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Background: Limb amputations are responsible for disability. We studied the outcomes of lower limb amputees in our daily practice. Methods: This prospective analytical study over 7 years (January 2009-December 2015) included 70 amputees of lower limb. They were mainly male (73%), aged on average of 42.4 AE 18.8 years. The mean time of follow-up was 3.2 AE 1.9 years. We assessed disability on balance, walking, disability in daily life for patients with prosthesis, and the socioeconomic impact of the amputation. Statistical analysis was performed with Chi 2 and Mann-Whitney tests; a p-value 0.05 was considered statistically significant. Results: The average Timed Up and Go Test was 18.5 s. Class II of Pohjolainen subjects were the most recovered (37%). The mean Houghton score in the 17 fitted patients was 6.2 AE 2.0. Socially, 90% of the patients no longer practiced leisure activities, and 4/53 patients were no longer in a couple. At the economic level, 87% of patients had a decreased monthly income. Factors that bear direct correlation to functional outcome of patients were the level of amputation, and the prosthesis fitting. Conclusion: Lower limbs amputations entail adverse consequences at the functional and socioeconomic level. Our country must review its policy on prosthetic fittings for amputees, and vote laws that involve private firms and government in socioeconomic reintegration, and empowerment of these subjects.

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Introduction: The increasing number of vehicles and the proliferation of two-wheeled vehicles accentuate the frequency of fractures in our country. The aim of this study is to describe the epidemiology of fractures in Cotonou. Materials and Methods: This prospective two-year study focused on all patients admitted to the emergency department of the National Teaching Hospital of Cotonou for a fracture injury. Results: 1794 fractures were collected in 1432 patients. Fractures accounted for 24.9% of surgical emergencies. The average age was 33.7 years (29 days -90 years). The dominance was male with a sex ratio of 3.62. Etiological circumstances were dominated by road traffic accidents (75.8%), The etiological circumstances were dominated by road accidents (75.8%), motorcyclists being the most affected (48.5%). The admission average was 27.33 hours (15 minutes -29 days). Fractures preferentially sat on the lower limbs (64.4%). In descending order of frequency, were distinguished the fractures of leg (32.2%), of the femur (19.8%) and of the forearm (14.8%). Conclusion: fractures are common.

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Abstract:Background: traumatic brain injury is a real health problem, especially in low-income countries. The aim of this study was to assess the impact of helmet wearing on primary injuries in motorcycle trauma. Methods: this was a crosssectional study from 1 st January to 31 st December 2013. It covered all motorcycle users, admitted in emergency at Cotonou National Teaching Hospital, with a traumatic brain injury. Epidemiological variables and primary lesions were identified. Statistical analysis was performed with Chi 2 and Fischer's tests; a p-value ≤ 0.05 was considered statistically significant. Results: we collected 310 patients (57.9% of traumatic brain injury), 11 of whom wore a helmet. They were predominantly male (male to female ratio =7.6), with a mean age of 33.2 ± 10.9 years. Craftsmen (24.4%) were the most affected. The head trauma was often opened (172 cases / 299) in patients without helmet compared with 4 cases / 11 in patients with helmet (p = 0.001). Similarly, primary lesions were often more severe in patients without helmet, with a large number of primary lesions requiring surgery. Conclusion: helmet wearing significantly reduces the risk of serious primary injuries in motorcyclists in our context. Strict enforcement of mandatory helmet use should reduce the incidence of disabling injuries in our country.

Introduction: The management of polytrauma patient should be beforehand and always in keeping in mind the damage control. the surgical treatment is secondary to the stabilization of the patient. Clinical Case: we are reporting a 34 years old polytrauma patient from a motor vehicle accident. On physical examination, we noted : a severe brain injury, a closed articular fracture of right distal radius associated to a dislocation of distal radius and ulna distal joint, a closed bilateral fracture of both trochanters, an open communitive tibial fracture of proximal epiphysis methaphysis and diaphysis. The last one was classified as type IIIB of Gustilo and Anderson and associated to a closed fracture of the head and the neck of right fibula, a closed fracture of the right lateral malleolus. After patient stabilization, the head injury improves to normal Glasgow score on 8th day of admission. Necrosis of soft tissus and exposition of the tibia was noted. The surgical treatment was done on 2 stages due to financial issues. A bone synthesis of the trochanteric fracture was done only on the left and external frame as well as a muscle flap was done for the right tibial fracture on the 18th day. On the 42nd day a PAPINEAU technic associated to a proximal inter tibiofibular graft was done. The functional outcome of the orthopaedic treatment of the wrist was bad (malunion). That last complication was managed by a SAUVE KAPANDJI surgery (at 6 months) and the contracture (pronation and supination) at 12 months post trauma. The outcome was fair good despite patient financial issue and local complications that compromise an optimal surgical management and a delay. He resumes normal professional activities at about 2 years. At 5 years follow up, functional and anatomical results were satisfactory. Conclusion: In a limited ressources’ setting, the management of lesions including a multiple fractures is a challenge for the practitioner and the injuried patient. A management taking into account social and economic ressources is mandatory to minimise sequelae. Keywords: Management, Polytrauma, Limited ressources.