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Management of Open Leg Fractures at Zinder National hospital

Surgical Science 2025年第1期16卷 49-54页

作者： Abdou Taofik Moussa Souleymane Adoum Fils Abdoulaye Idrissa Abdoul Madjid Magagi Ibrahim Idé Garba Kané Kaka Mm Abdoul Wahab Allasane Mohamed Doutchi Mahamadou Habou Oumarou Adamou Harissou Faculty of Health Sciences Andr Salifou University Zinder Niger department of traumatology-orthopedics National Hospital of Zinder Zinder Niger department of traumatology-orthopedics National Hospital of Niamey Niamey Niger department of general surgery National Hospital of Zinder Zinder Niger department of Infectious Diseases National Hospital of Zinder Zinder Niger department of Pediatric surgery National Hospital of Zinder Zinder Niger

Introduction: Open leg fracture is a diaphyseal or metaphyseal, extra-articular fracture of one or both leg bones, with communication between the fracture site and the external environment. To provide a broader context, studies conducted globally have highlighted the significance of understanding open leg fractures due to their complex management and potential complications. Previous research in Africa and Europe provides comparative data that emphasizes regional differences in fracture types, causes, and treatment outcomes. This study aims to contribute to improving the management of theses fractures in Niger. Materials and Methods: This was a prospective, descriptive study carried out in the traumatology-orthopedics department of the Zinder National hospital, Niger, from December 8, 2020 to June 8, 2022 (18 months). We included all patients over 15 years of age in whom an open leg fracture was diagnosed and managed. Inclusion criteria focused on patients aged over 15 years with confirmed diagnoses of open leg fractures. Results: Over an 18-month period, the frequency of open leg fractures was 16.28%. There was a predominance of males (85.93% or n = 116). The average age of patients was 31.79 years. Road accidents were the primary circumstance of occurrence (93.33% or n = 126). The fracture line was simple in 74 patients (54.81%) and complex in 61 cases (45.19%). Surgically, the external fixator was used in 78 cases (57.80%). Postoperative follow-up was mostly straightforward. The main complications were infection (4 cases) and delayed consolidation (4 cases). Conclusion: Open leg fractures in adults are frequent at Zinder National hospital. Public road accidents were the main cause of occurrence. An external fixator osteosynthesis was the most commonly used surgical option. These findings have important implications for healthcare policy, particularly in improving trauma care infrastructure and road safety initiatives in Niger. Future studies should prioritize the

关键词： Open Fracture Leg HNZ

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Spinal Cord Injuries without Visible Bone Lesions: Analysis of Four Consecutive Cases

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Open Journal of orthopedics 2018年第3期8卷 95-101页

作者： Magatte Gaye Sarah Ntshindj Mutomb Amadou Ndiasse Kasse N’famara Sylla Sagar Diop Alvin Nah Doe Aboubacar Sidiki Sangharé Mouhamadou Habib Sy Youssoupha Sakho department of Neurosurgery Grand-Yoff General Hospital Dakar Senegal department of orthopedics and trauma surgery Grand-Yoff General Hospital Dakar Senegal

Objectives: Interest of this study is to report four cases of spinal cord injuries without bone lesion. Evolution of the injured patients according to the initial clinic assessment at admission and the treatment performed are discussed. Materials and Methods: From January to December 2016, we performed a retrospective study at the Neurosurgery department of hospital general grand yoff of Dakar. Four patients were followed for spinal cord injury without visible bone lesions. We analyzed the clinical, radiological, therapeutic and evolutionary data. trauma caused by stabbing was excluded. Results: In a year, 83 cases of spinal trauma with neurological deficit were hospitalized in the department. Among them, 4 had spinal cord injuries without visible bone lesions. The average age was 31.7 years with extremes ranging from 14 to 47 years. The sex ratio of male/female was 3. We have recorded 2 cases of road traffic accidents, 1 case of fall from height and 1 case of sports accident. On the neurological level, we found 3 cases of tetraplegia, and 1 brachial monoplegia. Computed tomography in all patients was normal. All of them benefited from magnetic resonance imaging that showed spinal cord injury. All patients were under conservative treatment. One patient fully recovered, two partially and one passed away. Conclusion: In presence of any post traumatic myelopathy case, the absence of disco-vertebral lesions should bring to mind the SCIWORA as well as indicate the realization of magnetic resonance imaging.

