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Surgical Science 2024年第7期15卷 438-443页

作者： marc leroy guifo Albert Desiré Atangana Fouda Faustin Atemkeng Tsatedem Emini Ngono Mengale Ntang Ulrich Bisay Souhe Ginette Kalla Faculty of Medicine and Biomedical Sciences University of Yaound 1 Yaound Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Ebolowa Ebolowa Cameroon

Femoral neck fracture is classically a traumatic pathology in the elderly but it can also occur in young people during a road traffic accident or occasionally when the femoral neck has been weakened by a pathological process. In sickle cell patients, the hip is often subjected to aseptic necrosis. The authors report the case of the child NL, aged 5 years and 4 months in whom a fracture of the femoral neck classified Delbet 3 was found as well as his sickle cell status discovered and in whom treatment by surgical abstention was carried out with a favorable evolution. This association of factors of the femoral head necrosis or nonunion is unusual and confirms the osteogenetic potential of a child. However, monitoring is necessary because other anomalies may reveal themselves.

关键词： Sickle Cell Disease Fracture Femoral Neck Osteomyelitis

Clinical Epidemiology and Surgical Treatment of Spontaneous Perforations of the Terminal Ileum: A Multicentre Study in Cameroon

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Surgical Science 2024年第5期15卷 311-320页

作者： Eric Patrick Savom Richard II Mbele Mahamat Yannick Ekani Boukar Abdal Deudeu Cédric Paterson Atangana Fred Dikongue Dikongue Guy Aristide Bang marc leroy guifo Yaoundé General Hospital Yaound&#233 Cameroon Faculty of Medicine and Biomedical Sciences of the University of Yaoundé I Yaoundé Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences of the University of Dschang Dschang Cameroon Yaoundé Teaching Hospital Yaoundé Cameroon

Background: Perforations of the terminal ileum are a frequent clinical situation and a therapeutic challenge. Surgical treatment is controversial. Several surgical modalities have been proposed and postoperative morbidity and mortality remain high. The aim of this study was to review our experience in the surgical management of perforations of the terminal ileum. Patients and methods: This is a descriptive cross-sectional study with retrospective data collection from January 1, 2017 to December 31, 2021, in five hospitals in Cameroon. Patients’ demographic, clinical presentation, surgical findings and 30-days postoperative outcomes data were collected. Results: We collected 34 files. The sex ratio was 1.4 and the average age was 20.28 years. The average consultation time was 9.1 days. Abdominal pain was present in all our patients. Peritoneal irritation was present in 46 cases (88.5%). The mean time to treatment after admission was 17.5 hours. The perforation was unique in 40 cases (76.9%) and located between 6 and 10 cm from the ileocecal valve in 29 cases (55.8%). Typhoid was the most suspected etiology intraoperatively in 38 cases (73.1%). A simple suture was performed in 18 patients (34.6%), resection with anastomosis in 11 patients (21.2%) and an ileostomy in 5 patients (9.6%). The average length of hospitalization was 21.74 days. Postoperative morbidity and mortality were 32.7% and 17.3% respectively. Conclusion: Perforations of the terminal ileum are common and affect young people. Surgical procedures are varied. Reducing consultation and care times and respecting treatment principles could improve postoperative morbidity and mortality, which remain high.

关键词： Perforation of the Terminal Ileum Simple Suture Resection Morbidity Mortality

Thoracic Spinal Cord Stab Injury: A Case Report and Literature Review

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Open Journal of Modern Neurosurgery 2015年第4期5卷 113-117页

作者： Aurélien Ndoumbe marc leroy guifo Mathieu Motah Samuel Takongmo Faculty of Medicine & Pharmaceutical Sciences University of Douala Douala Cameroon Faculty of Medicine & Biomedical Sciences University of Yaoundé I CHU of Yaoundé Yaoundé Cameroon Faculty of Medicine & Pharmaceutical Sciences University of Douala Douala General Hospital Douala Cameroon

Thoracic spinal cord stab injuries are rare lesions. A 17-year-old boy was stabbed on his back by his classmate when he bent forward to pick up his cloth from the ground. On admission, he presented with: complete paraplegia with muscle strength of zero on all muscle groups, complete anesthesia from dermatome 10 and below, acute urinary retention, and a four-centimeter wound on the thoracolumbar region from which cerebrospinal fluid mixed with blood was oozing out. A high-dose methylprednisolone protocol was started (30 mg/kg in one hour and then 5.4 mg/kg over 23 hours) an indwelling urinary catheter placed and sterile dressing of the wound done. Antibiotics and analgesics were also administered. The computed tomography scanning revealed a spinal cord transection at T10-T11 level with incarceration of the broken knife blade. An emergency thoracic laminectomy was performed. Removal of the broken knife blade revealed complete spinal cord transection with a compressive hematoma within the spinal cord which was removed by smooth suction. The spinal dura was sutured and the wound closed in many layers. On day 14 after surgery, sensitivity was recovered with 3 on 5 muscle strength in both lower limbs except for both feet where motor function remained null. Urinary retention and fecal incontinence persisted. The patient was discharged from our service for a rehabilitation center. At 32-month follow-up, neurological examination was unchanged although patient noticed a slight improvement of sphincter disturbances.

