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Surgical Management of Recent Traumatic Epiphyseal Fractures-Detachments of the Distal Femur at Gabriel TouréUniversity Hospital

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Surgical Science 2023年第2期14卷 61-71页

作者： Mahamadou Diallo Abdoul Kadri Moussa Layes Toure Kalifa Coulibaly Mamadou Bassirou traoré Cheick Oumar Sanogo terna traoré Mamadou Diallo Amadou Maiga Adégné Togo Service d’Orthopédie-Traumatologie CHU Gabriel Touré Bamako Mali Service d’Orthopédie-Traumatologie Etablissement Hospitalier Publique Sikasso Sikasso Mali Service d’orthopédie traumatologie CHU de Kati Kati Mali Service de Neurochirurgie CHU Gabriel Touré Bamako Mali Service de chirurgie générale CHU Gabriel Touré Bamako Mali

Traumatic epiphyseal detachment fractures of the distal end of the femur are a rare lesion whose severity is linked to disabling sequelae such as limb length inequality or most often axial deviation. In this report, surgical treatment aims to reconstruct the anatomy of the distal femur, to avoid secondary displacements and to allow early mobilization of the knee. Surgery carried out mainly by the technique of plugging in or screwing, opened or better still closed, can be a source of complications including migration of pins, infections, knee stiffness, and growth disorders. The aim of this work was to describe their epidemiological, anatomo-clinical, therapeutic and evolutionary aspects in the Department of Orthopedics-Traumatology at the CHU Gabriel TOURE. It was a retrospective study over 30 months from July 2019 to December 2021. In fact, it concerned 42 patients with traumatic epiphyseal detachment of the distal femur occurring within 21 days or less, on a healthy knee with cartilage fertile treated surgically and followed in the department. However, the diagnosis of traumatic epiphyseal detachment of the distal femur was retained thanks to the clinical examination and supplemented by radiographic images of the knee from the front and from the side. The treatment was surgical. The functional results were evaluated according to the functional criteria of the Eastern Orthopedic Traumatology Society (SOTEST). Forty-two patients included 32 boys and 10 girls of average age of 12 years with extremes of 8 years and 16 years. The lesions were classified according to the Salter Harris classification. We noted 24% type I (n = 10), type II 71% (n = 30), type III 2% (n = 1), type IV 2% (n = 1). Union was achieved in all patients within an average of 6 weeks with extremes of 4 and 12 weeks. The functional result was considered good in 20% of cases and very good in 80%. Traumatic epiphyseal detachment fractures of the distal end of the femur are a rare lesion whose severity

关键词： Epiphyseal Detachment Distal Femur Treatment Surgical

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Fracture of the Humeral Palette in Adult Patient: Therapeutic and Evolutive Aspect at Gabriel Touré Hospital: About 35 Cases

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Surgical Science 2023年第4期14卷 271-276页

作者： Mahamadou Diallo Abdoul Kadri Moussa Kalifa Coulibaly Layes Touré Mahamadou Dama Mamadou Bassirou traoré Cheick Oumar Sanogo terna traoré Famakan Doumbia Mamadou Diallo Amadou Maiga Adégné Pierre Togo Tiéman Coulibaly Service d’Orthopédie-Traumatologie CHU Gabriel Touré Bamako Mali

