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Tchankoni MK, Togan RM, Abalo GA, Adoli LK, Walla A, Dosseh DE, Tchangaï B, Preux PM, Aboyans V, Ekouevi DK. Epidemiology of Non-Traumatic Lower Extremities Amputations in West Africa: Nationwide Data from Togo. Eur J Vasc Endovasc Surg 2024:S1078-5884(24)00115-1. [PMID: 38320645 DOI: 10.1016/j.ejvs.2024.01.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 12/22/2023] [Accepted: 01/30/2024] [Indexed: 02/08/2024]
Abstract
OBJECTIVE Non-traumatic lower limb amputation (NT-LLA) has consequences at individual and public health levels. Population based studies in sub-Saharan Africa are scarce and often related to single centre series. This study aimed to estimate the incidence of NT-LLA (minor and major) and to describe epidemiological, clinical, and prognostic aspects in Togo. METHODS This was a population based observational study conducted among all patients who underwent NT-LLA. Traumatic amputations were excluded. Sociodemographic, clinical, and work up data were collected from clinical files in any Togolese health centre from 1 January 2016 to 31 December 2021. Incidence rates were adjusted for age. RESULTS Over the six year period, 352 patients (59% males) underwent NT-LLA (mean ± standard deviation age 60 ± 15.7 years). The average age adjusted incidence rate of NT-LLA was 8.5 per million/year (95% confidence interval [CI] 7.6 - 9.4). Men were 1.7 times more likely to undergo a NT-LLA than women. The relative risk of NT-LLA was 48 times higher in patients with diabetes than in patients without diabetes. Around 61.0% of the NT-LLAs occurred within the 50 - 74 age group and 54.3% had diabetes mellitus. Among amputees, 54.5% had a diagnosis of peripheral artery disease (PAD) and 52.8% had diabetic ulcers, with co-existence of several factors. Less than 5% of participants had a history of smoking tobacco. Average length of hospital stay was 12 days. The in hospital mortality rate was 8.8% (9.0% for major, 6.7% for minor amputations). Only 18.2% had duplex ultrasound performed and 1.7% angiography prior to amputation. No patient underwent vascular intervention prior to amputation. CONCLUSION This is the first study to report nationwide and contemporary epidemiological data on NT-LLAs in West Africa, highlighting several specificities. Large scale interventions are needed to ameliorate the care of diabetes and PAD and improve facilities for optimal management of patients at risk of amputation in Africa.
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Affiliation(s)
- Martin K Tchankoni
- Inserm U1094, IRD U270, Univ. Limoges, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases In Tropical Zone, Institute of Epidemiology and Tropical Neurology, Omega Health, Limoges, France; Public Health Department, Faculty of Health Sciences, University of Lomé, Togo; African Research Centre in Epidemiology and Public Health (CARESP), Lomé, Togo
| | - Roméo M Togan
- Public Health Department, Faculty of Health Sciences, University of Lomé, Togo
| | - Grégoire A Abalo
- Traumatology-Orthopedics Department of the Sylvanus Olympio University Hospital (CHU) of Lomé, Faculty of Health Sciences of the University of Lomé, Lomé, Togo
| | - Latame K Adoli
- Public Health Department, Faculty of Health Sciences, University of Lomé, Togo
| | - Atchi Walla
- Department of Orthopaedics, Campus Medical Teaching Hospital, Lomé, Togo
| | - David E Dosseh
- Department of General Surgery, Faculty of Health Sciences, University of Lomé, Lomé, Togo
| | - Boyodi Tchangaï
- Department of Visceral Surgery, University Teaching Hospital, Lomé, Togo
| | - Pierre-Marie Preux
- Inserm U1094, IRD U270, Univ. Limoges, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases In Tropical Zone, Institute of Epidemiology and Tropical Neurology, Omega Health, Limoges, France
| | - Victor Aboyans
- Inserm U1094, IRD U270, Univ. Limoges, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases In Tropical Zone, Institute of Epidemiology and Tropical Neurology, Omega Health, Limoges, France; Department of Cardiology, Dupuytren-2 University Hospital, Limoges, France.
