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Open Journal of Orthopedics 2019年第9期9卷 191-196页

作者： marius monka Terence Olivier Ohoya Etsaka Albert Ngatsé-Oko Armand Moyikoua Department of Trauma-Orthopedics CHU-Brazzaville Teaching Hospital Brazzaville Congo

Objective: To assess the anatomical and functional results after surgical management of leg shaft mal-union in African environment. Methodology: This was a retrospective study of patients operated for leg mal-union at Brazzaville University Hospital between January 2014 and December 2018. The studied parameters were epidemiological and therapeutic. The anatomical evaluation was based on the quality of the leg’s relaxation and bone healing, which was indicated on standard X-rays. The functional evaluation was based on Thorensen’s criteria. Results: Five patients were selected for this study. There were 3 men and 2 women with an average age of 39 years with extremes of 27 and 59 years. Three patients were treated with locked intramedullary nail and 2 patients with screwed plate. At an average follow-up of 9 months, bone consolidation was achieved in all our patients. The average consolidation time was 4 months (range 3 to 7 months). We noted 1 case of residual mal-union in valgus (5°) on screwed plate and 1 case of valgus angulation (5°) on locked intramedullary nail. Walking was considered normal in 3 patients. The wearing of a 2 cm heel was indicated in 2 patients. According to Thorensen’s criteria, the overall results were considered good in 3 patients and average in 2 patients. Conclusion: Leg shaft mal-union are likely to cause serious functional issues. Their treatment is strictly surgical and osteotomy is the only management option to restore the anatomy of the deformed limb.

关键词： Leg Shaft Mal-Union Leg Osteotomy

Homolateral Combined Fracture of Monteggia and Galeazzi. Case Report and Review of the Literature

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Open Journal of Orthopedics 2019年第3期9卷 61-65页

作者： marius monka Kevin Bouhelo-Pam Ohoya Etsaka Terence Olivier Albert Ngatsé-Oko Armand Moyikoua Department of Trauma-Orthopedics CHU-Brazzaville Teaching Hospital Brazzaville Congo

Introduction: Homolateral combined fractures of Monteggia and Galeazzi are very rare. Their treatment is exclusively surgical and should be proposed early in order to restore the anatomy of the antebrachial skeleton, pronosupination, and the flexion-extension of the elbow and wrist. Observation: We reported the case of a 45-year-old woman who presented a homolateral fracture of Monteggia and Galeazzi following a road accident. This combination of fractures posed a problem of diagnosis and management. Surgical follow-up presented functional issues. Conclusion: The association of Monteggia and Galeazzi fracture is very rare and poorly reported in the literature. This observation reminds us of the importance of performing a complete clinical and paraclinical assessment before any therapeutic decision.

关键词： Ipsilateral Fracture Monteggia Galeazzi

Trauma Emergencies at University Hospital of Brazzaville, Congo

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Surgical Science 2022年第3期13卷 144-154页

作者： Massamba Miabaou Didace Boukassa Léon Note Madzele Murielle monka marius Ondima Irène Moyikoua Armand Massamba Alphonse Digestive Surgery Department University Hospital Brazzaville Congo Polyvalent Surgery Department University Hospital Brazzaville Congo Traumatology-Orthopaedic Department University Hospital Brazzaville Congo Department of Pediatric Surgery University Hospital Brazzaville Congo Laboratory of Numerical Analysis Computer Science and Applications Faculty of Sciences and Technology Marien Ngouabi University Brazzaville Congo

Background: Trauma is the main reason for consultation in the emergency unit. They deserve particular attention in the Congo where road accidents and violence of all kinds are increasingly observed. Methods: This study who carried out in the surgical emergencies at the University Hospital of Brazzaville, aims to analyze the epidemiological and etiological aspects, the anatomical lesions encountered;to describe their management, as well as to evaluate the induced mortality while emphasizing their place in all surgical emergencies. The prospective and analytical study included 2127 patients admitted to a traumatic emergency unit from January 1 to June 30, 2018. Medical records served as data sources. The measure of trauma severity was determined using Champion’s Trauma Score. The epidemiological, clinical and therapeutic parameters were studied. Results: The population most affected was adolescents and young adults (mean age, 27.3 years) with a male predominance: 1318 men (i.e. 61.9%) for 809 women (i.e. 38.1%). Road accidents (n = 819, or 38.5%) were the main cause of injuries, followed by violence (n = 702, or 33%) and falls (27.3%). The skull, limbs, thorax and abdomen are the main targets. The most observed lesions were limb fractures (n = 344, i.e. 16.1%), intracranial hematomas and contusions (n = 315, i.e. 14.8%), thoracic and abdominal wounds (n = 28, i.e. 1.3%). Mortality was evaluated at 0.6%, and was correlated with the severity of the lesions and the type of trauma. Conclusion: Trauma is very common in emergency consultations in Congo, with a hospital frequency of 75.1% of all emergencies. Preventive actions are essential to reduce their frequency.

