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Study of the Akouedo Landfill (Abidjan) Using the Electrical Resistivity Method: Implications for the Risk of Contamination of the Continental Terminal Water Table

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Journal of Geoscience and Environment Protection 2023年第11期11卷 103-115页

作者： Ehui Beh Jean Constantin Aka Loukou Nicolas Kouame kouassi eric Germain Kouakou Department Earth Sciences and Mineral Resources Félix Houphou&#235t-Boigny University Abidjan C&#244te d’Ivoire Department of Biological Sciences Peleforo Gon Coulibaly University Korhogo C&#244te d’Ivoire

An electrical resistivity survey was carried out on the household and industrial waste disposal site (landfill) of Akouédo (Central Abidjan) with a view to searching for a possible layer of clay in the stratification which could constitute a protective screen of the aquifer of the Continental Terminal of Abidjan against the migration of leachate. Electrical surveys (SE) carried out according to the Schlumberger configuration showed that the stratigraphy of the area is composed of three to four geoelectric layers depending on the SE positions. The correlation with the lithology of two piezometric boreholes carried out indicates that the lithology of the study area is dominated by clayey sand, sand, sandy clay and clay. The average thickness of accumulated waste varies between 30 and 40 m. The virtual absence of a continuous layer of clay under the waste exposes the Continental Terminal aquifer to contamination by leachate from waste accumulated over several decades in the Akouedo area.

关键词： Landfill Continental Terminal Aquifer Electrical Sounding Akouédo Abidjan

Ankle Arthrodesis in the Treatment of Neglected Ankle Fractures

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Open Journal of Orthopedics 2022年第4期12卷 123-130页

作者： M’bra Kouamé Innocent Krah Koffi Leopold kouassi Kouamé Jean-eric Yao Loukou Blaise Akobé Jean Regis Achie Ochou Pierre Germain Jr Sery Bada Justin Léopold kouassi Aya Adélaïde Michel Kodo Traumatology and Orthopedics Surgery of the University Hospital of Bouaké Bouaké C&ocirc te d’Ivoire

Introduction: Neglected ankle fractures are common in our regions. Patients first consult traditional healers and it is when the signs persist that they consult the surgeon for a swollen and painful ankle. Initially we always performed anatomical repairs with osteosynthesis, but the majority of patients still complained of pain and disability. We wondered whether a primary arthrodesis would not be indicated in old ankle fractures to avoid disabling pain for patients. We therefore performed a series of arthrodesis on neglected post-traumatic ankles. The objective of our study was to describe the results of arthrodesis on an old post-traumatic ankle and to propose a therapeutic indication in the face of any neglected ankle fracture. Material and Method: This was a prospective study over 8 years between December 2012 and November 2020, involving 36 cases of neglected ankle fractures treated by arthrodesis using Meary’s technique. We used AOFAS (American Orthopedic Foot and Ankle Score) preoperatively and postoperatively for an objective assessment. Results: The average follow-up was 4.2 years and our results were satisfactory (94.4%) with an average AOFAS score ranging from 27.8 preoperatively to 76.7 postoperatively. The fusion rate was 97.2%. Discussion: Arthrodesis appears here as an important alternative in the treatment of neglected ankle fractures with significant trophic disorders.

关键词： Arthrodesis Ankle Neglected Fracture Osteosynthesis Traditional Healers

Repair of Complex Post-Traumatic Facial Dislocations: Indications, Therapeutic Difficulties and Results at Treichville University Hospital, Abidjan, Cote d’Ivoire

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Open Journal of Stomatology 2022年第11期12卷 337-345页

作者： A. M. R. E. Anzouan-Kacou Christophe Konan Allah Romaric Evrard Assi Yapo eric kouassi Zegbeh N’guessan Kouadio Emmanuel Konan Department of Maxillofacial Surgery and Stomatology Treichville University Hospital Abidjan Cote d’Ivoire Department of Reconstructive and Aesthetic Plastic Surgery Hand Surgery and Burns Treichville University Hospital Abidjan Cote d’Ivoire Department of Stomatology and Maxillo-Facial Surgery University of Bouaké Health Centre Bouaké Cote d’Ivoire