| | - Didier K Ekouevi
- Public Health Department, Faculty of Health Sciences, University of Lomé, Togo; African Research Centre in Epidemiology and Public Health (CARESP), Lomé, Togo
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Darré T, Saka B, Walla A, Ekouévi KD, Folligan K. Sexuality, sexually transmitted infections and contraception among health sciences students in university of Lomé, Togo. BMC Res Notes 2018; 11:808. [PMID: 30428919 PMCID: PMC6234541 DOI: 10.1186/s13104-018-3923-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 11/09/2018] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Evaluate the practice of sexuality, contraception and the risk of sexually transmitted infections among students in the Faculty of Health Sciences, University of Lomé, Togo. RESULTS Three hundred and sixteen (316) students were interviewed, with a response rate of 43.3%. The average age of students completing the form was 21.4 ± 2.7 years and their sex ratio was 2.2. Of this number of students who completed the form, 51.8% have already had sex. The mean age of first intercourse was 17.9 ± 3.2 years; 70.3% were heterosexual. Regarding the number of sexual partners, 48.5% of students had more than one partner, of whom 15.9% had at least 5 sexual partners. 21.5% of these students had only one sexual intercourse per month. Regarding contraception among students with the card, 67.5% of students used a method of contraception. Among those using contraceptives, it was a 55.3% condom, followed by the Ogino method at 14.1%. Some of our respondents used more than one method of contraception and 28.5% of respondents indicated that their partners used a method of contraception. For STIs, 10.8% of students completing the form were already infected. Gonorrhea was reported in 30.4% of cases, candidiasis in 26.1% of cases.
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Affiliation(s)
- Tchin Darré
- Department of Pathology, University of Lomé, BP 1515, Lomé, Togo.
| | - Bayaki Saka
- Department of Dermatology, University of Lomé, Lomé, Togo
| | - Atchi Walla
- Orthopedic Trauma Department, University of Lomé, Lomé, Togo
| | | | - Koué Folligan
- Department of Histology-Embryology, University of Lomé, Lomé, Togo
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Darré T, Saka B, Mouhari-Toure A, Tchaou M, Dorkenoo AM, Doh K, Walla A, Amégbor K, Pitché VP, Napo-Koura G. Mycetoma in the Togolese: An Update from a Single-Center Experience. Mycopathologia 2018; 183:961-965. [PMID: 29557534 PMCID: PMC6305724 DOI: 10.1007/s11046-018-0260-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 03/11/2018] [Indexed: 10/26/2022]
Abstract
BACKGROUND Mycetoma is a chronic inflammatory process caused either by fungi (eumycetoma) or bacteria (actinomycetoma). In this retrospective study, we report epidemiologic and histopathological data of mycetoma observed in the Lome Hospital, Togo in a 25-year period (1992-2016). METHODOLOGY This is a retrospective study, over a period of 25 years, to analyze epidemiological and etiological findings of mycetomas seen in the single laboratory of pathological anatomy of the Lomé, Togo. RESULTS A total of 61 cases were retrieved from which only 33 cases were included which where clinically and microbiologically confirmed. The mean age of the patients was 29.7 ± 1.34 and a sex ratio (M/F) of 1.5. The majority of patients were farmers (n = 23 cases; 69.7%). Diagnosed etiologic agents were fungal in 24 cases (72.7%) and actinomycotic cases in 9 cases (27.3%). The fungal mycetomas consisted of Madurella mycetomatis (black grains) and Falcifomispora senegaliensis (black grains). The actinomycotic agents were represented by Actinomadura madurae (white grains), Actinomadurae pelletieri (red grains) and Nocardia sp. (yellow grains). CONCLUSION This report represents a single-center study which provides epidemiologic and histopathological data of mycetoma cases in Togo.
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Affiliation(s)
- Tchin Darré
- Department of Pathology, University Teaching Hospital of Lomé, Lomé, Togo. .,University of Lomé, BP 1515, Lomé, Togo.
