Batarabadja Bakriga | Université de Lomé (original) (raw)

Papers by Batarabadja Bakriga

National journal of clinical orthopaedics, Dec 31, 2022

International Journal of Orthopaedics Sciences, Dec 31, 2022

The aim of this study was to evaluate the anatomical and functional results of locked condylar pl... more The aim of this study was to evaluate the anatomical and functional results of locked condylar plate osteosynthesis in distal femur fractures in elderly Togo patients. Patients and Method: It was a continuous prospective study with descriptive and analytical aims, conducted over a period of 4 years 6 months, from 1 January 2019 to July 2023. The AO/OTA classification was used for the radiological classification of fractures. The walk was measured by the Parker score. Functional outcome of the knee was evaluated using the MEGY functional score. The population of study was 32 cases. The mean age of the patients was 74.25 years, and the most affected group was 35-45 age. Both sexes were equally represented. Fall at home were responsible of 43.8% distal femoral fracture in patients aged over 60 years old. Fractures were open in 18.8%. In 15.6% cases, these lesions were associated to polyfractures and/or polytrauma and in 3 cases we found "floating knee". AO/OTA A2 type fractures were the most frequent (25%). The average operating time was 25.3 days. The locked condylar plate was the implant used in all our patients. The average operating time was 2h05min. Results: The rehabilitation was started early in 87.5% of patients. The mean time to consolidation was 4 months. Residual knee pain was the most common late complication (62.5%), followed by knee osteoarthritis (15.6%), knee stiffness (15.6%), and mortality (9.4%). The functional outcome was very good in 18.8% of cases and good in 46.9%. Conclusion: Osteosynthesis using locked condylar plates for distal femur fractures in patients over 60 years of age must combine stability and solidity with short operability times in order to achieve a good functional result and avoid mortality. Despite our difficult working conditions, anatomical results were good in 59.4% of cases.

European Scientific Journal, ESJ

Le but de cette étude était de décrire les aspects cliniques, thérapeutiques et évolutifs des fra... more Le but de cette étude était de décrire les aspects cliniques, thérapeutiques et évolutifs des fractures diaphysaires des os de l’avant-bras dans un pays à faible revenu. Méthodologie : Cette étude rétrospective a été conduite de janvier 2019 à décembre 2022. Elle a concerné les patients opérés et suivis dans le service pour fracture d’un ou des deux os de l’avant-bras. Résultats : durant la période d’étude, 36 dossiers de patients ont été retenus. L’âge moyen était de 38,2 ans avec des extrêmes de 18 et 65. Il y avait 26 hommes et 10 femmes, soit un sex-ratio de 2,6. Il y avait 61% (n=22) de fractures diaphysaires simultanée des deux os de l’avant-bras, 22% (n=8) de fractures de Galeazzi, et 8% (n= 3) de fractures de Monteggia. Dans 3 autres cas (8%) il y avait une fracture isolée et non déplacée de l’ulna. La fracture siégeait sur le radius dans 30 cas et sur l’ulna dans 28 cas, soit un total de 58 fractures. Le trait de fracture était simple (2R2A et 2U2A) dans 35 cas (60%). La f...

Revue de Chirurgie Orthopédique et Traumatologique, 2012

Background.-Treatment of symptomatic spinoglenoid cysts has varied from observation, needle aspir... more Background.-Treatment of symptomatic spinoglenoid cysts has varied from observation, needle aspiration, and open excision to arthroscopic decompression with or without labral repair. The purpose of the main study was to prospectively evaluate whether labral repair alone would lead to cyst resolution and pain relief. In an additional study we have assessed whether the cysts were drained during debridement and the time to cyst resolution after surgery. Material and methods.-In the main study, 42 patients with and upper posterior labral tear and a ganglion cyst at the spinoglenoid notch were treated with arthroscopic debridement of the glenoid rim and labral repair, either with a resorbable tack or suture anchor. Patients ranged from 23 to 68 years. Seven patients had clinical and/or radiological evidence of atrophy of the infraspinatus muscle; one had atrophy of both the infraspinatus and the teres minor muscle while two had atrophy of the teres minor muscle. All patients had postoperative magnetic resonance imaging (MRI) performed twice, at an average of 15 months and again at an average of 43 months postoperatively. The clinical outcome, including Rowe score, was assessed for all patients at a median of 43 months postoperatively. In the additional study, 41 patients had MRI performed the day before surgery, the two postoperative days, and at 2, 6 and 12 weeks. Results.-In 37 (88%) of the 42 patients the cyst had resolved completely. In five patients, a cyst was still present, but with a clear reduction in size. These five had remission of pain and were subjectively satisfied. Three patients with preoperative muscular atrophy without fatty infiltration regained normal appearing muscle, while the seven with preoperative fatty changes continued to demonstrate to demonstrate those changes postoperatively. The median Rowe score improved from 61.5 points preoperatively to 98.0 points at follow-up. Thirty-one patients assessed their result as excellent, nine as good and two as fair. In the additional study, there was no significant difference in cyst size on preoperative and immediate postoperative imaging. The mean time to cyst resolution was 6 to 12 weeks. Discussion.-Most spinoglenoid cysts will resolve, and patient satisfaction can be expected high after labral fixation without cyst decompression. The cyst is not drained during debridement and will resolve between 6 and 12 weeks postoperatively.

