La prise en charge des fractures ouvertes de jambe dans une structure hospitalière en Côte d’Ivoire pose-t-elle problème et pourquoi ?

Kouassi, Kouamé Jean-Eric; Manon, Julie; Fonkoué, Loïc; Kodo, M; Detrembleur, Christine

doi:10.1016/j.rcot.2019.05.015

Cited by 8 publications

(12 citation statements)

References 12 publications

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“…Fisher's exact test analysis revealed an association between improved functional outcome and biplanar LDEF, in comparison with monoplanar constructs (p = 0.039). (Table 6) [7]. In addition, the union rate compares favorably with the outcomes reported by other authors [19,[26][27][28][29][30][31].…”

Section: Discussionsupporting

confidence: 74%

Locally-developed External Fixators as Definitive Treatment of Open Tibia Diaphyseal Fractures: A Clinical Prospective Study Conducted in Ivory Coast

Kouassi

Akobé

Kouassi

et al. 2020

Preprint

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Background: This study sought to evaluate the effectiveness of locally-developed external fixators (LDEF) as definitive treatment for open tibia diaphyseal fractures (OTDF) in Ivory Coast.Methods: Gustilo I, II and IIIA OTDFs of patients admitted within 24 hours of injury were prospectively included and treated with a locally-developed external fixator. The rates of union, mal-union, septic complications, as well as the functional results were assessed, in addition to the LDEF construct’s integrity. Predictive factors of failure or poor results were assessed.Results: Overall, 40 OTDF patients were admitted within 24 hours of injury. Gustilo I, II and IIIA fractures were observed in three, 13, and 24 patients, respectively. Uneventful fracture healing was obtained in 29 cases, with an average union time of 8.47 months. Mal-union and non-union were registered in three and four cases, respectively. Pin-track infection (PTI) was observed in 13 cases, and deep infection in seven. Infection resolved in all patients except four, who developed chronic osteomyelitis. None of the non-unions were associated with an infection. The overall functional result was satisfactory in 32 patients. PTI was the only predictive factor for chronic infection. Biplanar frames, when compared to monoplanar constructs, were associated with a significantly improved functional outcome.Conclusion: In comparison with the results obtained in the same environment without a locally-developed external fixator, the provision of such a device improved significantly the OTDF management, as it provided better stability and superior fracture healing rates. PTI remains an essential problem but with, hopefully, limited negative consequences. Trial registration: This study protocol was registered in Pan African Clinical Trial Registry under N°PACTR202009854874448. Date of registration 28 September 2020 ‘retrospectively registered’. www.pactr.org.

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Section: Discussionsupporting

confidence: 74%

Locally-developed External Fixators as Definitive Treatment of Open Tibia Diaphyseal Fractures: A Clinical Prospective Study Conducted in Ivory Coast

Kouassi

Akobé

Kouassi

et al. 2020

Preprint

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“…Under our conditions, the union rate was 35% with the standard of care, without LDEF [7]. This study aimed to reach a union rate of 70%.…”

Section: Discussionmentioning

confidence: 77%

“…The external xation system was removed, as an outpatient procedure, when fracture union was complete. Upon clinical examination, knee and ankle range of movement were examined by an independent examiner using a goniometer, in comparison to the contralateral healthy side [7,19]. The functional outcome measures were assessed at the last visit, including pain, knee and ankle motion ranges, and ability to return to normal walking, according to the Kitoko et al criteria [20] (Table 1).…”

Section: Postoperative Managementmentioning

confidence: 99%

“…In developed countries, primary debridement and intramedullary nailing are progressively becoming the preferred treatment of these fractures [6]. However, the situation differs in developing countries like Ivory Coast, where patients present late at hospitals and because adequate facilities in terms of manpower and theatres are not always available [7]. In our hospital, as in most centers in less developed regions, open tibial fractures have been traditionally managed by casting with Plaster of Paris (POP) [7].…”

Section: Introductionmentioning

confidence: 99%

“…However, the situation differs in developing countries like Ivory Coast, where patients present late at hospitals and because adequate facilities in terms of manpower and theatres are not always available [7]. In our hospital, as in most centers in less developed regions, open tibial fractures have been traditionally managed by casting with Plaster of Paris (POP) [7]. The high failure rate that was associated with this management protocol made us look into a locally-developed external xator as an alternative to the commercially available external xators and POP.…”

Section: Introductionmentioning

confidence: 99%

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Locally developed external fixators as definitive treatment of open tibia diaphyseal fractures: a clinical prospective study conducted in Ivory Coast

Kouassi

Akobé

Kouassi

et al. 2021

International Orthopaedics (SICOT)

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Background: This study sought to evaluate the effectiveness of locally-developed external xators (LDEF) as de nitive treatment for open tibia diaphyseal fractures (OTDF) in Ivory Coast. Methods: Gustilo I, II and IIIA OTDFs of patients admitted within 24 hours of injury were prospectively included and treated with a locally-developed external xator. The rates of union, mal-union, septic complications, as well as the functional results were assessed, in addition to the LDEF construct's integrity. Predictive factors of failure or poor results were assessed.Results: Overall, 40 OTDF patients were admitted within 24 hours of injury. Gustilo I, II and IIIA fractures were observed in three, 13, and 24 patients, respectively. Uneventful fracture healing was obtained in 29 cases, with an average union time of 8.47 months. Mal-union and non-union were registered in three and four cases, respectively. Pin-track infection (PTI) was observed in 13 cases, and deep infection in seven. Infection resolved in all patients except four, who developed chronic osteomyelitis. None of the nonunions were associated with an infection. The overall functional result was satisfactory in 32 patients.PTI was the only predictive factor for chronic infection. Biplanar frames, when compared to monoplanar constructs, were associated with a signi cantly improved functional outcome. Conclusion:In comparison with the results obtained in the same environment without a locally-developed external xator, the provision of such a device improved signi cantly the OTDF management, as it provided better stability and superior fracture healing rates. PTI remains an essential problem but with, hopefully, limited negative consequences. Trial registration: This study protocol was registered in Pan African Clinical Trial Registry under N°PACTR202009854874448. Date of registration 28 September 2020 'retrospectively registered'.

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Predictive factors for fracture-related infection in open tibial fractures in a Sub-Saharan African setting

Fonkoue,

Tissingh,

Muluem

et al. 2023

Injury

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La prise en charge des fractures ouvertes de jambe dans une structure hospitalière en Côte d’Ivoire pose-t-elle problème et pourquoi ?

Cited by 8 publications

References 12 publications

Locally-developed External Fixators as Definitive Treatment of Open Tibia Diaphyseal Fractures: A Clinical Prospective Study Conducted in Ivory Coast

Locally-developed External Fixators as Definitive Treatment of Open Tibia Diaphyseal Fractures: A Clinical Prospective Study Conducted in Ivory Coast

Locally developed external fixators as definitive treatment of open tibia diaphyseal fractures: a clinical prospective study conducted in Ivory Coast

Predictive factors for fracture-related infection in open tibial fractures in a Sub-Saharan African setting

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