关键词： Spinal Cord Injuries trauma MRI

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Threatened Aortic Injury by Thoracic Pedicle Screw: A Case Report

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Open Journal of orthopedics 2018年第2期8卷 51-56页

作者： Amadou Ndiassé Kassé Souleymane Diao Magatte Gaye Jean Claude Sané Jean Marie Vianey Hope Karim Hemmam Babacar Thiam Pape Adama Dieng Mouhamadou Habib Sy orthopedics and trauma surgery department of grand-yoff general hospital Dakar Sénégal Neurosurgery department of grand-yoff general hospital Dakar Sénégal Thoracic and Vascular surgery department of FANN University Teaching hospital Dakar Sénégal

Iatrogenic vascular injury during posterior spinal surgery is a rare but potentially serious complication with treatment challenges. We report the case of threatened aortic injury by pedicle screw impingement during posterior fixation of thoracic spine T7 - T8 fracture dislocation. The removal of the conflicting screws was done posteriorly after a visual control of the absence of adventitious break-in by a thoracotomy.

关键词： Thoracic Spine Pedicle Screw Aorta Thoracotomy

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Aligned fibers enhance nerve guide conduits when bridging peripheral nerve defects focused on early repair stage

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Neural Regeneration Research 2019年第5期14卷 903-912页

作者： Qi Quan Hao-Ye Meng Biao Chang Guang-Bo Liu Xiao-Qing Cheng He Tang Yu Wang Jiang Peng Qing Zhao Shi-Bi Lu department of Orthopedic surgery Key Laboratory of Musculoskeletal Trauma & War Injuries PLA Beijing Key Lab of Regenerative Medicine in Orthopedics Chinese PLA General Hospital School of Materials Science and Engineering University of Science & Technology Beijing department of Laser Medicine Chinese PLA General Hospital Neural Regeneration Co-innovation Center of Jiangsu Province department of Orthopedic surgery First Affiliated Hospital of PLA General Hospital

Nerve conduits enhance nerve regeneration in the repair of long-distance peripheral nerve defects. To help optimize the effectiveness of nerve conduits for nerve repair, we developed a multi-step electrospinning process for constructing nerve guide conduits with aligned nanofibers. The alignment of the nerve guide conduits was characterized by scanning electron microscopy and fast Fourier transform. The mechanical performance of the nerve guide conduits was assessed by testing for tensile strength and compression resistance. The biological performance of the aligned fibers was examined using Schwann cells, PC12 cells and dorsal root ganglia in vitro. Immunohistochemistry was performed for the Schwann cell marker S100 and for the neurofilament protein NF200 in PC12 cells and dorsal root ganglia. In the in vivo experiment, a 1.5-cm defect model of the right sciatic nerve in adult female Sprague-Dawley rats was produced and bridged with an aligned nerve guide conduit. Hematoxylin-eosin staining and immunohistochemistry were used to observe the expression of ATF3 and cleaved caspase-3 in the regenerating matrix. The recovery of motor function was evaluated using the static sciatic nerve index. The number of myelinated fibers, axon diameter, fiber diameter, and myelin thickness in the distal nerve were observed by electron microscopy. Gastrocnemius muscle mass ratio was also determined. The analyses revealed that aligned nanofiber nerve guide conduits have good mechanical properties and can induce Schwann cells, PC12 cells and dorsal root ganglia to aggregate along the length of the nanofibers, and promote the growth of longer axons in the latter two(neuronal) cell types. The aligned fiber nerve conduits increased the expression of ATF3 and cleaved caspase-3 at the middle of the regenerative matrix and at the distal nerve segment, improved sciatic nerve function, increased muscle mass of the gastrocnemius muscle, and enhanced recovery of distal nerve ultrastructure. Coll

关键词： nerve regeneration nerve guide conduit electrospinning peripheral nerve injury aligned fiber sciatic nerve structure mechanical function nerve scaffold nanofiber neural regeneration

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Recalcitrant distal humeral non-union following previous Leiomyosarcoma excision treated with retainment of a radiated non-angiogenic segment augmented with 20 cm free fibula composite graft: A case report

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World Journal of orthopedics 2019年第4期10卷 212-218页

作者： Martin Gathen Grayson Norris Simon Kay Peter V Giannoudis department of orthopedics and trauma surgery University Hospital of Bonn Academic department of trauma and Orthopaedics School of Medicine University of Leeds Plastic and Reconstructive surgery School of Medicine University of Leeds

