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BACKGROUND: Childhood fractures are frequent. The aim of this study was to evaluate their epidemiological and clinical peculiarities in our context. MATERIALS AND METHODS: This was a retrospective study that focused on the files of children with a fracture. They were aged 0-15 years and received between January 2011 and December 2015 at the Emergency Department of the National Teaching Hospital of Cotonou. RESULTS: Two hundred and eighty fractures were recorded in 257 children. The average age was 8.24 years (7 days-15 years). Older children (6-10 years) were the most affected with 33.8% of cases. The predominance was male (sex ratio = 2.3:1). The aetiologies were dominated by road traffic accidents (45.1%) followed by domestic accidents (42.7%). Fractures were predominant in the lower limbs (52.1%). The most affected segments were the leg (25.4%) and the femur (23.6%). The fracture was open in 13.9% of cases. CONCLUSION: Childhood fractures interest preferentially the older boys. Then, road traffic accidents are the most frequent circumstances of occurrence in our context. Measures to prevent the main causes of these fractures must be taken, in order to reduce their frequency and ensure the development of children.
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Serviço Hospitalar de Emergência , Hospitais de Ensino , Adolescente , Criança , Humanos , Masculino , Benin , Estudos Retrospectivos , Recém-Nascido , Lactente , Pré-Escolar , FemininoRESUMO
INTRODUCTION: Trauma to the cervical spine is a real public health problem. They can cause neurological complications that are sometimes irreversible and mortality remains high. The causes are dominated by traffic and work accidents. We assess their epidemiological and lesional aspects in our work environment. MATERIAL AND METHOD: This was a descriptive retrospective study of any cervical spine trauma patient admitted to the National teaching hospital Hubert Koutoukou Maga of Cotonou between January 2010 and June 2014 for which the clinical file was complete. RESULTS: 57 files were retained. The average age was 38.7 years (19 - 71 years). The predominance was male with a sex ratio of 4.2. The mean admission time was 27.5 days (3 hours - 175 days). As aetiologies, we found: traffic accidents (41 cases or 71.9%), work accidents (13 cases or 22.9%) and domestic accidents (3 cases or 5.3%). From an anatomopathological point of view, there were 16 simple fractures, one compression fracture, 13 dislocation fractures, 15 pure dislocations, 5 sprains, 2 post-traumatic disc herniations and 5 decompensations of cervicarthrosis myelopathy. The lesions involved the upper cervical spine (7%), the lower cervical spine (71.9%), the upper and lower cervical spine (21.1%). Thirty-two patients (56.1%) were quadriplegic and autonomic disorders were present in 7 patients (12.3%). CONCLUSION: Cervical spine trauma is frequent in Cotonou. They are often of interest to the young male subject. The lesions predominate on the lower cervical spine.
INTRODUCTION: Les traumatismes du rachis cervical constituent un véritable problème de santé publique. Ils peuvent engendrer des complications neurologiques parfois irréversibles et la mortalité reste élevée. Les étiologies sont dominées par les accidents de circulation et de travail. Nous étudions leurs aspects épidémiologiques et lésionnels dans notre milieu de travail. MATÉRIEL ET MÉTHODE: Il s'agissait d'une étude rétrospective descriptive portant sur tout traumatisé du rachis cervical admisdans le Centre National Hospitalier et Universitaire Hubert Koutoukou Maga de Cotonou entre janvier 2010 et juin 2014 dont le dossier clinique était complet. RÉSULTATS: 57 dossiers ont été retenus. L'âge moyen était de 38,7 ans (19 - 71 ans). La prédominance était masculine avec un sex-ratio de 4,2. Le délai moyen d'admission était de 27,5 jours (3 heures -175 jours). Comme étiologies, on retrouvait : lesaccidents de circulation (41 cas soit 71,9%), les accidents de travail (13 cas soit 22,9%) et les accidents domestiques (3 cas soit 5,3%). Au plan anatomopathologique, on dénombrait, 16 fractures simples, une fracture tassement, 13 fractures-luxations, 15 luxations pures, 5 entorses, 2 hernies discales post-traumatiques et 5 décompensations d'une myélopathie cervicarthrosique. Les lésions intéressaient le rachis cervical supérieur (7%), le rachis cervical inférieur (71,9%), le rachis cervical supérieur et inférieur (21,1%).Trente-deux patients (56,1%) étaient tétraplégiques et des troubles neurovégétatifs étaient présents chez 7 patients (12,3%). CONCLUSION: Les traumatismes du rachis cervical sont fréquents à Cotonou. Ils intéressent souvent le sujet jeune de sexe masculin. Les lésions prédominent sur le rachis cervical inférieur.
