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Fracture of the Humeral Palette in Adult Patient: Therapeutic and Evolutive Aspect at Gabriel Touré Hospital: About 35 Cases

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Surgical Science 2023年第4期14卷 271-276页

作者： Mahamadou diallo Abdoul Kadri Moussa Kalifa Coulibaly Layes Touré Mahamadou dama Mamadou Bassirou Traoré Cheick Oumar Sanogo Terna Traoré Famakan doumbia Mamadou diallo Amadou Maiga Adégné Pierre Togo Tiéman Coulibaly service d’orthopédie-traumatologie CHU Gabriel Touré Bamako Mali

Introduction: Fractures of the humeral pallet occur between the distal insertion of the anterior brachial muscle and the joint space of the elbow. It represents 2% of all elbow fractures. These lower humeral fractures present a therapeutic challenge to trauma. These fractures are in the majority of joint cases and can be accompanied by loss of substance, which makes their functional prognosis random despite the application of the main therapeutic principles: exact reduction with possible bone graft;stable osteosynthesis, usually allowing early rehabilitation. This work focused on identifying therapeutic aspects and assessing treatment outcomes. Material and Methods: This was a descriptive cross-sectional study of patients with a fracture of the humeral palette from January 2015 to december 2019 at the orthopaedic Trauma department CHU Gabriel Touré Bamako. Results: We collected 35 cases of fractures of the humeral palette. The average age was 39.25 years with extremes of 22 and 74 years. The male gender predominated (71.4%) with a sex ratio of 2.5. Etiologies were dominated by falls with 19 cases (54.3%) and stroke with 13 cases (37.1%). The standard X-ray of the face and profile of the elbow was performed in all our patients. The most frequent types of anatomoradiology were supra condylar fractures type A in 16 cases (45.7%), supra and inter condylar fractures type C in 15 cases (42.9%);4 cases of uni condylar fractures type B (11.4%). Associated lesions were observed in 42.85%. Surgical treatment was performed in 80% of cases. Complications were dominated by elbow stiffness in 18 cases (51.42%), secondary displacement in 5 cases (14.28%), ossifications in 4 cases (11.42%). At an average decrease of 3.2 years our results were considered good in 45.7%. Conclusion: Fractures of the humeral palette are relatively common with associated lesions. The complexity of the fracture with associated lesions makes treatment difficult with unpredictable evolution.

关键词： Fracture Humeral Palette Anatomopathology Treatment Evolution Bamako Mali

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Inveterate Posterior Shoulder dislocation Treated by Sub-Scapular Transfer, about One Case

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Open Journal of orthopedics 2017年第10期7卷 301-307页

作者： Koné Samba dogba Eric Kouassi Adélaide Ledion Anicet Adibo Godefroi Ote Pacome Be Jeancis Bana Abdoulaye Touré Stanislas Agoh Serge service de traumatologie orthopédie CHU de Cocody Abidjan Cote d’Ivoire service de traumatologie orthopédie CHU de Bouaké Bouaké Cote d’Ivoire

Glena-humeral dislocation is rare. More than the half of those dislocations is unremarked because the diagnostic is not an emergency. A delayed diagnostic alters the functional prognostic and sometimes forces to do a complex surgery with complications whose success rate remains uncertain. We report a case of inveterate posterior shoulder dislocation on a 42-year-old adult occurred during a sport accident and treated by sub-scapulars transfer (modified Mac Laughlin’s technical). The aim of this article is to highlight this pathology to ameliorate its diagnostic rate indeed prognostic. Our diagnostic approach and injury, noticed during surgery and therapeutic propositions, are described at the light of literature data on this subject.

关键词： Inveterate Posterior Shoulder dislocation

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Clinical Case of Bilateral Rupture of the Patellar Tendon of the Late diagnosis

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Open Journal of orthopedics 2017年第9期7卷 235-240页

