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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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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

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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

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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

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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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Madelung’s Deformity: Reverse Wedge Osteotomy of the Distal Radius Associate Ulnar Wedge Osteotomy: A Case Report

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Open Journal of Orthopedics 2018年第2期8卷 33-38页

作者： kouassi kouamé jean eric Sery Bada Justin Leopoeld Niaoré Yao Loukou Blaise M’bra kouame Innocent Krah Koffi Léopold kouassi Aya Adelaide Nathacha Assere Yao Aboh Ganyn Robert Arnaud Kodo Michel Traumatology and Orthopedics Surgery of the University Hospital of Bouake Bouake Cote d’Ivoire

Madelung deformity is rare, accounting for 1.7% of congenital anomalies. The treatment is essentially surgical and several techniques have been described. We report the result of a case treated in an adult patient by ... 详细信息

关键词： Madelung Deformity Cuneiform Osteotomy Radius Ulna

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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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Osteoarticular Lesions of the Shoulder Girdle by Hippopotamus Bite: Highly Septic Lesion

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Open Journal of Orthopedics 2024年第2期14卷 114-121页

作者： Jr Pierre Germain Ochou Achié jean Régis Akobe Yao Aboh Ganyn Robert Arnaud Assere kouamé jean-eric kouassi Adelaïde Aya Natacha kouassi Ibrahim Soumahoro Zolopégué Marcel Soro Sédi Loues De Randolphe Akpro Gbalé Yannick Blé kouamé Innocent M’bra Loukou Blaise Yao Bada Juste Léopold NiaoréSery Koffi Léopold Krah Michel Kodo Department of Orthopaedic and Traumatological Surgery Bouaké University Hospital Bouaké Ivory Coast Raoul Follereau Institute Manikro Centre Bouaké Ivory Coast

Hippopotamus bites are rare in medical consultations, despite several studies exposing their aggressive character. A case of a hippopotamus bite on the shoulder of a fisherman has been reported. In addition to the osteoarticular aspect representing a therapeutic problem, the infectious aspect was marked by sepsis, with a death in less than 48 hours. Based on this observation, a protocol for the initial management of large animal bites was submitted.

关键词： Bite Hippopotamus Septic Shock

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Improvement of Rice Plant Root by Kaolin Application in Iron Toxicity Condition at Zoukougbeu (Central-West of Côte d’Ivoire)

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Open Journal of Soil Science 2024年第5期14卷 308-318页

作者： Sehi Zokagon Sylvain Konan kouassi Urbain Adechina Olayossimi Ouattara Amidou kouamé Firmin Bongoua jeanne Devisme Cherif Mamadou Brahima Koné Dé partement des Sciences et Techniques Universit&#233 Alassane Ouattara Bouak&#233 C&#244te d&#8217Ivoire Centre d’ Excellence Africain sur le Changement Climatique la Bidiversit&#233 et l&#8217Agriculture DurableUniversit&#233 F&#233lix Houphouet Boigny Abidjan C&#244te d&#8217Ivoire Dé partement Agriculture et Technologie Nouvelle Universit&#233 de San-Pedro San-Pedro C&#244te d'Ivoire Unité de Formation et de Recherche en Agroforesterie D&#233partement des Sciences de la Terre Universit&#233 Jean Lorougnon Gu&#233d&#233 de Daloa Daloa C&#244te d&#8217Ivoire Dé partement de Physiologie V&#233g&#233tale Universit&#233 Felix Houphouet Boigny Abidjan C&#244te d&#8217Ivoire Dé patartement des Sciences du sol Universit&#233 Felix Houphouet Boigny Abidjan C&#244te d&#8217Ivoire

In the tropics, lowland rice cultivation is often confronted with the problem of iron toxicity. The solution proposed by research in general is the use of industrial silicon. However, the high cost of industrial silicon limits its adoption by farmers. A study was carried out in Zakogbeu;Center-West of Côte d’Ivoire, to assess the potential of kaolin to mitigate the effect of this soil constraint on the root of the rice plant. Five kaolin-based treatments were analyzed (T0 = 0 kg kaolin ha−1, T1 = 366 kg kaolin ha−1, T2 = 736 kg kaolin ha−1, T3 = 1097 kg kaolin ha−1 and T4 = 1465 kg kaolin ha−1 are 0, 200, 400, 600 and 800 kg SiO2 ha−1) in a device in complete random blocks, with 5 repetitions. The results obtained show that kaolin supply increases the length of the root tissue as well as the number of branching of the root of the rice plant. Root tissue increased from 10 cm with T0 treatment to more than 15 cm with treatment T4. The microscopic observation of the roots shows that in the treatment T0, the roots present only primary ramifications and the tertiary and quaternary ramifications are observed with the treatments T3 and T4. The contribution of kaolin is an alternative to inhibit the effect of iron toxicity on the rice plant root development in iron toxicity condition.

关键词： Iron Toxicity Kaolin Root Rice Cote d’Ivoire

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Supervised Learning Method: Critical Analysis and Updating of Cubing Rate Formulas for Determining Bark Masses of Prunus africana (Hook. f.) Kalkman (Rosaceae) in Cameroon

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Open Journal of Forestry 2024年第3期14卷 346-368页

作者： Armand Ndedy Bile Alain Mpouam Benoit Fouadjio Lorette Guedeu Kambale Muhesi Steve Tassiamba Paulette kouam eric Wete Marius Ela Michèle Yimga Joseph Ambara Louis Aimé Fono jean Lagarde Betti Department of Plant Biology Faculty of Science The University of Douala Douala Cameroon Department of Wood and Forest Sciences ISABEE University of Bertoua Bertoua Cameroon Department of Water and Forests Higher Institute of Agronomic Veterinary and Forestry Studies of Butembo Butembo Democratic Republic of Congo Department of Forestry Faculty of Agronomy and Agricultural Sciences University of Dschang Dschang Cameroon Department of Biology and Plant Faculty of Sciences University of Maroua Maroua Cameroon Deutsche Gresellschaft fur Internationale Zusammenarbeit GmbH (GIZ) Bertoua Cameroon Department of Mathematics and Computer Science Faculty of Science The University of Douala Douala Cameroon

The stem barks of Prunus africana are used in the treatment of the benign prostate. Cameroon is one of the important exporters of the barks. Despite the important measures adopted in Cameroon for sustaining its harvesting, some many chalenges still remain. The objective of this work is to refine the forest management parameters in relation to P. africana in the regions of Adamaoua and the South-West by developing a volume rate which makes it possible to estimate the production for a new stem. The work took place in two phases: in the South-West in 2010 and in Adamaoua in 2011. Data collection used the semi-direct method, while the cubing equation was deduced by the multiple linear regression method. Two models for volume estimation and three models for mass prediction were developed. The predictive parameters retained are diameter, height of the bole and thickness of the bark. Results show that the average mass of the dry bark for a given P. africana tree species is 27.55 ± 14.44 kg and this varies according to the site. The strong adjusted coefficient of determination (adjusted R2) observed illustrates the reliability of the proposed models. These models provide a reliable tool that can be adopted as a standard in Cameroon for P. africana.

关键词： Prunus africana Prostate Quota Mass Model Sustainable Management

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