International Journal of Orthopaedics Sciences, Apr 1, 2020

We aimed to report outcome of a limb salvage of 3 weeks open infected tibia fibula fracture treat... more We aimed to report outcome of a limb salvage of 3 weeks open infected tibia fibula fracture treated by Ilizarov external fixator (IEF). A male 42-year-old male, had sustained a motorcycle accident leading to a midshaft open type IIIB comminuted tibia fibula fracture. In face of poor prognosis, after 10 days, due to inadequate wound care, the orthopedic team made a decision to amputate the leg. In the context of lack of means, the patient has been transferred to a community hospital at Kpalime, town located at 120km from Togo's capital in other to be managed by a team of trip missionary. After three procedures and intensives wound care associated to appropriate antibiotic, the consolidation was achieved at 6 months. A year follow up showed healing without infection. Patient walked with a limp and no cane. A combination of a stronger immune system, proper external fixation with adequate compression and thorough wound care treatments allowed this patient to keep his leg and perform daily activities.

Introduction: Tripolar lesions of the thoracic limb are rare. We report a rare a Galéazzi fractur... more Introduction: Tripolar lesions of the thoracic limb are rare. We report a rare a Galéazzi fracture associated with an ipsilateral fracture of ulna and olecranon in a 45-year-old patient. Surgical management has been delayed due to limited resources of the patient. Case presentation: It was a 45-year-old man admitted in our emergency after a fallen on bicycle. He presented a fracture of olecranon, shaft bone fracture of radius and ulnar, and distal radio-ulnar disjunction. The assessment at 18 months has found a consolidation of fractures. The elbow and wrist regained joint range, but we noted a limitation of prono-supination related to radioulnar synostosis. This limitation had no impact on the professional and sporting activities of the patient. Conclusion: Apart the difficulties to describe mechanism responsible of this complex lesion, the functional prognosis of the limb depends on a correct diagnosis and adequate management. At the last follow-up, the patient was satisfied with the result obtained. Longer term follow-up will allow us to determine the issue of this complex lesion in this patient. For the moment patient is not complained so we just wait and see.

International Journal of Orthopaedics Sciences, Apr 1, 2020

The purpose of this study was to describe the indications of Ilizarov's technique in orthopedic t... more The purpose of this study was to describe the indications of Ilizarov's technique in orthopedic trauma and their results. Material and method: The study involved a retrospective multicenter cohort. It included patients treated with Ilizarov's technique between July 2014 and September 2019 and followed through to recovery. The analysis focused on types of lesions, intraoperative data, complications, cure and failure rates. Only the pins were the responsibility of the patient and cost between 60,000 to 120,000 CFA (91, 5-183 euros). Results: Forty-seven patients were treated. The average age was 37.4 years. Males represented 63.8%. The main diagnoses were: tibial fractures (n = 31; 65.9%), including 14 fractures of the tibial plateau; vicious ankle calluses (3; 6.4%); loss of bone substances (3; 6.4%). The main interventions carried out were: Osteosynthesis (n = 34; 72.3%); ankle arthrodesis (n = 5; 10.6%); equine varus foot correction (n = 4; 8.5%). The average duration of an intervention was 130.5 min. the average ablation time was 98.7 days. The cure rate was 95.6%. The main complications were: infection on a spindle (n = 11; 23.4%); pain (n = 6; 12.8%), stiff knee (n = 7; 15.9%). Conclusion: The rate of positive results is similar to that observed in the literature. Ilizarov's external fixator has achieved satisfactory results for complex leg and ankle injuries at a reduced cost.

Open Journal of Orthopedics, 2018

Chronic osteomyelitis in children is frequent in the developing countries. Their complications an... more Chronic osteomyelitis in children is frequent in the developing countries. Their complications and morbidity burden the functional prognosis. The reconstruction of diaphyseal bone loss after sequestrectomy in young children remains a difficult and expensive challenge in our context. The delay in care and the lack of social security for all, are risk factors for morbidity. The induced membrane technique described by Masquelet starts to be applied and showed satisfactory results. We report the results of a case of reconstruction of the proximal humerus by using a non-vascularized fibula and supplemental bone substitute in a boy of 2 years with sickle cell. No scarring occurred at the sampling site. The process of bone consolidation is underway.

