Introduction:In July 2014, a United Nations Multidimensional Integrated Mission for the Stabilization of Mali (MINUSMA) had started. Soldiers of this mission were frequently attacked and many of them are wounded. Togo's Level 2 hospital has been deployed in Kidal to provide emergency medical and surgical care to all wounded in the northern sector. The purpose of this work was to determine the epidemiological profile of the fractures presented by these wounded. Materials and methods: It was a continuous prospective study from January 2015 to December 2016, concerning patients who were admitted for a fracture and confirmed by a standard radiography. The parameters studied were the age of the wounded, the sex, the civil or military status, the etiology of the fracture, the seat of the bone lesions, the associated lesions and the type of opening according to the Gustilo-Anderson classification. Results: Two hundred and fifty patients (250) were admitted for fractures during this period. The etiology of fractures was dominated by firearms (27.2%) and traffic accidents (22.7%). Three hundred and two (302) fractures were reported from the 250 patients. They were in the lower limb in 145 cases (48%), upper limb in 130 cases (43.1%). Fractures were open in 216 cases (71.5%) and dominated by Gustilo-Anderson type III (69.4%). Conclusion:The fractures found during the peacekeeping missions are associated with other lesions that make their severities. The care of these wounded should be multidisciplinary. Otherwise, the military surgeon deployed in these missions must have many skills to optimize the results of this care.
Introduction: Knee trauma is very common and sometimes compromises its stability. The treatment of these lesions is more and more surgical, but nonsurgical treatment remain having an importance in the management. The purpose of this study was to determine the results of nonsurgical treatment of ligamentous knee injuries in soldiers deployed in northern Mali during a stabilization mission. Materials and methods: It was a prospective study concerning ligamentous lesions of the knee, treated by orthopedic means in Togo's level 2 hospital and followed for a period of at least 6 months. The International Knee Score (IKS) was used to determine our results. Patient satisfaction was determined by taking into account pain, knee stability and resumption of previous activities.Results: Twenty-one (21) patients were treated. They were 18 men (85.7%) and 3 women (14.3%). The average age of the patients was 32.43 years old. We found 7 cases (33.4%) of benign sprain, 9 cases (42.8%) of medium severity sprain and 5 cases (23.8%) of severe sprain. After administration of the analgesic, immobilization was made by a knee brace and sometimes a plaster splint. Rehabilitation was started at the end of immobilization. The control after 6 months of follow-up allowed to find 57,1% of excellent result and 9,5% of bad result Conclusion: Nonsurgical treatment of ligamentous lesions gives good results when properly conducted. When a surgical treatment is decided for these lesions, it is recommended to make the rehabilitation of the knee before the operation to improve the results.
The purpose of this study was to describe the indications of Ilizarov's technique in orthopedic trauma and their results. Material and method: The study involved a retrospective multicenter cohort. It included patients treated with Ilizarov's technique between July 2014 and September 2019 and followed through to recovery. The analysis focused on types of lesions, intraoperative data, complications, cure and failure rates. Only the pins were the responsibility of the patient and cost between 60,000 to 120,000 CFA (91, 5 -183 euros). Results: Forty-seven patients were treated. The average age was 37.4 years. Males represented 63.8%. The main diagnoses were: tibial fractures (n = 31; 65.9%), including 14 fractures of the tibial plateau; vicious ankle calluses (3; 6.4%); loss of bone substances (3; 6.4%). The main interventions carried out were: Osteosynthesis (n = 34; 72.3%); ankle arthrodesis (n = 5; 10.6%); equine varus foot correction (n = 4; 8.5%). The average duration of an intervention was 130.5 min. the average ablation time was 98.7 days. The cure rate was 95.6%. The main complications were: infection on a spindle (n = 11; 23.4%); pain (n = 6; 12.8%), stiff knee (n = 7; 15.9%). Conclusion:The rate of positive results is similar to that observed in the literature. Ilizarov's external fixator has achieved satisfactory results for complex leg and ankle injuries at a reduced cost.
Introduction: Tripolar lesions of the thoracic limb are rare. We report a rare a Galéazzi fracture associated with an ipsilateral fracture of ulna and olecranon in a 45-year-old patient. Surgical management has been delayed due to limited resources of the patient. Case presentation: It was a 45-year-old man admitted in our emergency after a fallen on bicycle. He presented a fracture of olecranon, shaft bone fracture of radius and ulnar, and distal radio-ulnar disjunction. The assessment at 18 months has found a consolidation of fractures. The elbow and wrist regained joint range, but we noted a limitation of prono-supination related to radioulnar synostosis. This limitation had no impact on the professional and sporting activities of the patient. Conclusion: Apart the difficulties to describe mechanism responsible of this complex lesion, the functional prognosis of the limb depends on a correct diagnosis and adequate management. At the last follow-up, the patient was satisfied with the result obtained. Longer term follow-up will allow us to determine the issue of this complex lesion in this patient. For the moment patient is not complained so wejust wait and see. Keywords: Galeazzi fracture, distal radioulnar disjunction, fractures, forearm, olecranon.
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