作者： Koné Samba dogba Eric Nguianbanda Léandre Kouassi Adélaide Ledion Anicet Krah Léopold Bana Abdoulaye Touré Stanislas Agoh Serge service de traumatologie orthopédie CHU de Cocody Abidjan C&ocirc te d'Ivoire service de traumatologie orthopédie Hô pital des Instructions des Armées (HIA-OBO) Libreville Gabon service de traumatologie orthopédie CHU de Bouaké Bouaké C&ocirc te d'Ivoire

defined as a continuity solution on the muscular-osseous-tendinous chain of the knee, ensuring the extension of the leg on the thigh, the traumatic rupture of the knee’s extensor apparatus is often reported in literature. They are dominated by patellar fractures. The patellar or quadricipital tendon damage is rare and even exceptional in a bilateral topography. The aim of this work was to highlight the clinical case of bilateral rupture of the patellar tendon of late diagnosis, occurring in an adult with a particular field. It was an adult, who presented a bilateral rupture of the knee extensor apparatus following a minimal traumatism. Anamnesis found a chronic kidney disease correctly follow-up. The diagnosis was delayed so was the surgical management (Krackow’s technique and protection by a metallic frame). At 8 months post surgery the functional result is acceptable. The bilateral rupture of the patellar tendon stays a rare pathologic entity, which always seems associated at a particular field. The diagnosis delay (and so did the care) is an important bad prognosis factor. Treatment of this old form (unknown) is exclusively surgical.

关键词： Knee Extensor Apparatus Bilateral Late

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Surgical Management of Recent Traumatic Epiphyseal Fractures-detachments of the distal Femur at Gabriel TouréUniversity Hospital

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Surgical Science 2023年第2期14卷 61-71页

作者： Mahamadou diallo Abdoul Kadri Moussa Layes Toure Kalifa Coulibaly Mamadou Bassirou Traoré Cheick Oumar Sanogo Terna Traoré Mamadou diallo Amadou Maiga Adégné Togo service d’orthopédie-traumatologie CHU Gabriel Touré Bamako Mali service d’orthopédie-traumatologie Etablissement Hospitalier Publique Sikasso Sikasso Mali service d’orthopédie traumatologie CHU de Kati Kati Mali service de Neurochirurgie CHU Gabriel Touré Bamako Mali service de chirurgie générale CHU Gabriel Touré Bamako Mali

Traumatic epiphyseal detachment fractures of the distal end of the femur are a rare lesion whose severity is linked to disabling sequelae such as limb length inequality or most often axial deviation. In this report, surgical treatment aims to reconstruct the anatomy of the distal femur, to avoid secondary displacements and to allow early mobilization of the knee. Surgery carried out mainly by the technique of plugging in or screwing, opened or better still closed, can be a source of complications including migration of pins, infections, knee stiffness, and growth disorders. The aim of this work was to describe their epidemiological, anatomo-clinical, therapeutic and evolutionary aspects in the department of orthopedics-Traumatology at the CHU Gabriel TOURE. It was a retrospective study over 30 months from July 2019 to december 2021. In fact, it concerned 42 patients with traumatic epiphyseal detachment of the distal femur occurring within 21 days or less, on a healthy knee with cartilage fertile treated surgically and followed in the department. However, the diagnosis of traumatic epiphyseal detachment of the distal femur was retained thanks to the clinical examination and supplemented by radiographic images of the knee from the front and from the side. The treatment was surgical. The functional results were evaluated according to the functional criteria of the Eastern orthopedic Traumatology Society (SOTEST). Forty-two patients included 32 boys and 10 girls of average age of 12 years with extremes of 8 years and 16 years. The lesions were classified according to the Salter Harris classification. We noted 24% type I (n = 10), type II 71% (n = 30), type III 2% (n = 1), type IV 2% (n = 1). Union was achieved in all patients within an average of 6 weeks with extremes of 4 and 12 weeks. The functional result was considered good in 20% of cases and very good in 80%. Traumatic epiphyseal detachment fractures of the distal end of the femur are a rare lesion whose severity

关键词： Epiphyseal detachment distal Femur Treatment Surgical

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Traumatic Closed Floating Kneecap: Clinical Case about Traumatic Bipolar Tendon Rupture of Extensor Knee System

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Open Journal of orthopedics 2019年第8期9卷 159-164页

作者： Koné Sam Pemboura dom Eric dogba Akué Koffi Abdoulaye Bana Serge Agoh service de traumatologie-orthopédie CHU de Cocody-Abidjan Abidjan Cote D’Ivoire

The simultaneous traumatic rupture of the patellar tendon and the quadricipital tendon is a rare lesion entity. We report the case of a bipolar rupture of the extensor knee system in a young adult following sports traumatism. Magnetic Resonance Imaging allowed the assessment of associated lesions. The management of this “floating” kneecap was surgical associated with rehabilitation. A functional assessment at 02 years of follow-up was performed. The functional prognosis is related on the one hand to the difficulties of positioning of the patella and on the other hand to the associated lesions (meniscus-ligamentous knee injuries).

