Emergency Intramedullary Nailing in Open Leg Fractures: What Results?

Introduction: Leg fractures are the prerogative of violent trauma, which lead to pluritissular lesions, including the opening of the focus, thus worsening the prognosis. The indication of centromedullary nailing (CMN) is subject to time and trained team requirements. The aim of this work is to evaluate the results of CMN in emergency cases of open leg fractures in adults. Patients and Methods: This was a retrospective, descriptive and analytical study from January 1, 2014 to December 31, 2018. It concerned adult patients with an open leg fracture treated by CMN in emergency at the Orthopedics-Traumatology Department of the Yalgado Ouedraogo University Hospital. During five years, 91 patients were registered. Their average age was 34.1 years with a sex ratio of 2.2. The average admission time was 1 hour 41 minutes. Cauchoix and Duparc type I open fractures predominated (64.8%). Antibiotic therapy was instituted as soon as the patient arrived. The functional results of osteosynthesis were evaluated according to the Lysholm score after an average follow-up of 48 months. Results: The majority of our patients (51.3%) were operated on between the 6th and 18th hour. After careful trimming of the open fracture, CMN was performed in all our patients. The average hospital stay was six days. The mean Lysholm score was 87.23 ± 11.06 with a satisfactory functional result in 81.3% of cases. Discussion: The satisfactory results observed in 81.3% of our study testify to the reliability of the indication of CMN as specified by Dakouré et al. [4] in their series. Conclusion: Open leg fractures are very frequent injuries and have a considerable socio-economic impact. Centromedullary nailing is a suitable solution for adequate and rapid socio-professional reintegration of the patient.

Osteosynthesis Results of Tibia Plateau Fractures at the Yalgado Ouedraogo University Hospital Center

The sophistication of the implants allows the extension of the surgical indications for tibia plateau fractures. These fractures, which are often comminuted, are caused by a high velocity trauma, making treatment difficult. Objective: The aim of this study was to determine the indications for osteosynthesis of tibia plateau fractures in the orthopaedic-traumatology department of the Yalgado Ouédraogo University Hospital, in order to evaluate the results for their better management. Patients and Methods: it was a 5-year retrospective study of the records of patients with tibia plateau fracture operated and hospitalized in our department. The anatomical-clinical and therapeutic aspects collected from the complete files were analysed. A cortico-cancellous graft was performed in 67.4% of cases. The results were evaluated according to the criteria of Merle d’Aubigné and Mazas [1]. Road traffic accidents (97.4%) were the predominant etiology, involving mainly motorcycles (97.8%). Results: Spino-tuberository and uni-tuberository fractures were the most common. The average consolidation time was 12.5 weeks. One urinary infection, 3 superficial suppurations, 3 vicious calluses and 2 equipment dismantlings were the main complications. Our results were excellent and good in 91.3% and fair in 6.5%. Osteosynthesis of tibial plateau fractures provides excellent results and remains the most appropriate procedure to treat these fractures. Conclusion: reduce the operating time, modernize the technical platform, will allow stable osteosynthesis and early functional rehabilitation to optimize their results.