National journal of clinical orthopaedics, Oct 1, 2018

Introduction: In July 2014, a United Nations Multidimensional Integrated Mission for the Stabiliz... more Introduction: In July 2014, a United Nations Multidimensional Integrated Mission for the Stabilization of Mali (MINUSMA) had started. Soldiers of this mission were frequently attacked and many of them are wounded. Togo's Level 2 hospital has been deployed in Kidal to provide emergency medical and surgical care to all wounded in the northern sector. The purpose of this work was to determine the epidemiological profile of the fractures presented by these wounded. Materials and methods: It was a continuous prospective study from January 2015 to December 2016, concerning patients who were admitted for a fracture and confirmed by a standard radiography. The parameters studied were the age of the wounded, the sex, the civil or military status, the etiology of the fracture, the seat of the bone lesions, the associated lesions and the type of opening according to the Gustilo-Anderson classification. Results: Two hundred and fifty patients (250) were admitted for fractures during this period. The etiology of fractures was dominated by firearms (27.2%) and traffic accidents (22.7%). Three hundred and two (302) fractures were reported from the 250 patients. They were in the lower limb in 145 cases (48%), upper limb in 130 cases (43.1%). Fractures were open in 216 cases (71.5%) and dominated by Gustilo-Anderson type III (69.4%). Conclusion: The fractures found during the peacekeeping missions are associated with other lesions that make their severities. The care of these wounded should be multidisciplinary. Otherwise, the military surgeon deployed in these missions must have many skills to optimize the results of this care.

Journal de la Recherche Scientifique de l'Universite de Lome, Sep 20, 2016

International Journal of Orthopaedics Sciences, 2017

The aims of this work were to assess functional and radiographic results of primary total hip art... more The aims of this work were to assess functional and radiographic results of primary total hip arthroplasty and to determine the profile of patients and the different indications. Materials and Methods: We conducted a retrospective study of 56 patients operated for total hip arthroplasty at Afagnan hospital (Togo), from first January 2007 to 31 December 2016. The clinical evaluation was made with Devane activity score and Postel Merle D'Aubigné (PMA) score. Radiologicaly, the analysis focused on the inclination of the cup, and the osseointegration of implants. Results: 56 patients underwent total hip arthroplasty with dual-mobility cups in which two bilateral. The average passing time of follow-up was 6, 5 years [range1-9 yrs.]. The mean age was 42.69 years (20-77). The main indications were: aseptic osteonecrosis of hip 28 cases (48.27%), sequelae of trauma 11 cases (18.96%), hip dysplasia 4 cases (06.90%), and primitive degenerative arthritis 12 cases (20.69%). The PMA score increased from 9.1 (2-15) preoperatively to 15.8 (13-18) at the last follow. The average of the inclination cups was 42 degrees. No episode of luxation was watched for the arthroplasty with dualmobility cup. The survival rate was 100%. Conclusion: Total hip arthroplasty were mainly impacted with a dual-mobility cup at the last follow; the overall results are satisfactory with PMA score of 15.8. Our study confirms the medium-term reliability of dual-mobility cup with 100% survival rate. These results must be tempered because of the occurrence of long-term complications related to the risk of dual mobility among young people.

Burns Open, 2021

Abstract Four children, from 5 to 10 years aged, presented to the Sylvanus Olympio Hospital (SOTH... more Abstract Four children, from 5 to 10 years aged, presented to the Sylvanus Olympio Hospital (SOTH) of Lome (Togo) with severe (second- and third-degree) burns of 25-78% of total body surface area (TBSA) due to flame in domestic accidents and were treated using skin substitutes. We conducted skin substitution by dermal templates (Integra®) for two children and by skin allografts for the other two. In the two cases of dermal templates, we performed a wound excision on day 30 (15%) in one case, and on day 28 (18%) in the other. In one case, we associated the coverage with the dermal template to a negative pressure wound therapy; we applied skin graft on day 18 and day 21. In the follow-up, we observed no complication in both cases. In one of the two cases of skin allograft, we performed an eschar excision on day 8 (18%) and a donor skin allograft. After the allograft, we conducted another excision on day 15 (10%) and a skin autograft. The patient died ten hours after this last procedure. The second patient had sequential excisions at day 13 (18%), day 20 (15%) with skin autograft, and on day 27 (10%) with donor skin allograft, and a skin autograft on day 42 following allograft necrosis. In the fourth month, the child was discharged with a wound coverage of 74%, which was completed by another skin graft in the sixth month. The availability of dermal templates compelled the choice between the two skin substitutes. The access to other grafting options, such as a deceased skin bank, could allow the SOTH surgical team to step forward to the burn care.

National Journal of Clinical Orthopaedics, 2020

Introduction: Thromboembolic complications arise when the Virchow triad is brought together. In t... more Introduction: Thromboembolic complications arise when the Virchow triad is brought together. In trauma, trauma, bed rest and even treatment promote these complications. The aim: To determine the epidemiological aspects of these complications in trauma patients of the limbs in order to improve prevention and management. Material and method: It was a prospective study from January 1 to December 31, 2018 on the trauma of members admitted to the orthopedic trauma service and who presented a thromboembolic complication. The parameters studied were age, sex, weight, nature of the limb lesion, site of the lesion, type of thromboembolic complications, time to onset of the complication. Results: Twelve (12) patients including 8 men and 4 women presented thromboembolic complications after their trauma. The average age of the patients was 35.4 years. Complications were observed after surgery in 5 cases and after orthopedic treatment in 3 cases. Deep vein thrombosis (DVT) was found in 9 cases and pulmonary embolism in 3 cases. The limb trauma consisted of a fracture in 10 patients and a dislocation of the knee in 2 cases. Complications mainly occurred on pelvic fracture with 4 cases. The delay of onset of these complications was the first 4 post-traumatic days in most of the patients.

