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Initial Treatment of Knee Dislocation at Yopougon Teaching Hospital/Abidjan, Ivory Coast

Open Journal of Orthopedics 2016年第11期6卷 337-343页

作者： Traoré Alidou kouassi Kouamé Jean Eric kouassi aya Adelaïde natacha Mbende Alban Slim Sie Essoh Jean Baptiste Bamba Insa Lambin Yves Trauma and Orthopaedics Department Yopougon Teaching Hospital Abidjan Ivory Coast Trauma and Orthopaedics Department Bouak&eacute Teaching Hospital Bouak&eacute Ivory Coast Neurosurgery Unit Yopougon Teaching Hospital Abidjan Ivory Coast

Knee dislocation is a serious and rare injury. Its rarity and the variety of injuries that result from it mean that there is no adequate management that is universally accepted. The aim of this study was to evaluate our emergency care strategy for these injuries. Materials and methodology: This was a retrospective study conducted from January 1992 to December 2004 on nine cases of knee dislocation. It consisted of six men and three women. The average age of these subjects was 35, ranging from 15 to 50 years. The causes for these injuries included: public road accidents (n = 4), household accidents (n = 3), a sporting accident and a dislocation that occurred following a fight. The dislocations were anteromedial (n = 4), posterolateral (n = 2), posterior (n = 2) and anterior (n = 1). Associated injuries were sore joint (n = 2), contusion of the common peroneal nerve (n = 1) and vascular injury (n = 1). An angiography was performed on one patient for a vascular injury and an Elecmyography (EMG) for a common peroneal nerve injury. Closed reduction was used for eight patients and open reduction for one patient. Results: Five knees were stable with normal range of motion and some residual pain. Four patients had knee instability;two anterior, one anteroposterior and one lateral. In three of these patients, the CT arthrography/arthro-scan confirmed central pivot damage, with meniscal damage in two of them. The four patients were referred to a knee surgeon in a private practice. The post-operational effects were minimal in vascular injury. The EMG performed for the common peroneal nerve detected a nerve contusion. Conclusion: Our emergency care strategy remains closed reduction. This therapeutic management is consistent, at least in the first 15 days, with the literature.

关键词： Knee Dislocation Initial Management Instability

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Triceps Brachii Tendon Reconstruction with V-Y Plasty: Indication and Functional Results of a Case at BouakéTeaching Hospital

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Open Journal of Orthopedics 2017年第12期7卷 396-399页

作者： Krah Koffi Léopold Sery Bada Léopold Kone Samba Digbeu Kévin Assere Arnaud kouassi aya natacha kouassi Eric M’Bra Innocent Yao Loukou Blaise Kodo Michel Traumatology and Orthopedics Surgery of the University Hospital of Bouaké Bouaké C&ocirc te d’Ivoire Traumatology and Orthopedics Surgery of the University Hospital of Abidjan Abidjan C&ocirc te d’Ivoire

Repair of an old lesion of the triceps brachii tendon is infrequent. A V-Y plasty was performed 4 years after the injury in an adult. Post traumatic osteoarthritis limits functional outcomes. The patient is satisfied.

关键词： Reconstruction Tendon Triceps Brachii

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Primary Abscess of the Psoas of the Child: About a Case Observed at the University Hospital Center of Bouake

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Open Journal of Pediatrics 2018年第2期8卷 154-157页

作者： Benie Adoubs Celestin Asse Kouadio Vincent Irie Bi Gohi Serge Kakou Aka Gerard Lohourou Grah Franck Traore Ibrahim kouassi aya Adelaide natacha Kpangni AhuaJean Bertrand Department of Pediatric Surgery University Hospital Center of BouakeBouakeIvory Coast Pediatric Department University Hospital Center of BouakeBouakeIvory Coast Anesthesia-Resuscitation Department University Hospital Center of BouakeBouakeIvory Coast Department of General and Digestive Surgery University Hospital Center of BouakeBouakeIvory Coast Department of Traumatology-Orthopedics University Hospital Center of BouakeBouakeIvory Coast

The primary abscess of the psoas of the child is a rare affection, the pathogenesis of which is still unexplained. The positive diagnosis of this condition is difficult and relies mainly on medical imaging. We report a case of primary psoas abscess in an immunocompetent child, whose diagnosis was facilitated by the provision of abdominal radiography without preparation and abdominal ultrasound. The evolution was favorable thanks to the combination of antibiotic therapy and surgery.