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PURPOSE: To study the management and evaluate anatomical and functional outcomes of patients with ipsilateral proximal and shaft femoral fractures. METHODS: A retrospective, descriptive and analytic study lasted for ten years and a half ranging from January 1, 2005 to June 30, 2015. The following parameters were studied: epidemiology, fracture characteristics, therapeutic, anatomical and functional outcomes. The correlation between different parameters was analyzed with Fischer test. The significant threshold was defined for p value <0.05. RESULTS: Ten medical files were registered. There were 7 men and 3 women, with a sex ratio of 2.33. The average age was 46 years (range: 29-62 years). It was about traffic road accidents in all cases. Motorcycle-motorcycle and motorcycle-car collision were most frequent. Average admission delay was 7 h (range: 1.5-24 h). Left side was most reached in 8 cases. According to Garden classification, there was type III cervical fracture in 2 cases, type II in 1 case and type IV in 1 case. According to Ender classification, there was type I trochanteric fracture in 3 cases, type VI in 2 cases and type VII in 1 case. According to AO classification, there was type A shaft fracture in 6 cases (A2 in 4 cases and A3 in 2 cases), type B in 2 cases (B1 in 1 case and B2 in 1 case) and type C in 2 cases (C1 in 1 case and C2 in 1 case). Average surgical delay was 28.7 days (range: 11-61 days). For proximal femoral fracture, Moore prosthesis was used in 1 case, blade plate 130° in 2 cases, long Gamma nail in 4 cases, double screwing in 2 cases and dynamic hip screw in 1 case. For shaft femoral fracture, blade plate 95° was used in 3 cases, low compressive plate in 2 cases. Osseous contention was achieved in 4 cases with long Gamma nail and in 1 case with long blade plate 130°. Nonunion of cervical fracture was achieved in 2 cases. The average osseous healing delay was 5.14 months (range: 3-12 months) for proximal femoral fracture and 5 months (range: 3-8 months) for shaft femoral fractures. According to Friedman and Wyman criteria, functional results were good in 4 cases, average in 4 cases and bad in 2 cases. Regarding implants, healing delay showed no statistic difference between one-implant group and two-implant group (p = 0.52), and among the patients with different functional outcomes (p = 0.52). Functional outcomes showed no statistic difference between one-implant group and two-implant group (p = 0.46). CONCLUSION: Ipsilateral proximal and shaft femoral fractures are relatively uncommon in our daily activities. It is difficult to recognize proximal femoral fractures which are unnoticed. Results are generally good if the doctors take the two fractures into account in the management.
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Fraturas do Fêmur/cirurgia , Adulto , Feminino , Fraturas do Fêmur/fisiopatologia , Consolidação da Fratura , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de TempoRESUMO
We report the case of a traumatic amputation by circular saw of the ring and small fingers, associated with middle finger nail matrix loss and tendon, bone and joint exposure. The replantation was not attempted with patient's consent. Since the nail unit from the ring finger was intact, we decided to harvest the ring finger nail unit for major finger reconstruction. Although the principle of vascularized transfer from a severely damaged finger is widely recognized and the vascularized nail transfer from toe is a relatively common procedure, there is no description of a vascularized nail transfer from a non-replantable digit in the literature.