关键词： Emergencies Trauma Accidents Public Road Violence

Results of Femoral Neck Fractures Screwing in Adults at University Hospital of Brazzaville

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Open Journal of Orthopedics 2018年第6期8卷 227-234页

作者： marius monka Carine Mboutol Mandavo Kevin Bouhélo-Pam Albert Ngatsé-Oko Patrick W. H. Dakouré Armand Moyikoua Service d’Orthopédie Traumatologie CHU de Brazzaville République du Congo Service de Chirurgie Pédiatrique CHU de Brazzaville République du Congo Service d’Orthopédie Traumatologie CHU Sour&ocirc Sanou Bobo-Dioulassou Burkina Faso

Purpose: The good of this survey was to analyze the epidemiological aspects and evaluate anatomical and functional results of the treatment by screwing of femoral neck fracture in adulthood at the Teaching Hospital of an underequipped country. Material and Methods: This is a retrospective study from January 1, 2011 to December 31, 2015, concerning patients hospitalized for fractures of femoral neck and having been operated by screwing. The variables studied were epidemiological and therapeutic aspects. Anatomical results were examined on standard x rays of the pelvis in front and the hip in profil, based on the consolidation of the bony axis. Functional results were analyzed according to the quotation of Postel Merle D’Aubigné. Results: Eleven screwings of femoral neck have been done to 11 patients (9 men and 2 women), average age was 47 years (29 and 60 years) from January 2011 to December 2015, at the mean recoil of 19 months (12 and 24 months). Amongst consolidated patients (n = 7), one patient presented a necrosis of femoral head at two years hindsight. Four patients presented an aseptic pseudarthrosis of femoral neck, or a bad anatomical result. Amidst this group of patients, one underwent a joint replacement type Moore and suggestion of intermediary prothesis was recommended to three patients. According to the quotation of Postel Merle D’Aubigné, results were very satisfactory to 5 patients, good to 2 patients and bad to 4 patients. According to the score of Parker, 7 patients presented a score of 9 and 4 patients a score of 7. Conclusion: The treatment of femoral neck fractures in adulthood requires a surgical approach by osteosynthesis and must be precocious before 24 hours in order to reduce risks of pseudarthrosis of femoral neck and necrosis of femoral head.

关键词： Screwing Fracture Femoral Neck

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 Régis 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

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 Regis 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

Arthroscopic Treatment of Gonarthrosis in a Low-Income Setting

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Open Journal of Orthopedics 2024年第1期14卷 75-82页

作者： Kevin Parfait Bienvenu Bouhelo-Pam Affleck Romaric Ledier Angalla Norbert Edgard Lamini N’soundhat marius monka Arnauld Sledje Wilfrid Bilongo Bouyou Paul Yèlai Ikounga Térence Olivier Etsaka-Ohoya Department of Orthopaedic Surgery and Traumatology University Hospital of Brazzaville Brazzaville Congo Faculty of Health Sciences Marien N’GOUABI University Brazzaville Congo Department of Rhumatology University Hospital of Brazzaville Brazzaville Congo

Background: Knee osteoarthritis is a frequent, debilitating, and degenerative condition. It is the most common operative indication for surgical arthroscopy. Hypothesis: Arthroscopy allows painless treatment of knee osteoarthritis and functional recovery. Patients and Methods: Our study was conducted in a private medical center in the city of Brazzaville in Congo, during the period from September 2020 to February 2023. It was prospective and based on patients with mechanical knee pain caused by osteoarthritis. A mobile arthroscopy device was used. The IKDC and KOOS scores allowed the evaluation of the treatment. Results: Our work involved 15 men and 7 women, with an average age of 39.9 years. Knee osteoarthritis was classified as type 2 according to Ahlbäck in 26 cases (70.27%) and type 3 in 11 cases (29.73%). In 7 patients, arthroscopy revealed lesions not visualized on MRI. Joint lavage was performed in all cases, synovial debridement in 17 cases (45.94%), and extraction of cartilaginous foreign bodies in 10 cases (27.03%). 20 patients were very satisfied with the surgery and 2 moderately satisfied. The EVA, subjective IKDC and KOOS scores were acceptable on a long-term follow-up. Discussion: Arthroscopy is a modern surgical technique for the management of intra-articular lesions of the knee. It relieves pain and stabilizes the degenerative process. A mobile arthroscopy device used here was preferred because of the low cost of installation and production.

关键词： Arthroscopy Surgery Imaging Knee