关键词： Primary Abscess of the Psoas Child Ultrasound Surgery

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Severe Musculoskeletal Injuries in Children during Play

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Open Journal of Orthopedics 2022年第11期12卷 393-399页

作者： Soumahoro Ibrahim Akobé Achié Jean Régis Krah Koffi Léopold kouassi Kouamé Jean-Eric Bénié Adoubs Célestin kouassi aya Adelaïde natacha Ochou Jr Pierre Germain Digbeu Ogou Kevin Elie Traoré Ibrahim Traoré Abdoul Massandjé Norah Soro Zolopégué Marcel Blé Gbalé Yannick Akpro Sédy Louess De Randolphe Kodo Michel Orthopaedics-Traumatology Department of the University Hospital of Bouaké (Cô te d’Ivoire)/Alassane Ouattara University Bouake Ivoiry Coast Paediatric Surgery Unit of the CHU of Bouaké (Cô te d’Ivoire)/Alassane Ouattara University Bouake Ivoiry Coast

Introduction: Musculoskeletal injuries are common in children but rarely severe. Their treatment varies according to the type of injury observed. The aim was to describe the epidemiological and therapeutic aspects of severe musculoskeletal injuries in children during play. Patients and Methods: This was a retrospective descriptive study conducted in the Orthopaedic-Traumatology Department and the Paediatric Surgery Unit of the University Hospital of Bouaké between January 2018 and December 2020. It concerned patients less than 16 years of age hospitalised for more than 24 hours for a musculoskeletal trauma following a gambling accident. The variables studied were epidemiological and therapeutic. Results: A total of 53 patients were collected. The frequency was 2.9%. The mean age was 9 ± 3.99 years. There were 38 (71.7%) boys and 15 (28.3%) girls. The sex ratio was 2.5. The patients were attending school in 79.3% (n = 42). The circumstances of occurrence were dominated by falls during play accidents (n = 35;66%). Football was observed in 93.5% (n = 49). The thoracic limb (n = 35;66%) was the preferred site of these injuries. The injuries were closed (86.7%) with a predominance of forearm fractures (n = 22;41.6%). The average hospital stay was 2.8 ± 1.4 days. Most of the patients were treated orthopedically (n = 37;69.9%). The evolution was favourable without complications. Conclusion: Musculoskeletal injuries during play were infrequent (2.9%). The circumstances were dominated by falls during play. The injuries were mainly closed fractures, most of which were treated orthopedically.

关键词： Children Fractures Musculoskeletal Trauma Orthopaedic Treatment

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Surgical Site Infections in Trauma and Orthopaedics at Bouaké Teaching Hospital (Côte d’Ivoire)

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Open Journal of Orthopedics 2024年第9期14卷 381-390页

作者： Loukou Blaise Yao Koffi Léopold Krah aya Adelaïde natacha kouassi Kouamé Innocent M’bra Kouamé Jean-Eric kouassi Michel Kodo Department of Trauma and Orthopaedics Bouak Teaching Hospital Bouak Cte dIvoire