International Journal of Orthopaedics Sciences, Jul 1, 2018

Introduction: Knee trauma is very common and sometimes compromises its stability. The treatment o... more Introduction: Knee trauma is very common and sometimes compromises its stability. The treatment of these lesions is more and more surgical, but nonsurgical treatment remain having an importance in the management. The purpose of this study was to determine the results of nonsurgical treatment of ligamentous knee injuries in soldiers deployed in northern Mali during a stabilization mission. Materials and methods: It was a prospective study concerning ligamentous lesions of the knee, treated by orthopedic means in Togo's level 2 hospital and followed for a period of at least 6 months. The International Knee Score (IKS) was used to determine our results. Patient satisfaction was determined by taking into account pain, knee stability and resumption of previous activities. Results: Twenty-one (21) patients were treated. They were 18 men (85.7%) and 3 women (14.3%). The average age of the patients was 32.43 years old. We found 7 cases (33.4%) of benign sprain, 9 cases (42.8%) of medium severity sprain and 5 cases (23.8%) of severe sprain. After administration of the analgesic, immobilization was made by a knee brace and sometimes a plaster splint. Rehabilitation was started at the end of immobilization. The control after 6 months of follow-up allowed to find 57,1% of excellent result and 9,5% of bad result Conclusion: Nonsurgical treatment of ligamentous lesions gives good results when properly conducted. When a surgical treatment is decided for these lesions, it is recommended to make the rehabilitation of the knee before the operation to improve the results.

International Journal of Orthopaedics Sciences

The purpose of this study is to present our surgical strategy and describe the advantages and out... more The purpose of this study is to present our surgical strategy and describe the advantages and outcomes of the Ilizarov method in the treatment of bilateral tibia nonunion in an adult with OI. The major of bone fracture fixation drawback is the difficult placement of nails due to abnormal bony anatomy, non-linear and imperforate canals, marked bowing and unusually short limbs. A female adult aged 18yo with bilateral tibia nonunion affected with OI type V was treated with the Ilizarov method. The tibia was in varus (15° at left, 14° at right) and recurvatum (18° on the left, 27° on the right). Surgical technic was same for both tibia in one-time procedure and it's compounded: primary fibula osteotomy, tibia and osteotomy taking out interfragmentary fibrosis, reduction and fixation by Ilizarov frame. Full weightbearing was allowed at 3 months. The complications that occurred were minors. Bone's consolidation was obtained at 5 months and the frames were removed at 6 months in the office without anesthesia. At the follow-up visit 5 months after removal, the ASAMI functional and radiological score was excellent on the left side and good on the right side. The use of the Ilizarov method for treating a tibia bilateral nonunion in an adult patient with moderate OI provides good stability. This technique ensures early weight full bearing, above joint motion, and recovery functional necessary to normal bone tissue regeneration. This is an alternative to avoid difficulties and complications due to internal fixation in deformities correction in adults with acquired bone-weakening conditions.

National Journal of Clinical Orthopaedics

Bilateral fracture of clavicle are rare. The injury mecanism is difficult to specify and there ar... more Bilateral fracture of clavicle are rare. The injury mecanism is difficult to specify and there are sevral hypotheses that have been developed. The management can be orthopedics or chirurgical. We reported the 52 years man who presented a bilateral fracture of clavicle following a trafic road accident. The management was chirurgical with satisfatory result.

Journal de la Recherche Scientifique de l'Universite de Lome, 2018

Journal de la Recherche Scientifique de l’Université de Lomé, 2017

Objectif : Le but de ce travail était de rapporter les résultats anatomiques et fonctionnels de t... more Objectif : Le but de ce travail était de rapporter les résultats anatomiques et fonctionnels de trois cas de fracture du trapèze pris en charge chirurgicalement au CHU de rabat au Maroc.Méthodologie : Trois patients ayant présenté une fracture du trapèze ont été opéré dansle service entre janvier 2006 et janvier 2012 et revu en consultation avec un recul moyen de 5 ans. Le traitement a été chirurgical chez tous les patients avec une immobilisation plâtrée complémentaire de quatre semaines. L’évaluation a été faite par Cotation clinique de l'opposition et de la contre-opposition du pouce de KapandjiRésultats : La cotation clinique de l'opposition et de la contre-opposition du pouce de Kapandji était respectivement à 8 et à 3, dans la première observation. Le second patient, au dernier recul à 5 ans, la cotation clinique de l'opposition et de la contreopposition du pouce de Kapandji était respectivement à 6 et à 2. L’ablation de la vis dans la troisième observation s’est f...

