Objective: The purpose of this work was to study the factors of cancellations or postponement of regulated operating programs of the Orthopedic-Traumatology unit of Yalgado Ouédraogo University Teaching Hospital....Objective: The purpose of this work was to study the factors of cancellations or postponement of regulated operating programs of the Orthopedic-Traumatology unit of Yalgado Ouédraogo University Teaching Hospital. Materials and Methods: This was a prospective descriptive study over a period of six months. All interventions postponed or canceled during the study period were included. Patients who died or were lost to follow-up before surgery were not included. Results and Comments: the postponement/ cancellation rate was 24.5%. Out of 83 operations cancelled, 72.3% of patients were under 50 years old [extreme 15 and 88 years old]. ASA classes I and II were dominant with 57% and 37% of patients canceled, respectively. There were more postponed interventions (67.5%) than definitive cancellations (32.5%). The causes found were avoidable in 68.7% of cases. The most common was the unavailability of labile blood products (57%), the lack of financial means (36%) and the absence of the patient (28%). The results of our study show that 53% of the causes of cancellations were related to the organization of the hospital. Conclusion: the cancellation rate of orthopedic surgeries remains high at Yalgado Ouédraogo University Teaching Hospital. Most of the causes of cancellations are potentially preventable and the vast majority of them are related to the organization of the hospital. Financial accessibility to care plays an important role in cancellations.展开更多
Purpose： To study the management and evaluate anatomical and functional outcomes of patients with ipsilateral proximal and shaft femoral fractures. Methods： A retrospective, descriptive and analytic study lasted for...Purpose： To study the management and evaluate anatomical and functional outcomes of patients with ipsilateral proximal and shaft femoral fractures. Methods： A retrospective, descriptive and analytic study lasted for ten years and a half ranging from January 1, 2005 to June 30, 2015. The following parameters were studied： epidemiology, fracture char- acteristics, therapeutic, anatomical and functional outcomes. The correlation between different param- eters was analyzed with Fischer test. The significant threshold was defined for p value 〈0.05. Results： Ten medical files were registered. There were 7 men and 3 women, with a sex ratio of 2.33. The average age was 46 years （range： 29-62 years）. It was about traffic road accidents in all cases. Motorcycle -motorcycle and motorcycle-car collision were most frequent. Average admission delay was 7 h （range： 1.5-24 h）. Left side was most reached in 8 cases. According to Garden classification, there was type Ⅲ cervical fracture in 2 cases, type Ⅱ in 1 case and type Ⅳ in 1 case. According to Ender classification, there was type I trochanteric fracture in 3 cases, type Ⅵ in 2 cases and type Ⅶ in 1 case. According to AO classification, there was type A shaft fracture in 6 cases （A2 in 4 cases and A3 in 2 cases）, type B in 2 cases （BI in 1 case and B2 in 1 case） and type C in 2 cases （CI in 1 case and C2 in 1 case）. Average surgical delay was 28.7 days （range： 11-61 days）. For proximal femoral fracture, Moore prosthesis was used in 1 case, blade plate 130° in 2 cases, long Gamma nail in 4 cases, double screwing in 2 cases and dynamic hip screw in 1 case. For shaft femoral fracture, blade plate 95° was used in 3 cases, low compressive plate in 2 cases. Osseous contention was achieved in 4 cases with long Gamma nail and in 1 case with long blade plate 130°. Nonunion of cervical fracture was achieved in 2 cases. The average osseous healing delay was 5.14 months （range： 3-12 months） for proximal femoral fracture and 5 months （range： 3-8 months） for shaft femoral fractures. According to Friedman and Wyman criteria, functional results were good in 4 cases, average in 4 cases and bad in 2 cases. Regarding implants, healing delay showed no statistic difference between one-implant group and two-implant group （p = 0.52）, and among the patients with different functional outcomes （p = 0.52）. Functional outcomes showed no statistic difference between one-implant group and two-implant group （p = 0.46）. Conclusion： Ipsilateral proximal and shaft femoral fractures are relatively uncommon in our daily ac- tivities. It is difficult to recognize proximal femoral fractures which are unnoticed. Results are generally good if the doctors take the two fractures into account in the management.展开更多