关键词： Spinal Cord Injury Thoracic Spine Stab Wound Knife Seventeen-Year-Old Boy

Potential Association between Anterior Cruciate Ligament Tear and “Bi-Collateral” Ligamentous Rupture: A Retrospective Study

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Open Journal of Radiology 2015年第4期5卷 217-223页

作者： Jean Roger Moulion Tapouh Boniface Moifo Cathy Monabang Zoé marc leroy guifo Haoua Tebere Annick Laure Edzimbi Samuel Nko’o Amvene Department of Radiology and Radiation Oncology Faculty of Medicine and Biomedical Sciences (FMBS) The University of Yaoundé I Yaounde Cameroon Yaounde Gynaeco-Obstetric and Pediatric Hospital (YGOPH) Yaounde Cameroon Yaounde University Teaching Hospital Yaounde Cameroon Department of Surgery and Sub-Specialties (FMBS) Yaounde Cameroon

Background: Anterior cruciate ligament (ACL) tears are common complications of knee trauma. This entity can be reliably diagnosed by Magnetic Resonance Imaging. There is a lack of data on the epidemiology of ACL tears in Sub-Saharan Africa. The aim of this study is to describe the radiological aspects of post traumatic ACL tears in a black African setting (Yaounde Teaching Hospital). Methods: ninety six (96) MR studies of the knee were retrospectively reviewed. They were realized on a low field device (0.2T) from July 2012 to December 2013. All the examinations were indicated for knee trauma. Ligamentous, meniscal, bony and joint lesions were sought on coronal and sagittal sections. Results: the sample consists of 70% (68/96) of men. The mean age is 35.36 ± 11.86 years. The prevalence of ACL tears is 45.8% (44/96) of which 36 (81.81%, 36/44) are total tears. 23 (24%) have associated meniscal lesion and 8 (8.3%) have a simultaneous damage of the collateral ligaments. The most frequently injured part of the meniscus is its posterior horn (12/23 cases). Meniscal and “bi-collateral” ligament injuries are independently associated to ACL tears. Conclusion: The prevalence of ACL tears at the Yaounde Teaching Hospital is 45.8%. It is independently associated to meniscal tears and concomitant injury of the tibial and fibular collateral ligaments.

关键词： Anterior Cruciate Ligament Magnetic Resonance Imaging Meniscal Tears Knee Trauma

Chronic Lymphoedema and Bone Infarction: Rare Complications of Multiple Segmental Fractures of the Lower Limb in a Young Adult

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Open Journal of Orthopedics 2022年第3期12卷 79-84页

作者： Ngo Yamben Marie-Ange Nana Chunteng Theophile Nseme Etouckey Eric Muluem Kennedy Olivier Tsiagadigui Tsiagadigui Jean Gustave Ndongo Mvela Laurent Stephane Manga Alexandre guifo marc leroy Faculty of Medecine and Biomedical Sciences Department of Surgery and Specialities University of Yaounde 1 Yaounde Cameroon National Center of Rehabilitation of Disabilities Persons Yaounde Cameroon Faculty of Health Sciences Department of Surgery University of Buea Buea Cameroon Teaching Hospital of Yaounde Yaounde Cameroun

Multiple segmental fractures of the lower limbs, common in developing countries, are the prerogative of Road Traffic Accidents (RTA) involving two-wheeled vehicles. Their management is difficult, associated with complications, and is most often based on a two-stage strategy: Damage Control Orthopaedics, followed by delayed internal osteosynthesis. The aim is to allow early functional rehabilitation and rapid recovery of patients. We report the case of a 39-year-old man, bike rider, after his RTA, presented with segmental homolateral fractures of the femur and two bones of the left leg. Short-term evolution was marked by the appearance of significant lymphedema and bone infarctions of the lower left limb necessitating a transfemoral amputation. Through this observation, the authors highlight the problems related to the complexity of the management of multiple segmental fractures of the lower limb by emphasizing two post-traumatic complications rarely described but to be feared: chronic lymphedema and bone infarction.

关键词： Lymphœdema Multiple Fractures Bone Infarction Amputation Damage Control Orthopaedic