Introduction: Fractures of the humeral pallet occur between the distal insertion of the anterior brachial muscle and the joint space of the elbow. It represents 2% of all elbow fractures. These lower humeral fractures present a therapeutic challenge to trauma. These fractures are in the majority of joint cases and can be accompanied by loss of substance, which makes their functional prognosis random despite the application of the main therapeutic principles: exact reduction with possible bone graft;stable osteosynthesis, usually allowing early rehabilitation. This work focused on identifying therapeutic aspects and assessing treatment outcomes. Material and Methods: This was a descriptive cross-sectional study of patients with a fracture of the humeral palette from January 2015 to December 2019 at the Orthopaedic Trauma Department CHU Gabriel Touré Bamako. Results: We collected 35 cases of fractures of the humeral palette. The average age was 39.25 years with extremes of 22 and 74 years. The male gender predominated (71.4%) with a sex ratio of 2.5. Etiologies were dominated by falls with 19 cases (54.3%) and stroke with 13 cases (37.1%). The standard X-ray of the face and profile of the elbow was performed in all our patients. The most frequent types of anatomoradiology were supra condylar fractures type A in 16 cases (45.7%), supra and inter condylar fractures type C in 15 cases (42.9%);4 cases of uni condylar fractures type B (11.4%). Associated lesions were observed in 42.85%. Surgical treatment was performed in 80% of cases. Complications were dominated by elbow stiffness in 18 cases (51.42%), secondary displacement in 5 cases (14.28%), ossifications in 4 cases (11.42%). At an average decrease of 3.2 years our results were considered good in 45.7%. Conclusion: Fractures of the humeral palette are relatively common with associated lesions. The complexity of the fracture with associated lesions makes treatment difficult with unpredictable evolution.

关键词： Fracture Humeral Palette Anatomopathology Treatment Evolution Bamako Mali

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Surgical Management of Recent Traumatic Epiphyseal Fractures-Detachments of the Distal Femur at Gabriel Touré University Hospital

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Surgical Science 2023年第2期

作者： Mahamadou Diallo Abdoul Kadri Moussa Layes Toure Kalifa Coulibaly Mamadou Bassirou traoré Cheick Oumar Sanogo terna traoré Mamadou Diallo Amadou Maiga AdégnéTogo

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Fracture of the Humeral Palette in Adult Patient: Therapeutic and Evolutive Aspect at Gabriel Touré Hospital: About 35 Cases

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Surgical Science 2023年第4期

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Management of Subtalar Fractures-Dislocations at Ségou Hospital in Mali: A 7 Cases Series

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Surgical Science 2020年第4期11卷 51-60页

作者： Mahamadou Diallo Abdoul Kadri Moussa Layes Toure Louis traoré Cheick Oumar Sanogo terna traore Seydina Alioune Beye Abdrahamane Toure Making Mounkoro Mahamadou Kane Tiéman Coulibaly Orthopedic-Trauma Service Nianankoro Fomba Hospital Ségou Mali Orthopedic-Trauma Service Gabriel Touré Hospital Bamako Mali Orthopedic-Trauma Service Sikasso Hospital Sikasso Mali Orthopedic-Trauma Service Kati Hospital Kati Mali Anesthesia-Resuscitation Service Nianankoro Fomba Hospital Ségou Mali.

Introduction: Subtalar or peritalian dislocation is rare;it represents 15% of peritalian injuries. The aim of this study was to describe the radioclinical and therapeutic characteristics and to assess the functional result. Patients and Methods: This study is about a continuous descriptive and prospective study over a period of 5 years. It has been conducted from March 2013 to February 2018 at the Ségou Hospital, a second referral hospital in Mali. The functional results were evaluated by the score of the American Orthopedic Foot and Ankle Society (AOFAS). Results: Seven cases of subtalar dislocation fractures were diagnosed in six male patients with an average age of 38 years (36 to 47 years old). In five cases the etiology of the trauma was a motorcycle accident and a fall from height. The lesion was bilateral in one case. The average time to care was 3 hours (1 to 9 hours). There was one case of open dislocation fracture with talus enucleation. The dislocation was medial in 6 cases and lateral in one case. It was pure in three cases. The treatment was orthopedic in 2 cases and surgical in 5 cases. The post-operative complications were complicated by an infection of the operative site in one case. The average length of hospital stay was 4 days. The functional result was excellent in 2 cases;good in 2 cases, fair in 2 cases and poor for 1 case. Conclusion: Subtalar dislocation is a rare and serious lesion of the posterior tarsus. The long-term prognosis depends on the earliness of treatment and the severity of the associated injuries.