Background: Surgical site infections are serious healthcare problems. The aim was to describe the epidemiological, diagnostic, therapeutic, and prognostic aspects of surgical site infections in Trauma and Orthopaedics at Bouaké Teaching Hospital. Method: This retrospective, descriptive, and analytical study was conducted from January 2019 to December 31, 2021. The data studied included prevalence, initial lesions, type of surgical intervention, type of SSI, bacteria involved, treatment, and outcomes. Results: Forty-four (11%) of the 399 patients included in the study developed a surgical site infection. The mean age was 27 years, with 36 male and 8 female. Initial lesions were predominantly open fractures (n = 31;70%), with a mean delay of 48 hours for surgical management. Emergency interventions accounted for 70% (n = 31) of cases. The NNISS infection risk score was 1 in 80% (n = 35) of cases. Superficial infections (n = 34;77%) appeared early, on a mean 6 days postoperatively. Bacteriological analysis primarily identified Pseudomonas aeruginosa (n = 10;23%), sensitive to Imipenem and Chloramphenicol but resistant to Amoxicillin-clavulanic acid, Ceftriaxone, Gentamicin, and Ciprofloxacin. Multidrug-resistant bacteria were found in 89% (n = 8) of cases, with all bacteria resistant to Ceftriaxone. Surgical revision was performed in 10 patients (23%), primarily involving debridement with hardware retention (n = 7;70%). Chloramphenicol was the most commonly used antibiotic post-antibiogram (61%). Outcomes were favourable in 98% of cases. Identified risk factors included the type of lesion according to NRC classification, the delay in managing open fractures, and the NNISS score. Conclusion: The prevalence of surgical site infection was 11%, favoured by the delayed operation of open fractures.

关键词： Surgical Site Infection Open Fractures Pseudomonas aeruginosa Ceftriaxone

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Fractures of Patella: Prospective Analysis of a Series of 51 Cases

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Open Journal of Orthopedics 2024年第11期14卷 535-546页

作者： Pierre Germain Ochou Jr Adélaïde aya natacha kouassi Achié Jean Régis Akobe Zolopegué Marcel Soro Ibrahim Soumahoro Koffi Léopold Krah Michel Kodo Surgical Department Regional Hospital of San-Pedro San-Pedro Ivoiry Coast Orthopeadics Traumatology Department University Hospital of Bouak (Alassane Ouattara University) Bouak Ivoiry Coast

Introduction: The patella is a key component of the knee’s extensor system. Fractures of the patella can be treated using a variety of methods. The objective of this study was to describe the epidemiological, anatomical-clinical, therapeutic and evolutionary aspects. Methods: This was a prospective, observational, analytic study conducted from January 2018 to December 2021. It concerned all patients over 15 years of age treated surgically for a patella fracture. The variables to be studied were epidemiological, anatomo-clinical, therapeutic and evolutionary. Statistical analysis was performed using the Chi-square test and Fisher’s exact test. Results: It concerned 51 cases. There were 39 men and 12 women. The average age was 35.13 years. The fracture was caused in 78.5% of cases by a road traffic accident. The main fracture was transverse (49.1%). Tension band technique predominated (92.1%). Complications included superficial suppuration (n = 7) and irritation of the material (n = 7). Mean time to consolidation was 66.39 days. Bösman scores were Excellent (n = 23;45.10%). Some patients presented osteoarthritic knee symptoms (n = 14;27.45%), and no pseudarthrosis. Conclusion: Patella fractures are rare. Surgical treatment gives good results, and the choice of method depends essentially on the anatomo-clinical characteristics of the fracture. Kinesitherapy is an essential and important weapon in functional recovery.

关键词： Patella Fracture Haubanage Patellectomy Kinesitherapy

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Peri-Operative Morbidity and Mortality of Elderly Patients in Traumatology-Orthopedics in Bouaké

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Open Journal of Orthopedics 2024年第11期14卷 524-534页

作者： aya Adélaïde natacha kouassi Achié Jean-Régis Akobe Loukou Blaise Yao Kouamé Innocent M’bra Zolopégué Marcel Soro Ibrahim Soumahoro Koffi Léopold Krah Michel Kodo Department of Trauma and Orthopaedics Bouak Teaching Hospital Bouak Cte dIvoire Surgery Department Alassane OUATTARA University Bouak Cte dIvoire