| | - Bayaki Saka
- Department of Dermatology, University Teaching Hospital of Lomé, Lomé, Togo
| | - Abas Mouhari-Toure
- Department of Dermatology, University Teaching Hospital of Lomé, Lomé, Togo
| | - Mazamaesso Tchaou
- Department of Radiology, University Teaching Hospital of Lomé, Lomé, Togo
| | - Améyo Monique Dorkenoo
- Department of Parasitology and Mycology, University Teaching Hospital of Lomé, Lomé, Togo
| | - Kwamé Doh
- Department of Pathology, University Teaching Hospital of Lomé, Lomé, Togo
| | - Atchi Walla
- Department of Trauma, University Teaching Hospital of Lomé, Lomé, Togo
| | - Koffi Amégbor
- Department of Pathology, University Teaching Hospital of Lomé, Lomé, Togo
| | | | - Gado Napo-Koura
- Department of Pathology, University Teaching Hospital of Lomé, Lomé, Togo
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Darre T, Kpatcha TM, Bagny A, Maneh N, Gnandi-Piou F, Tchangai B, Daré S, Adani-Ifé S, Walla A, Amégbor K, Napo-Koura G. Descriptive Epidemiology of Cancers in Togo from 2009 to 2016. Asian Pac J Cancer Prev 2017; 18:3407-3411. [PMID: 29286611 PMCID: PMC5980902 DOI: 10.22034/apjcp.2017.18.12.3407] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background: Cancer is a global public health problem. According to World Report on Cancer in 2000, developing
countries are becoming increasingly affected. Methods: This retrospective and descriptive 8-year study of all histological
confirmed cancers was conducted using data from the anatomical pathology laboratory registry of Togo’s only laboratory.
The parameters were frequency, site and histological type as well as age and gender. Results: We found 1,738 cancers in
patients aged from 4 months to 109 years (mean, 50.4 ± 4. The sex ratio (M/F) was 1.3. The most frequent localizations
of the cancers were the prostate (10.3%) followed by the breast (9.9%), the stomach (8.4%) and the cervix (7.2%). In
women, the median age was 47.4 ± 2.9 years, and the most common cancers were breast cancer (21.2%), followed
by cervical cancer (16.3%). In men, the median age was 53.2 ± 7.3 years and the most frequent cancers were prostate
cancer (18.5%), non-Hodgkin’s lymphoma (13.2%) and stomach cancer (10.7%). In children, Burkitt’s lymphoma
(41.8%), retinoblastoma (11.6%) and nephroblastoma (9.6%) were the most important cancers. Conclusion: Cancers
are frequent in Togo, those of the prostate, breast and cervix being most important with a worse prognosis. Emphasis
should be placed on early detection and diagnosis.
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Affiliation(s)
- Tchin Darre
- Department of Pathology, University Teaching Hospital of Lomé, Lomé, Togo. Email :
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Kombate NK, Walla A, Ayouba G, Bakriga BM, Dellanh YY, Abalo AG, Dossim AM. Reconstruction of traumatic bone loss using the induced membrane technique: preliminary results about 11 cases. J Orthop 2017; 14:489-494. [PMID: 28839352 DOI: 10.1016/j.jor.2017.06.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 06/22/2017] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION The use of Masquelet technique is a serious option to consider for biologic reconstruction of severe bone loss. Here is exposed a continuous and prospective study on bone loss management using that technique. The aims of this study were to assess epidemiology of bone loss due either to trauma or to non-unions and to give preliminary results. PATIENTS AND METHODS It was a prospective study from April 2015 to december 2016 involving patients treated using the induced membrane technique for a diaphyseal bone defect due either to trauma or non-unions. AO plates or Orthofix external fixators were used for osteosynthesis. Bone healing was radiologically assessed and any complications were listed. RESULTS During the study period, 11 patients were treated using the induced membrane technique. There were 8 males and 3 females. Their mean age was 40.45 years (21-59). The skeletal segments concerned were 2 humerus, 6 femurs and 3 tibias with a mean bone defect length of 4,45 cm (2.5-8). The delay between reconstruction and trauma was 8 months (20 days - 3 years). After a mean follow-up of 6.54 months (3-11) six patients presented a good radiological healing (4 femurs, 2 humerus) whereas in four patients, autograft osteointegration was still ongoing (2 femurs, 2 tibias). A tibia secondary infection was observed in a patient with the graft partial resorption. In another patient, an initial gangrene lead to a leg amputation. CONCLUSION The induced membrane technique is an excellent option for bone defect reconstruction compared to other usual bone graft techniques. It helped us to manage large bone loss in various skeletal segments.
