[Tuberculosis dactylis: a case report]. / La tuberculose digitale: à propos d'un cas.

INTRODUCTION: Tuberculosis dactylis is exceptional. We report one case in an 11 years old girl. OBSERVATION: N.D., 11 years old, was admitted for a right hand second finger tumour evolving since six months and linked to a trauma. Clinical examination founded a painful fusiform of the right second finger with limited movements of the finger. The hand radiography showed a second phalange osteitis of the finger without periosteitis reaction. The sedimentation rate was accelerated to 130 mm at the first hour. The intracutaneous reaction with tuberculin was positive to 19 mm. In her preceding, her mother would have suffered from pulmonary tuberculosis two years before incompletely treated during eight months. Histological examination showed a caseous necrosis and an epithelial giant cellular follicle. A twelve months antituberculosis polychimiotherapy permitted a healing without sequelae. DISCUSSION: Tuberculosis dactylis has to be evoked with epidemiological, clinical, radiological and immunological arguments. The antituberculosis treatment permitted to do the retrospective diagnosis and to get a healing.

[Perforation and haemorrhage duodenal bulbar ulcers in a child: a case report]. / Perforation et hémorragie d'ulcères du bulbe duodénal chez une enfant.

A perforation rarely reveals a primary duodenal ulcer. The occurring of digestive haemorrhage in post operative followings evokes spontaneously a stress ulcer. We report an observation of a child who presented on fourth day delay after operation an ulcer of the anterior duodenal bulbar face and a haemorrhage of the posterior bulbar face. A 7-year-old girl with no particular pathological antecedent was admitted for abdominal pain, bile vomiting and constipation evolving since 6 days. Clinical examination revealed a general state thickening, an infectious syndrome, a meteoric and general abdominal sensitivity. The abdominal radiography without preparation showed a pneumoperitoneum. The surgical exploration discovered a perforated ulcer on the bulbar anterior face. A simple closure associated with omental patch was performed. Four days after operation, she presented an abundant digestive haemorrhage with shock. The resuscitation did not improve the patient's general state. The upper digestive endoscopy revealed a haemorrhage of the posterior bulbar face. An adrenalin injection stopped the bleeding. The treatment by neutron pump inhibitors and an eradicating treatment of Helicobacter pylori permitted the healing of the ulcers. The occurring of digestive haemorrhage in the followings of surgical intervention for perforated ulcer involves an upper digestive endoscopy. This examination can reveal misdiagnosed ulcer during the surgical exploration and permits to perform a haemostatic act.

[Prune Belly syndrome: epidemiologic, clinic and therapeutic aspects]. / Syndrome de Prune Belly : aspects épidémiologiques, cliniques et thérapeutiques.

UNLABELLED: Prune Belly syndrome (PBS) is a rare complex malformation with male predominance. His pathogeny is not yet completely elucidated. The goal of this work is to analyze the epidemiological, anatomoclinical and treatment aspects of a retrospective trial in Aristide-Le-Dantec Hospital. PATIENTS AND METHODS: We carried out a retrospective study about 22 cases collected in the departments of urology-andrology and pediatric surgery in Aristide-Le-Dantec Hospital between April 1995 and November 2004. RESULTS: The mean age of the patients was 15 months with extremes of one day and 10 years. The somatic examination revealed 20 cases of complete abdominal muscle aplasia, one right partial form and the last case had a left partial form. Nineteen patients were managed with conservative treatment and three patients benefited a surgical act for urinary abnormalities. The Montfort intervention was performed in two patients respectively aged eight and 10 years. The orchidopexy, stage 1, by Fowler-Stephens technique was performed in 13 cases. Five cases of death and nine cases of testicular atrophy after orchidopexy occurred. The followings were satisfactory in the three operated patients for urinary abnormalities. CONCLUSION: The renal failure is the main cause of death. The management of the urinary tract abnormalities must be performed individually. The testis descending should be performed in newborn period to enhance the fertility chances. The abdominoplasty also should be done early for aesthetic reason and to improve pulmonary, defecation, and voiding functions.

