ABSTRACT
The aim of this work was to discribe the lesions caused by the use of blasting landmines among civilians in south Senegal, and to evaluate their surgical management. The prospective study, which was conducted from February 2001 to September 2002, took place in the orthopedics and trauma clinic of the Ziguinchor regionle hospital. The average age of the patients was 22, and they included 13 men and 2 women. In 12 cases, the lesions were unilateral and bilateral in 3 cases. Surgical management began with an assessment of the lesions using the classification of Coupland and De Wind. Treatment was based on a pre-established protocol in order to end up with a stump of good quality. The major lesion would consist in one or both lower limbs crushed or amputated. It would be open and of the I- type according to Coupland and De Wind. Lesions as a result of several shrapnel impact and burns were considered as associated lesions with the main lesion. Six patients presented an infection of the stump. Some stumps healed completely after about 15 days, and some took no more than 75 days before closing up. Only one stump needed grafting. All our patients had the advantage of a casting off. The young and rural people were the most vulnerable. Lesions were rather distal-based. Infection delayed healing. No matter what the form of the lesion, there was always a partial loss of a limb. Landmine feet injuries as serious lesions. The objective of the surgical treatment is to facilitate the further use of a prosthesis.
Subject(s)
Amputation, Surgical , Explosions , Foot Injuries/etiology , Foot Injuries/surgery , Adolescent , Adult , Artificial Limbs , Female , Humans , Male , Middle Aged , Prospective Studies , Prosthesis Design , Rural Population , Senegal , Wound HealingABSTRACT
The authors studied restrospecively their cases of trochanteric fractures to evoluate the frequency, the mortality, the morbidity and the results according to the diferent types of osteosynthesis used. 68 cases were collected in a 45 months. Mean age was 75 with 33 men and 35 women. 28 patients were sick before the accident. Using the A.O. classification, the patients were divided in three groups: 19 type A1, 37 type A2 and 12 type A3. 28 patients were operated an emergency basis. An A.O. nail plaque was used in the 43 cases and a staca screw plaque was used in the 11 remaining cases. Early in hospital mobilisation and weigh bearing with assistant was used and continued after discharge. After 17 months of follow up and according to Merle d'AUBIGNE'S, criteria, 91. 42% of the patients showed satisfactory results--16 patients died 8 of them had another desease. Anatomically, bone consolidation was gained after a mean period of 97 days and 40 % of Coxa-vara was reorganised. The frequency of trochanteric fracture inthe elderly is 69,3% in our experience. The patients operated on in emergency for whom a stacca nail plate had a better results with an earlier walking autonomy. In mean follow up there was no different in the two groups.
Subject(s)
Hip Fractures , Aged , Aged, 80 and over , Female , Hip Fractures/epidemiology , Hip Fractures/surgery , Humans , Male , Middle Aged , Prognosis , Retrospective Studies , Treatment OutcomeABSTRACT
The West African Onchocerciasis Control Programme (OCP), launched in 1974, seeks to interrupt transmission o f Onchocerca volvulus (Fig. I) over a vast area now encompassing 11 countries. The main strategy has been vector control using larvicides (particularly temephos) against blockfly larvae in fast-flowing rivers and streams. More recently, the programme has also begun to implement large-scale chemotherapy using ivermectin. The OCP has an operational budget approaching US$25 million a year. The control activities have led to a dramatic decrease in the incidence of new cases, while overall prevalence of infection has been reduced from about 25-30% to below 5%, accomponied by a similar drop in the numbers o f people presenting severe ocular involvement or blindness. Entomological, clinical and epidemiological results of the programme have been discussed in detail -particularly in the various reports produced by programme personnel and associated researchers (eg. Ref. I). Here, we asked James Senghor and Ebrohim Samba to discuss what the programme has meant to the people involved.