BACKGROUND Leiomyosacromas in the Extremities are rare malignant smooth muscle *** radiation therapy, in combination with wide surgical excision allows the best chance of treatment. During the follow up pathological fractures are common complications that can be accompanied by Implant failure and defect situations that are most challenging in their *** SUMMARY We present a case of a 52-year-old female suffering from a pathological fracture of the humeral shaft 10 yr after resection of a Leiomyosarcoma and postoperative radiotherapy. She developed implant failure after retrograde nailing and another failure after revision to double plate fixation. In a two-stage revision, the implants were removed and the huge segmental defect created after debridement was bridged by a compound osteosynthesis with nancy nails and bone cement for formation of the induced membrane. Due to the previous radiotherapy treatment,20 cm of the humeral shaft were declared devascularized but were left in situ as a scaffold. In the second stage, a vascularized fibula graft was used in combination with a double plate fixation and autologous spongiosa grafts for final *** This combinatory treatment approach led to a successful clinical outcome and can be considered in similar challenging cases.

关键词： Humerus Fibular graft Bone tumor Osseous defect Implant failure Leiomyosarcoma Case report

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Temporal changes in the spinal cord transcriptome after peripheral nerve injury

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Neural Regeneration Research 2020年第7期15卷 1360-1367页

作者： Jian Weng Dong-Dong Li Bao-Guo Jiang Xiao-Feng Yin department of orthopedics and trauma Peking University People's HospitalBeijingChina department of Bone&Joint surgery Peking University Shenzhen HospitalShenzhenGuangdong ProvinceChina department of surgery the 517th Hospital of the People's Liberation ArmyXinzhouShanxi ProvinceChina

Peripheral nerve injury may trigger changes in mRNA levels in the spinal *** key mRNAs is important for improving repair after nerve *** study aimed to investigate changes in mRNAs in the spinal cord following sciatic nerve injury by transcriptomic *** left sciatic nerve denervation model was established in C57 BL/6 *** left L4–6 spinal cord segment was obtained at 0,1,2,4 and 8 weeks after severing the sciatic *** expression profiles were generated by RNA *** sequencing results of spinal cord mRNA at 1,2,4,and 8 weeks after severing the sciatic nerve were compared with those at 0 weeks by bioinformatic *** identified 1915 differentially expressed mRNAs in the spinal cord,of which 4,1909,and 2 were differentially expressed at 1,4,and 8 weeks after sciatic nerve injury,*** results indicated that the number of differentially expressed mRNAs in the spinal cord was highest at 4 weeks after sciatic nerve *** mRNAs were associated with the cellular response to lipid,ATP metabolism,energy coupled proton transmembrane transport,nuclear transcription factor complex,vacuolar proton-transporting V-type ATPase complex,inner mitochondrial membrane protein complex,tau protein binding,NADH dehydrogenase activity and hydrogen ion transmembrane transporter *** these mRNAs,Sgk1,Neurturin and Gpnmb took part in cell growth and *** analysis showed that these mRNAs were mainly involved in aldosterone-regulated sodium reabsorption,oxidative phosphorylation and collecting duct acid *** assessment indicated that these mRNAs were associated with inflammation and cell morphology *** findings show that the number and type of spinal cord mRNAs involved in changes at different time points after peripheral nerve injury were *** number of differentially expressed mRNAs in the spinal cord was highest at 4 weeks after sciatic nerve *** results

关键词： deep sequencing expression profile gene therapy mRNAs nerve regeneration peripheral nerve injury RNA sequencing sciatic nerve injury spinal cord transcriptome

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Reduction of postoperative bleeding following operative treatment of proximal humerus fractures using a collagen sponge

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Health 2010年第12期2卷 1421-1424页

作者： Sylvia Doleschal Thomas Schmickal Alexander Schuh department of trauma surgery Neumarkt Hospital Research Unit orthopedics and general surgery Neumarkt Hospital