[Newborn and infant fractures secondary to traditional massage]. / Fractures du nouveau-né et du nourrisson secondaires au massage traditionnel.

The traditional massage of the newborn and young infant is an ancient practice in Africa and other regions. It has many benefits that are currently recognized, even in Western societies. However, it can be dangerous. We report two cases of fractures of the femur and clavicle that occurred in a 17-day-old newborn and a 1-month-old infant secondary to a traditional massage. In both cases, there was no concept of trauma or a history of osteogenesis imperfecta in the family or the presence of other fractures suggesting abuse. We concluded in a fracture caused by traditional massage in both cases. Given its many benefits as described in the literature, the traditional massage of young infants cannot be considered a harmful practice. However, it should be practiced with care to prevent the occurrence of such complications.

[Rare elbow fractures in children: Epidemiological, therapeutic and prognosis aspects in the Aristide Le Dantec Hospital of Dakar]. / Les fractures rares du coude chez l'enfant: aspects epidemiologiques, therapeutiques et pronostiques a l'Hôpital Aristide le Dantec de Dakar.

AIMS: To describe the epidemiological and therapeutic aspects of rare fractures of the elbow in children and assess their prognosis. MATERIALS AND METHODS: This was a retrospective study conducted from 1st January 2008 to 31st August 2009 in all children aged 0-15 years treated for rare fractures of the elbow seen before 21 days and followed in the service. RESULTS: Rare elbow fractures represented 19.42% of total elbow fractures during the study period. Male dominance was clear: 28 boys for 6 girls with a sex ratio of 4.66:1. The average age of the children was 8.2 years with extreme of 3 and 15 years. These fractures, in most cases, were the result of a play accident in 16 cases (47.1%). The main reason for consultation was represented by a sore elbow (91.2%). Trauma was found in the right elbow 61.8% of the time and in the left elbow 38.2%. Among the most common fractures were those of the lateral epicondyle and the olecranon which accounted for 11 cases (6.28%) and 10 cases (5.71%) of all fractures of the elbow. Twenty-one children received orthopedic treatment and 13 children received surgical treatment. The average assessment of our patients follow-up was 10 months with extreme of 6 months and 16 months. The results were good in 32 children without any radiological abnormality or functional sequelae. CONCLUSION: The prognosis of rare fractures of the elbow is usually good if the management is efficient. Monitoring should be continued long term to watch the sequelae.

OBJECTIFS: Décrire les aspects épidémiologiques et thérapeutiques des fractures rares du coude chez l'enfant et d'évaluer leur pronostic. MATÉRIELS ET MÉTHODES: Il s'agissait d'une étude rétrospective allant du 1er janvier 2008 au 31août 2009 chez tous les enfants âgés de 0 à 15 ans pris en charge pour fractures rares du coude dont le délai de consultation n'excédait pas 21 jours et suivis dans le service. RÉSULTATS: Les fractures rares du coude ont représenté 19,42% du total des fractures du coude durant la période d'étude. La prédominance masculine était nette: 28 garçons pour 6 filles soit un sexe ratio de: 4,66 :1. L'âge moyen des enfants était de 8,2 ans avec des extrêmes de 3 ans et 15 ans. Ces fractures, dans la majorité des cas, étaient consécutives à un accident ludique dans 16 cas (47,1%). Le principal motif de consultation était représenté par un coude douloureux (91,2%).Le traumatisme a intéressé dans 61,8% des cas le coude droit et dans 38,2% le coude gauche. Parmi ces fractures les plus fréquentes étaient celles de l'épicondyle latéral et de l'olécrâne qui ont représenté respectivement 11cas (6,28%) et 10cas (5,71%) de l'ensemble des fractures du coude.Vingt et un (21) enfants ont bénéficié d'un traitement orthopédique et 13 enfants ont bénéficié d'un traitement chirurgical. Le recul moyen d'évaluation de nos patients était de 10 mois avec des extrêmes de 6 mois et 16 mois. Les résultats ont été bons chez 32 enfants sans aucune anomalie radiologique ou séquelle fonctionnelle. CONCLUSION: Le pronostic des fractures dites rares du coude est généralement bon si la prise en charge est efficiente. Le suivi doit être poursuivi à long terme pour guetter d'éventuelles séquelles.

