tunnel syndrome depend on the precocity of the diagnosis and the surgical indication.

关键词： Neurolysis Median Nerve Carpal Tunnel Mini-Open Technique

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