Symphyseal dissection results from high-energy trauma and usually occurs in poly trauma context. The treatment is only orthopedic in our department. The aim of this work was to study the current therapeutic aspects ma...Symphyseal dissection results from high-energy trauma and usually occurs in poly trauma context. The treatment is only orthopedic in our department. The aim of this work was to study the current therapeutic aspects management of the disjunction of the pubic symphysis in the department of ortho-traumatology of CHU Gabriel Touré of Bamako MALI. This was a prospective and analytical study;from 1 July 2021 to 30 June 2022, within 15 patients classified according to Young and Burgess, with a functional evaluation according to Majeed and a minimum follow-up of 4 months. We report symphyseal disconnections accounted for 20.83% of the traumas of the pelvic ring, and 1.84% of patients hospitalized for fracture in the department during the period of the study. We noted a predominance of gender male in 87% of cases with a ratio of 2.75 and the average age in our series was 32 years, with extremes ranging from 18 to 63 and a SD of 13.96. The most common etiologies are APR with 66.7% and traditional mine slide cases with 20%, and the anteroposterior compression mechanism is most frequently encountered at 73.3%. The APCI types: 20%, APCII: 40% and VC: 20% of the Young and Burgess classification are the most found. The treatment of these patients was surgical in 53% cases by locked screw plate. The surgical approach of Pfannenstiel was preferred to the ilio-inguinal of Judet. Non-surgical treatment by trans-osseous traction and the wearing of a pelvic belt was recommended for cases of stable disjunction or severe associated lesions. The average length of stay is 17.27 days with extremes of 5 and 34 days. The functional assessment according to Majeed allowed us to classify 73.3% of patients’ cases as excellent, showing a good socio-professional reintegration. Symphyseal disjunction is a rare pathology but of serious functional consequences, regardless of the therapeutic method good management allows to minimize these functional sequelae.展开更多
Introduction: Traumatic hip dislocation associated with femur fracture is a rare and complex injury that occurs in the context of multiple trauma. Public road accidents represent more than 64% of the circumstances (au...Introduction: Traumatic hip dislocation associated with femur fracture is a rare and complex injury that occurs in the context of multiple trauma. Public road accidents represent more than 64% of the circumstances (automobiles 46% and two-wheelers 18%). Objective: Report a rare case of injury association and the speed of treatment (less than 6 hours). Clinical case: 26-year-old patient, victim of a road traffic accident. Admitted to the emergency room one hour after the trauma in a context of severe pain and absolute functional impotence of both pelvic limbs. Clinical examination reveals closed trauma to both pelvic limbs, with deformation of the right thigh, a vicious attitude of the contralateral lower limb in adduction, shortening and medial rotation. Conclusion: This is a rare injury association, which benefited from treatment within less than 6 hours.展开更多
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, s...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 is linked to disabling sequelae such as limb length inequality or most often axial deviation. Surgical treatment aims to reconstruct the anatomy of the distal femur, to avoid secondary displacements and to allow early mobilization of the knee.展开更多
Introduction: Subtalar or peritalian dislocation is rare;it represents 15% of peritalian injuries. The aim of this study was to describe the radioclinical and therapeutic characteristics and to assess the functional r...Introduction: Subtalar or peritalian dislocation is rare;it represents 15% of peritalian injuries. The aim of this study was to describe the radioclinical and therapeutic characteristics and to assess the functional result. Patients and Methods: This study is about a continuous descriptive and prospective study over a period of 5 years. It has been conducted from March 2013 to February 2018 at the Ségou Hospital, a second referral hospital in Mali. The functional results were evaluated by the score of the American Orthopedic Foot and Ankle Society (AOFAS). Results: Seven cases of subtalar dislocation fractures were diagnosed in six male patients with an average age of 38 years (36 to 47 years old). In five cases the etiology of the trauma was a motorcycle accident and a fall from height. The lesion was bilateral in one case. The average time to care was 3 hours (1 to 9 hours). There was one case of open dislocation fracture with talus enucleation. The dislocation was medial in 6 cases and lateral in one case. It was pure in three cases. The treatment was orthopedic in 2 cases and surgical in 5 cases. The post-operative complications were complicated by an infection of the operative site in one case. The average length of hospital stay was 4 days. The functional result was excellent in 2 cases;good in 2 cases, fair in 2 cases and poor for 1 case. Conclusion: Subtalar dislocation is a rare and serious lesion of the posterior tarsus. The long-term prognosis depends on the earliness of treatment and the severity of the associated injuries.展开更多