Journal de la Recherche Scientifique de l’Université de Lomé, 2020

National journal of clinical orthopaedics, Dec 31, 2022

International Journal of Orthopaedics Sciences, Dec 31, 2022

The aim of this study was to evaluate the anatomical and functional results of locked condylar pl... more The aim of this study was to evaluate the anatomical and functional results of locked condylar plate osteosynthesis in distal femur fractures in elderly Togo patients. Patients and Method: It was a continuous prospective study with descriptive and analytical aims, conducted over a period of 4 years 6 months, from 1 January 2019 to July 2023. The AO/OTA classification was used for the radiological classification of fractures. The walk was measured by the Parker score. Functional outcome of the knee was evaluated using the MEGY functional score. The population of study was 32 cases. The mean age of the patients was 74.25 years, and the most affected group was 35-45 age. Both sexes were equally represented. Fall at home were responsible of 43.8% distal femoral fracture in patients aged over 60 years old. Fractures were open in 18.8%. In 15.6% cases, these lesions were associated to polyfractures and/or polytrauma and in 3 cases we found "floating knee". AO/OTA A2 type fractures were the most frequent (25%). The average operating time was 25.3 days. The locked condylar plate was the implant used in all our patients. The average operating time was 2h05min. Results: The rehabilitation was started early in 87.5% of patients. The mean time to consolidation was 4 months. Residual knee pain was the most common late complication (62.5%), followed by knee osteoarthritis (15.6%), knee stiffness (15.6%), and mortality (9.4%). The functional outcome was very good in 18.8% of cases and good in 46.9%. Conclusion: Osteosynthesis using locked condylar plates for distal femur fractures in patients over 60 years of age must combine stability and solidity with short operability times in order to achieve a good functional result and avoid mortality. Despite our difficult working conditions, anatomical results were good in 59.4% of cases.

European Scientific Journal, ESJ

Le but de cette étude était de décrire les aspects cliniques, thérapeutiques et évolutifs des fra... more Le but de cette étude était de décrire les aspects cliniques, thérapeutiques et évolutifs des fractures diaphysaires des os de l’avant-bras dans un pays à faible revenu. Méthodologie : Cette étude rétrospective a été conduite de janvier 2019 à décembre 2022. Elle a concerné les patients opérés et suivis dans le service pour fracture d’un ou des deux os de l’avant-bras. Résultats : durant la période d’étude, 36 dossiers de patients ont été retenus. L’âge moyen était de 38,2 ans avec des extrêmes de 18 et 65. Il y avait 26 hommes et 10 femmes, soit un sex-ratio de 2,6. Il y avait 61% (n=22) de fractures diaphysaires simultanée des deux os de l’avant-bras, 22% (n=8) de fractures de Galeazzi, et 8% (n= 3) de fractures de Monteggia. Dans 3 autres cas (8%) il y avait une fracture isolée et non déplacée de l’ulna. La fracture siégeait sur le radius dans 30 cas et sur l’ulna dans 28 cas, soit un total de 58 fractures. Le trait de fracture était simple (2R2A et 2U2A) dans 35 cas (60%). La f...

Revue de Chirurgie Orthopédique et Traumatologique, 2012

Background.-Treatment of symptomatic spinoglenoid cysts has varied from observation, needle aspir... more Background.-Treatment of symptomatic spinoglenoid cysts has varied from observation, needle aspiration, and open excision to arthroscopic decompression with or without labral repair. The purpose of the main study was to prospectively evaluate whether labral repair alone would lead to cyst resolution and pain relief. In an additional study we have assessed whether the cysts were drained during debridement and the time to cyst resolution after surgery. Material and methods.-In the main study, 42 patients with and upper posterior labral tear and a ganglion cyst at the spinoglenoid notch were treated with arthroscopic debridement of the glenoid rim and labral repair, either with a resorbable tack or suture anchor. Patients ranged from 23 to 68 years. Seven patients had clinical and/or radiological evidence of atrophy of the infraspinatus muscle; one had atrophy of both the infraspinatus and the teres minor muscle while two had atrophy of the teres minor muscle. All patients had postoperative magnetic resonance imaging (MRI) performed twice, at an average of 15 months and again at an average of 43 months postoperatively. The clinical outcome, including Rowe score, was assessed for all patients at a median of 43 months postoperatively. In the additional study, 41 patients had MRI performed the day before surgery, the two postoperative days, and at 2, 6 and 12 weeks. Results.-In 37 (88%) of the 42 patients the cyst had resolved completely. In five patients, a cyst was still present, but with a clear reduction in size. These five had remission of pain and were subjectively satisfied. Three patients with preoperative muscular atrophy without fatty infiltration regained normal appearing muscle, while the seven with preoperative fatty changes continued to demonstrate to demonstrate those changes postoperatively. The median Rowe score improved from 61.5 points preoperatively to 98.0 points at follow-up. Thirty-one patients assessed their result as excellent, nine as good and two as fair. In the additional study, there was no significant difference in cyst size on preoperative and immediate postoperative imaging. The mean time to cyst resolution was 6 to 12 weeks. Discussion.-Most spinoglenoid cysts will resolve, and patient satisfaction can be expected high after labral fixation without cyst decompression. The cyst is not drained during debridement and will resolve between 6 and 12 weeks postoperatively.

