Introduction: Total hip arthroplasty of complex morphology is a challenge for the orthopaedic surgeon. Careful analysis of the hip’s anatomy helps to unravel the difficulties and anticipate the procedures to be perfo...Introduction: Total hip arthroplasty of complex morphology is a challenge for the orthopaedic surgeon. Careful analysis of the hip’s anatomy helps to unravel the difficulties and anticipate the procedures to be performed and the implants to be planned. The aim was to identify the types of hip that make first-line THR difficult, specify the technical procedures to be used on these sites, and assess the functional results of the series. Material and Methods: This was a retrospective study that concerned patients operated on for total hip arthroplasty between January 2015 and December 2022 at the medical center “La Grâce” in Bobo-Dioulasso, Burkina Faso. Patients with coxarthrosis (on hip dysplasia, acetabular protrusio, acetabular malunion or neurological hip) and those with ankylosis of the hip, osteonecrosis secondary to neglected dislocation of the hip or hemoglobinopathy were included. Results: A total of 31 total hip replacements were performed in 30 patients. The mean age of patients at the surgery time was 36.2 years with extremes of 17 and 61 years. The male-to-female sex ratio was 1. The main indications for THA were the dysplasic hip osteoarthritis (11 cases) and the neglected hip dislocations (7 cases). In situ femoral neck osteotomy before hip dislocation was performed in seven cases. The acetabulum reconstruction techniques varied from the structural iliac bone graft (n = 3) and cancellous bone graft (n = 4) to the Kerboull plate (n = 1). After 45 months of mean follow-up, all hips were evaluated. The mean PMA score increased from 7.1 [4 - 8] before the surgery to 13.2 [13 - 17]. Conclusion: The large spectrum of challenges in complex hip management requires effective preoperative planning. Preoperative planning minimizes complications and ensures a better outcome.展开更多
Introduction: Neglected knee dislocation is an unusual injury, only a few cases have been reported in the literature. The circumstances of onset are generally an unnoticed knee dislocation in a polytrauma context or a...Introduction: Neglected knee dislocation is an unusual injury, only a few cases have been reported in the literature. The circumstances of onset are generally an unnoticed knee dislocation in a polytrauma context or a delay in consultation after the initial trauma. Presentation of case: We report the case of a 48-year-old female patient who sustained a knee injury during a domestic accident. Initial treatment was traditional and was followed for 3 years. She then consulted hospital, where a neglected knee dislocation was identified and treated with femorotibial arthrodesis. Discussion and conclusion: The treatment options of neglected knee dislocation include open reduction and fixation, arthrodesis and total knee arthroplasty. That the choice depends on the old unreduced of dislocation.展开更多
Conservation agriculture (CA) is one option for dealing with such a challenge, but its main difficulty in West Africa is in maintaining permanent soil cover, particularly with crop residues, due to their preferential ...Conservation agriculture (CA) is one option for dealing with such a challenge, but its main difficulty in West Africa is in maintaining permanent soil cover, particularly with crop residues, due to their preferential use for livestock fodder. The aim of our study was to determine the effect of crop residue mulching on the efficiency of cropping systems based on the principles of conservation agriculture. The experimental design was based on on-station experiments, intended to assess the specific effect of different levels of crop residue mulching on the biological and chemical soil fertility parameters, while in on-farm experiments we mainly assessed the ability of farmers to actually collect crop residues for soil cover and the associated effects on weeds and yields. The on-station experimental design was in fully randomized factorial blocks comprising five treatments and three replicates. The treatments compared the conventional system, tillage and cropping without mulching, and CA systems with 1 ton, 2 tons, and 4 tons of straw per hectare in plots of 10 m<sup>2</sup>. The effects of CA on the macrofauna, respiratory activity, and soil chemical parameters were evaluated in the 2014 and 2015 growing seasons. For the on-farm experiments, the conventional and CA practices of 15 farmers were compared to conventional practices in 2013 and 2014 in plots of 626 m<sup>2</sup>. The on-station results showed that the presence of crop residue mulching induced an increase in the density of termites. A significant release of carbon dioxide (CO<sub>2</sub>) in the CA treatments compared to the conventional treatment was also observed. For the chemical parameters (pH, N, P and K) were significantly and positively affected by mulch in the top 5 centimeters of soil. The on-farm experiments confirmed the difficulty of farmers in collecting enough biomass, with negative effects on grass cover leading to generally lower yields than conventional treatments. Other practices also affected the results, such as the maize sowing date, the gap between sowing and weeding, the gap between sowing and urea supply, the number of years of CA practices in the plot and, the gap between maize sowing and cowpea sowing. For the farmers having the human resources to collect enough crop residues for soil cover and follow the steps of the crop management sequences, it was possible to maintain yields compared to the conventional practice.展开更多
