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Necrotizing Fasciitis in Low Income Countries: About 23 Cases of Bujumbura Hospitals

Open Journal of Orthopedics 2021年第2期11卷 33-39页

作者： Jean Claude Niyondiko Evrard Niyonkuru Gilbert Ndayizeye stève nimubona Clovis Paulin Baramburiye Léodégal Bazira Kamenge Teaching Hospital Department of Trauma and Orthopedic Surgery Bujumbura Burundi Kamenge Teaching Hospital Department of General Surgery Bujumbura Burundi

Background: Necrotizing fasciitis is a rapidly spreading soft tissue infection involving the deep facial layers. It can cause secondary necrosis leading to significant morbidity and mortality. The most important predictor of mortality is a delay in diagnosis. In low income countries, that delay must be high and other predictors of morbidity and mortality must be pointed out. Objective: To determine necrotizing fasciitis (NF) prognostic factors in a low income country. Patients and Methods: It is a prospective and descriptive study conducted over a one-year period from November 1, 2017 to November 1, 2018 about 23 cases of necrotizing fasciitis in two hospitals of Bujumbura. Results: The incidence of necrotizing fasciitis in these 2 hospitals (Kamenge Teaching Hospital and Prince Regent Charles Hospital) was 1%. The average age of patients was 41.76 years. Males were predominant with a sex ratio of 1.55. The risk factors for NF were: NSAIDs in 39%;HIV infection in 13%, diabetes mellitus in 4% and high blood pressure in 4%. The average time from symptoms onset to admission was 17.13 days. The mean time from admission to surgical treatment was 4 days with extremes of 1 to 22 days. The most affected site was the lower limb in 82% of cases. All patients (96%) were treated with necrotic tissue debridement. It was associated with skin grafting in 48% of cases. One patient (4%) with diabetes mellitus and HIV infection was amputated. The mortality rate was 22% (n = 5). Among those 5 patients, there was a combination of risk factors (diabetes mellitus, NSAID use and HIV infection) in 80% (n = 4), 60% (n = 3) were over 60 years of age and 60% (n = 3) were operated 10 days after the onset of symptoms. The average time of hospital stay was 101 days with extremes of 14 to 400 days. Conclusion: Necro

关键词： Necrotizing Fasciitis Prognosis Low Income Countries

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Necrotizing Fasciitis in Low Income Countries: About 23 Cases of Bujumbura Hospitals

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Open Journal of Orthopedics（矫形学期刊） 2021年第2期

作者： Jean Claude Niyondiko Evrard Niyonkuru Gilbert Ndayizeye stève nimubona Clovis Paulin Baramburiye LéodégalBazira

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Unilateral Femoral Neck Fracture after Epileptic Seizure in Young Patient: A Case Report

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Open Journal of Orthopedics 2020年第8期10卷 166-171页

作者： J. C. Niyondiko P. Hakizimana P. Barasukana S. Manirakiza G. Ndayizeye C. P. Baramburiye S. nimubona Service de Chirurgie Orthopédique et Traumatologie Centre Hospitalo-Universitaire de Kamenge Bujumbura Burundi Service de Neurologie Centre Hospitalo-Universitaire de Kamenge Bujumbura Burundi Service de Radiologie Centre Hospitalo-Universitaire de Kamenge Bujumbura Burundi

Femoral neck fracture occurring after an epileptic seizure is a rare and under-diagnosed injury. The majority of the reported cases in literature are old patients with osteoporosis. Younger patients present several risk factors of osteopenia and the treatment remains controversial. We present an outcome of a 23 years old patient with unilateral femoral neck fracture occurring during an epileptic seizure and we discuss the associated multiple risk factors of osteopenia and osteonecrosis of the hip. The patient was brought to the emergency department of Teaching Hospital of Kamenge (CHUK) complaining of pain in his left hip that had been progressing for one month after an epileptic seizure. There is a history of HIV infection since birth and epileptic seizures with ongoing treatments for both diseases. Despite the high risk of avascular necrosis, the treatment choice has been influenced by the patient’s age and a conservative surgery by internal fixation with Dynamic Hip Screw has been made. Unfortunately, this treatment early resulted in osteonecrosis of the hip since HIV infection itself and the highly active anti-retroviral therapy increase its risk.

关键词： Femoral Neck Fracture Epileptic Seizure Osteopenia Internal Fixation

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Unilateral Femoral Neck Fracture after Epileptic Seizure in Young Patient: A Case Report

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Open Journal of Orthopedics（矫形学期刊） 2020年第8期

作者： J.C.Niyondiko P.Hakizimana P.Barasukana S.Manirakiza G.Ndayizeye C.P.Baramburiye S.nimubona

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