Introduction: Osteonecrosis is the cellular death of the various components of bone. It mostly affects the femoral head, and its real incidence is unknown. Many causative factors may be involved in its genesis. In Sub...Introduction: Osteonecrosis is the cellular death of the various components of bone. It mostly affects the femoral head, and its real incidence is unknown. Many causative factors may be involved in its genesis. In Sub-Saharan Africa, it affects mainly young patients and the S and C hemoglobinopathies are the most affected backgrounds. Objective: To determine factors associated with aseptic osteonecrosis of the femoral head in hospital settings in Yaounde, Cameroon. Methodology: It was a cross-sectional multicentric study on 29,474 files of black Cameroonian patients seen during consultation or admission, within a five-year period, carried at the Central Hospital, the National Center for Rehabilitation of Handicaped Persons and at the FROT Clinic in Yaounde, Cameroon. Files of patients with aseptic osteonecrosis of the femoral head (1 file = 1 patient) were enrolled. The diagnosis was retained solely based on clinical and radiologic criteria. Magnetic resonance imaging, tomodencitometry and/or bone scintigraphy were also considered when available. Classification of lesions obeyed Ficat-Arlet criteria. Patients’ files with little information and hip diseases other than aseptic osteonecrosis were excluded. Results: Fifty-one cases (0.17%) of aseptic osteonecrosis were recruited;among them, there are 28 males (55%) and 23 females (45%). Their mean age was 38.9 ± 16.4 years (extremes: 7 and 78 years). Those aged 21 to 30 years represented 25.5% of cases. Pain and loss of function were present in all patients. The lesion occurred in the right hip in 22 cases (41.1%), and left hip in 13 cases (25.5%);16 patients (31.4%) had both hip affected. X-ray was performed for all patients. Radiologic lesions were at Stage IV in 2 cases (3.9%), III for 44 cases (86.3%), and II in 5 cases (9.8%). Factors associated with aseptic osteonecrosis were observed in 29 patients and their frequencies were as follows: sickle cell disease: n = 12 (25.3%);trauma: n = 10 (19.6%);alcoholism: n = 3 (5.9%);athletic practice: n = 3 (5.9%);and 2 patients (3.9%) were on treatment with steroid. HIV infection occurred in 2 cases (1.9%);dyslipidemia, hyperuricemia and systemic lupus erythematosus were diagnosed in 1 case (1.9%) each. Conclusion: The relative incidence of aseptic osteonecrosis of the femoral head in hospital settings in Yaounde is 0.17% and mostly young adults are affected. Lesions are discovered at an advanced radiographic stage and sickle cell disease is the first associated factor.展开更多
Introduction: Obstetric palsy of the brachial plexus (OPBP) is a paralytic lesion common to obstetric trauma, whose clinical presentation varies according to the severity and extent of the root lesions at birth. Early...Introduction: Obstetric palsy of the brachial plexus (OPBP) is a paralytic lesion common to obstetric trauma, whose clinical presentation varies according to the severity and extent of the root lesions at birth. Early and appropriate rehabilitation is necessary in order to improve the functional prognosis of the injured limb. Under special conditions, parents could carry out this physiotherapy themselves. Objective: The aim of this work was to assess limb functional recovery in newborns and infants with OPBP after rehabilitation by their parents. Patients and Methods: We conducted a prospective study at the NCRDP in Yaoundé over a period of 18 months. We included all patients aged 0 to 2 years with OPBP, isolated or associated with other lesions and followed at least two (02) years at the NCRDP. Results: We recruited 69 cases. The hospital frequency of OPBP was estimated at 1.02%. The age at first consultation was [0 - 28 d] in 50.8% of cases. The sex ratio was 0.68. The right side was reached in 54.4% of cases. The Erb’s palsy predominated in 79.7% of cases. The risk factors for OPBP were vaginal delivery, cephalic presentation, shoulder dystocia and macrosomia. Physiotherapy was performed as prescribed in 94.9% of cases allowing excellent and good functional recovery in 76.81% of cases. Conclusion: In the care of their children’s OPBP rehabilitation by sensitized, actively involved and supervised parents would be a good alternative to professional physiotherapy in all situations where the latter would not be possible.展开更多
