Trauma of the external genital in children: Emasculation, a paediatric case report.

An 8-year-old boy was brought to the paediatric surgery department having amputated his penis and both testicles during a road traffic accident. Examination of the perinea showed a complete amputation of penis, scrotum and testicles. We performed debridement and skin suture initially. The urethral orifice was catheterized by a 10 F Foley's catheter. I the herein case report, we discuss the incidence, management and complications of genital amputation in a young boy. Moreover, the existing literature in this subject is reviewed.

Les complications de la circoncision au CHU de Yopougon

Circoncision masculine - méthodes

Surgical treatment of femoral diaphyseal fractures in children using elastic stable intramedullary nailing by open reduction at Yopougon Teaching Hospital.

INTRODUCTION: Elastic stable intramedullary nailing (ESIN) has transformed children's femoral shaft fracture treatment, but this technique requires an image intensifier. Without it, open reduction is used to check fracture reduction and pin passage. The aim of this study was to describe our techniques and to evaluate our results at the middle term. HYPOTHESIS: The open reduction and ESIN technique provides satisfactory results with few major complications. PATIENTS AND METHODS: This was a retrospective study that focused on femoral diaphyseal fractures treated in the pediatric surgery unit at Yopougon Teaching Hospital (Abidjan, Côte d'Ivoire) between January 2007 and December 2013. Twenty children older than 6 years of age who underwent open reduction and ESIN without image intensifier assistance were included. Functional outcomes were assessed using Flynn's criteria. Postoperative complications and sequelae were recorded. RESULTS: At the 16-month follow-up, the results were excellent in 11 (55%) cases, good in eight (40%), and poor in one (5%) case. The mean duration of surgery was 71min (range, 57-103 min). The mean time for bone healing was 11.6 weeks (range, 7-15 weeks) and the average time to nail removal was 6 months. Complications included wood infection (n=3), skin irritation (n=3), knee stiffness (n=2), malunion (n=3), scar (n=5), and leg length discrepancy (n=3). DISCUSSION: Open reduction and ESIN yielded satisfactory results with few major complications. This method could be an alternative in low-income countries where the image intensifier is often unavailable. LEVEL OF EVIDENCE: Level IV retrospective study.

Infections osteo-articulaires (IOA) des nourrissons de moins de 3 ans: particularites cliniques; bacteriologiques; therapeutiques et pronostiques

Contexte. Dans les pays industrialises; les IoA sont prises en charge tres rapidement au debut des manifestations cliniques contrairement aux pays en developpement ou elles sont traitees tard au stade subaigu ou chronique. L'objectif de cette etude etait de decrire les IAo chez les enfants de moins de 3 ans afin de definir leurs particularites cliniques; d'identifier les bacteries en cause. Patients et methode. Sur une periode de 11 ans; de Decembre 2002 a Janvier 2013; nous avons collige des dossiers d'Infections osteo Articulaires (IoA) d'enfants au Centre Hospitalier Universitaire de Yopougon Abidjan Cote d'Ivoire. Les donnees cliniques concernaient; le delai de consultation; les portes d'entrees; la symptomatologie clinique (signes generaux; signes fonctionnels; signes physiques); Les parametres etudies etaient cliniques; biologiques; bacteriologiques; therapeutiques et evolutifs. Resultats. Au total; nous avons collige 105 dossiers d'Infections osteo Articulaires (IoA) d'enfants de 0 a 36 mois. Les resultats de l'hemoculture ont ete positifs dans 22%; ceux de la ponction articulaire ont ete positifs dans 51;5%; ceux de la ponction metaphysaire dans 22% et ceux du prelevement de la porte d'entree dans 60% . Les bacteries isolees etaient; le staphylococcus aureus dans 54%; Salmonella dans 23%; Klebsiella pneumoniae dans 19%; Pyocianique dans 4%. L'antibiogramme a montre une sensibilite des bacteries isolees dans 100% des cas aux Aminosides; aux Fluoroquinolones; a la Fosfomycine; aux Imipenemes et aux Glycopeptides. La sensibilite aux Betalactamines etait de 60%. Conclusion. Il faut eviter les betalactamines en mono antibiotherapie de premiere ligne au cours des IAo chez les nourrissons de moins de 3 ans. Nous suggerons l'utilisation d'une mono antibiotherapie avec amoxicilline acide clavulanique qui vise l'elimination du Kingella Kingae premiere bacterie en cause au cours des infections orL des nourrissons mais aussi a cause de l'acide clavulanique pour eliminer les staphylocoques dores producteurs de betalactamase