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Epidemiological and Clinical Pattern of open fractures of Long Bones of the Lower Limbs in the South-West Region of Cameroon: A 5-Year Review

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open Journal of Orthopedics 2021年第9期11卷 278-287页

作者： Chunteng T. Nana Fokam Pius Mokake N. Martin Morane Mbongnu Sam D. Movuh Freddy Mertens Bombah Ndasi Henry Palle J. Ngunde A. Chichom-Mefire Department of Surgery Faculty of Health Sciences University of Buea Buea Cameroon Departement of surgery Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon

Background: An open fracture is an injury in which the fracture site and/or hematoma communicates with the external environment. It is associated with significant morbidity and disability and is a challenge to the surgical team. The lower extremities are the most often exposed to traumatic injuries compared to other anatomical parts of the body. Patterns of open fractures differ with different mechanisms of injury and the segment of the long bone affected. The correct and timely management of open fractures is beneficial to the patients and leads to a more favorable outcome. This study aimed at describing the pattern of open fractures of long bones of the lower limb treated in 3 major hospitals of the south west region, Cameroon. Methodology: This was a hospital-based retrospective review of files of patients with open fractures of long bones of the lower limb managed at the surgical units of three secondary health facilities in the South-West region of Cameroon from the 1st of January 2015 to the 31st of December 2019. The socio-demographic characteristics, clinical presentation, treatment modalities, and outcomes were recorded. The data was stored and analyzed using Epi info version 7.0 and SPSS version 23.0 respectively. Results: A total of 195 files of patients aged 8 to 80 years were studied. The main age group affected was between 20 -

Outcome of application of primary versus secondary Illizarov＇s fixator in open tibial shaft fractures

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World Journal of Emergency Medicine 2016年第3期7卷 221-226页

作者： Anil Joshi Saurabh Singh Sudeep Jain Narender Rohilla Vivek Trikha Chandra Yadav Medical College V.C.S.G. Government Medical Sciences and Research Institute Srinagar Pauri Garhwal India H.N.B. Base & Teaching Hospital P O.-Srikot Srinagar Srinagar Garhwal Uttarakhand 246174 India Department of Orthopaedics IMS BHU Varanasi India Varanasi Uttar Pradesh 221005 India Fortis Flt Lt Rajah Dhall Hospital Ringgold Standard Institution Safdarjung Enclave New Delhi Delhi 110070 India Fortis Hospital Shalimar Bagh Ringgold Standard Institution Safdarjung Enclave New Delhi Delhi 110033 India Department of Orthopaedics All India Institute of Medical Sciences Ringgold Standard Institution New Delhi Delhi 110029 India

BACKGROUND: The present study aimed to compare outcome of primary and secondary Illizarov's fi xator application as a treatment method for type III open tibial fractures in terms of nonunion and wound infection.METHODS: This prospective study was done in a tertiary care center. Forty-eight type III tibial fractures were treated with Illizarov's apparatus between 2008 and 2011. The patients were divided into two groups depending on the treatment protocol, timing of wound closure and Illizarov's application, primary(n=28) and secondary(n=20).RESULTS: In the primary group, healing was achieved in all 28 patients. The median time to recovery was 24 weeks, and the median number of operations was 3. There were 6 patients with a bone defect. In the secondary group, complete recovery was achieved in 18 out of 20 patients. The median time to recovery was 30 weeks, and the median number of operations 5. There were 9 patients with a bone defect. The median time to recovery and the number of operations were signifi cantly smaller in patients undergoing primary operation. Union was 100% in the primary group and more than 95% in the secondary group. Chronic osteomyelitis persisted in one patient and below amputation was done in one patient in the secondary group.CONCLUSION: Primary wound closure and Illizarov's fixation required a smaller number of operations and shorter time to recovery than secondary wound closure and Illizarov's fi xation, mostly due to a signifi cantly less number of patients with a bone defect in the primary group.

关键词： open fractures Limb salvage Debridement Illizarov’s fi xator Tibial fractures

Physics of open fractures: Reconsidering Tissue Viability, Contamination Risk and Importance of Wound Debridement

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Journal of Applied Mathematics and Physics 2021年第1期9卷 176-182页

作者： Ahmed Abdelmoez Alsayed The Welsh Burn Centre for Burns & Plastic Surgery Morriston Hospital Swansea Bay University Health Board Swansea UK

Understanding basic physics behind open fractures leads to a better understanding of mechanism of injury, open fractures pathophysiology and management. Explaining local changes in viability of open fracture involved tissues, importance of debridement and reconsidering contamination risks will be ultimate objectives after going through this review. The controversy is still there between minimal/conservative debridement of open fracture wounds in favour of direct closure of soft tissue on the same session against generous debridement and delayed closure by more complicated choices on the reconstructive ladder to avoid infection, delayed healing, wound chronicity, limb loss and prolonged hospital stay. In the article, basic physics behind open fractures is highlighted to gain a deeper understanding of tissue viability changes and contamination risks after injury.

关键词： Physics open fractures High Energy Trauma Collision Stress Strain

Emergency Intramedullary Nailing in open Leg fractures: What Results?