Introduction: Elderly subjects have physiological and clinical characteristics that make surgical management more complex and have a major impact on their prognosis. The primary objective of this study was to assess peri-operative hospital morbidity and mortality in the elderly. Secondary objectives were to identify factors predictive of death. Methods: This was a retrospective observational descriptive and analytical study carried out over 02 years, based on hospitalized patient records. It concerned patients aged 65 or over who had undergone surgery or for whom an indication for surgery had been given, all pathologies included. A total of 138 files were collected. The mean age was 74.15 years. Diabetes (n = 52;37.68%) and arterial hypertension (n = 38;27.54%) were the most common comorbidities. The reasons for hospitalization were mostly degenerative (n = 56;40.58%) and traumatic (n = 49;35.51%) pathologies. Preoperative delay, intraoperative and postoperative complications, hospital stay, evolution (mode of discharge), time of occurrence and presumed cause of death were studied. Univariate (p Results: The mean preoperative delay was 5.53 days (1 - 23). Intraoperative complications were mainly hemodynamic instability (n = 26, 18.8%). Postoperatively, the main complications were anemia (n = 62;48.44%) and glycemic imbalance (n = 28;21.86%). Average hospital stay was 13.4 days. Age (>75 years), the existence of comorbidities, degenerative pathologies, ASA score > 2, delay in treatment > 3 days, the occurrence of complications and the blood transfusion requirement were the independent predictors of the occurrence of death in the multifactorial analysis. Conclusion: Peri-operative morbidity in the elderly was influenced by age (>75 years), the existence of comorbidities, degenerative pathologies, ASA score > 2, time to treatment > 3 days, the occurrence of complications and the blood transfusion requirement.

关键词： Comorbidity Elderly Patient Mortality Surgery

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Predictive Factors of Functional Outcome of Open Fractures of the Foot at the Bouaké Hospital and University Center

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Open Journal of Orthopedics 2024年第11期14卷 510-523页

作者： Kouamé Innocent M’bra Achié Jean-Régis Akobe aya Adélaide natacha kouassi Ibrahim Soumahoro Loukou Blaise Yao Bada Justin Léopold Niaoré Sery Koffi Léopold Krah Michel Kodo Orthopaedics-Traumatology Department of the University Hospital of Bouak Ivoiry Coast (Alassane Ouattara University) Bouak Ivoiry Coast

The study evaluated functional outcomes of foot open fractures, finding satisfactory results in 89.6% of cases. It identified associated lesions, more than two fractures, and lack of rehabilitation as predictors of po... 详细信息

关键词： AOFAS-Open Fracture-Foot-Functional Outcome

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Recent Traumatic Dislocations of the Shoulder in Adults: Epidemiological, Therapeutic and Evolutionary Aspects

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Open Journal of Orthopedics 2023年第7期13卷 267-274页

作者： Inza Bamba Achié Jean-Régis Akobe Kouamé Jean-Eric kouassi Serge Amos Ekra aya natacha Adélaide kouassi Sédi Louess De Randolphe Akpro Ibrahim Soumahoro Zolopégué Marcel Soro Gbale Yannick Ble Koffi Léopold Krah Michel Kodo Traumatology and Orthopaedic Surgery Department of The University Hospital of Bouaké Alassane Ouattara University Bouaké C&ocircte d’Ivoire General Surgery Department of The University Hospital of Bouaké Alassane Ouattara University Bouaké C&ocircte d’Ivoire