关键词： Rupture Bipolar Extensor Knee System

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Epdemiology and Treatment of Pseudarthrosis of Long Bones in the Servce d orthopedics-Traumatology of the University Hospital of donka

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Open Journal of orthopedics 2024年第3期14卷 133-138页

作者： Camara Nouhou Mangué diallo Mamadou Moustapha Moustapha Alhassane diallo Alpha Mamadou Fela Sidimé Sory Camara Abdoulaye Kolié Germain Lamah Léopold service d’orthopédie-traumatologie Centre Hospitalier Universitaire de Donka Conakry Republic of Guinea

Introduction: Pseudarthrosis (PSA) of the diaphysis of long bones still remains a current problem, despite improvements in the treatment of these fractures. Our study aims to study the epidemiological and therapeutic aspects of PSA of the diaphysis of long bones. Method: This retrospective work concerns 30 cases of non-union of the diaphysis of long bones treated in the orthopedic and trauma surgery department at donka National Hospital, during a period of 18 months from January 1, 2019 to June 30, 2020. Results: We recruited 30 patients, 80% of whom were male, with an average age of 39.9 years. Public road accidents (AVP) represented the main cause of fractures of the diaphysis of long bones 87%, they were open in 25 cases or 83%. The fractures were located in the middle 1/3 of the diaphysis of the long bones in 50% of cases. Treatment of initial fractures was traditional in 21 cases, orthopedic in 2 cases and surgical in 7 cases. It was aseptic nonunion in 28 cases (93%) and septic nonunion in 2 cases. They were hypertrophic in 7 cases, slightly hypertrophic in 5 cases, oligotrophic in 11 cases, atrophic in 6 cases and with bone defect in 1 case. The treatment was based on osteosynthesis including 16 cases of screwed “PV” plate: 7 cases of centromedullary “ECM” nailing, 2 cases of external fixator, 1 case of broaching and 4 cases of Plastering. The results according to ASAMI criteria on an anatomical level were excellent in 19 cases, good in 3 cases and poor in 3 cases, with a union rate of 76%. And 5 patients undergoing consolidation. Conclusion: Based on the literature data and the experience of our department, the true treatment of PSA requires correct management of the initial fracture without forgetting the interest in preventing AVP which appears to be an element essential, making it possible to reduce the incidence of fractures of the diaphysis.

关键词： Pseudarthrosis Aseptic-Septic-diaphysis Long Bones Screwed Plate Intramedullary Nailing Bone Graft Osteo-Muscular decortication

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Evaluation of the Surgical Treatment of Patella Fractures in 17 Cases in the orthopedic-Traumatology department of the University Hospital Center of donka, Republic of Guinea

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Open Journal of orthopedics 2023年第9期13卷 391-396页

作者： Abdoulaye Camara Abdoul Karim Balde Nouhou Mangué Camara Léopold Lamah Mamadou Moustapha diallo Alhassane Barry Fatoumata Camara Ibrahima Marie Camara service d’orthopédie-traumatologie du Centre Hospitalier Universitaire de donka Conakry Republic of Guinea

Objectives: To determine the epidemiological, therapeutic and evolutionary aspects. Methodology: This was a retrospective study, from January 1, 2016 to december 31, 2018, on the files of patients aged 16 and over, admitted for patella fractures, treated surgically and followed up in our service. Results: The study involved 17 patients including 15 men (88.24%) and 02 women (11.76%) with an average age of 36.65 years. Workers were the most represented (29.42%);AVP were the leading cause of these fractures (52.94%). The fractures were open in 70.58% of cases. Associated lesions were dominated by femur fractures in 29.42%. duparc type II was the most encountered bone lesion with 47.06% of cases. All our patients benefited from regional anesthesia. Bracing was the most used surgical treatment in 58.83%;the anterior approach was performed in all our patients. Four (04) cases of knee stiffness, two (02) postoperative infections and skin necrosis complicated the short and medium term consequences. After a two-year follow-up, radiologically one case of pseudarthrosis and one case of patellofemoral osteoarthritis were noted. According to the Bosman score, we found 17.65% excellent, 47.06% good and 35.29% poor functional results. Conclusion: Patella fractures are relatively rare. Treatment is primarily surgical for transverse and/or displaced fractures;Bracing is the osteosynthesis technique of choice. However, knee stiffness, pseudarthrosis and patellofemoral osteoarthritis are not uncommon.

