[Closed traumas of the thorax. Assessment of two years activity at the Dakar Trauma Center]. / Traumatismes fermés du thorax. Bilan de deux années d'activité au Centre de Traumatologie de Dakar.

Two years after opening the Dakar Trauma Center has received 179 cases of blunt chest trauma without prehospital treatment. Road accidents were the leading cause. The initial mortality was 29 patients (16.20%) and 150 patients arrived alive and were treated. The initial mortality was primarily due to the associated extrathoracic injuries mainly hemorrhagic with hemoperitoneum in 44.82% and brain hemorrhage in 24.14% of cases. Secondly, it was due to the thoracic injuries with 41.37% of anterior flail chest and massive hemothorax in 65.51% of cases. Among the 150 patients treated, 42% had extrathoracic injuries, mainly head trauma. 56% were admitted to intensive care units with 39 chest drainages and 6 thoracotomies were performed. The mortality in this group was about 11.33%. The very high initial mortality could be reduced by the organisation of prehospital treatment to take better care of patients involved in road accidents.

[Chronic osteomyelitis at Dantec UHC , at Dakar]. / Ostéomyélite chronique au CHU A. Le Dantec, a Dakar.

The authors report 82 cases of osteomyelitis treated and followed up at the CHU Le Dantec, from March 1979 to September 1991. The patients were young, with an average age of 18 and a half years. Some susceptibility factors were identified: malnutrition (12.20%) and sickle cell anemia (26.83%). The infection was more frequently located on long bones of the lower limber (62.77%) and mainly on the metaphysis. Fistula forms with sequestra were the most frequent ones. Sixty-six patients were healed right after the first operation, 13 after two operations, 3 after three operations, the laters were mainly relapsing cases related to insufficient curreting of the infected bone or persisting sequestrum.

[Mycetoma of the fingers. Apropos of 5 case reports]. / Mycétomes des doigts. A propos de cinq observations.

The authors report 5 cases of mycetomas of the fingers observed over a period of 5 years in a series of 18 mycetomas of the hand. In 3 cases, the lesion only involved the soft tissues, which were excised with 2 apparent cures after 2 and 5 years and one recurrence. In the other 2 cases, the bone was invaded and 2 digital amputations were performed without recurrence after 2 and 6 years. The authors review the epidemiology and histopathology of this disease as well as the absence of any truly effective medical treatment. In the presence of bone invasion, only excision can ensure cure.

[Neurotraumatic emergencies at the University Hospital Center in Dakar. Apropos of 120 injuries of the cervical spine]. / Urgences neuro-traumatiques au C.H.U. de Dakar. A propos de 120 traumatismes du rachis cervical.

In Senegal, traumas of spinal column are characterized not only by their high frequency and their etiology, but also and mainly by the extreme severity of their neurological lesions. A review of 120 traumas of cervical spine revealed: The importance of the neurological lesions (75%). The influence of the factors of severity and of the treatment. Global mortality rate of 35% raises to 46.46%, consequent on neurological lesion and to 85.71% consequent on total tetraplegia.

[Severe mutilations of the hand. Preliminary evaluation of a study of 24 cases in an African milieu]. / Mutilations graves de la main. Bilan préliminaire d'une étude de vingt-huit cas en milieu africain.

Mutilations of the hand are very frequent in Africa. More than any other disease, they destroy the hopes for a normal active life. The authors report the preliminary results of a study of 28 severe mutilations occurring between September 1983 and December 1985. The principal cause was traumatic, dominated by work accidents and household accidents. In the majority of cases, the anatomical defect was severe, but not always proportional to the functional and psycho-social repercussions. The inadequacies of the final result do not always depend on the simple and effective techniques used, but rather on a lack of appropriate rehabilitation and ignorance of the patient's needs, which include aesthetic aspects.