Introduction: Total hip prostheses are a reliable means of treating hip disorders. It is indicated when pain and reduced mobility of the hip become incompatible with the patient’s daily activities. In low-income coun...Introduction: Total hip prostheses are a reliable means of treating hip disorders. It is indicated when pain and reduced mobility of the hip become incompatible with the patient’s daily activities. In low-income countries, the risk factors for hip disease are numerous, but the means for its management, such as total hip prostheses, are not. The aim of this work was to determine the morbi-mortality of total hip prostheses in the short and medium term in our department and to review the literature. Patients and Method: This was a prospective and descriptive study over a period of 9 years. It involved 50 THPs performed on 45 patients. Patients who had received a THP and were followed up for at least two years were included. We excluded patients who were lost to follow-up. The Moore-type posterolateral minimally invasive approach was used. Complications were investigated from the immediate postoperative period and in the medium term. The final functional results were evaluated according to the Postel Merle d’Aubigné score. Results: We performed 50 THPs out of 750 procedures, i.e. , 6.6%. The indications were: primary coxarthrosis 60%, necrosis of the femoral head 26%, post-infectious balloon hip 4%, and pseudarthrosis of the femoral neck 10%. The average time to the consultation was 2.4 years with extremes of 1 and 5 years. According to the terrain, sickle cell disease represented 18%, tuberculosis 12%. Postoperative complications were lameness 12%, dislocation 6%, suppuration 6%, death 4%, peri-prosthetic fracture 8%, loosening 2%, peri-articular ossification 2%, and paralysis of the external popliteal nerve 2%. Conclusion: Whoever performs a THP is obliged to monitor the patient as long as he/she is alive. Complications are possible at any time and can negatively change the assigned goal and force the surgeon to be expensive and sometimes inconclusive secondary interventions.展开更多
Carpo-metacarpal dislocations are rare hand injuries. They are misdiagnosed due to their non-specific clinical signs. The authors report on their experience in the management of carpometacarpal dislocations in a speci...Carpo-metacarpal dislocations are rare hand injuries. They are misdiagnosed due to their non-specific clinical signs. The authors report on their experience in the management of carpometacarpal dislocations in a specialized hand surgery center. Our study included patients received and treated in the department for a carpometacarpal dislocation. Dislocation fractures of Bennett and Rolando were excluded. The postoperative functional evaluation took place after 18 months by the DASH score. Twelve patients participated: one case of neuro-algodystrophy and one pin infection. The mean DASH functional outcome score was 1.10 at 18 months. Since carpometacarpal dislocations are rare and easily misdiagnosed, the surgeon should assume the possibility of them in patients with high-energy trauma, and imaging studies should be carefully evaluated. Pinning is an effective treatment option that provides good long-term functional results.展开更多
文摘Introduction: Total hip prostheses are a reliable means of treating hip disorders. It is indicated when pain and reduced mobility of the hip become incompatible with the patient’s daily activities. In low-income countries, the risk factors for hip disease are numerous, but the means for its management, such as total hip prostheses, are not. The aim of this work was to determine the morbi-mortality of total hip prostheses in the short and medium term in our department and to review the literature. Patients and Method: This was a prospective and descriptive study over a period of 9 years. It involved 50 THPs performed on 45 patients. Patients who had received a THP and were followed up for at least two years were included. We excluded patients who were lost to follow-up. The Moore-type posterolateral minimally invasive approach was used. Complications were investigated from the immediate postoperative period and in the medium term. The final functional results were evaluated according to the Postel Merle d’Aubigné score. Results: We performed 50 THPs out of 750 procedures, i.e. , 6.6%. The indications were: primary coxarthrosis 60%, necrosis of the femoral head 26%, post-infectious balloon hip 4%, and pseudarthrosis of the femoral neck 10%. The average time to the consultation was 2.4 years with extremes of 1 and 5 years. According to the terrain, sickle cell disease represented 18%, tuberculosis 12%. Postoperative complications were lameness 12%, dislocation 6%, suppuration 6%, death 4%, peri-prosthetic fracture 8%, loosening 2%, peri-articular ossification 2%, and paralysis of the external popliteal nerve 2%. Conclusion: Whoever performs a THP is obliged to monitor the patient as long as he/she is alive. Complications are possible at any time and can negatively change the assigned goal and force the surgeon to be expensive and sometimes inconclusive secondary interventions.
文摘Carpo-metacarpal dislocations are rare hand injuries. They are misdiagnosed due to their non-specific clinical signs. The authors report on their experience in the management of carpometacarpal dislocations in a specialized hand surgery center. Our study included patients received and treated in the department for a carpometacarpal dislocation. Dislocation fractures of Bennett and Rolando were excluded. The postoperative functional evaluation took place after 18 months by the DASH score. Twelve patients participated: one case of neuro-algodystrophy and one pin infection. The mean DASH functional outcome score was 1.10 at 18 months. Since carpometacarpal dislocations are rare and easily misdiagnosed, the surgeon should assume the possibility of them in patients with high-energy trauma, and imaging studies should be carefully evaluated. Pinning is an effective treatment option that provides good long-term functional results.