关键词： Fractures Patella Bracing Patellofemoral Osteoarthritis

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TRAITEMENT dES FRACTURES dE L’OLECRANE PAR SUTURE PERCUTANEE

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Journal of Shanghai Second Medical University 1988年第1期 43-49页

作者：马元璋郑纯波陈正中周泰仁 Institut Institut de Recherches sur la traumatologie et l’orthopédie de Shanghai. service de traumatologie et d’orthopédie H(?)pital Ruijin SSMU Shanghai

The authors devised a method of percutaneous suture for treating fracture of olecranon. There are two operative technics for percutaneous suture: one is the suture through two skin holes and another the suture through four skin holes. 40 cases of fracture of olecranon were resorted to the method of percutaneous suture. Suture with steel wire through two skin holes was used in 3 cases and suture with steel wire through four skin holes in 37 cases. Most of the fractures had satisfactory reduction and all the fractures healed well. 33 cases had been followed for more than one year, the late results were excellent in 20, good in 8, fair in 4 and poor in 1. The operative technic of the percutaneous suture is simple and less traumatic to the local tissues. The late functional recovery is not inferior to that of open reduction with internal fixation.

关键词： olecranon fracture percutaneous suture

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Challenges of Total Arthroplasty for Neglected Fracture-dislocations of the Hip

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Open Journal of orthopedics 2023年第10期13卷 421-426页

作者： Papa Amadou Ba Souleymane diao Chérif Sadibou djiba service d’orthopédie-traumatologie H&ocircpital d’Instruction des Armées Principal Dakar Senegal service d’orthopédie-traumatologie H&ocircpital Général de Grand-Yoff Dakar Senegal

This study examined neglected hip fracture-dislocations in developing countries, focusing on five cases in dakar. The research adopted a prospective method, assessing epidemiological, clinical, radiological, and therapeutic aspects, utilizing the Postel Merle d’Aubigné scoring system for functional assessment. Results demonstrated that total joint replacement surgery, predominantly following traffic accidents, significantly improved mobility and reduced limb length disparity, with most patients achieving independent walking post-operation. The study concludes that early diagnosis and total hip arthroplasty are critical for optimal outcomes.

关键词： Arthroplasty Hip Neglected Fracture-Luxation

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Kahler’s disease with a Rare Clinical form and Review of Literature

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Open Journal of orthopedics 2018年第2期8卷 39-45页

作者： R. d. Gogoua d. G. Gogoua M. Kaba Maitre de Conférence Agrégé Service d’Orthopédie Traumatologie Abidjan Ivory Coast

Kahler’s disease or “multiple myeloma” is a cancerous disease of the bone marrow. It may appear straightaway in its multiple myeloma form or in the form of solitary bone plasmacytoma or extra bone plasmacytoma. In the extra bone form, its orbital location as the first symptom is exceptional. Our case concerned a 49-year-old female patient without significant medical history who was followed for 6 months for a voluminous left exophthalmos. This ocular symptomatology was accompanied six months after by acute bone pains in the spine and pelvis then by a pathological fracture of the left trochanter. Histological assessment during the treatment showed the diagnosis of Kahler’s disease. The serum calcium was 106 mmol/l, a blood level of chloride to 96 mmol/l, of potassium to 5.36 mmol/l, of sodium to 136 mmol/l. The 24-hour proteinuria was 0.30 g/l and indicated renal impairment. The patient had anemia with a hemoglobin level to 8.8 g/l. Tumor markers were normal;in particular the CA was 13.148, ACE-2 to 1.013 ng/ml and CA19-9 to 5.029 IU/ml. The patient was transferred to a specialized unit but died before the start of treatment. Thus any isolated exophthalmos or accompanied by bone signs must systematically suggest Kahler’s disease and make undertake investigations in this direction. It is on this condition that an early management of the disease can improve the prognosis of the disease and prolong the patient’s life.

关键词： Kahler’s disease Plasmacytoma Orbital Location of

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