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open Journal of Orthopedics 2020年第9期10卷 241-251页

作者： M. N. Dabiré J. Hien N. L. M. Ouedraogo S. C. Da H. Kafando M. Kaboré J. Simporé University Saint Thomas d’Aquin (USTA) Ouagadougou Burkina Faso Orthopaedics-Traumatology Department of the University Hospital Center Yalgado Ouédraogo (UHCYO) Ouagadougou Burkina Faso

Introduction: Leg fractures are the prerogative of violent trauma, which lead to pluritissular lesions, including the opening of the focus, thus worsening the prognosis. The indication of centromedullary nailing (CMN) is subject to time and trained team requirements. The aim of this work is to evaluate the results of CMN in emergency cases of open leg fractures in adults. Patients and Methods: This was a retrospective, descriptive and analytical study from January 1, 2014 to December 31, 2018. It concerned adult patients with an open leg fracture treated by CMN in emergency at the Orthopedics-Traumatology Department of the Yalgado Ouedraogo University Hospital. During five years, 91 patients were registered. Their average age was 34.1 years with a sex ratio of 2.2. The average admission time was 1 hour 41 minutes. Cauchoix and Duparc type I open fractures predominated (64.8%). Antibiotic therapy was instituted as soon as the patient arrived. The functional results of osteosynthesis were evaluated according to the Lysholm score after an average follow-up of 48 months. Results: The majority of our patients (51.3%) were operated on between the 6th and 18th hour. After careful trimming of the open fracture, CMN was performed in all our patients. The average hospital stay was six days. The mean Lysholm score was 87.23 ± 11.06 with a satisfactory functional result in 81.3% of cases. Discussion: The satisfactory results observed i

关键词： open fractures Nailing Leg

Therapeutic Strategies and Evolution in the Short Term: fractures by Firearms in Civilian Practice about 35 Operated Lesions

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外科学(英文) 2023年第10期14卷 618-625页

作者： Dikongue Dikongue Fred Mohamadou Guemse Hans Moevi Akue Bahebeck Jean Fondop Joseph Department of Surgery and Specialties Faculty of Medicine University of Dschang Dschang Cameroon Department of Surgery and Specialties Faculty of Medicine University of Yaoundé 1 Yaoundé Cameroon Faculty of Health Sciences of Cotonou University of Abomey Calavi National University Hospital Center of Cotonou Cotonou Benin Department of Morphological and Anatomopathological Sciences Faculty of Medicine University of Dschang Bafoussam Regional Hospital Dschang Cameroon

Fracture by firearms is a surgical emergency. The aim of our study was to report our experience in the management of open fractures by firearms and monitoring with a decline of 6 months the lesions observed in peacetime. This retrospective study over 3 years (January 2007-November 2010), supplemented by a prospective (December 2010-November 2011) is based on an analysis of operative reports and clinical records of patients admitted to the Yaoundé Central Hospital. 29 cases were selected, including 35 lesions were observed. Our series consists of 27 men and 2 women, mean age 30 years. 40% of our patients were initially supported (debridement) before the 6th hour and 51.42% between the 6th and 24th hours. In terms of internal fixation, these figures were 66% between the 25th and 96th hours. The type of material was used as the external fixate (64.9%). Conversion processing by the establishment of an internal hardware, after 3 - 6 weeks and control NFS (numeration of blood count or blood count), VS (rate of sedimentation), CRP (C reactive protein). Unfortunately this has been possible only in two cases because of financial means. In 40% of cases, surgical outcome was simple, and complications to a type of osteomyelitis, shortening, suppuration in 42.7% of cases.

关键词： open fractures Firearm Treatment Surgery Trauma Orthopedics Public Health Africa

Overview of Epidemiological and Etiological Amputation in Kisangani Democratic Republic of Congo (DRC)

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open Journal of Epidemiology 2016年第2期6卷 154-159页

作者： Lehumadi Talona Azabali Maoneo Toha Kuyigwa Basandja Ossinga Lokosa Lomodo Ona L. Ahuka Department of Surgery Medical School University of Kisangani Kisangani Democratic Republic of the Congo Department of Surgery Medical School Catholic University of Bukavu Bukavu Democratic Republic of the Congo Department of Internal Medicine Medical School University of Kisangani Kisangani Democratic Republic of the Congo University Clinics of Kisangani Kisangani Democratic Republic of the Congo

Background: Amputations and disarticulation of the limbs are becoming a public health problem. Goal: To describe the epidemiological and etiological aspects of limb amputation in Kisangani. Methods: A retrospective study of three health facilities in the city of Kisangani: Kisangani Clinical University, General Hospital Makiso-Kisangani Reference and Kabondo Reference General Hospital from 1st January 2005 to 31st December 2014 counted 62 cases of amputation. Results: The prevalence of 14.69% of all interventions of limbs. The age group of 57 - 75 years is the most concerned and the male/female sex ratio is 2.9/1. The unemployed are most affected 51.6%. The lower limb is concerned in 88.7%, including 30.6% in the lower leg and the right side is reached in 56.5% of cases. Diabetic gangrene (30.1%) is criminalized followed by traumatism (27.4%). The mortality rate is 17.8%. Conclusion: The amputation of limbs is a situation encountered in Kisangani. The adult male is most affected. Diabetic gangrene and open fractures are the most encountered causes. Mortality is high. The early management of diabetics and open fractures is a mandatory.

关键词： Amputation Diabetic Gangrene open fractures Kisangani

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