Introduction: Complex post-traumatic facial disfigurements are caused by civilian or ballistic trauma. Their repercussions are functional, aesthetic and psychological. The initial emergency or secondary management of facial damage is difficult. The objective is to report, through the clinical observation of three patients, the results of the management of complex facial dislocations in a context of limited technical resources. Patients and methods: Three complex post-traumatic facial dislocations were managed between May 2006 and June 2017. Results: Primary treatment and secondary repair were established on a case-by-case basis. Local autoplasty was the indication of choice. Multidisciplinary management resulted in satisfactory functional and cosmetic outcomes. Two of the patients were lost to follow-up before the end of treatment. Discussion: The complete management of facial dislocations remains difficult and complex, in an extreme exercise situation. In an emergency, the priority is to save the life of the injured person. Several factors are involved in the therapeutic decision: the choice of the maxillofacial reconstruction technique, the availability of the technical platform, the financial capacity and the psychological state of the patient and his entourage. Sequential and multidisciplinary treatment gives satisfactory results in terms of morphology, function and aesthetics, despite the limited technical resources available. Psychological support is an essential complement for successful socio-professional and family reintegration.

关键词： Dislocation Face Complex Difficulties Treatment

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

Management of Congenital Malformations of the Face in the GbèkèRegion (Côte d’Ivoire)

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Open Journal of Stomatology 2022年第5期12卷 166-174页

作者： eric kouassi Zegbeh-N’Guessan Rokiatou Kone Pornan Issa Jules Berete Ernest Martial Djemi Affoué Ba Diane Marina Amenou Tuo Karna Drissa Grébéret Emmanuel Crezoit Department of Odontology and Maxillofacial Surgery Bouaké University Hospital Bouaké C&ocirc te d’Ivoire Department of Stomatology and Maxillofacial Surgery Bamako University Hospital National Center of Odonto-Stomatology Bamako Mali

Background: Congenital malformations of the face are relatively frequent in the Gbèke region (Côte d’Ivoire). Objectives: Identify the epidemiological aspects, describe the management method, distinguish the anatomical-clinical aspects and identify the therapeutic methods and their results. Material and methods: A retrospective and descriptive study was carried out over a period of 8 years (2012-2019) in the Odontostomatology and Maxillofacial Surgery Department of the University Hospital Centre (Bouaké) and in the “Jean Baptiste Vatelot” religious hospital of Bouaké. The study concerned patients whose congenital malformations of the face had undergone primary surgery. Results: 439 patients were collected, i.e. an annual frequency of 54.88 cases per year. The sex ratio was 1.07 and the mean age was 6.82 years (range 5 months to 48 years). There were 434 (98.86%) cleft lips and palates and 5 (1.14%) Tessier’s clefts. Among the cleft lip and palate, there were 214 (49.31%) cleft lip, 127 (29.26%) cleft palate and 93 (21.43%) combined cleft lip and cleft palate. Surgical treatments numbered 532 and included 293 (55.08%) cheiloplasties, 113 (21.24%) pushback uranostaphyloraphies and 90 (16.92%) double flap palatoplasties. Complications were noted in 43 cases. Conclusion: Congenital malformations of the face were managed relatively late in the Gbèkè region with satisfactory results. Ante-natal diagnosis, early psychotherapy and a better screening system should allow an improvement of the management.