关键词： Fracture Dislocation Subtalar Prognosis Treatment

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Treatment of Pelvic Limb Fractures in a Hospital of 2^e Reference in Mali

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Surgical Science 2023年第5期14卷 347-354页

作者： Souleymane Diallo Sory Ibrahim Tambassi Bilal Bore terna traore Kalifa Coulibaly Laye Touré Ibrahima Djire Aboubacar Sidiki Sangare Salif Kone Drissa Kaloga Bagayogo Aboucar Diallo Souleymane Kone Mamadou Konaté Soumana traoré Cheick Oumar Sanogo Ahmadou Ibrahim Drame Abdoulaye G. Diarra Orthopedic Surgery and Traumatology Unit Tombouctou Hospital Tombouctou Mali Department of Orthopedic Surgery and Traumatology CHU BSS of Kati Kati Mali Department of Orthopedic Surgery and Traumatology Sikasso Hospital Sikasso Mali Department of Neurosurgery Mali Hospital Bamako Mali Department of Anesthesia and Resuscitation CHU Mère Enfant “Le Luxemburg” Bamako Mali Department of Surgical Hospital in Mopti Mopti Mali Department of Anesthesia and Resuscitation Mali Hospital Bamako Mali Department of General Surgery CHU of Kati Kati Mali

Introduction: A fracture is a solution in the continuity of a bone. Pelvic limb fractures may involve one or more of the bones. They constitute a real public health problem, which requires the identification of the factors inherent to this phenomenon for better prevention, but also for quality management of fractures and sequelae. Objectives: Were to describe the epidemiological, clinical and therapeutic profile of pelvic limb fractures in Timbuktu Hospital. Patients and Method: We conducted a prospective, descriptive study in the Surgery Department of Timbuktu Hospital, covering a period of one year from January 1 to December 31, 2017. We collected 39 patients who presented with fractures of the pelvic limbs, who were hospitalized and monitored throughout our study. Results: We obtained a hospital frequency of 2.86% limb fractures. Among the 39 patients included in our study, the male sex was predominant in 69.2% of cases, the average age of our patients was 20.5 years. Pupils and students were in the majority in 48.7% of cases. Road traffic accidents were the most common cause of fracture with 59.0% of cases. The tibia was the most affected segment in 38.5% of cases. Surgical treatment was predominant in 64.0% of cases. We obtained very good results in 94.87% of cases. Conclusion: Limb fractures remain frequent due to road traffic accidents. Osteosynthesis treatment provides a good result with fewer complications.

关键词： Fractures Pelvic Limb Surgical

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Surgical Treatment of Recent Traumatic Epiphyseal Detachments of the Distal Femur in the Orthopedic and Traumatological Surgery Department of the CHU Bocar Sidy Sall de Kati: About 20 Cases

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Surgical Science 2023年第5期14卷 338-346页

作者： Souleymane Diallo Sory Ibrahim Tambassi Kaly Tounkara terna traore Kalifa Coulibaly Aboubacar Diallo Soumana traore Aboubacar Sidiki Sangaré Salif Kone Drissa Kaloga Bagayoko Cheick Oumar Sanogo Department of Orthopedics and Traumatology CHU Pr Bocar Sidy Sall of Kati Kati Mali Department of Orthopedics and Traumatology Etablissement Public Hospitalier Sikasso Sikasso Mali Department of Anesthesia and Intensive Care University Hospital of Luxembourg Bamako Mali