[Management of thermal severe burns in children in Le Dantec University Teaching Hospital]. / Prise en charge des brûlures thermiques Graves de l'Enfant au CHU le Dantec.

INTRODUCTION: Bums in children are serious public health problem. Burns management in developing countries encounters huge problems at any stage. The goals of this study were to descrive the epidemiological, clinical and therapeutic characterics. MATERIALS AND METHODS: In the university Teaching Hospital of Dakar from January to December 2003, we conducted a retrospective survey of 41 patients less than 16 years admitted for severe thermal burns. We carried a year retrospective study in ICU and pediatric surgery unit of Aristide Le Dantec Hospital. Were involved all. The following parameters were studied: age, sex, mechanism and circumstances of the burns, period time between the injury and the admission, clinical status of the patient, management and outcome. RESULTS: The age range between 5 days and 13 years, 47.72% are less than 3 years. The average period before admission was 33 hours (2 hours to 7 days). The accident occurs in 75% of cases in the kitchen. Bum by hot water was the most frequent mechanism with a percentage of 62%. Areas interested the whole body with frequent face localisation (n=18) and the perineal region (n=22). Immediate complications were shock in 37% of children and acute respiratory failure in 7 patients. Fluids and electrolytes resuscitation using Parkland formula (75%) or Carvajal formula (25%). Feeding was done to enteral route. Spontaneous epitheliasation through secondary heeling was the main therapeutic attitude, skin grafting was performed in 10 childrens. Total mortality was 18.18%; These death concerns patients for whom the UBS score range between 75 and 140 UB and the ABSI score between 9 and 12. Sepsis was the direct main cause of death. Sequellaes were jointed a nd facial contractures. CONCLUSION: The authors emphasize on the need in setting up adequate preventive measures towards high risk population (under 3 years), and specialized unit for adapted management.

Traumatic right diaphragmatic hernia in children: Diagnostic difficulties.

Traumatic right diaphragmatic hernia is rare in children. Its diagnosis can be difficult in the acute phase of trauma because its signs are not specific, especially in a poly trauma context. We report two cases of traumatic right diaphragmatic hernia following a blunt thoraco-abdominal trauma, highlighting some difficulties in establishing an early diagnosis and the need for a high index of suspicion.

[Urological emergencies in paediatric surgery: a survey of 40 cases]. / Les urgences urologiques en chirurgie pediatrique: a propos de 40 cas.

AIMS: The objective of this study is to report our experience on the epidemiology of urological emergencies in pediatric surgery, and to analyze the diagnosis and therapeutic process. MATERIALS AND METHODS: It was a prospective survey which was carried out between January 2010 and June 2011 in the pediatric service of Aristide Le Dantec Hospital (HALD). All the children who came for a urological emergency consultation were included in the study. THE RESULTS: the urological emergencies accounted for forty cases which represented 2.57% of pediatric surgery emergencies. The average age of our patients was 4.5 years with extremes of 10 days and 15 years of age. 29 cases of severe big bursae were observed and among them there were strangulated hernia and ten cases of suspicious spermatic cord torsion. The other admission motives consisted of three cases of urine retention, two pyelonephritis cases, two cases of post circumcision glans sections, two paraphimosis cases, one tight phimosis case, one case of penis traumatism provoked by a game incident. The scrotum ultrasound performed on six patients helped find out a specificity of 66.6%. 60% of strangulated hernia have been reduced through under sedation taxis. In case of confirmed torsion, a detorsion followed by an orchidopexy were performed. Two orchidectomy were performed for a testicular necrosis. CONCLUSION: the painful big bursa is the number one cause for a urology pediatric consultation. It implies a fast and adequate diagnosis and treatment so as not to miss a digestive or testicular pain.