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Affiliation(s)
| | - Atchi Walla
- Orthopedic and Traumatology Department of Sylvanus Olympio Teaching Hospital, Lome-Togo, P.O Box 57, Africa
| | - Gamal Ayouba
- Orthopedic and Traumatology Department of Sylvanus Olympio Teaching Hospital, Lome-Togo, P.O Box 57, Africa
| | - B Moïse Bakriga
- Orthopedic and Traumatology Department of Sylvanus Olympio Teaching Hospital, Lome-Togo, P.O Box 57, Africa
| | - Yaovi Yannick Dellanh
- Orthopedic and Traumatology Department of Sylvanus Olympio Teaching Hospital, Lome-Togo, P.O Box 57, Africa
| | - Anani Grégoire Abalo
- Orthopedic and Traumatology Department of Sylvanus Olympio Teaching Hospital, Lome-Togo, P.O Box 57, Africa
| | - Assang Michel Dossim
- Orthopedic and Traumatology Department of Afagnan Saint-Jean-de- Dieu Hospital, Lome-Togo, P.O Box 1170, Africa
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Kombate NK, Walla A, Akloa K, Amakoutou K, Bakriga B, Ayouba G, Dellanh YY, Abalo A, Dossim AM. Epidemiology of Open Limb Fractures in a Country with Low-Income. ACTA ACUST UNITED AC 2017. [DOI: 10.4236/ojo.2017.711036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Kpelao E, Beketi KA, Moumouni AK, Doleagbenou A, Ntimon B, Egbohou P, Mouzou T, Tomta K, Sama DH, Abalo A, Walla A, Dossim A. Clinical profile of subdural hematomas: dangerousness of subdural subacute hematoma. Neurosurg Rev 2015; 39:237-40; discussion 240. [DOI: 10.1007/s10143-015-0669-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Accepted: 08/09/2015] [Indexed: 11/30/2022]
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Akpoto YM, Abalo A, Adam S, Sama HD, Dellanh YY, Amavi KA, Bakriga B, Walla A, Dossim A. Extremity injuries in soldiers during the conflict in Mali: experience of Togo Level two Hospital. Int Orthop 2015. [PMID: 26197945 DOI: 10.1007/s00264-015-2909-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE The aim of this study was to analyse war-related and non-war-related extremity injuries in soldiers in the Mali conflict. MATERIALS AND METHODS This prospective study was performed from 1 May 1 to 31 December 2014. It concerned extremity injuries in soldiers treated at Togo Level 2 Hospital. RESULTS Seventy-nine patients with an average age of 31.19 years were assessed. Among them, 50 were admitted after war injury and 29 from nonwar injury. Most war-related injuries were due to improvised explosive devices (IEDs) (36 %); road traffic accidents (51.72 %) were the main mechanism of non-war injury. A total of 125 injuries were analysed. Limb fractures were identified in 37 patients (29.6 %), and 22 cases (59.46 %) were open fractures. Twenty-six (20.8 %) patients had soft tissue wounds. The other injuries were sprains (18.4 %), muscle contusions (15.2 %), dislocations (8.8 %), traumatic amputations (4 %) and burns (3.2 %). Surgical debridement and external fixator application were the most frequently performed surgical procedures. Thirty-nine per cent of patients were evacuated to a level 3 hospital for better care. CONCLUSION The severity of injuries and their rapid treatment require orthopaedic surgeons to have high levels of surgical experience and knowledge pertaining to military or disaster surgical doctrine.
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Affiliation(s)
- Yao Messanvi Akpoto
- Department of Orthopedics, Sylvanus Olympio Teaching Hospital, BP 60241, Lomé, Togo.
