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1.
Bénin Médical ; 69: 105-109, 2024. figures, tables
Artigo em Francês | AIM (África) | ID: biblio-1554645

RESUMO

Objectif : Décrire les aspects médico-légaux de la réparation des amputations traumatiques de membres en milieu professionnel. Méthodologie : Etude descriptive retrospective réalisée au centre des urgences de Yaoundé (CURY) de Janvier 2017 à Decembre 2022. Etait inclus, tout patient consentant ayant subi une amputation de membre consécutive à un accident de travail durant la période d'étude. Résultats : Au total, 96 patients amputes de membres ont ete colliges. Les victimes étaient majoritairement de sexe masculin soit 70.8%, la tranche d'âge la plus representee était celle de 30 à 35 ans. La categorie professionnelle la plus representee etait la categorie H (transport et entreposage) soit 34.5%. L'ecrasement a constitué le type lésionnel le plus pourvoyeur d'amputation soit 46,9 %, les membres inferieurs etaient le plus souvent atteint (66,6%). La duree moyenne d'arrêt de travail etait de 90,5 jours et l'incapacité permanent partielle (IPP) moyen etait de 47.9 %. Des patients amputes, 47.9 % avaient beneficies d'un changement de poste de travail. Conclusion: Les amputations traumatiques de membres en milieu professionnel sont relativement fréquentes. Toutes les catégories socioprofessionnelles peuvent être concernees. Elles sont source de prejudices importants.


Objective : To describe the medico-legal aspects of repairing traumatic limb amputations in the workplace. Methodology : Retrospective descriptive study conducted at the Yaounde emergency centre (YEC) from January 2017 to December 2022. All consenting patients who underwent a limb amputation following a work-related accident during the study period were included. Results : A total of 96 patients with limb amputations were enrolled. The victims were predominantly male (70.8%), and the most common age group was between 30 and 35 years. The most common occupational category was H (transport and storage), at 34.5%. Crushing was the most common type of injury causing amputations (46.9%), with the lower limbs most often affected (66.6%). The average length of time off work was 90.5 days, and the average permanent partial disability (PPD) was 47.9%. Of the amputated patients, 47.9% had benefited from a change of workstation. Conclusion : Traumatic limb amputations in the workplace are relatively common. All socioprofessional categories may be affected. They are a source of significant prejudice


Assuntos
Humanos , Masculino , Feminino , Ferimentos e Lesões
2.
Med Sante Trop ; 27(4): 426-430, 2017 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-29313512

RESUMO

The authors examined mortality during road traffic accidents (RTAs) to propose solutions for their prevention. This descriptive prospective study took place over a 12-month period (June 1, 2011, to May 30, 2012) and included all fatalities from RTAs brought to selected hospitals. These RTA fatalities were studied in the morgues and selected sites. An autopsy was conducted for each victim to clarify the cause of death. An injury severity score (ISS) was also calculated for each victim. The data were analyzed with Epi-Info 2008. The study included 1283 victims of RTAs, 217 of whom died, for a lethality rate of 16.9%. Among the deceased, 116 died before reaching the hospital, for a prehospital lethality rate of 53.5%. The 101 remaining victims died in hospital, 68 of them in the emergency department before admission. Head trauma accounted for the largest proportion of deaths (57.6%), followed by the polytrauma (25.7%). Passengers in cargo trucks (39.3%) and motorcyclists (13.9%) were the most exposed to fatal accidents. For an ISS > 25, the mortality rate was 41.7%, and for an ISS > 40, 100%. Based on the ISS, most of these deaths could have been avoided. The urgent establishment of a public transportation system, improvement of transportation of RTA victims to hospitals, and an effective healthcare system could reduce this high mortality rate.


Assuntos
Acidentes de Trânsito/mortalidade , Adolescente , Adulto , Distribuição por Idade , República Centro-Africana/epidemiologia , Feminino , Humanos , Escala de Gravidade do Ferimento , Masculino , Estudos Prospectivos , Distribuição por Sexo , Ferimentos e Lesões/mortalidade , Adulto Jovem
3.
Artigo em Francês | AIM (África) | ID: biblio-1263818

