We found residual or delayed sequelae in 23% of our patients. Close follow-up and utilization of diagnostic studies, including two-dimensional echocardiography during the early postoperative period, can identify late sequelae and allow elective repair.
La maladie de Madelung est une déformation du poignet due à une atrophie de la partie médiale du cartilage de croissance distal du radius. Il en résulte une subluxation antéro-médiale du carpe,limitant les amplitudes articulaires. Cette dysplasie osseuse est rare et représente 1,7% des anomalies congénitales. Les auteurs rapportent un cas bilatéral chez une fille de 21 ans. L’étude de cette observation nous a permis d’étudier la fréquence, les signes et les moyens de son diagnostic ainsi que les mesures thérapeutiques adéquates afin de pouvoir répondre aux attentes des patientes.
Objective: To identify the determinants of secondary limb amputation in advanced squamous cell carcinoma. Material and Methods: This was a retrospective study carried out in the Orthopedic Traumatology Department of the Bouaké University Hospital in Côte d'Ivoire from January 2013 to December 2016. It involved ten patients with locally advanced skin squamous cell carcinoma, confirmed by histology and having amputated limbs. The parameters studied were: demographic data (gender, age), socio-economic conditions (occupation, place of residence), the risk factors involved, the use of topical self-medication and the use of traditional medicine, antecedents and comorbidities factors, lifestyle, clinical aspects (seat, size), extension assessment (X-ray), anatomo-pathological examination data, duration of evolution of squamous cell carcinoma, the function of the affected limb, the treatment performed, the evolutionary modalities and the equipment. Results: Between 2013 and 2016, ten patients underwent either upper or lower limb amputations following locally advanced squamous cell carcinoma. The average age was 34.1 years (19 -64 years). There were 7 men (70%) and 3 women (30%) and all our patients were black (sub-Saharan Africa). The majority of our patients were farmers (70%). The risk factors for squamous cell carcinoma were neglected chronic wounds. All our patients recognized during the interrogation a large use of the topicals of traditional medicine for the treatment of the initial cutaneous lesions. In terms of lifestyle, five (50%) were smokers and alcoholics. The mean time to progression of squamous cell carcinoma was 5.9 years. Lesions were localized preferentially to the pelvic limbs six (60%) cases and four (40%) to the limbs chest. The lesion was diagnosed late in all our patients. The size of the tumor in all our patients was greater than 5 cm and had a deep invasion (nerves, vessels and bone). The proximal ipsilateral ganglionic How to cite this paper:
Madelung deformity is rare, accounting for 1.7% of congenital anomalies. The treatment is essentially surgical and several techniques have been described. We report the result of a case treated in an adult patient by a double osteotomy of the radius and ulna. The patient is satisfied.
Knee dislocation is a serious and rare injury. Its rarity and the variety of injuries that result from it mean that there is no adequate management that is universally accepted. The aim of this study was to evaluate our emergency care strategy for these injuries. Materials and methodology: This was a retrospective study conducted from January 1992 to December 2004 on nine cases of knee dislocation. It consisted of six men and three women. The average age of these subjects was 35, ranging from 15 to 50 years. The causes for these injuries included: public road accidents (n = 4), household accidents (n = 3), a sporting accident and a dislocation that occurred following a fight. The dislocations were anteromedial (n = 4), posterolateral (n = 2), posterior (n = 2) and anterior (n = 1). Associated injuries were sore joint (n = 2), contusion of the common peroneal nerve (n = 1) and vascular injury (n = 1). An angiography was performed on one patient for a vascular injury and an Elecmyography (EMG) for a common peroneal nerve injury. Closed reduction was used for eight patients and open reduction for one patient. Results: Five knees were stable with normal range of motion and some residual pain. Four patients had knee instability; two anterior, one anteroposterior and one lateral. In three of these patients, the CT arthrography/arthro-scan confirmed central pivot damage, with meniscal damage in two of them. The four patients were referred to a knee surgeon in a private practice. The post-operational effects were minimal in vascular injury. The EMG performed for the common peroneal nerve detected a nerve contusion. Conclusion: Our emergency care strategy remains closed reduction. This therapeutic management is consistent, at least in the first 15 days, with the literature.
Repair of an old lesion of the triceps brachii tendon is infrequent. A V-Y plasty was performed 4 years after the injury in an adult. Post traumatic osteoarthritis limits functional outcomes. The patient is satisfied.
Background: To describe the mechanisms of injury and the anatomo-clinical aspects of trauma caused by motorized two-wheeled vehicles at the Bouaké University Hospital. Methods: This was a retrospective descriptive study performed in the surgical emergency department of the Bouaké University Hospital. It lasted for a period of 08 months from February 1, 2015 to September 30, 2015. It concerned patients admitted to surgical emergencies for injuries that occurred during an accident involving a motorcycle. Neglected trauma due to accidents involving motorcycles, accident victims not involving motorcycles were not included in our study. The data collected were: age, sex, occupation, circumstances and mechanism of the accident, seat of the lesion and injury report. Results: During this study period, 2,647 emergency room patients were registered with 615 injuries due to motorcycle accidents. The frequency of road accidents caused by motorized two-wheelers accounted for 23.23% of surgical emergency room admissions. The average age of the victims was 31.9±16.7 years with extremes of 1 day and 95 years. There were 468 men (76.09%) and 147 women (23.91%), and the 21-30 age group was the most representative with (n=195, 31.70%) case. Students were the most affected (n=270, 43.91%) on traders (n=142, 23.09%). Motorcycle drivers (n=304, 49.44%) and motorcycle rear passengers (n=175, 28.45%) were the most affected. The most common types of accidents were motorcycle versus car (n=174, 28.29%), motorcycle versus pedestrian (n=154, 25.05%), and mishandled motorcycles (n=174; 143, 23.25%) of the cases. The majority of patients did not wear safety helmets (n=492, 80%). The lesions observed during our study sat preferentially at the limb level (n=344, 55.93%) and Skull n=115; 18.7%). Soft-tissue wounds (n=247, 40.15) predominated the cases, followed by fractures (n=145, 23.57%). There were eleven deaths (n=11, 1.79%). Conclusion: Road accidents due to two-wheeled vehicles (motorcycles) are more and more frequent in Bouaké. Motorcycle-to-car accidents are common. Deaths were due to head trauma in the majority of cases. Compliance with the Highway Code and mandatory use of a safety helmet could reduce the number and severity of injuries.
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