Current Issue : April-June Volume : 2025 Issue Number : 2 Articles : 5 Articles
Introduction: The patella is a key component of the knee’s extensor system. Fractures of the patella can be treated using a variety of methods. The objective of this study was to describe the epidemiological, anatomical-clinical, therapeutic and evolutionary aspects. Methods: This was a prospective, observational, analytic study conducted from January 2018 to December 2021. It concerned all patients over 15 years of age treated surgically for a patella fracture. The variables to be studied were epidemiological, anatomo-clinical, therapeutic and evolutionary. Statistical analysis was performed using the Chi-square test and Fisher’s exact test. Results: It concerned 51 cases. There were 39 men and 12 women. The average age was 35.13 years. The fracture was caused in 78.5% of cases by a road traffic accident. The main fracture was transverse (49.1%). Tension band technique predominated (92.1%). Complications included superficial suppuration (n = 7) and irritation of the material (n = 7). Mean time to consolidation was 66.39 days. Bösman scores were Excellent (n = 23; 45.10%). Some patients presented osteoarthritic knee symptoms (n = 14; 27.45%), and no pseudarthrosis. Conclusion: Patella fractures are rare. Surgical treatment gives good results, and the choice of method depends essentially on the anatomo-clinical characteristics of the fracture. Kinesitherapy is an essential and important weapon in functional recovery....
Introduction: Elderly subjects have physiological and clinical characteristics that make surgical management more complex and have a major impact on their prognosis. The primary objective of this study was to assess peri-operative hospital morbidity and mortality in the elderly. Secondary objectives were to identify factors predictive of death. Methods: This was a retrospective observational descriptive and analytical study carried out over 02 years, based on hospitalized patient records. It concerned patients aged 65 or over who had undergone surgery or for whom an indication for surgery had been given, all pathologies included. A total of 138 files were collected. The mean age was 74.15 years. Diabetes (n = 52; 37.68%) and arterial hypertension (n = 38; 27.54%) were the most common comorbidities. The reasons for hospitalization were mostly degenerative (n = 56; 40.58%) and traumatic (n = 49; 35.51%) pathologies. Preoperative delay, intraoperative and postoperative complications, hospital stay, evolution (mode of discharge), time of occurrence and presumed cause of death were studied. Univariate (p < 0.2) and multivariate (p < 0.05) binary logistic regression were performed to search for risk factors for death. Results: The mean preoperative delay was 5.53 days (1 - 23). Intraoperative complications were mainly hemodynamic instability (n = 26, 18.8%). Postoperatively, the main complications were anemia (n = 62; 48.44%) and glycemic imbalance (n = 28; 21.86%). Average hospital stay was 13.4 days. Age (>75 years), the existence of comorbidities, degenerative pathologies, ASA score > 2, delay in treatment > 3 days, the occurrence of complications and the blood transfusion requirement were the independent predictors of the occurrence of death in the multifactorial analysis. Conclusion: Peri-operative morbidity in the elderly was influenced by age (>75 years), the existence of comorbidities, degenerative pathologies, ASA score > 2, time to treatment > 3 days, the occurrence of complications and the blood transfusion requirement....
Background: Reduced bone density is a major risk factor for fragility fracture. Previous studies reported, that 69% to 100% of patients with fragility fractures had low bone mineral density (BMD). Objective: The objective of the study is to estimate the prevalence of osteoporosis and osteopenia among patients with fragility fractures. Results: The result of the study revealed that the mean age of patients included in the study was 65.11 ± 10.17 and the majority (77.3%) were females. The most common sites of fractures were the femur, radius and vertebra (30.7%, 17.0% and 14.8% respectively). Moreover, more than 95% of patients with fragility fracture who underwent BMD testing had low bone mineral density. In female with fragility fracture the prevalence of osteoporosis was higher in comparison to male (58.8% and 45.0% respectively). Conclusion: Our data showed that low BMD measurement is prevalent in patient with fragility fracture. It also highlighted the importance of implementation of Fracture liaison service, to reduce the gap between fragility fracture and osteoporosis treatment....
Objective: To evaluate the radiological and functional results of patients treated with dynamic screw plates (DHS) for trochanteric fractures in the Orthopedics- Traumatology Department of the Donka National Hospital. Methodology: This was a five (05)-year continuous retrospective study from January 1, 2019, to December 31, 2023. We used the Watson-Jones pathway without an image intensifier. Patients were evaluated according to the Postel-Merle D’Aubigné evaluation criteria. Results: A total of 25 trochanteric fractures were recorded. The patients were 16 men and 9 women, with a sex ratio of 1.77 and an average age of 63.5 years, with extremes of 31 and 96 years. The average fracture management time was 4.04 days. Etiologies were dominated by road traffic accidents (52.00%), followed by domestic accidents (falls) (44.00%). Merchants and housewives were the most affected (32.00%). According to the Ender classification, type III fractures (n = 15; 60.00%) were the most common, followed by type VII (n = 4; 16.00%). The procedure was performed 23 times (92.00%) under spinal anesthesia, 2 times (8.00%) under general anesthesia. The average hospital stay was 9.6 days. The mean operative time was 105.6 min, with extremes ranging from 90 to 120 min. The mean time to consolidation was 14.88 weeks, with extremes of twelve and twenty weeks. Comorbidities included hypertension and diabetes. The majority of patients (76.00%) had good anterior autonomy according to the Parker index. The mean index was 8.2 [standard deviation ±1.8]. We noted three cases of post-operative death (12.00%). We evaluated nineteen patients with a mean follow-up of 24 months, and the functional results according to Postel and Merle d’Aubigné scores were excellent in 42.10% (n = 8), good in 52.63% (n = 10), and fair in 5.2% (n = 1). Conclusion: The DHS dynamic screw-plate has enabled us to achieve good radiological and functional results, enabling us to resume daily activities as quickly as possible. It appears to be a reliable solution for trochanteric fractures. It can be performed without an image intensifier, provided we are aware of its limitations....
Introduction: Proximal femur fractures are traumatic injuries involving the neck and trochanteric region of the femur. The aim was to identify risk factors for death following proximal femur fractures in elderly patients. Patients and methods: This was a prospective, observational, longitudinal study conducted over an 18-month period in the Orthopedics-Traumatology Department of Aristide Le Dantec Hospital in Dakar. We evaluated a total of 93 patients aged at least 60 years with a proximal femur fracture whose date of onset was less than 3 weeks. The identification of risk factors for death took into account socio-demographic, clinical and therapeutic parameters. Results: The number of patients who died was 19 (20.43%). There was no significant difference in mortality according to age, gender or residence. There was no association between admission time and mortality. The association between the number of comorbidities and mortality was significant. The association between mortality and ASA score and type of treatment was highly significant. Operating time had no influence on mortality. Type of anesthesia, on the other hand, did influence mortality. Conclusion: Mortality due to proximal femur fractures in the elderly remains high. In our practice, this mortality was related to the presence of comorbidity, impaired cognitive function, ASA score, type of treatment and type of anesthesia....
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