RESUMO

Introduction: Les cals vicieux diaphysaires du fémur sont le plus souvent les complications du traitement traditionnel des fractures. Cette étude avait pour objectifs de préciser les formes anatomo-cliniques des lésions, décrire la technique utilisée, et évaluer les résultats obtenus.Matériel et méthodes. Cette étude prospective incluait tous les cals vicieux diaphysaires du fémur de l'adulte traités entre juin 2011 et mai 2015. Leur gravité de la déformation était classée selon des critères propres. Les résultats du traitement étaient évalués au recul minimum de 12 mois avec les critères de Thorensen.Résultats L'étude incluait 34 patients (28 hommes et 6 femmes) avec un âge moyen de 30 ans (16 et 65). Les patients ont consulté après un délai moyen de 7,6 mois (4 et 24). Les cals vicieux siégeaient au tiers supérieur (n=6), au tiers moyen (n=16) et au tiers inferieur (n=12). Le traitement initial des fractures était traditionnel (n=22), chirurgical (n=8)et orthopédique (n=4). Les motifs de consultation étaient mixtes associant boiterie à la marche et douleurs articulaires (n=17), douleur isolée (n=8), boiterie (n= 8). Un patient a consulté pour raison esthétique (n=1). Le raccourcissement du membre était en moyenne de 2,6 cm (2 à 4). L'angulation moyenne était de 26,7° (4 à 45°). La mobilité du genou était de 90,4° en moyenne (45 à 120°). Le délai moyen de réalisation de l'ostéotomie était de 7 mois (4 et 25) après le traumatisme. L'ostéotomie était faite après décortication ostéo musculaire selon Judet. Un enclouage avec clou de Kuntscher a été faite pour 29 fractures médiodiaphysaires. Une plaque vissée a été utilisée pour 5 fractures proximales et distales. Aucun patient n'a été perdu de vue. Nous n'avons noté ni fracture iatrogène, ni lésion vasculaire et/ou nerveuse. Aucune infection du site opératoire n'était notée. La mobilité moyenne post-opératoire du genou était de 124° (110 et 135). Au recul moyen de 21 mois les résultats selon les critères de Thorensen étaient bon (n=12) et moyen (n=22).Conclusion Les cals vicieux fémoraux avec un raccourcissement maximal de 4 cm et une angulation à 45° peuvent être corrigés à foyer ouvert en un temps opératoire après une décortication ostéomusculaire


Assuntos
República Centro-Africana , Fraturas do Fêmur , Fixação de Fratura/enfermagem , Osteotomia
4.
Ann Chir Plast Esthet ; 61(5): 613-621, 2016 Oct.
Artigo em Francês | MEDLINE | ID: mdl-27692236

RESUMO

"Palsy of the upper limb" in children includes various diseases which leads to hypomobility of the member: cerebral palsy, arthrogryposis and obstetrical brachial plexus palsy. These pathologies which differ on brain damage or not, have the same consequences due to the early achievement: negligence, stiffness and deformities. Regular entire clinical examination of the member, an assessment of needs in daily life, knowledge of the social and family environment, are key points for management. In these pathologies, the rehabilitation is an emergency, which began at birth and intensively. Splints and physiotherapy are part of the treatment. Surgery may have a functional goal, hygienic or aesthetic in different situations. The main goals of surgery are to treat: joints stiffness, bones deformities, muscles contractures and spasticity, paresis, ligamentous laxity.


Assuntos
Artrogripose/fisiopatologia , Neuropatias do Plexo Braquial/fisiopatologia , Paralisia Cerebral/fisiopatologia , Extremidade Superior/fisiopatologia , Extremidade Superior/cirurgia , Artrogripose/cirurgia , Traumatismos do Nascimento/fisiopatologia , Traumatismos do Nascimento/cirurgia , Neuropatias do Plexo Braquial/cirurgia , Paralisia Cerebral/cirurgia , Criança , Humanos , Procedimentos Ortopédicos , Paralisia Obstétrica/fisiopatologia , Paralisia Obstétrica/cirurgia , Extremidade Superior/inervação
5.
Bull Soc Pathol Exot ; 106(2): 100-3, 2013 May.
Artigo em Francês | MEDLINE | ID: mdl-23440650

RESUMO

Little published data exist on the morbidity and mortality associated with poor trauma care in developing countries. This report highlights our experience with iatrogenic limb gangrene related to fracture management by traditional bonesetters. Children with bonesetter's gangrene were identified from a prospectively recorded paediatric surgery database at the Regional Hospital of Kaolack in Central Senegal. 21 children were treated for bonesetter's gangrene during a 18-month period (January 2007 up to June 2008). The average age was 10 years (range, 5 to 15 years). Bonesetter's gangrene was more common in boys (90.5%) and occurred almost exclusively in children from rural areas where access to health care was limited. 16 children underwent proximal extremity amputation. Complications included one case of tetanus. Bonesetter's gangrene is a preventable complication that results from a failure of child health planners to recognize the importance of basic trauma care. Management of fractures should be considered an essential component of child health programs in developing countries.