International Journal of Orthopaedics Sciences, Apr 1, 2020

We aimed to report outcome of a limb salvage of 3 weeks open infected tibia fibula fracture treat... more We aimed to report outcome of a limb salvage of 3 weeks open infected tibia fibula fracture treated by Ilizarov external fixator (IEF). A male 42-year-old male, had sustained a motorcycle accident leading to a midshaft open type IIIB comminuted tibia fibula fracture. In face of poor prognosis, after 10 days, due to inadequate wound care, the orthopedic team made a decision to amputate the leg. In the context of lack of means, the patient has been transferred to a community hospital at Kpalime, town located at 120km from Togo's capital in other to be managed by a team of trip missionary. After three procedures and intensives wound care associated to appropriate antibiotic, the consolidation was achieved at 6 months. A year follow up showed healing without infection. Patient walked with a limp and no cane. A combination of a stronger immune system, proper external fixation with adequate compression and thorough wound care treatments allowed this patient to keep his leg and perform daily activities.

Introduction: Tripolar lesions of the thoracic limb are rare. We report a rare a Galéazzi fractur... more Introduction: Tripolar lesions of the thoracic limb are rare. We report a rare a Galéazzi fracture associated with an ipsilateral fracture of ulna and olecranon in a 45-year-old patient. Surgical management has been delayed due to limited resources of the patient. Case presentation: It was a 45-year-old man admitted in our emergency after a fallen on bicycle. He presented a fracture of olecranon, shaft bone fracture of radius and ulnar, and distal radio-ulnar disjunction. The assessment at 18 months has found a consolidation of fractures. The elbow and wrist regained joint range, but we noted a limitation of prono-supination related to radioulnar synostosis. This limitation had no impact on the professional and sporting activities of the patient. Conclusion: Apart the difficulties to describe mechanism responsible of this complex lesion, the functional prognosis of the limb depends on a correct diagnosis and adequate management. At the last follow-up, the patient was satisfied with the result obtained. Longer term follow-up will allow us to determine the issue of this complex lesion in this patient. For the moment patient is not complained so we just wait and see.

International Journal of Orthopaedics Sciences, Apr 1, 2020

The purpose of this study was to describe the indications of Ilizarov's technique in orthopedic t... more The purpose of this study was to describe the indications of Ilizarov's technique in orthopedic trauma and their results. Material and method: The study involved a retrospective multicenter cohort. It included patients treated with Ilizarov's technique between July 2014 and September 2019 and followed through to recovery. The analysis focused on types of lesions, intraoperative data, complications, cure and failure rates. Only the pins were the responsibility of the patient and cost between 60,000 to 120,000 CFA (91, 5-183 euros). Results: Forty-seven patients were treated. The average age was 37.4 years. Males represented 63.8%. The main diagnoses were: tibial fractures (n = 31; 65.9%), including 14 fractures of the tibial plateau; vicious ankle calluses (3; 6.4%); loss of bone substances (3; 6.4%). The main interventions carried out were: Osteosynthesis (n = 34; 72.3%); ankle arthrodesis (n = 5; 10.6%); equine varus foot correction (n = 4; 8.5%). The average duration of an intervention was 130.5 min. the average ablation time was 98.7 days. The cure rate was 95.6%. The main complications were: infection on a spindle (n = 11; 23.4%); pain (n = 6; 12.8%), stiff knee (n = 7; 15.9%). Conclusion: The rate of positive results is similar to that observed in the literature. Ilizarov's external fixator has achieved satisfactory results for complex leg and ankle injuries at a reduced cost.

Open Journal of Orthopedics, 2018

Chronic osteomyelitis in children is frequent in the developing countries. Their complications an... more Chronic osteomyelitis in children is frequent in the developing countries. Their complications and morbidity burden the functional prognosis. The reconstruction of diaphyseal bone loss after sequestrectomy in young children remains a difficult and expensive challenge in our context. The delay in care and the lack of social security for all, are risk factors for morbidity. The induced membrane technique described by Masquelet starts to be applied and showed satisfactory results. We report the results of a case of reconstruction of the proximal humerus by using a non-vascularized fibula and supplemental bone substitute in a boy of 2 years with sickle cell. No scarring occurred at the sampling site. The process of bone consolidation is underway.

