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Sep.ic Ch.onic Multifocal Osteomyelitis in Ch.ldren: A Ch.llenging p.esentation of Osteomylitis in a Low.Income Country

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Op.n Journal of Orth.p.dics 2018年第6期8卷 213-220页

作者： S. A. Kissou p. w. h. dakouré J. M. Somé M. Soulama M. Diallo Dep.rtment of p.diatrics Nazi BONI University Bobo-Dioulasso Burkina Faso Dep.rtment of Orth.p.edics and Trauma Nazi BONI University Bobo-Dioulasso Burkina Faso Dep.rtment of Medical Imaging University Teaching Hospital Ouahigouya Burkina Faso

Background: Th. aim of th.s study w.s to describe th. clinical, biological and x-ray p.esentation of Sep.ic Ch.onic Multifocal Osteomyelitis (SCMO) and discuss th. th.rap.utic difficulties of th.s p.th.logy in an African Sub-Sah.ran teach.ng h.sp.tal. p.tients and Meth.ds: A retrosp.ctive study w.s conducted in th. Orth.p.dics and Trauma dep.rtment of th. university teach.ng h.sp.tal of Bobo-Dioulasso (Burkina Faso). Over a p.riod of tw. years, w. selected all cases of ch.onic osteomyelitis. w. studied th. ep.demiological, diagnostic and th.rap.utic asp.cts of SCMO cases. Results: Eleven cases of SCMO w.re identified. Th. mean age of th. p.tients w.s 11.8 years and th. sex ratio w.s 1.75. Th.re w.re 7 rural p.tients. Th. mean time to visit th. h.sp.tal w.s 158 days. Th. most common reasons for consultation w.re p.in (10 cases), sw.lling (9 cases), and fever (7 cases). Tw. w.re sickle cell p.tients. Th. most affected bones w.re th. femur (10 cases), th. tibia (9 cases) and th. fibula (6 cases). Th. most frequent sp.cific radiological lesions w.re sequestra (6 cases) follow.d by p.ndiap.ysitis. Stap.ylococcus aureus w.s th. most common aetiology. Treatment combined antibioth.rap. and surgery (sequestrectomy and/or bone curettage and/or fistulectomy). h.p.dislocations, p.th.logical fractures and bone defect comp.icated th. course of th.s disease. Th. th.rap.utic results w.s good in 3 p.tients and bad in 5 p.tients;th. oth.r 3 p.tients w.re lost to follow.up. Conclusion: Sep.ic ch.onic multifocal osteomyelitis is a rare but formidable form of osteomyelitis in ch.ldren. Th.rap.utic outcomes are often p.or in h.sp.tals w.th.limited resources. Th. best strategy is p.evention th.ough.early diagnosis and aggressive treatment of acute osteomyelitis.

关键词： Bacterial Ch.ldren h.matogen Multifocal Osteomyelitis

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Results of Femoral Neck Fractures Screw.ng in Adults at University h.sp.tal of Brazzaville

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Op.n Journal of Orth.p.dics 2018年第6期8卷 227-234页

作者： Marius Monka Carine Mboutol Mandavo Kevin Bouh.lo-p.m Albert Ngatsé-Oko p.trick w. h. dakouré Armand Moyikoua Service d’Orth.p.die Traumatologie CHU de Brazzaville République du Congo Service de Ch.rurgie p.diatrique CHU de Brazzaville République du Congo Service d’Orth.p.die Traumatologie CHU Sour&ocirc Sanou Bobo-Dioulassou Burkina Faso

p.rp.se: Th. good of th.s survey w.s to analyze th. ep.demiological asp.cts and evaluate anatomical and functional results of th. treatment by screw.ng of femoral neck fracture in adulth.od at th. Teach.ng h.sp.tal of an underequip.ed country. Material and Meth.ds: Th.s is a retrosp.ctive study from January 1, 2011 to December 31, 2015, concerning p.tients h.sp.talized for fractures of femoral neck and h.ving been op.rated by screw.ng. Th. variables studied w.re ep.demiological and th.rap.utic asp.cts. Anatomical results w.re examined on standard x rays of th. p.lvis in front and th. h.p.in p.ofil, based on th. consolidation of th. bony axis. Functional results w.re analyzed according to th. quotation of p.stel Merle D’Aubigné. Results: Eleven screw.ngs of femoral neck h.ve been done to 11 p.tients (9 men and 2 w.men), average age w.s 47 years (29 and 60 years) from January 2011 to December 2015, at th. mean recoil of 19 month. (12 and 24 month.). Amongst consolidated p.tients (n = 7), one p.tient p.esented a necrosis of femoral h.ad at tw. years h.ndsigh.. Four p.tients p.esented an asep.ic p.eudarth.osis of femoral neck, or a bad anatomical result. Amidst th.s group.of p.tients, one underw.nt a joint rep.acement typ. Moore and suggestion of intermediary p.oth.sis w.s recommended to th.ee p.tients. According to th. quotation of p.stel Merle D’Aubigné, results w.re very satisfactory to 5 p.tients, good to 2 p.tients and bad to 4 p.tients. According to th. score of p.rker, 7 p.tients p.esented a score of 9 and 4 p.tients a score of 7. Conclusion: Th. treatment of femoral neck fractures in adulth.od requires a surgical ap.roach.by osteosynth.sis and must be p.ecocious before 24 h.urs in order to reduce risks of p.eudarth.osis of femoral neck and necrosis of femoral h.ad.

关键词： Screw.ng Fracture Femoral Neck

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