We report an unusual case of basic bilateral fracture of fifth metatarsals in a 48 years old post-menopausal woman. She had previously been treated for arterial high blood pressure, parathyroidectomy and rheumatoid ar...We report an unusual case of basic bilateral fracture of fifth metatarsals in a 48 years old post-menopausal woman. She had previously been treated for arterial high blood pressure, parathyroidectomy and rheumatoid arthritis by a long corticotherapy treatment. The lesion was caused by an indirect mechanism in an overweight context. The diagnosis of a pseudarthrosis of the base of the fifth metatarsals was maintained after 7-month treatment. The patient received a treatment of both pseudarthrosis. The post-operative periods were simple. After a 9-month follow-up, the treatment allowed consolidation with painless feet allowing her to resume work.展开更多
文摘Symphyseal dissection results from high-energy trauma and usually occurs in poly trauma context. The treatment is only orthopedic in our department. The aim of this work was to study the current therapeutic aspects management of the disjunction of the pubic symphysis in the department of ortho-traumatology of CHU Gabriel Touré of Bamako MALI. This was a prospective and analytical study;from 1 July 2021 to 30 June 2022, within 15 patients classified according to Young and Burgess, with a functional evaluation according to Majeed and a minimum follow-up of 4 months. We report symphyseal disconnections accounted for 20.83% of the traumas of the pelvic ring, and 1.84% of patients hospitalized for fracture in the department during the period of the study. We noted a predominance of gender male in 87% of cases with a ratio of 2.75 and the average age in our series was 32 years, with extremes ranging from 18 to 63 and a SD of 13.96. The most common etiologies are APR with 66.7% and traditional mine slide cases with 20%, and the anteroposterior compression mechanism is most frequently encountered at 73.3%. The APCI types: 20%, APCII: 40% and VC: 20% of the Young and Burgess classification are the most found. The treatment of these patients was surgical in 53% cases by locked screw plate. The surgical approach of Pfannenstiel was preferred to the ilio-inguinal of Judet. Non-surgical treatment by trans-osseous traction and the wearing of a pelvic belt was recommended for cases of stable disjunction or severe associated lesions. The average length of stay is 17.27 days with extremes of 5 and 34 days. The functional assessment according to Majeed allowed us to classify 73.3% of patients’ cases as excellent, showing a good socio-professional reintegration. Symphyseal disjunction is a rare pathology but of serious functional consequences, regardless of the therapeutic method good management allows to minimize these functional sequelae.
文摘Introduction: Traumatic hip dislocation associated with femur fracture is a rare and complex injury that occurs in the context of multiple trauma. Public road accidents represent more than 64% of the circumstances (automobiles 46% and two-wheelers 18%). Objective: Report a rare case of injury association and the speed of treatment (less than 6 hours). Clinical case: 26-year-old patient, victim of a road traffic accident. Admitted to the emergency room one hour after the trauma in a context of severe pain and absolute functional impotence of both pelvic limbs. Clinical examination reveals closed trauma to both pelvic limbs, with deformation of the right thigh, a vicious attitude of the contralateral lower limb in adduction, shortening and medial rotation. Conclusion: This is a rare injury association, which benefited from treatment within less than 6 hours.
文摘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 is linked to disabling sequelae such as limb length inequality or most often axial deviation. Surgical treatment aims to reconstruct the anatomy of the distal femur, to avoid secondary displacements and to allow early mobilization of the knee.
文摘Introduction: Subtalar or peritalian dislocation is rare;it represents 15% of peritalian injuries. The aim of this study was to describe the radioclinical and therapeutic characteristics and to assess the functional result. Patients and Methods: This study is about a continuous descriptive and prospective study over a period of 5 years. It has been conducted from March 2013 to February 2018 at the Ségou Hospital, a second referral hospital in Mali. The functional results were evaluated by the score of the American Orthopedic Foot and Ankle Society (AOFAS). Results: Seven cases of subtalar dislocation fractures were diagnosed in six male patients with an average age of 38 years (36 to 47 years old). In five cases the etiology of the trauma was a motorcycle accident and a fall from height. The lesion was bilateral in one case. The average time to care was 3 hours (1 to 9 hours). There was one case of open dislocation fracture with talus enucleation. The dislocation was medial in 6 cases and lateral in one case. It was pure in three cases. The treatment was orthopedic in 2 cases and surgical in 5 cases. The post-operative complications were complicated by an infection of the operative site in one case. The average length of hospital stay was 4 days. The functional result was excellent in 2 cases;good in 2 cases, fair in 2 cases and poor for 1 case. Conclusion: Subtalar dislocation is a rare and serious lesion of the posterior tarsus. The long-term prognosis depends on the earliness of treatment and the severity of the associated injuries.
文摘We report an unusual case of basic bilateral fracture of fifth metatarsals in a 48 years old post-menopausal woman. She had previously been treated for arterial high blood pressure, parathyroidectomy and rheumatoid arthritis by a long corticotherapy treatment. The lesion was caused by an indirect mechanism in an overweight context. The diagnosis of a pseudarthrosis of the base of the fifth metatarsals was maintained after 7-month treatment. The patient received a treatment of both pseudarthrosis. The post-operative periods were simple. After a 9-month follow-up, the treatment allowed consolidation with painless feet allowing her to resume work.