National journal of clinical orthopaedics, Oct 1, 2018

Introduction: In July 2014, a United Nations Multidimensional Integrated Mission for the Stabiliz... more Introduction: In July 2014, a United Nations Multidimensional Integrated Mission for the Stabilization of Mali (MINUSMA) had started. Soldiers of this mission were frequently attacked and many of them are wounded. Togo's Level 2 hospital has been deployed in Kidal to provide emergency medical and surgical care to all wounded in the northern sector. The purpose of this work was to determine the epidemiological profile of the fractures presented by these wounded. Materials and methods: It was a continuous prospective study from January 2015 to December 2016, concerning patients who were admitted for a fracture and confirmed by a standard radiography. The parameters studied were the age of the wounded, the sex, the civil or military status, the etiology of the fracture, the seat of the bone lesions, the associated lesions and the type of opening according to the Gustilo-Anderson classification. Results: Two hundred and fifty patients (250) were admitted for fractures during this period. The etiology of fractures was dominated by firearms (27.2%) and traffic accidents (22.7%). Three hundred and two (302) fractures were reported from the 250 patients. They were in the lower limb in 145 cases (48%), upper limb in 130 cases (43.1%). Fractures were open in 216 cases (71.5%) and dominated by Gustilo-Anderson type III (69.4%). Conclusion: The fractures found during the peacekeeping missions are associated with other lesions that make their severities. The care of these wounded should be multidisciplinary. Otherwise, the military surgeon deployed in these missions must have many skills to optimize the results of this care.

Journal de la Recherche Scientifique de l'Universite de Lome, Sep 20, 2016

International Journal of Orthopaedics Sciences, 2017

The aims of this work were to assess functional and radiographic results of primary total hip art... more The aims of this work were to assess functional and radiographic results of primary total hip arthroplasty and to determine the profile of patients and the different indications. Materials and Methods: We conducted a retrospective study of 56 patients operated for total hip arthroplasty at Afagnan hospital (Togo), from first January 2007 to 31 December 2016. The clinical evaluation was made with Devane activity score and Postel Merle D'Aubigné (PMA) score. Radiologicaly, the analysis focused on the inclination of the cup, and the osseointegration of implants. Results: 56 patients underwent total hip arthroplasty with dual-mobility cups in which two bilateral. The average passing time of follow-up was 6, 5 years [range1-9 yrs.]. The mean age was 42.69 years (20-77). The main indications were: aseptic osteonecrosis of hip 28 cases (48.27%), sequelae of trauma 11 cases (18.96%), hip dysplasia 4 cases (06.90%), and primitive degenerative arthritis 12 cases (20.69%). The PMA score increased from 9.1 (2-15) preoperatively to 15.8 (13-18) at the last follow. The average of the inclination cups was 42 degrees. No episode of luxation was watched for the arthroplasty with dualmobility cup. The survival rate was 100%. Conclusion: Total hip arthroplasty were mainly impacted with a dual-mobility cup at the last follow; the overall results are satisfactory with PMA score of 15.8. Our study confirms the medium-term reliability of dual-mobility cup with 100% survival rate. These results must be tempered because of the occurrence of long-term complications related to the risk of dual mobility among young people.

Burns Open, 2021

Abstract Four children, from 5 to 10 years aged, presented to the Sylvanus Olympio Hospital (SOTH... more Abstract Four children, from 5 to 10 years aged, presented to the Sylvanus Olympio Hospital (SOTH) of Lome (Togo) with severe (second- and third-degree) burns of 25-78% of total body surface area (TBSA) due to flame in domestic accidents and were treated using skin substitutes. We conducted skin substitution by dermal templates (Integra®) for two children and by skin allografts for the other two. In the two cases of dermal templates, we performed a wound excision on day 30 (15%) in one case, and on day 28 (18%) in the other. In one case, we associated the coverage with the dermal template to a negative pressure wound therapy; we applied skin graft on day 18 and day 21. In the follow-up, we observed no complication in both cases. In one of the two cases of skin allograft, we performed an eschar excision on day 8 (18%) and a donor skin allograft. After the allograft, we conducted another excision on day 15 (10%) and a skin autograft. The patient died ten hours after this last procedure. The second patient had sequential excisions at day 13 (18%), day 20 (15%) with skin autograft, and on day 27 (10%) with donor skin allograft, and a skin autograft on day 42 following allograft necrosis. In the fourth month, the child was discharged with a wound coverage of 74%, which was completed by another skin graft in the sixth month. The availability of dermal templates compelled the choice between the two skin substitutes. The access to other grafting options, such as a deceased skin bank, could allow the SOTH surgical team to step forward to the burn care.

National Journal of Clinical Orthopaedics, 2020

Introduction: Thromboembolic complications arise when the Virchow triad is brought together. In t... more Introduction: Thromboembolic complications arise when the Virchow triad is brought together. In trauma, trauma, bed rest and even treatment promote these complications. The aim: To determine the epidemiological aspects of these complications in trauma patients of the limbs in order to improve prevention and management. Material and method: It was a prospective study from January 1 to December 31, 2018 on the trauma of members admitted to the orthopedic trauma service and who presented a thromboembolic complication. The parameters studied were age, sex, weight, nature of the limb lesion, site of the lesion, type of thromboembolic complications, time to onset of the complication. Results: Twelve (12) patients including 8 men and 4 women presented thromboembolic complications after their trauma. The average age of the patients was 35.4 years. Complications were observed after surgery in 5 cases and after orthopedic treatment in 3 cases. Deep vein thrombosis (DVT) was found in 9 cases and pulmonary embolism in 3 cases. The limb trauma consisted of a fracture in 10 patients and a dislocation of the knee in 2 cases. Complications mainly occurred on pelvic fracture with 4 cases. The delay of onset of these complications was the first 4 post-traumatic days in most of the patients.