BUTS: Rapporter notre expérience sur l'épidémiologie des urgences urologiques en chirurgie pédiatrique, d'analyser la prise en charge diagnostique et thérapeutique. MATÉRIELS ET MÉTHODES: Il s'agissait d'une étude prospective réalisée dans le service de chirurgie pédiatrique de l'hôpital Aristide Le Dantec de Dakar (HALD), de janvier 2010 à juin 2011. Tous les enfants reçus pour une urgence urologique ont été inclus. RÉSULTATS: Les urgences urologiques représentaient 2,57% des urgences chirurgicales pédiatriques. L'âge moyen des patients était de 4,5 ans avec des extrêmes de 10 jours et de 15 ans. Nous avons noté 29 cas de grosses bourses aigues dont 15 hernies étranglées et 10 suspicions de torsion du cordon spermatique. Les autres motifs d'admission étaient représentés par 3 cas de rétentions aigues d'urine, 2 cas de pyélonéphrites, 2 cas de sections de gland post circoncision, 2 cas de paraphimosis, 1 cas de phimosis serré, 1 cas de traumatisme pénien. L'échographie scrotale réalisée chez 6 patients avait une spécificité de 66,6%. Soixante pour cent des hernies compliquées ont été réduites par taxis sous sédation. Deux orchidectomies ont été effectuées pour nécrose testiculaire. CONCLUSION: la grosse bourse aigue est le 1er motif de consultation en urologie pédiatrique. Elle implique une prise en charge rapide et adéquate pour ne pas passer à coté d'une souffrance testiculaire ou digestive.

[Results of emergengy colectomy in the management of the colon volvulus in Dakar hospital]. / Résultats de la colectomie en urgence dans le traitement du volvulus du côlon au centre hospitalier universitaire (CHU) de Dakar.

PURPOSE: The aim of this study was to evaluate the results of emergency colectomies for the management of colon volvulus. PATIENTS AND METHODS: This retrospective study was undertaken on 50 cases of colon volvulus operated in the Surgical Department of the Aristide Le Dantec teaching hospital of Dakar from January 1994 to December 2000. It concerned 42 men and 8 women with an mean age of 42 years. All patients presented an occlusive syndrome suggestive of colon volvulus, which required a laparotomy, through a xypho-pubic incision. The patients were divided into two groups. Group I concerned 13 patients who underwent an ideal colectomy and group II, 37 patients in whom we performed a colectomy associated with a temporary colostomy with either Bouilly-Volkman procedure (n = 23) or Hartman procedure (n = 14) followed one month later by intestinal continuity restoration. Mortality and morbidity were compared in the two groups. RESULTS: The overall mortality rate was 12% (6/50). The mortality rate was 31% (4/13) in group I and 5 % (2/37) in group II. The overall morbidity rate was 14%. In group I, the morbidity rate was 15 % (2/13) and 13,5% (5/37) in group II. CONCLUSION: In our study the mortality rate was higher after colectomy with primary anastomosis than after colectomy with temporary colostomy followed by secondary anastomosis. We recommend colectomy without anastomosis for the emergency management of the colon volvulus in Africa.

[Intussusception in children: about 20 cases]. / Invagination intestinale de l'enfant a propos de 20 cas.

The authors report on a retrospective study 20 cases of intussusception in senegalese children. The diagnosis is essentially clinical. In difficult cases plane abdominal X-rays, barium meal and echography are indispensable exams. In our context the diagnosis is most of the time late and it is due to the unknown nature of the affection and early consultation to the traditional practitionners. The lateness of the diagnosis leads to the lateness of the management. This explains the importance of intestinal necrosis noticed in our serie and the high mortality rate which is 10%. The authors suggest recommendations to ameliorate the prognosis of this ailment which is good elsewhere.