| | - Anani Abalo
- Department of Orthopedics, Sylvanus Olympio Teaching Hospital, BP 60241, Lomé, Togo
| | - Saliou Adam
- Departments of Surgery, Sylvanus Olympio Teaching Hospital, Lomé, Togo
| | - Hamza Doles Sama
- Department of anesthesia, Sylvanus Olympio Teaching Hospital, Lomé, Togo
| | | | | | - Batarabadja Bakriga
- Department of Orthopedics, Sylvanus Olympio Teaching Hospital, BP 60241, Lomé, Togo
| | - Atchi Walla
- Department of Orthopedics, Sylvanus Olympio Teaching Hospital, BP 60241, Lomé, Togo
| | - Assang Dossim
- Department of Orthopedics, Sylvanus Olympio Teaching Hospital, BP 60241, Lomé, Togo
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Dellanh YY, Abalo A, Fortey K, Akpoto MY, Akloa K, James YE, Walla A, Bakriga B, Dossim A. Luxation obturatrice de la hanche: à propos d’un cas. Pan Afr Med J 2015. [DOI: 10.11604/pamj.2015.22.195.7812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Gnassingbe K, Walla A, Akakpo-Numado GK, Ketevi A, Tekou H. [Epiphyseal growth fractures: epidemiology and treatment. Retrospective report of 44 cases]. Mali Med 2011; 26:1-3. [PMID: 22953335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To value the frequency of epiphyseal growth fracture and to take out the therapeutic aspects of the epiphyseal growth fracture and to value the results for un good management. PATIENTS AND METHOD It is about a retrospective study carrying on 44 children aged of less than 15 years hospitalized and treated in the pediatric surgery department or the Tokoin teaching hospital (Lome) from 1st January 2002 to 31st December 2006. RESULTS The prevalence of epiphyseal growth fracture was of 3.6% with a masculine predominance(59.1%). The middle age was of 9.8 }3.2 years.The type 2 lesions of Salter and Harris classification represented 44%. The accidents of game were the main suppliers (41 %) with affluence in April and August. The orthopedic treatment was applied in 64.4% of case. With a middle receding of 2 years, 4 patients had presented some afterrnaths. CONCLUSION Epiphyseal growth fracture has a relatively frequency. The diagnostic trap of the epiphyseal growth fracture is numerous and is sometimes the origin of the therapeutic mistake. Their treatment must be well codified to avoid some long-term afterrnaths.
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Abalo A, Tomta K, James N, Walla A, Agounke W, Dossim A. [Results of transosseous reattachment for distal rupture of the biceps tendon. Evaluation of results]. ACTA ACUST UNITED AC 2010; 30:35-9. [PMID: 21074476 DOI: 10.1016/j.main.2010.09.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2009] [Revised: 05/29/2010] [Accepted: 09/27/2010] [Indexed: 11/19/2022]
Abstract
Avulsion of the distal biceps brachii tendon is an uncommon injury. This is a retrospective review of cases operated in our department by transosseous suture fixation on the radial tuberosity, using the single anterior incision. Between 2000 and 2007, a total of 10 patients with distal biceps tendon injury were included. All were men, with an average age of 39 years. The most common mechanism was passive extension against active flexion. The dominant limb was affected in all patients. Clinical diagnosis was the rule. Surgical reattachment to the radial tuberosity through the anterior approach to the elbow was performed. The preoperative period was one week in three cases, between one and three weeks in five cases, and superior to three weeks in two cases. Clinical and instrumental evaluation of the results was done. Average follow-up was 48 months. Subjective results were good in seven cases, acceptable in two cases and poor in one case. Nine patients return to their previous level activity with no limitations. The average range of motion was 0° of extension to 135° of flexion. Strength testing of the injured limbs, compared to the contralateral, using the criteria described by Baker and Bierwagen, revealed a loss of 22% of supination strength and 32% of supination endurance. There was a loss of 14% of flexion strength and 27% of flexion endurance. There were two cases of superficial surgical site infection. There were no cases of nerve damage or heterotopic bone formation. Two main factors were found to explain the poor outcomes: experience of the surgeon and a long preoperative delay. Despite the limitations of this study, we found that transosseous reattachment of the biceps' distal tendon to the radial tuberosity can restore supination. Strength and endurance for supination can be better restored by early intervention. Complications are easily avoided if surgery is performed early and by experts.
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Affiliation(s)
- A Abalo
- Service d'orthopédie traumatologie, CHU Tokoin, Lomé, Togo.
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Abstract
PURPOSE To retrospectively study the epidemiology and treatment of acute avulsion fractures of the tibial tubercle in 12 patients. METHODS Records of 12 patients aged 11 to 17 (mean, 14) years with avulsion fractures of the tibial tubercle presenting to our hospital from April 1998 to September 2004 were studied. Patient age, gender, involved side, injury mechanism, clinical and radiographic records, treatment, complications, and outcomes were reviewed. RESULTS Eight patients injured the right side, 3 the left side, and one both sides. They all engaged in sports or active play during the injury. Two fractures were type IA, one type IB, 2 type IIB, 5 type IIIA, 2 type IIIB, and one type IV. Three patients with type-I fractures and one with a type-IIB fracture were treated with closed reduction and cast immobilisation for 3 to 4 (mean, 3.8) weeks. The remaining 9 fractures were treated with open reduction and internal fixation. The mean follow-up period was 39 (range, 23-59) months. No complications were noted. Ten patients had excellent results and 2 had fair results. CONCLUSION Closed reduction and cast immobilisation for minimally displaced fractures, and open reduction and internal fixation for displaced fractures resulted in favourable outcomes.