International Journal of Orthopaedics Sciences, Jul 1, 2018

Introduction: Knee trauma is very common and sometimes compromises its stability. The treatment o... more Introduction: Knee trauma is very common and sometimes compromises its stability. The treatment of these lesions is more and more surgical, but nonsurgical treatment remain having an importance in the management. The purpose of this study was to determine the results of nonsurgical treatment of ligamentous knee injuries in soldiers deployed in northern Mali during a stabilization mission. Materials and methods: It was a prospective study concerning ligamentous lesions of the knee, treated by orthopedic means in Togo's level 2 hospital and followed for a period of at least 6 months. The International Knee Score (IKS) was used to determine our results. Patient satisfaction was determined by taking into account pain, knee stability and resumption of previous activities. Results: Twenty-one (21) patients were treated. They were 18 men (85.7%) and 3 women (14.3%). The average age of the patients was 32.43 years old. We found 7 cases (33.4%) of benign sprain, 9 cases (42.8%) of medium severity sprain and 5 cases (23.8%) of severe sprain. After administration of the analgesic, immobilization was made by a knee brace and sometimes a plaster splint. Rehabilitation was started at the end of immobilization. The control after 6 months of follow-up allowed to find 57,1% of excellent result and 9,5% of bad result Conclusion: Nonsurgical treatment of ligamentous lesions gives good results when properly conducted. When a surgical treatment is decided for these lesions, it is recommended to make the rehabilitation of the knee before the operation to improve the results.

International Journal of Orthopaedics Sciences

The purpose of this study is to present our surgical strategy and describe the advantages and out... more The purpose of this study is to present our surgical strategy and describe the advantages and outcomes of the Ilizarov method in the treatment of bilateral tibia nonunion in an adult with OI. The major of bone fracture fixation drawback is the difficult placement of nails due to abnormal bony anatomy, non-linear and imperforate canals, marked bowing and unusually short limbs. A female adult aged 18yo with bilateral tibia nonunion affected with OI type V was treated with the Ilizarov method. The tibia was in varus (15° at left, 14° at right) and recurvatum (18° on the left, 27° on the right). Surgical technic was same for both tibia in one-time procedure and it's compounded: primary fibula osteotomy, tibia and osteotomy taking out interfragmentary fibrosis, reduction and fixation by Ilizarov frame. Full weightbearing was allowed at 3 months. The complications that occurred were minors. Bone's consolidation was obtained at 5 months and the frames were removed at 6 months in the office without anesthesia. At the follow-up visit 5 months after removal, the ASAMI functional and radiological score was excellent on the left side and good on the right side. The use of the Ilizarov method for treating a tibia bilateral nonunion in an adult patient with moderate OI provides good stability. This technique ensures early weight full bearing, above joint motion, and recovery functional necessary to normal bone tissue regeneration. This is an alternative to avoid difficulties and complications due to internal fixation in deformities correction in adults with acquired bone-weakening conditions.

National Journal of Clinical Orthopaedics

Bilateral fracture of clavicle are rare. The injury mecanism is difficult to specify and there ar... more Bilateral fracture of clavicle are rare. The injury mecanism is difficult to specify and there are sevral hypotheses that have been developed. The management can be orthopedics or chirurgical. We reported the 52 years man who presented a bilateral fracture of clavicle following a trafic road accident. The management was chirurgical with satisfatory result.

Journal de la Recherche Scientifique de l'Universite de Lome, 2018

Journal de la Recherche Scientifique de l’Université de Lomé, 2017

Objectif : Le but de ce travail était de rapporter les résultats anatomiques et fonctionnels de t... more Objectif : Le but de ce travail était de rapporter les résultats anatomiques et fonctionnels de trois cas de fracture du trapèze pris en charge chirurgicalement au CHU de rabat au Maroc.Méthodologie : Trois patients ayant présenté une fracture du trapèze ont été opéré dansle service entre janvier 2006 et janvier 2012 et revu en consultation avec un recul moyen de 5 ans. Le traitement a été chirurgical chez tous les patients avec une immobilisation plâtrée complémentaire de quatre semaines. L’évaluation a été faite par Cotation clinique de l'opposition et de la contre-opposition du pouce de KapandjiRésultats : La cotation clinique de l'opposition et de la contre-opposition du pouce de Kapandji était respectivement à 8 et à 3, dans la première observation. Le second patient, au dernier recul à 5 ans, la cotation clinique de l'opposition et de la contreopposition du pouce de Kapandji était respectivement à 6 et à 2. L’ablation de la vis dans la troisième observation s’est f...

Journal de la Recherche Scientifique de l’Université de Lomé, 2020