Factors for Postponement or Cancellation of Operating Programs Set in the Orthopedics-Traumatology Department of Yalgado Ouédraogo University Teaching Hospital in Ouagadougou (Burkina Faso)

Objective: The purpose of this work was to study the factors of cancellations or postponement of regulated operating programs of the Orthopedic-Traumatology unit of Yalgado Ouédraogo University Teaching Hospital. Materials and Methods: This was a prospective descriptive study over a period of six months. All interventions postponed or canceled during the study period were included. Patients who died or were lost to follow-up before surgery were not included. Results and Comments: the postponement/ cancellation rate was 24.5%. Out of 83 operations cancelled, 72.3% of patients were under 50 years old [extreme 15 and 88 years old]. ASA classes I and II were dominant with 57% and 37% of patients canceled, respectively. There were more postponed interventions (67.5%) than definitive cancellations (32.5%). The causes found were avoidable in 68.7% of cases. The most common was the unavailability of labile blood products (57%), the lack of financial means (36%) and the absence of the patient (28%). The results of our study show that 53% of the causes of cancellations were related to the organization of the hospital. Conclusion: the cancellation rate of orthopedic surgeries remains high at Yalgado Ouédraogo University Teaching Hospital. Most of the causes of cancellations are potentially preventable and the vast majority of them are related to the organization of the hospital. Financial accessibility to care plays an important role in cancellations.

Mortality of Traumatic Injuries in Traumatological Emergencies of the Yalgado Ouedraogo University Hospital Center in Ouagadougou (Burkina Faso)

Background: Serious trauma is the main cause of death for people under 40 years old. According to the WHO, in 2002, nearly 1.2 million people died worldwide from road traffic injuries. The vast majority (90%) are from low and middle-income countries. The diagnostic performance, the quality of the treatments offered, and the optimization of trauma care channels, make it possible to improve the management of serious trauma. This is not always the case in our context of a country with limited resources. Objectives: The objective is o describe the epidemiological, diagnostic and therapeutic aspects of premortal death in patients with traumatic injuries. Methods: This was a descriptive study with retrospective collection in the trauma emergency department of Yalgado Ouedraogo Teaching Hospital (Ouagadougou, Burkina Faso). All patients who died on the ward while in the hospital or on arrival were included. Results: 192 deaths were listed. The annual mortality was 1.6%, the sex ratio was 6.1 and the average age was 36 years. Road traffic accidents were the main etiology: 163 deaths (85%). Head injuries were the most common injuries: 45.3% of deceased patients had a Glasgow score ≤ 8. There was no pre-hospital care in 63% of the patients who died. The first six hours, on-call periods and the weekend were correlated with the death rate. Discussion: the high mortality in road traffic accident injuries in Africa is due to the weakness of pre-hospital care, the non-medicalization of the transport of the injured and also the non-wearing of helmets by motorcyclists. The MGAP (Mechanism, Glasgow coma scale, Age, arterial Pressure) score is reliable in predicting the mortality of serious injuries.

Giant Cell Tumor of the Proximal Phalanx of the Little Finger about One Case in Our Milieu

Giant cell tumor is a benign primary bone tumor. The phalangeal localization is rare. It is distinguished from other locations by the local aggressiveness of the tumor and a high rate of recurrence. We report one case of a 25-year-old right-handed nurse with no reported pathological history who complained about an ulcero-budding mass of the right little finger evolving one year ago. She would have initially consulted a bonesetter who would have taken care of her by using decoctions. The hand X-ray showed an osteolytic tumor of the first phalanx of the right little finger with a “honeycomb” appearance invading the soft tissues. We carried out the amputation of the radius. The postoperative course was simple with healing of the surgical wound and disappearance of the axillary adenopathy. The surgical specimen after anatomopathology exam concluded to be a grade 2 giant cell tumor of Senerkin.

Open Fractures of Limbs by the Bite of Domestic Donkeys: An Unusual Aetiology

Introduction: The aim of this study is to describe the epidemiological, lesional, therapeutic and evolutionary profile of open fractures of limbs by bites of domestic donkeys. Patients and Methods: This is a prospective descriptive study over 28 months made in the Orthopedics-Traumatology department of the Tambacounda Regional Hospital in Senegal, concerning patients bitten by donkeys, resulting in an open fracture of the thoracic and pelvic limbs. Results: Twelve male patients were included. The average age was 10.50 years ± 2.60. The most common circumstance was the bite when two donkeys were separated. The thoracic limbs were the most affected by the occurrence of the arm. Cauchoix-Duparc type II and AO A2 and B2 were predominant. The essential trimming/osteosynthesis was carried out within 24 hours of the bite. Serovaccination was systematic, but on the other hand, a single dose of anti-rabies serum was administered. Pinning was the most commonly used bone synthesis. Complications were mainly infectious, followed by a case of radial nerve palsy and non-union on pins. Conclusion: The typical profile of an open donkey bite fracture is a male child/adolescent who is bitten during the separation of two fighting donkeys. The lesions are most often found in the thoracic limbs with a predominance of Cauchoix-Duparc type II and type A2 and B2 fractures of the AO, whose treatment consisted of trimming and pinning. The infectious complications of the soft tissues marked the evolution.

Olecranon Bone Tumor Complicated by Ulnar Nerve Paresis Revealing Tuberculous Osteitis—About a Case

Introduction: The localization of bone tuberculosis at the level of the olecranon is rare and can pose a problem of differential diagnosis with a tumoral affection. Only the biopsy allows the diagnosis of certainty. The goal was to report our first case to do a review of the literature. Clinical Observation: This was a 64-year-old patient who consulted 2 years after the onset of symptoms for swelling and mechanical pain in the left elbow. On clinical examination there was a firm consistent mass measuring 6/4 cm in diameter, not very painful and hot on the posterior surface of the left elbow, accompanied by paresthesias in the territory of the ulnar nerve associated with partial functional impotence of the left forearm with little altered general condition. The X-rays of the left elbow showed extensive bone lysis of the olecranon with fracture of the base of the olecranon. The CT Scan of the elbow performed showed osteolysis of the olecranon with extensive bone reactions at the distal end of the humerus. The biopsy carried out with histological examination concluded with an aspect of tuberculous osteitis and the culture came back sterile. A curettage was performed associated with anti-tuberculosis treatment for 12 months as well as the placement of a posterior splint. The evolution at 9 months was unsatisfactory with persistence of paresis and stiffness of the elbow. Conclusion: Tuberculous osteitis of the olecranon can simulate a malignant tumor with non-specific signs of bone tuberculosis. Only the anatomopathological examination is definitive for the diagnosis. The treatment is multidisciplinary. Orthopedic evolution is difficult to predict.