The purpose of this study is to evaluate our results of treatment of post-traumatic bone defect of members through various bone reconstruction techniques. Patients and method: It is a retrospective study continues from January 2008 to December 2012. It involved 27 patients who had bone loss following trauma members. The average age of patients was 36.2 years. We noted a male predominance (22 men). The causes of injuries were dominated by accidents of public roads (12 cases) and ballistic trauma (14 cases). We noted one case of work accident. The BL was localized in 10 cases the tibia, femur in 4 cases, 8 cases in the humerus, 2 cases in the fibula, 1 case was located in the olecranon, 1 case at the distal radius and 1 case to the ball. All lesions were open fractures. After a mean of support for 3 days, we performed emergency around 19 associated with internal fixation (10 cases external fixation, internal fixation 9 cases), 8 single around. Bone reconstruction was performed secondarily in the majority of cases (24 cases). Only 4 reconstructions were performed in emergency. Reconstruction techniques were dominated by conventional grafts (24 cases) associated or not with the technique of induced membrane. Bone reconstruction techniques we used were as follows: 24 cases of traditional autografts and 3 cases of intertibio-fibular graft. After an average decline of 43.6 months, our patients were evaluated clinically (axis and limb length) and radiological (bone healing). Results: bone healing was achieved in 22 cases after a mean of 3.8 surgeries and an average of 14.8 months. Conclusion: the main principles governing the reconstruction of a defect are pre healing associated infection and repair soft tissue whenever it can do. The current trend is to hybridization of the reconstruction process of the great losses of substance by developing strategies based on both the deliberate shortening.
The purpose of this study is to identify the causes of mechanical complications of osteosynthesis of members to prevent and improve the results of our surgical treatments. Patients and Method: Retrospective study including all patients diagnosed with mechanical complications after osteosynthesis of the limbs and who received medical follow-up. 42 patients with an average age of 42.2 years, with a male predominance (36 cases) were selected. These complications predominated in the femur with 26 cases. The implants involved were predominantly screwed plates with 25 cases. We investigated and analyzed the different types of dismantling of material as well as the etiological factors that may be at the origin of these disassembly. Results: After a mean follow-up of 15.47 months, four types of complications were identified: material expulsion (20 cases), migration (3 cases), incurvation (7 cases), fracture of material (12 cases). 4 types of factors causing dismantling have been identified: the factors related to the patient, factors related to fracture, the factors related to the implant and factors related to the surgeon. Conclusion: Disassembly of orthopedic implants is most often of multifactorial origin. These factors may act in isolation but are most often entangled in the patient. Proper preoperative planning can help prevent them. However, unexpected stresses of the implant and certain factors related to the ground remain difficult to control.
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