Aim of the present study is to investigate the efficacy and safety of TachoSil? to reduce afterbleeding and hematoma following operative treatment of proximal humerus fractures. In a prospective randomized study we included a consecutive series of 40 patients with a proximal humeral fracture in this study. All fractures were stabilized surgically with a fixed-angle “Philos plate” from May 2008 through May 2009. All patients were divided in two groups: Group I with plate osteosynthesis without TachoSil, Group II with plate osteosynthesis with TachoSil. For statistical analysis Chi2- Test and U- Test were used. There were 4 perioperative complica- tions in group II and one complication in group I (Chi2-Test: p=0.233). In group II one hardware failure occurred due to osteoporosis requiring revision and reosteosynthesis. Another patient suffered from paralysis of the radial nerve which healed uneventfully. One superficial postopera-tive infection and one superficial hematoma re-quired revision surgery, too. In this group no subfascial hematoma developed. One subfascial hematoma which required no revision occurred in group I. Blood transfusion was required 2 times in group I and 3 times in group II (Chi2-Test: p = 0.549). In sum in group II there was a sig-nificant lower blood loss for the subfascial drain, the region where TachoSil was applied. No ad-verse affects related to TachoSil could be de-tected. TachoSil was found to be safe and effective for reduction of postoperative bleeding following operative treatment of proximal hume-rus fractures. Further studies with larger sample size are required to confirm the efficacy of TachoSil? in orthopedic surgery.

关键词： Hematoma TachoSil Proximal Humerus Fracture Plate Osteosynthesis Reduction

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Ruxolitinib improves the inflammatory microenvironment,restores glutamate homeostasis,and promotes functional recovery after spinal cord injury

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Neural Regeneration Research 2024年第11期19卷 2499-2512页

作者： Jiang Cao Xiao Yu Jingcheng Liu Jiaju Fu Binyu Wang Chaoqin Wu Sheng Zhang Hongtao Chen Zi Wang Yinyang Xu Tao Sui Jie Chang Xiaojian Cao department of orthopedics The First Affiliated Hospital of Nanjing Medical UniversityNanjingJiangsu ProvinceChina department of trauma surgery Subei People’s Hospital of JiangsuClinical Medical College of Yangzhou UniversityYangzhouJiangsu ProvinceChina department of orthopedics Zhongda HospitalSoutheast UniversityNanjingJiangsu ProvinceChina department of Orthopedic surgery Nanjing Drum Tower HospitalThe Affiliated Hospital of Medical School of Nanjing UniversityNanjingJiangsu ProvinceChina

The inflammatory microenvironment and neurotoxicity can hinder neuronal regeneration and functional recovery after spinal cord ***,a JAK-STAT inhibitor,exhibits effectiveness in autoimmune diseases,arthritis,and managing inflammatory cytokine *** studies have shown the neuroprotective potential of ruxolitinib in neurological trauma,the exact mechanism by which it enhances functional recovery after spinal cord injury,particularly its effect on astrocytes,remains *** address this gap,we established a mouse model of T10 spinal cord contusion and found that ruxolitinib effectively improved hindlimb motor function and reduced the area of spinal cord *** sequencing analysis showed that ruxolitinib alleviated inflammation and immune response after spinal cord injury,restored EAAT2 expression,reduced glutamate levels,and alleviated excitatory ***,ruxolitinib inhibited the phosphorylation of JAK2 and STAT3 in the injured spinal cord and decreased the phosphorylation level of nuclear factor kappa-B and the expression of inflammatory factors interleukin-1β,interleukin-6,and tumor necrosis factor-α.Additionally,in glutamate-induced excitotoxicity astrocytes,ruxolitinib restored EAAT2 expression and increased glutamate uptake by inhibiting the activation of STAT3,thereby reducing glutamate-induced neurotoxicity,calcium influx,oxidative stress,and cell apoptosis,and increasing the complexity of dendritic ***,these results indicate that ruxolitinib restores glutamate homeostasis by rescuing the expression of EAAT2 in astrocytes,reduces neurotoxicity,and effectively alleviates inflammatory and immune responses after spinal cord injury,thereby promoting functional recovery after spinal cord injury.