[Fractures of the medial humeral epicondyle in child: preliminary study about 18 cases]. / Les fractures de l'epitrochlée chez l'enfant: etude préliminaire a propos de 18 cas.

The aim of this work is to study the epidemiological, radiological, clinical views of fractures of the medial humeral epicondyle in child and mainly to appreciate the results of surgical treatment. For this, we looked at again in a retrospective study eighteen (18) files of children with fracture of the medial humeral epicondyle. The average age of children was eleven (11) and the male sex most represented (16 boys versus 2 girls). Medial humeral epicondyle's fracture often occurs by accident in playing (15 cases). Accurate diagnostic of the fracture of the medial humeral epicondyle was rarely formulated on the clinical plan. It's the radiography who shown the fracture of the medial humeral epicondyle and permitted to specially the type in accordance with Marion's and Faysse's classifications and also Lechevallier. It was always surgical and consisted on a open reduction and fixation by pins or a periostee's stich. With ten (10) months of background, we assessed our results either on morphological plan than the functional plan. 1/ On morphological plan: an hypertrophy of the medial humeral epicondyle is 3-fold mentioned. Others children have not presented a morphological animaly. 2/ On functional plan: Ten children had an elbow's mobility considered as normal after self reeducation at home. Six enjoyed physical therapy in a specialized department. Two of the children had an extension gap from 30 degrees to 35 degrees respectively. We obtained thirsteen (13) good results in general, three (3) means results and two (2) bad results. In conclusion, the fracture of medial humeral epicondyle occurs around ten (10) years old in boy victim in playing. Diagnostic is sometimes difficult. Surgical treatment gives good results. However, it can be the origin of sequellaes which can justify correct previous refunding.

[The ovarian tumors in children. A report of 12 cases]. / Les tumeurs ovariennes de l'enfant: a propos de 12 cas.

The objectives emphasize the diagnosis and therapical problems concerning the child's ovary tumors for a better care in our conditions of work. We collected in a retrospective study 12 cases of ovarian tumors during 30 years. The middle age of the patients was of 11 years with extremes of 2 years and 15. The circumstances of discovery of the tumor were represented by order of frequency by an abdominal tumor (10 cases), an abdominal pain (8 cases) and of the compression signs digestive or urinary (6 cases). The medical imagery (echography, intravenous urography, Chest X-ray) permitted to evoke in the majority of the cases the ovarian origin of the mass. The surgical treatment consisted in an ovariectomy (5 times), an salpingo - ovariectomy (6 times) and a surgery of partial exeresis associated to a chemotherapy. The operative continuations were simple. A patient died of intercurrentes complications. The histological exam of the operative piece showed that it was about benign tumors. However a brought closer surveillance proves to be necessary had consideration to the two noted recidivisms.

[Trichobezoard revealed by intestinal perforation. A case report]. / Perforation intestinale révélatrice d'un trichobézoard. A propos d'une observation.

This paper presents a case of gastric and ileal trichobézoard on a 12 years-old girl. It was revealeds by ileal perforation which was confirmed by abdominal X-ray. Trichobézoard diagnosis was not performed before surgery despite two contradictory/abdominal ultrasound scans. The trichobézoard was removed surgicaly by ileotomy and gastrotomy. The patient had an satisfactory post-operative convalescence after a follow-up of six months.

[Ectopia testicular in child: about 3 cases]. / Les ectopies testiculaires de l'enfant: a propos de trois cas.

The authors report 3 cases of testicular ectopia. Of these 3 cases, two proved tobe cases of penial ectopia whose diagnosis was mentionned before the intervention. One case proved tobe a case of tranverse testicular ectopia diagnosed as an inguino-scrotal hernia. Surgical exploration has always allowed to reach a correct diagnosis. In all three cases the testicle was of normal size and the cord long enough to lower the testicle between the skin an the dartos Surraco's procedure. The authors discuss the pathogenis of this affection, echography contribution in the diagnosis, and the therapeutics aspects.