文摘Introduction: Osteonecrosis is the cellular death of the various components of bone. It mostly affects the femoral head, and its real incidence is unknown. Many causative factors may be involved in its genesis. In Sub-Saharan Africa, it affects mainly young patients and the S and C hemoglobinopathies are the most affected backgrounds. Objective: To determine factors associated with aseptic osteonecrosis of the femoral head in hospital settings in Yaounde, Cameroon. Methodology: It was a cross-sectional multicentric study on 29,474 files of black Cameroonian patients seen during consultation or admission, within a five-year period, carried at the Central Hospital, the National Center for Rehabilitation of Handicaped Persons and at the FROT Clinic in Yaounde, Cameroon. Files of patients with aseptic osteonecrosis of the femoral head (1 file = 1 patient) were enrolled. The diagnosis was retained solely based on clinical and radiologic criteria. Magnetic resonance imaging, tomodencitometry and/or bone scintigraphy were also considered when available. Classification of lesions obeyed Ficat-Arlet criteria. Patients’ files with little information and hip diseases other than aseptic osteonecrosis were excluded. Results: Fifty-one cases (0.17%) of aseptic osteonecrosis were recruited;among them, there are 28 males (55%) and 23 females (45%). Their mean age was 38.9 ± 16.4 years (extremes: 7 and 78 years). Those aged 21 to 30 years represented 25.5% of cases. Pain and loss of function were present in all patients. The lesion occurred in the right hip in 22 cases (41.1%), and left hip in 13 cases (25.5%);16 patients (31.4%) had both hip affected. X-ray was performed for all patients. Radiologic lesions were at Stage IV in 2 cases (3.9%), III for 44 cases (86.3%), and II in 5 cases (9.8%). Factors associated with aseptic osteonecrosis were observed in 29 patients and their frequencies were as follows: sickle cell disease: n = 12 (25.3%);trauma: n = 10 (19.6%);alcoholism: n = 3 (5.9%);athletic practice: n = 3 (5.9%);and 2 patients (3.9%) were on treatment with steroid. HIV infection occurred in 2 cases (1.9%);dyslipidemia, hyperuricemia and systemic lupus erythematosus were diagnosed in 1 case (1.9%) each. Conclusion: The relative incidence of aseptic osteonecrosis of the femoral head in hospital settings in Yaounde is 0.17% and mostly young adults are affected. Lesions are discovered at an advanced radiographic stage and sickle cell disease is the first associated factor.
文摘Introduction: Obstetric palsy of the brachial plexus (OPBP) is a paralytic lesion common to obstetric trauma, whose clinical presentation varies according to the severity and extent of the root lesions at birth. Early and appropriate rehabilitation is necessary in order to improve the functional prognosis of the injured limb. Under special conditions, parents could carry out this physiotherapy themselves. Objective: The aim of this work was to assess limb functional recovery in newborns and infants with OPBP after rehabilitation by their parents. Patients and Methods: We conducted a prospective study at the NCRDP in Yaoundé over a period of 18 months. We included all patients aged 0 to 2 years with OPBP, isolated or associated with other lesions and followed at least two (02) years at the NCRDP. Results: We recruited 69 cases. The hospital frequency of OPBP was estimated at 1.02%. The age at first consultation was [0 - 28 d] in 50.8% of cases. The sex ratio was 0.68. The right side was reached in 54.4% of cases. The Erb’s palsy predominated in 79.7% of cases. The risk factors for OPBP were vaginal delivery, cephalic presentation, shoulder dystocia and macrosomia. Physiotherapy was performed as prescribed in 94.9% of cases allowing excellent and good functional recovery in 76.81% of cases. Conclusion: In the care of their children’s OPBP rehabilitation by sensitized, actively involved and supervised parents would be a good alternative to professional physiotherapy in all situations where the latter would not be possible.