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Affiliation(s)
- A Abalo
- Department of Orthopaedics, Tokoin Medical University Hospital, Lome, Togo.
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Abalo A, Dossim A, Ouro Bangna AF, Tomta K, Assiobo A, Walla A. Dynamic hip screw and compression plate fixation of ipsilateral femoral neck and shaft fractures. J Orthop Surg (Hong Kong) 2008; 16:35-8. [PMID: 18453656 DOI: 10.1177/230949900801600109] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE To evaluate surgical outcomes of ipsilateral femoral neck and shaft fractures. METHODS Between April 1997 and September 2004, 29 men and 8 women (mean age, 37 years) underwent fixation of femoral neck and shaft fractures using a dynamic compression plate plus a dynamic hip screw or screws. There were 30 femoral neck and 7 pertrochanteric fractures. Functional results were assessed according to the Friedman and Wyman classification. RESULTS The mean follow-up period was 49 months. Of the femoral neck fractures, 34 united in a mean of 4 months; 33 of them healed anatomically and one with a 6-degree varus angulation. No osteonecrosis of the femoral head was noted. Of the femoral shaft fractures, 32 united in a mean of 6 months, 5 were non-unions (2 persisted even after revision surgery). Seven patients developed infections (5 superficial and 2 deep), which resolved with debridement and antibiotic treatment. Functional results were good in 29 patients, fair in 5, and poor in 3. CONCLUSION The use of dynamic hip screws and compression plates for ipsilateral femoral neck and shaft fractures is reliable in achieving bone union with few complications.
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Affiliation(s)
- A Abalo
- Department of Orthopaedics, Tokoin Medical University Hospital, Lome, Togo.
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Abalo A, Dossim A, Assiobo A, Walla A, Ouderaogo A. Intramedullary fixation using multiple Kirschner wires for forearm fractures: a developing country perspective. J Orthop Surg (Hong Kong) 2007; 15:319-22. [PMID: 18162679 DOI: 10.1177/230949900701500316] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE To evaluate treatment results of intramedullary fixation using multiple Kirschner wires for diaphyseal forearm fractures. METHODS Between January 2001 and January 2004, 184 patients (122 men and 62 women) with 288 displaced diaphyseal forearm fractures underwent intramedullary fixation using multiple Kirschner wires. The wires were inserted by opening the fracture site because radiographic facility for closed pinning was unavailable. The time to union, functional recovery, and the complication rates were assessed. RESULTS 11 patients were lost to follow-up, leaving 173 whose data was analysed. In 167 (97%) of the patients the fractures united, and in 14 (8%) of them union was delayed. The mean time to union for closed fractures was 13 (range, 7-16) weeks and for open fractures it was 15 (range, 12-22) weeks. The mean time in cast was 6 (range, 3-14) weeks. In all, 34/173 (20%) had complications: superficial infection (n=13), deep infection (n=4), cross-union between bones (n=4), open fracture 'needing' a skin graft (n=2), radial nerve palsy (n=3), paraesthesia (n=1), and non-union (n=7). Among the 173 analysed patients, the infection rate was 10% and the non-union rate was 4%. 130 (75%) of the patients had the wires removed; no re-fracture occurred after wire removal. Based on the Anderson criteria, 47 (27%) of the patients attained excellent, 78 (45%) satisfactory, and 39 (23%) unsatisfactory results. In 9 (5%) of the patients, union failed (7 plain non-union and 2 due to chronic osteomyelitis). CONCLUSION Kirschner wires are much cheaper than plates and screws, and require minimal expertise for insertion and removal. They remain acceptable for stabilising displaced diaphyseal forearm fractures in developing countries.
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Affiliation(s)
- A Abalo
- Department of Orthopaedics, Tokoin Teaching Hospital, Lome, Togo.
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Walla A, Sadanani N, Kapoor P, Kapoor R. Preparation, Mössbauer and IR spectra of some triorgano Sn(IV) chloride with diarsino phosphine, tritertiary phosphine and triphenyl stibine. ACTA ACUST UNITED AC 1980. [DOI: 10.1016/0022-1902(80)80333-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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