Assuntos
Amputação Cirúrgica/estatística & dados numéricos , Braquetes/efeitos adversos , Extremidades/irrigação sanguínea , Fraturas Ósseas/terapia , Gangrena/etiologia , Isquemia/etiologia , Medicinas Tradicionais Africanas/efeitos adversos , Contenções/efeitos adversos , Acidentes por Quedas , Adolescente , Bambusa , Criança , Pré-Escolar , Países em Desenvolvimento , Feminino , Fraturas Ósseas/complicações , Gangrena/epidemiologia , Gangrena/cirurgia , Humanos , Isquemia/cirurgia , Masculino , Estudos Prospectivos , População Rural , Senegal
6.
Orthop Traumatol Surg Res ; 98(7): 784-7, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23026727

RESUMO

INTRODUCTION: In developing countries, malunion, after diaphyseal femur fractures initially untreated by internal fixation, is not rare. Their difficult management contrasts with the deficiency of the technical operating room facilities. PATIENTS AND METHODS: Our prospective study, conducted over a 1-year period, reports 16 open osteotomies fixed using Küntscher intramedullary nailing in patients who presented malunion of the femoral diaphysis. Twelve males and four females (mean age, 34.5 years; range, 18-67 years) were managed with a mean time to surgery of 8 months (range, 4-14 months). All had initially consulted a bonesetter. The mean length inequality was 3 cm (range, 2-6 cm); the mean knee flexion limitation was 90° (range, 10°-120°). Locking of the rotation was obtained by the obliquity of the osteotomy line. No bone filling was added but reaming and decortications were systematic. The patients were clinically and radiographically assessed at D21, D45, D90, and D120, based on the evaluation of the length inequality, mobility, and bone union. Rotational malunion or deformity were not analyzed. RESULTS: Fifteen patients had achieved union in 90 days. In one case, secondary incurvation of the nail led to changing the nail, allowing union with no axis deformity at D120. The mean postoperative knee flexion was 120° (range, 45°-130°). The mean gain in length was 2 cm (range, 1.5-4 cm). DISCUSSION: This open technique using non-interlocking material allowed us to obtain bone union while improving joint mobility and length inequality. LEVEL OF EVIDENCE: Level IV. Retrospective study.


Assuntos
Países em Desenvolvimento , Fraturas do Fêmur/cirurgia , Fixação Intramedular de Fraturas , Fraturas Mal-Unidas/cirurgia , Osteotomia , Adolescente , Adulto , África Ocidental , Idoso , Feminino , Fraturas do Fêmur/diagnóstico por imagem , Fraturas do Fêmur/fisiopatologia , Fraturas Mal-Unidas/diagnóstico por imagem , Fraturas Mal-Unidas/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Radiografia , Amplitude de Movimento Articular , Recuperação de Função Fisiológica , Resultado do Tratamento , Adulto Jovem
7.
Chir Main ; 30(5): 327-32, 2011 Oct.
Artigo em Francês | MEDLINE | ID: mdl-21820935

RESUMO

OBJECTIFS: Consensual treatment of the Galeazzi's fracture is a plate osteosynthesis of the radius more or less associated to the confection of a plaster cast in distal radio-ulnar joint (DRUJ) dislocation. The authors are reporting in this study the clinical and functionnal results of the intra-medullary pinning of the radius in this type of fracture in adult. METHODS: During a prospective study from January 2003 to December 2006, 23 patients (20 men and three women), average-aged of 32 years (16-70 years) presenting with a Galeazzi's fracture were treated by an intra-medullary pinning of the radius. The DRUJ dislocations were locked 17 times by a brachio-ante-brachio-palmar plaster cast in the supination position, and six times by an ulno-radial pinning. Only the 16 over-aged patients presenting with closed recent fractures were included in this study. The DRUJ dislocation was ranked according to Mansat, the radial fracture according to Müller (AO). The assessment of the treatment results used Mestdagh's criteria. In this study, each pseudarthrosis of the radius was considered as a failure. RESULTS: The DRUJ dislocation was reparted into six sprains, eight subdislocations, and three Galeazzi's fracture equivalents. The radius fractures were simple (n=20) or wedge fractures (n=3). These fractures were located at the proximal third (n=13), middle third (n=7) and distal third (n=3). The average consolidation delay was 10 weeks (8 to16 weeks). Two pseudarthrosis have been observed and then treated by a plate osteosynthesis. At the mean follow up of 37 months (18 to 41 months), the mean score according to Mestdagh was 7.8 points, with 20 satisfying results. Nineteen patients were satisfied by their treatment; the reasons were: the esthetic care of their scar, and the good functionnal resumption, as well as before the fracture. CONCLUSION: The intra-medullary pinning of radius in Galeazzi's fractures, in contrary to the previous studies, give good results compared to a plate osteosynthesis treatment. The systematic complementary lock by brachio-ante-brachio-palmar plaster cast during 3 to 4 weeks has balanced the stability defect that Mikic was reproaching to it. Moreover, it confers the benefits of elastic closed osteosynthesis. That less simple and less expensive method represents an alternative to a plate osteosynthesis in Galeazzi's fractures in adult, if it is well standardized.


Assuntos
Fixação Intramedular de Fraturas , Fraturas do Rádio/cirurgia , Adolescente , Adulto , Idoso , Moldes Cirúrgicos , Feminino , Humanos , Luxações Articulares/cirurgia , Instabilidade Articular/cirurgia , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Estudos Prospectivos , Articulação do Punho/cirurgia , Adulto Jovem
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