关键词： Congenital Malformation Face

Treatment of Neglected Elbow Dislocations by Z-Lengthening of the Triceps Brachii

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Open Journal of Orthopedics 2022年第4期12卷 142-152页

作者： M’Bra Kouamé Innocent kouassi Kouamé Jean-eric Yao Loukou Blaise AkobéJean Regis Achie Sery Bada Justin Léopold kouassiAya Adélaïde Natacha Krah Koffi Leopold Michel Kodo Traumatology and Orthopedics Surgery of the University Hospital of Bouaké Bouaké C&ocirc te d’Ivoire

Introduction: Neglected elbow dislocations are much more common in developing and underdeveloped countries. The main reason for the delay in diagnosis is that patients initially seek treatment from traditional healers. These will immobilize the elbow in extension, which will lead to the retraction of the triceps muscle and collateral ligaments. Patients and Method: We carried out a prospective study over five years (2014-2019). The study involved patients with unreduced elbow dislocation older than 21 days. All patients with a dislocated fracture and those whose x-ray showed joint fusion were not included in the study. We collected 26 patients, 20 men and 6 women with an average age of 27.5 years (17 and 45 years). The average consultation time was 8.9 months (3 - 13). The approach was posterior about 8 cm above the olecranon and 2 cm below the olecranon, the ulnar nerve was identified and isolated. The triceps tendon was cut in a Z from its myotendin junction to the beak of the olecranon, and then lengthened. Results: The patients were reviewed after a mean follow-up of 24 months (12 - 36). The Mayo Clinic’s average elbow performance index was 77.1 (60 - 85), with 19 good and 6 average results. The mean flexion was 114°(100°- 135°) and the mean extension deficit was 31.15°(10°- 55°). The average range of motion was 82.5°(60°- 120°). We did not find a correlation between the duration of the lesion and functional recovery (p > 0.05). The Wilcoxon test showed that surgery significantly improved the overall range of motion of the elbow (p = 0.001). Discussion: Based on this study, open reduction with tendon lengthening should remain a treatment option regardless of the age and chronicity of the dislocation.

关键词： Elbow Dislocation Neglected Triceps Plasty Posterior Approach

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

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

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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

Major Limb Amputation Secondary to Locally Advanced Cutaneous Squamous Cell Carcinoma in Tropical Environments: Determinants

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Open Journal of Orthopedics 2018年第4期8卷 139-147页

作者： kouassi Kouamé Jean eric Yao Loukou Blaise Sery Bada Justin Leopold Niaoré M’bra Kouamé Innocent Krah Koffi Léopold kouassi Aya Adelaide Nathacha Assere Yao Aboh Ganyn Robert Arnaud Kodo Michel Trauma and Orthopedics Department Bouake Teaching Hospital Bouake Ivory Coast

Objective: To identify the determinants of secondary limb amputation in advanced squamous cell carcinoma. Material and Methods: This was a retrospective study carried out in the Orthopedic Traumatology Department of the Bouaké University Hospital in Côte d’Ivoire from January 2013 to December 2016. It involved ten patients with locally advanced skin squamous cell carcinoma, confirmed by histology and having amputated limbs. The parameters studied were: demographic data (gender, age), socio-economic conditions (occupation, place of residence), the risk factors involved, the use of topical self-medication and the use of traditional medicine, antecedents and comorbidities factors, lifestyle, clinical aspects (seat, size), extension assessment (X-ray), anatomo-pathological examination data, duration of evolution of squamous cell carcinoma, the function of the affected limb, the treatment performed, the evolutionary modalities and the equipment. Results: Between 2013 and 2016, ten patients underwent either upper or lower limb amputations following locally advanced squamous cell carcinoma. The average age was 34.1 years (19 - 64 years). There were 7 men (70%) and 3 women (30%) and all our patients were black (sub-Saharan Africa). The majority of our patients were farmers (70%). The risk factors for squamous cell carcinoma were neglected chronic wounds. All our patients recognized during the interrogation a large use of the topicals of traditional medicine for the treatment of the initial cutaneous lesions. In terms of lifestyle, five (50%) were smokers and alcoholics. The mean time to progression of squamous cell carcinoma was 5.9 years. Lesions were localized preferentially to the pelvic limbs six (60%) cases and four (40%) to the limbs chest. The lesion was diagnosed late in all our patients. The size of the tumor in all our patients was greater than 5 cm and had a deep invasion (nerves, vessels and bone). The proximal ipsilateral ganglionic invasion was constant.

关键词： Amputation Squamous Cell Carcinoma Cutaneous Histology