文摘Introduction: Total hip arthroplasty of complex morphology is a challenge for the orthopaedic surgeon. Careful analysis of the hip’s anatomy helps to unravel the difficulties and anticipate the procedures to be performed and the implants to be planned. The aim was to identify the types of hip that make first-line THR difficult, specify the technical procedures to be used on these sites, and assess the functional results of the series. Material and Methods: This was a retrospective study that concerned patients operated on for total hip arthroplasty between January 2015 and December 2022 at the medical center “La Grâce” in Bobo-Dioulasso, Burkina Faso. Patients with coxarthrosis (on hip dysplasia, acetabular protrusio, acetabular malunion or neurological hip) and those with ankylosis of the hip, osteonecrosis secondary to neglected dislocation of the hip or hemoglobinopathy were included. Results: A total of 31 total hip replacements were performed in 30 patients. The mean age of patients at the surgery time was 36.2 years with extremes of 17 and 61 years. The male-to-female sex ratio was 1. The main indications for THA were the dysplasic hip osteoarthritis (11 cases) and the neglected hip dislocations (7 cases). In situ femoral neck osteotomy before hip dislocation was performed in seven cases. The acetabulum reconstruction techniques varied from the structural iliac bone graft (n = 3) and cancellous bone graft (n = 4) to the Kerboull plate (n = 1). After 45 months of mean follow-up, all hips were evaluated. The mean PMA score increased from 7.1 [4 - 8] before the surgery to 13.2 [13 - 17]. Conclusion: The large spectrum of challenges in complex hip management requires effective preoperative planning. Preoperative planning minimizes complications and ensures a better outcome.
文摘Introduction: Neglected knee dislocation is an unusual injury, only a few cases have been reported in the literature. The circumstances of onset are generally an unnoticed knee dislocation in a polytrauma context or a delay in consultation after the initial trauma. Presentation of case: We report the case of a 48-year-old female patient who sustained a knee injury during a domestic accident. Initial treatment was traditional and was followed for 3 years. She then consulted hospital, where a neglected knee dislocation was identified and treated with femorotibial arthrodesis. Discussion and conclusion: The treatment options of neglected knee dislocation include open reduction and fixation, arthrodesis and total knee arthroplasty. That the choice depends on the old unreduced of dislocation.
文摘Conservation agriculture (CA) is one option for dealing with such a challenge, but its main difficulty in West Africa is in maintaining permanent soil cover, particularly with crop residues, due to their preferential use for livestock fodder. The aim of our study was to determine the effect of crop residue mulching on the efficiency of cropping systems based on the principles of conservation agriculture. The experimental design was based on on-station experiments, intended to assess the specific effect of different levels of crop residue mulching on the biological and chemical soil fertility parameters, while in on-farm experiments we mainly assessed the ability of farmers to actually collect crop residues for soil cover and the associated effects on weeds and yields. The on-station experimental design was in fully randomized factorial blocks comprising five treatments and three replicates. The treatments compared the conventional system, tillage and cropping without mulching, and CA systems with 1 ton, 2 tons, and 4 tons of straw per hectare in plots of 10 m<sup>2</sup>. The effects of CA on the macrofauna, respiratory activity, and soil chemical parameters were evaluated in the 2014 and 2015 growing seasons. For the on-farm experiments, the conventional and CA practices of 15 farmers were compared to conventional practices in 2013 and 2014 in plots of 626 m<sup>2</sup>. The on-station results showed that the presence of crop residue mulching induced an increase in the density of termites. A significant release of carbon dioxide (CO<sub>2</sub>) in the CA treatments compared to the conventional treatment was also observed. For the chemical parameters (pH, N, P and K) were significantly and positively affected by mulch in the top 5 centimeters of soil. The on-farm experiments confirmed the difficulty of farmers in collecting enough biomass, with negative effects on grass cover leading to generally lower yields than conventional treatments. Other practices also affected the results, such as the maize sowing date, the gap between sowing and weeding, the gap between sowing and urea supply, the number of years of CA practices in the plot and, the gap between maize sowing and cowpea sowing. For the farmers having the human resources to collect enough crop residues for soil cover and follow the steps of the crop management sequences, it was possible to maintain yields compared to the conventional practice.