[Evaluation of the management of femoral shaft fractures in children by flexible intramedullary nailing]. / Evaluation du traitement des fractures de la diaphyse fémorale chez l'enfant par embrochage centromédullaire elastique stable (ECMES).

The purpose of this study was to evaluate the morphological and functional outcomes of femoral shaft fractures of the child using a centromedullary elastic nailing. We led a retrospective study including 22 children operated from January 1997 to December 2000 at the surgical emergency department of "Hôpital Aristide Le Dantec". The follow-up was made in the department of paediatric surgery. The patients included 16 boys and 6 girls presenting a total of 23 femoral shaft fractures. The main circumstance was traffic accident(15 cases). All the children underwent an ascending centromedullary elastic nailing controlled by a C-arm after a period of traction. The outcomes were appreciated after a period of 10 months. We observed: A union in all cases, four infections well managed by antibiotics, one vicious callus of 15 degrees, a mobility limitation of knee in two cases (45 degrees and 100 degrees), an inferior limb length inequality in one case, scabs in one patient who died at the 3rd month of a septicopyohemia. The functional evaluation of the outcomes (flexion, extension, limb length inequality) and morphological outcomes (axis, consolidation) showed 21 good results and one bad result. The centromedullary elastic nailing is a safe procedure owing to the low complication rates and the rapid consolidation allowing an early walk in femoral shaft fractures, compared with the orthopaedic treatment.

[Evaluation of the management of omphalocele at Dakar]. / Evaluation de la prise en charge de l'omphalocèle a Dakar.

Omphalocele is a congenital malformation of the abdominal wall of children, characterized by an ombilical defect living the abdominal organ visible through a translucent amniotic membrana. The goals of this study were to describe the epidemiological, clinical and therapeutic characteristics at the University Teaching Hospital of Dakar. We conducted a retrospective study at the UniversityTeaching Hospital of Dakar from January 1997 to December 2002. Fifty cases of Omphalocele diagnosed at the Unit of Paediatric Surgery of the Department of General Surgery at Aristide Le Dantec Hospital, were included in this study. We described the epidemiological, clinical and therapeutic characteristics of omphalocele. Omphalocele is a condition diagnosed late in boys from poor sphere. The study revealed that weight from birth, omphalocele size, local state, and existance of associated malformation correlated with death rate. The treatment option was a spontaneous epidermisation as described by Grob in the absence of omphalocele rupture wich imposed a primary closure of abdominal wall. The overall death rate was 42%. The improvement of results will need an antenative diagnosis, paediatric reanimation unit wich will notably reduce death rate.

Cοngenital diaphragmatic hernia in dakar, senegal.

BACKGROUND: Congential diaphragmatic herniae pose serious challenges in their management in this environment.Aim & Objective: To determine the pattern, as well as the diagnostic and management challenges of congenital diaphragmatic hernia in Dakar, Senegal. PATIENTS AND METHODS: This is a retrospective review of 14 children with congenital diaphragmatic hernia (CDH) managed within eleven years in Dakar, Senegal. RESULTS: There were nine boys and five girls with the age range of one day to 22 months and a mean of 5 months. Respiratory signs (respiratory distress, cough, current pulmonary infection) were found in 13 patients and gastrointestinal symptoms (vomiting, Difficulty sucking, anorexia) in 6 patients. The thoracic-abdominal radiography was performed in all patients and revealed a Bochdalek hernia on the left in 10(71%) cases and 4(29%) were Morgagni hernia. Treatment was by repair of the diaphragmatic defect with non-absorbable sutures. The postoperative course was uneventful in 13 children while one patient died on the first postoperative day one. CONCLUSION: Congenital diaphragmatic hernia presents mainly with postnatal respiratory features in this setting. Thoracic-abdominal radiography allows for early diagnosis, prompt and effective treatment with good outcome. KEYWORDS: Congenital diaphragmatic hernia, Respiratory insufficiency, Radiological features, Good surgical outcome.