Introduction: To our knowledge, no scientific study has been conducted at the university hospital of Kati on recent traumatic epiphyseal detachment fractures of the distal femur. However, every day, children present in consultation for knee trauma. Conjugal plate fractures are by definition single to children. Any break in any solution of continuity of this plate is called an epiphyseal fracture or detachment. Objectives: To evaluate the results of surgical treatment of traumatic epiphyseal in detachments of the distal femur recent in children and adolescents. Patients and Method: This was a 13-month prospectively collected longitudinal descriptive study from September 1, 2016 to September 30, 2017. We identified and reviewed 20 medical records of recent traumatic epiphyseal detachments of the distal femur. The parameters studied were sociodemographic, lesion, surgical technique and evolutionary. Results: During the study period, the most affected group age was 12 to 17 years (85%) with an average of 14.65 ± 1.61 years (6 and 20 years). The victims were male (95%). The most frequent etiology was road traffic accident (95%), with a mean time to care of 26.42 ± 10.21 hours and Type II was frequently encountered (85%) with 35% of immediate complications. Cross-bracketing was the most commonly used surgical technique (85%). The result was good (65%). Conclusion: This study allowed us to observe a significant hospital incidence of epiphyseal detachment fractures of the distal femur. Cross pinning was the most commonly used surgical technique with fewer complications (35%) and a satisfactory result in 90% of cases.

关键词： Fractures Epiphyseal Detachments Distal End of Femur Pinning

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Poor Reproducibility in the Evaluation of Paranasal Sinus X-Rays in Chronic Rhinosinusitis

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Open Journal of Radiology 2017年第1期7卷 23-34页

作者： A. Luukkainen E. terna J. Numminen A. Markkola P. Dastidar J. Jarnstedt H. Huhtala M. Karjalainen K. Blomgren P. Kauppi M. Rautiainen S. Toppila-Salmi Transplantation Laboratory Haartman Institute University of Helsinki Helsinki Finland Department of Otolaryngology Yong Loo Lin School of Medicine National University of Singapore Singapore Department of Ear and Oral Diseases Tampere University Hospital Tampere Finland University of Helsinki and HUS Imaging Helsinki Finland Medical Imaging Centre Department of Radiology Tampere University Hospital Tampere Finland School of Health Sciences University of Tampere Tampere Finland Department of Otorhinolaryngology University of Helsinki and Helsinki University Hospital Helsinki Finland Department of Allergy University of Helsinki and Helsinki University Hospital Helsinki Finland Department of Otorhinolaryngology University of Tampere Tampere Finland

Objective: The aim of this study was to evaluate intra- and inter-observer reproducibility of sinus x-rays in comparison to sinus computed tomography (CT) in chronic rhinosinusitis (CRS) patients. Methods: This was a prospective controlled study for which 14 adult CRS patients were recruited. Patients underwent a sinus multi-detector CT scan as well as additional sinus x-rays at the same time. Symptom interview and skin prick tests were performed. Lund-Mackay (LM) scores and 43 other findings in paranasal sinuses were analyzed by three blinded observers from CT-scans and x-rays. We compared agreement between sinus CT and x-rays (intra-observer reproducibility) and between three observers (inter-observer reproducibility) by Cohen’s kappa. Results: In at least 90% of the cases, the status of 47/49 structures was detectable in CT scans, whereas the status of only 8/49 structures was detectable in x-rays. The majority of the 25 visualized structures had poor intra-observer and inter-observer reproducibility. Conclusion: Only a few structures can be visualized in paranasal sinus x-rays and compared to paranasal sinus CT-scans, their reproducibility is poor. Our results strongly support the current consensus of radiation dose reduction by limiting the number of x-rays.

关键词： Sinusitis Paranasal Sinus Computed Tomography Magnetic Resonance Imaging X-Ray

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Treatment of Pelvic Limb Fractures in a Hospital of 2^e Reference in Mali

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Surgical Science 2023年第5期

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Surgical Treatment of Recent Traumatic Epiphyseal Detachments of the Distal Femur in the Orthopedic and Traumatological Surgery Department of the CHU Bocar Sidy Sall de Kati:About 20 Cases

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Surgical Science 2023年第5期

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