关键词： astrocytes EAAT2 excitotoxicity glutamate homeostasis JAK-STAT pathway locomotor function neurotoxicity ruxolitinib spinal cord injury transcriptome analysis

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Qian-Zheng-San promotes regeneration after sciatic nerve crush injury in rats

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Neural Regeneration Research 2019年第4期14卷 683-691页

作者： Zhi-Yong Wang Li-Hua Qin Wei-Guang Zhang Pei-Xun Zhang Bao-Guo Jiang department of Anatomy and Histo-embryology School of Basic Medical Sciences Peking University department of trauma and orthopedics Peking University People's Hospital

Qian-Zheng-San, a traditional Chinese prescription consisting of Typhonii Rhizoma, Bombyx Batryticatus, Scorpio, has been found to play an active therapeutic role in central nervous system diseases. However, it is unclear whether Qian-Zheng-San has therapeutic value for peripheral nerve injury. Therefore, we used Sprague-Dawley rats to investigate this. A sciatic nerve crush injury model was induced by clamping the right sciatic nerve. Subsequently, rats in the treatment group were administered 2 mL Qian-Zheng-San(1.75 g/mL) daily as systemic therapy for 1, 2, 4, or 8 weeks. Rats in the control group were not administered Qian-Zheng-San. Rats in sham group did not undergo surgery and systemic therapy. Footprint analysis was used to assess nerve motor function. Electrophysiological experiments were used to detect nerve conduction function. Immunofluorescence staining was used to assess axon counts and morphological analysis. Immunohistochemical staining was used to observe myelin regeneration of the sciatic nerve and the number of motoneurons in the anterior horn of the spinal cord. At 2 and 4 weeks postoperatively, the sciatic nerve function index, nerve conduction velocity, the number of distant regenerated axons and the axon diameter of the sciatic nerve increased in the Qian-Zheng-San treatment group compared with the control group. At 2 weeks postoperatively, nerve fiber diameter, myelin thickness, and the number of motor neurons in the lumbar spinal cord anterior horn increased in the Qian-Zheng-San treatment group compared with the control group. These results indicate that QianZheng-San has a positive effect on peripheral nerve regeneration.

关键词： nerve regeneration traditional Chinese medicine crush injury peripheral nerve regeneration nerve conduction velocity sciatic function index nerve injury nerve repair formula scorpion neural regeneration

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Long-term results of an anatomically implanted hip arthroplasty with a short stem prosthesis (MiniHip^(TM))

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World Journal of orthopedics 2018年第10期9卷 210-219页

作者： Lars V von Engelhardt Andreas Breil-Wirth Christian Kothny Jorn Bengt Seeger Christian Grasselli Joerg Jerosch Faculty of Health University of Witten/Herdecke department of trauma surgery orthopedics and Sports Medicine Katholisches Karl-Leisner Klinikum department of orthopedics Trauma Surgery and Sports MedicineJohanna Etienne Hospital Munich Ortho Center department of Orthopaedics and Orthopaedic surgery University Hospital Giessen and Marburg department of Orthopaedics and traumatology Waldburg-Zeil Clinic Tettnang

AIM To evaluate the clinical and radiological outcome nineand ten years after short-stemmed, bone preserving and anatomical hip arthroplasty with the MiniHip^(TM) system. METHODS In a prospective study, 186 patients underwent hip arthroplasty with a partial neck preserving short stem(MiniHip^(TM), Corin). Elderly patients were not excluded from this study, thus the mean age at the time of surgery was 59.3 years(range 32 to 82 years). surgery and the follow-up assessments were performed at two Centers. Up until now, the mean follow-up was 112.5 ± 8.2 mo. The Oxford Hip Score(OHS) and the Hip Dysfunction Osteoarthritis and Outcome Score(HOOS) was assessed pre-and each year after surgery. The clinical follow-up was accompanied by standardized a.p. and axial radiological examinations. Periprosthetic lucencies, hypertrophies within the Gruen zones one to fourteen were assessed. A subsidence of the stem was investigated according to Morray and heterotopic ossifications were assessed according to *** The OHS and HOOS improved from 18 ± 3.3 to 46 ± 2.0 and from 30 ± 8.3 to 95 ± 4.6 points, P 0.05). Two stems were revised due to a symptomatic subsidence four and twelve months postoperatively. Thus, the survivorship for aseptic loosening at nine to ten years was 98.66%. Including one stem revision due to a symptomatic exostosis, bursitis and thigh pain as well as one revision because of a septic stem loosening, the overall survival for the stem with revision for any reason was 97.32%. Besides one asymptomatic patient, radiological signs of a proximal stress-shielding, such as bone resorptions within the proximal Gruen zones, were not noticed. Findings suggesting a distal loading, e.g., bony hypertrophies or bone appositions of more than 2 mm, were also not detected. CONCLUSION Regarding these first long-term results on the MiniHip^(TM), the implant performed excee

关键词： Primary hip arthroplasty Long-term results Short stem endoprothesis Prospective follow-up study Stress-shielding

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