Introduction: Fractures of the humeral pallet occur between the distal insertion of the anterior brachial muscle and the joint space of the elbow. It represents 2% of all elbow fractures. These lower humeral fractures present a therapeutic challenge to trauma. These fractures are in the majority of joint cases and can be accompanied by loss of substance, which makes their functional prognosis random despite the application of the main therapeutic principles: exact reduction with possible bone graft; stable osteosynthesis, usually allowing early rehabilitation. This work focused on identifying therapeutic aspects and assessing treatment outcomes. Material and Methods: This was a descriptive cross-sectional study of patients with a fracture of the humeral palette from January 2015 to December 2019 at the Orthopaedic Trauma Department CHU Gabriel Touré Bamako. Results: We collected 35 cases of fractures of the humeral palette. The average age was 39.25 years with extremes of 22 and 74 years. The male gender predominated (71.4%) with a sex ratio of 2.5. Etiologies were dominated by falls with 19 cases (54.3%) and stroke with 13 cases (37.1%). The standard X-ray of the face and profile of the elbow was performed in all our patients. The most frequent types of anatomoradiology were supra condylar fractures type A in 16 cases (45.7%), supra and inter condylar fractures type C in 15 cases (42.9%); 4 cases of uni condylar fractures type B (11.4%). Associated lesions were observed in 42.85%. Surgical treatment was performed in 80% of cases. Complications were dominated by elbow stiffness in 18 cases (51.42%), secondary displacement in 5 cases (14.28%), ossifications in 4 cases (11.42%). At an average decrease of 3.2 years our results were considered good in 45.7%. Conclusion: Fractures of the humeral palette are relatively common with associated lesions.
Introduction: To our knowledge, no scientific study has been conducted at the university hospital of Kati on recent traumatic epiphyseal detachment fractures of the distal femur. However, every day, children present in consultation for knee trauma. Conjugal plate fractures are by definition single to children. Any break in any solution of continuity of this plate is called an epiphyseal fracture or detachment. Objectives: To evaluate the results of surgical treatment of traumatic epiphyseal in detachments of the distal femur recent in children and adolescents. Patients and Method: This was a 13-month prospectively collected longitudinal descriptive study from September 1, 2016 to September 30, 2017. We identified and reviewed 20 medical records of recent traumatic epiphyseal detachments of the distal femur. The parameters studied were sociodemographic, lesion, surgical technique and evolutionary. Results: During the study period, the most affected group age was 12 to 17 years (85%) with an average of 14.65 ± 1.61 years (6 and 20 years). The victims were male (95%). The most frequent etiology was road traffic accident (95%), with a mean time to care of 26.42 ± 10.21 hours and Type II was frequently encountered (85%) with 35% of immediate complications. Cross-bracketing was the most commonly used surgical technique (85%). The result was good (65%). Conclusion: This study allowed us to observe a significant hospital incidence of epiphyseal detachment fractures of the distal femur. Cross pinning was the most commonly used surgical technique with fewer complications (35%)
Introduction: Varus equine foot deformity is common in developing countries. The management of these deformities is surgical in adults. Several surgical techniques have been described with more or less satisfactory results. To our knowledge, no study has been performed on the simultaneous association of double arthrodesis, posteromedial release, and posterior tibial transfer in a single operation in inveterate paralytic varus equines feet. The purpose of this work was to evaluate the results obtained. Patients and Method: This was a retrospective descriptive study from January 01, 2018 to December 31, 2021. It concerned inveterate paralytic varus equines feet operated on by the simultaneous association in a single operative time of double arthrodesis of the foot, posteromedial release of the back foot and transfer of the posterior tibial muscle to the lateral cuneiform. We identified seven patients with a mean age of 22.1 years with extremes of 11 years and 36 years. There were three males and four females. The cause of the deformity was neurological in all cases. All patients had painful walking discomfort and shoeing difficulties. The average time to management was 13.3 years with extremes of 4 and 25 years. The chronology of the interventional steps was posteromedial release, arthrodesis, and transfer of the posterior tibial muscle to the lateral cuneiform. The average postoperative follow-up was 21.7 months with extremes of 6 and 48 months. The parameters studied were the duration of the procedure, complications related to the procedure, muscle strength at the last recoil, consolidation of the arthrodesis, residual pain, patient activity, gait perimeter, stepping, ankle mobility, residual deformity, footwear, protrusion of the transferred tendon, and the possibility of walking on the heel.
174 Open Journal of Orthopedics terior tibial tuberosity was performed for 15 days in all patients. The hip was flexed to 45˚ and the knee to 35˚. Fixation was performed with one or two screws. No contralateral preventive fixation was performed. Minimum follow-up was one year. Functional outcome was assessed by the Postel Merle d'Aubigné score. Anatomical outcome was assessed by the quality of reduction, the occurrence or non-occurrence of femoral head necrosis, and chondrolysis. Results: We identified nine patients with a mean age of 12.8 years and extremes of 9 and 17 years. There were three boys and six girls. Trauma was mentioned in four cases. The cause was idiopathic in five cases. Functional impotence was complete in all patients. The slippage was acute on a chronic background in all patients. The left side was affected in 7 cases and the right side in 2 cases. The patients were overweight in 7 cases. The patient's weight was within the normal range in two cases. At final follow-up, all nine patients were asymptomatic. Anatomically, all nine patients had a femoral head free of avascular necrosis. In eight patients, the posterior tilt was absent, identical to that obtained after the traction period. Only one patient had a moderate posterior tilt with a neck uncovering of less than 25%. Functionally, the PMA score was very good in eight cases and good in one case. Conclusion: This study shows that the treatment of acute and unstable forms of upper femoral epiphysiolysis by progressive reduction with transtibial traction can lead to satisfactory results. Reduction in large displacement forms should be gentle, progressive and limited to the minimum necessary for osteosynthesis. Magnetic resonance imaging examination is an essential and indispensable prognostic element. Indications for preventive fixation should be selectively reserved for specific cases.
Introduction: A fracture is a solution in the continuity of a bone. Pelvic limb fractures may involve one or more of the bones. They constitute a real public health problem, which requires the identification of the factors inherent to this phenomenon for better prevention, but also for quality management of fractures and sequelae. Objectives: Were to describe the epidemiological, clinical and therapeutic profile of pelvic limb fractures in Timbuktu Hospital. Patients and Method: We conducted a prospective, descriptive study in the Surgery Department of Timbuktu Hospital, covering a period of one year from January 1 to December 31, 2017. We collected 39 patients who presented with fractures of the pelvic limbs, who were hospitalized and monitored throughout our study. Results: We obtained a hospital frequency of 2.86% limb fractures. Among the 39 patients included in our study, the male sex was predominant in 69.2% of cases, the average age of our patients was 20.5 years. Pupils and students were in the majority in 48.7% of cases. Road traffic accidents were the most common cause of fracture with 59.0% of cases. The tibia was the most affected segment in 38.5% of cases. Surgical treatment was predominant in 64.0% of cases. We obtained very good results in 94.87% of cases. Conclusion: Limb fractures remain frequent due to road traffic accidents. Osteosynthesis treatment provides a good result with fewer complications.
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