[Peritonitis following gastroduodenal ulcer perforation disease in children: report of 4 cases]. / Les péritonites par perforation d'ulcère gastroduodénal chez l'enfant : à propos de 4 observations.

Peritonitis due to gastroduodenal ulcer perforation disease is a rare entity in pediatric surgery. In Senegal, no study has been dedicated to ulcer complications in children. The aim of this study was to describe the epidemiology, diagnosis, and treatment of perforated peptic ulcer in patients less than 15 years old. This retrospective study was conducted in the Surgical Emergencies and Paediatric Surgery Department at Aristide Le Dantec University Hospital Center in Dakar, Senegal, during a period of 11 years (January 1999 to December 2010). We found 4 children who presented perforated gastroduodenal ulcer: 3 females and 1 male. The average age of these patients was 9 years (range, 7-14 years). No family history was found. We noted 3 cases of perforated duodenal ulcer and one perforated gastric ulcer. The clinical diagnosis was suspected based on a peritoneal irritation syndrome. A plain x-ray of the abdomen was taken in all patients, which objectified a pneumoperitoneum image in 3 cases. The leukocytosis was constant. Treatment in all patients consisted on pre-, intra-, and postoperative intensive care, supra- and infraumbilical midline laparotomy, which allowed us to perform a debridement-suture of the gap followed by epiploplasty and extensive washing with lukewarm physiologic serum. Adjuvant therapy based on anti-ulcer and antibiotic therapy was initiated. Bacteriological examination of peritoneal fluid isolated a polymicrobial flora. Helicobacter pylori was not isolated. Histological examination of the biopsied perforation edges showed a benign ulcer in all cases. The follow-up endoscopy was performed 4 weeks after surgery and showed cicatrization of the ulcer in all patients. After a mean of 2 years, no recurrence was noted. The gastric or duodenal ulcer in children is rare. It is often discovered at the stage of perforation, a complication for which the essential treatment is surgery. Routine screening would certainly help to reduce the risk of this complication.

Aphallia: a case report and literature review.

Aphallia is a complex urogenital malformation. It is rarely described in literature. Treatment calls upon feminising genitoplasty in most cases. Authors describe a case in a neonate, insisting on the sociocultural realities which guided their indications.

Osteogenesis imperfecta in a pediatric surgical center in dakar, senegal: clinical and radiological aspects.

INTRODUCTION: Osteogenesis imperfecta presents with a set of constitutional disorders of varying severity, genetically determined and characterized by an abnormal production of collagen and matrix of the bone leading to bone fragility responsible for multiple fractures and many skeletal deformities. The aim of our study was to analyze the clinical and radiological aspects of the pathology. PATIENTS AND METHODS: This was a retrospective study of 10 cases of children with osteogenesis imperfecta who consulted the Pediatric Surgery Unit of the University Center Aristide Le Dantec Hospital over a period of 6 years. The parameters analyzed were the reasons for consultation, physical examination findings and findings on standard radiographs. After collecting all the data, children were divided according to the classification of Silence and Glorieux. RESULTS: Pain was the reason for consultation in eight children. The saber blade deformity of the legs was found in nine children. Physical examination found tenderness in 80% of cases. Blue sclera was found in one child. The teeth were normal in eight patients. Standard radiographs showed an osteopenic skeleton with multiple fractures (3.7 fractures on the average) associated with vicious callus formation and deformity. According to the classification of Silence and Glorieux, six children were type VI, two children type IV, a child type III and one type I. CONCLUSION: Osteogenesis imperfecta is a rare disease. In our environment, the diagnosis is made late - a stage associated with deformity. Of these, the occurrence of sabber deformity of the lower limbs is the most common. Radiological aspects are dominated by vicious callus formation, deformed bones and osteopenia. Moderate forms are predominant. Parents need to be educated about the risk of repeat fractures and the need to present deformed children to hospital early.