Introduction: Shoulder dislocations represent about 50% of all joint dislocations. The objective was to describe the epidemiological, therapeutic and evolutionary aspects of traumatic shoulder dislocations in Bouaké. Methods: This retrospective and descriptive study was conducted between January 2017 and December 2019. It concerned patients over 15 years of age with a recent traumatic shoulder dislocation treated and followed in the department. The variables studied were epidemiological, therapeutic and evolutionary. The severity of the trauma was assessed according to the Injury Severity Score (ISS). Functional outcome was assessed according to the Constant score. Results: There were 49 patients (49 dislocations) out of 22,569 patients. The prevalence was 0.2%. The mean age was 32 years (17 - 62). There were 38 men (77.5%). The sex ratio was 3.4. Students predominated (n = 10;20.4%). The etiology was dominated by road traffic accidents (n = 19;38.8%). Anterior dislocation was the most common (n = 45;92%). The ISS score was minor (n = 46;93.8%). The mean time to reduction was 7 hours (4 - 16). Orthopaedic reduction using the Kocher technique predominated (n = 44;89.8%). The mean duration of external rotation immobilisation of the shoulder was 23 days (16 - 45). Recurrence occurred in 8 patients (21.6%). The functional outcome at a mean Constant follow-up of 15 months (8 - 20) was satisfactory (n = 44;89.8%). Conclusion: Traumatic dislocation of the shoulder represented 0.2%. Treatment was mainly orthopaedic. Recurrence was rare.

关键词： Adult Shoulder Anterior Dislocation Traumatic Orthopaedic Treatment

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Clinical Performances of Pure TB-Lamp Kit for <i>M. tuberculosis</i>Complex Detection in Sputum Samples

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Journal of Tuberculosis Research 2017年第2期5卷 129-138页

作者： kouassi N’guessan Jacob Adegbele Ibrahima Coulibaly natacha Kouame-N’takpé Hortense Seck-Angu André Guei Jacquemin Kouakou Mireille Dosso Laboratoire Nationale de Référence de la Tuberculose Institut Pasteur de C&ocirc te d’Ivoire Abidjan C&ocirc te d’Ivoire Centre Antituberculeux de Yopougon Abidjan C&ocirc te d’Ivoire Programme National de Lutte contre la Tuberculose Abidjan C&ocirc te d’Ivoire

Tuberculosis represents a main concern for public health worldwide. In poor countries, the most prevalent method for bacteriological confirmation re- mains Smear Sputum Microscopy (SSM). This study objective was to assess clinical performances of Loop Mediated Isothermal Amplification for TB detection (Lamp-TB). Sputum of patients presenting symptoms consistent with tuberculosis were collected according to the National Tuberculosis Control Programme guidelines in Centre Antituberculeux de Yopougon. SSM after Ziehl-Neelsen staining and TB-Lamp were blindly performed with spot sputum specimen. Samples, transported at Institut Pasteur de Cote d’Ivoire were decontaminated according to N-acetyl-L-cystein (NALC) method. In Mycobacteria Growth Indicator Tube (MGIT), 500 μl of pellet were inoculated and incubated in MGIT 960 instrument. MPT64 antigen was detected on positive culture. Of 500 patients enrolled, 469 were included. Clinical isolates of M. tuberculosis Complex were detected for 157 (33.5%). Comparatively to culture, Sensitivity and Specificity of SSM were 86% (95% Confidence interval (CI): 81% - 91%) 96% (95%IC: 94% - 98%) respectively. TB-Lamp Sensitivity was 92% (95%CI: 88% - 96%), and Specificity 94% (95%CI: 91% - 97%). Positive Predictive Value of SSM and TB-Lamp was 91.8% and 88.8% respectively. Negative Predictive Value of TB-Lamp assay was 95.7% whereas this of SSM was 93.3%. Positive Likelihood Ratio was 15.3 for TB-Lamp and 21.5 for SSM 21.5 whereas negative Likelihood of TB-Lamp was lower than SSM. Active tuberculosis was detected in162/469 (34.5%) with TB-Lamp and 147 (31.3%) with SSM. TB-Lamp assay performances estimated from sputum samples may improve detection of active TB cases in routine.

关键词： Tuberculosis Ziehl-Neelsen TB-Lamp Assay

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