Septic Hip Arthritis at CHU Gabriel TOURE: Therapeutic and Evolutionary Aspects

Introduction: Septic hip arthritis involves the functional prognosis of the hip in case of joint destruction. The aim of this work was to evaluate the hospital frequency, to determine the therapeutic and evolutionary aspects of septic arthritis of the hip at the trauma orthopedic department of CHU Gabriel TOURE Bamako. Methods: This was a descriptive, monocentric, cross-sectional study of patients with septic hip arthritis, managed from January 2010 to December 2019. Results: We collected 48 patients. Gender male was represented 58.3% with a sex ratio of 1.4. The average age of our patients was 17.02, with extremes of 7 and 80. Septic hip arthritis was observed in a chronic mode in 87.5% (more than 3 weeks). Diagnosis was based on clinical, bacteriological and imaging. Trauma was incriminated in 5 cases (10.4%). The radiographic assessment at the time of the consultation was normal in 66.7% of cases. Staphylococcus aureus was the most common germ with 47.9%, and the culture was sterile in 10.4%. Septic hip arthritis was complicated in 18.75% of cases. Antibiotic therapy was probabilistic with the combination of ciprofloxacin and metronidazole in 24 cases (50%). Watson Jones antero-lateral arthrotomy was performed in 35.71%. We observed 66.6% complications. After an average decrease of 41.6 months, functional results were good in 58.3%. Conclusion: Septic hip arthritis is a serious condition of the child and adolescent. Diagnosis must be early;management must also be early, multidisciplinary and adapted to minimize sequelae.

Management of Subtalar Fractures-Dislocations at Ségou Hospital in Mali: A 7 Cases Series

Introduction: Subtalar or peritalian dislocation is rare;it represents 15% of peritalian injuries. The aim of this study was to describe the radioclinical and therapeutic characteristics and to assess the functional result. Patients and Methods: This study is about a continuous descriptive and prospective study over a period of 5 years. It has been conducted from March 2013 to February 2018 at the Ségou Hospital, a second referral hospital in Mali. The functional results were evaluated by the score of the American Orthopedic Foot and Ankle Society (AOFAS). Results: Seven cases of subtalar dislocation fractures were diagnosed in six male patients with an average age of 38 years (36 to 47 years old). In five cases the etiology of the trauma was a motorcycle accident and a fall from height. The lesion was bilateral in one case. The average time to care was 3 hours (1 to 9 hours). There was one case of open dislocation fracture with talus enucleation. The dislocation was medial in 6 cases and lateral in one case. It was pure in three cases. The treatment was orthopedic in 2 cases and surgical in 5 cases. The post-operative complications were complicated by an infection of the operative site in one case. The average length of hospital stay was 4 days. The functional result was excellent in 2 cases;good in 2 cases, fair in 2 cases and poor for 1 case. Conclusion: Subtalar dislocation is a rare and serious lesion of the posterior tarsus. The long-term prognosis depends on the earliness of treatment and the severity of the associated injuries.

Fracture of the Humeral Palette in Adult Patient: Therapeutic and Evolutive Aspect at Gabriel Touré Hospital: About 35 Cases

Introduction: Fractures of the humeral pallet occur between the distal insertion of the anterior brachial muscle and the joint space of the elbow. It represents 2% of all elbow fractures. These lower humeral fractures present a therapeutic challenge to trauma. These fractures are in the majority of joint cases and can be accompanied by loss of substance, which makes their functional prognosis random despite the application of the main therapeutic principles: exact reduction with possible bone graft;stable osteosynthesis, usually allowing early rehabilitation. This work focused on identifying therapeutic aspects and assessing treatment outcomes. Material and Methods: This was a descriptive cross-sectional study of patients with a fracture of the humeral palette from January 2015 to December 2019 at the Orthopaedic Trauma Department CHU Gabriel Touré Bamako. Results: We collected 35 cases of fractures of the humeral palette. The average age was 39.25 years with extremes of 22 and 74 years. The male gender predominated (71.4%) with a sex ratio of 2.5. Etiologies were dominated by falls with 19 cases (54.3%) and stroke with 13 cases (37.1%). The standard X-ray of the face and profile of the elbow was performed in all our patients. The most frequent types of anatomoradiology were supra condylar fractures type A in 16 cases (45.7%), supra and inter condylar fractures type C in 15 cases (42.9%);4 cases of uni condylar fractures type B (11.4%). Associated lesions were observed in 42.85%. Surgical treatment was performed in 80% of cases. Complications were dominated by elbow stiffness in 18 cases (51.42%), secondary displacement in 5 cases (14.28%), ossifications in 4 cases (11.42%). At an average decrease of 3.2 years our results were considered good in 45.7%. Conclusion: Fractures of the humeral palette are relatively common with associated lesions. The complexity of the fracture with associated lesions makes treatment difficult with unpredictable evolution.

Study of Complications of Traditional Treatment. <br/>Member Fractures

Introduction: Since the times of our ancestors, traditional medicine has existed to cure all diseases [1]. The objective of this study was to assess the complications of traditional fracture treatment. Patients and Methods: This was a prospective study extending from January 01, 2018 to June 30, 2018, duration of six months. It concerned patients who had traditionally been treated beforehand for traumas with bone lesion in a traditional therapist and who had developed a complication, the definitive management of which was made in the department. Results: This study involved 102 patients, including 71 men (69.6%), with a sex ratio of 2.2. 33 patients or 32.4% were under 15 years old. The average of our patients’ age was 29.61 years with extremes of 2 and 89 years. Pupils/students (44 pupils and 5 students) were the most represented with 49 cases or 48.1% of the cases. The majority of patients (59.8% of cases) were educated or had a basic level. The majority of patients (36.3%) came as motif for a painful swelling. Gangrene was the most common complication with 37 cases or 36.3% of cases. Conclusion: At the end of our study, we have noticed that the traditional preliminary treatment of fractures was based mainly on trial and error. Practicing with inadequate means and measures without respecting the anatomical structures, is a real source of disabling handicaps. We have recorded 38, among the 102 patients who came for a complication of traditional treatment: that is 45.2% amputation, which is deplorable.

Bilateral Fracture of the Base of the Fifth Metatarsal. A Case Report and Review of the Literature

We report an unusual case of basic bilateral fracture of fifth metatarsals in a 48 years old post-menopausal woman. She had previously been treated for arterial high blood pressure, parathyroidectomy and rheumatoid arthritis by a long corticotherapy treatment. The lesion was caused by an indirect mechanism in an overweight context. The diagnosis of a pseudarthrosis of the base of the fifth metatarsals was maintained after 7-month treatment. The patient received a treatment of both pseudarthrosis. The post-operative periods were simple. After a 9-month follow-up, the treatment allowed consolidation with painless feet allowing her to resume work.