文摘Objective: The purpose of this work was to study the factors of cancellations or postponement of regulated operating programs of the Orthopedic-Traumatology unit of Yalgado Ouédraogo University Teaching Hospital. Materials and Methods: This was a prospective descriptive study over a period of six months. All interventions postponed or canceled during the study period were included. Patients who died or were lost to follow-up before surgery were not included. Results and Comments: the postponement/ cancellation rate was 24.5%. Out of 83 operations cancelled, 72.3% of patients were under 50 years old [extreme 15 and 88 years old]. ASA classes I and II were dominant with 57% and 37% of patients canceled, respectively. There were more postponed interventions (67.5%) than definitive cancellations (32.5%). The causes found were avoidable in 68.7% of cases. The most common was the unavailability of labile blood products (57%), the lack of financial means (36%) and the absence of the patient (28%). The results of our study show that 53% of the causes of cancellations were related to the organization of the hospital. Conclusion: the cancellation rate of orthopedic surgeries remains high at Yalgado Ouédraogo University Teaching Hospital. Most of the causes of cancellations are potentially preventable and the vast majority of them are related to the organization of the hospital. Financial accessibility to care plays an important role in cancellations.
文摘Purpose： To study the management and evaluate anatomical and functional outcomes of patients with ipsilateral proximal and shaft femoral fractures. Methods： A retrospective, descriptive and analytic study lasted for ten years and a half ranging from January 1, 2005 to June 30, 2015. The following parameters were studied： epidemiology, fracture char- acteristics, therapeutic, anatomical and functional outcomes. The correlation between different param- eters was analyzed with Fischer test. The significant threshold was defined for p value 〈0.05. Results： Ten medical files were registered. There were 7 men and 3 women, with a sex ratio of 2.33. The average age was 46 years （range： 29-62 years）. It was about traffic road accidents in all cases. Motorcycle -motorcycle and motorcycle-car collision were most frequent. Average admission delay was 7 h （range： 1.5-24 h）. Left side was most reached in 8 cases. According to Garden classification, there was type Ⅲ cervical fracture in 2 cases, type Ⅱ in 1 case and type Ⅳ in 1 case. According to Ender classification, there was type I trochanteric fracture in 3 cases, type Ⅵ in 2 cases and type Ⅶ in 1 case. According to AO classification, there was type A shaft fracture in 6 cases （A2 in 4 cases and A3 in 2 cases）, type B in 2 cases （BI in 1 case and B2 in 1 case） and type C in 2 cases （CI in 1 case and C2 in 1 case）. Average surgical delay was 28.7 days （range： 11-61 days）. For proximal femoral fracture, Moore prosthesis was used in 1 case, blade plate 130° in 2 cases, long Gamma nail in 4 cases, double screwing in 2 cases and dynamic hip screw in 1 case. For shaft femoral fracture, blade plate 95° was used in 3 cases, low compressive plate in 2 cases. Osseous contention was achieved in 4 cases with long Gamma nail and in 1 case with long blade plate 130°. Nonunion of cervical fracture was achieved in 2 cases. The average osseous healing delay was 5.14 months （range： 3-12 months） for proximal femoral fracture and 5 months （range： 3-8 months） for shaft femoral fractures. According to Friedman and Wyman criteria, functional results were good in 4 cases, average in 4 cases and bad in 2 cases. Regarding implants, healing delay showed no statistic difference between one-implant group and two-implant group （p = 0.52）, and among the patients with different functional outcomes （p = 0.52）. Functional outcomes showed no statistic difference between one-implant group and two-implant group （p = 0.46）. Conclusion： Ipsilateral proximal and shaft femoral fractures are relatively uncommon in our daily ac- tivities. It is difficult to recognize proximal femoral fractures which are unnoticed. Results are generally good if the doctors take the two fractures into account in the management.
