[show abstract][hide abstract] ABSTRACT: The low aggressiveness of Grade I chondrosarcomas is compatible with conservative surgical treatment.
We asked whether combined curettage and cryotherapy would yield low rates of recurrence and whether supplemental internal fixation would retain function with low rates of complications in patients with Grade I central chondrosarcomas of the proximal humerus or distal femur.
We retrospectively reviewed 15 patients: nine women and six men with a mean age of 45 years (range, 26-70 years). All patients underwent curettage and cryosurgery through a cortical window; we replaced the window and plated the region with at least three screws beyond the curetted area. None of the patients was lost to followup, and 14 patients (93%) were reexamined by us after a minimum of 5 years (mean, 8 years; range, 5-11 years).
There were no perioperative anesthetic, neurologic, hardware, or healing complications. None of the patients had local recurrence or metastases develop. At last followup, the Musculoskeletal Tumor Society score was 27.9 (range, 22-30) and all patients had resumed their previous activities. No complications were associated with this simplified cryotherapy technique.
The data confirm the appropriateness of conservative surgery for central low-grade chondrosarcomas of the proximal humerus and distal femur based on a combination of intralesional curettage and cryogenic parietal sterilization. Candidates for this approach should be chosen on the basis of the affected bone site, local extension staging, and clinicopathologic grading. We recommend supplementary internal fixation.
Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Clinical Orthopaedics and Related Research 07/2010; 468(7):1956-62. · 2.79 Impact Factor
[show abstract][hide abstract] ABSTRACT: The authors report the first eight documented cases of rheumatoid arthritis in Niger, all diagnosed during one year at the National Lamordé Hospital of Niamey. Systemic manifestations were rare.
[show abstract][hide abstract] ABSTRACT: It is about a retrospective and prospective study on thirty two cases of the femur diaphysis malunion at the national lamordé hospital from 2003 march at December 2008. As farrnas the masculine sex is concerned, it represents 87.5% of the cases. The majority of the patients are less than forty years old (81.2%). The road traffic accidents constituted the principal etiology of initial fracture with 75% of the cases. 75% of the patients had been initially treated by the traditional medicine makers. The malunion had been in their great number angularly (95.65%) and without proportional dispositions. The osteosynthesis had been the centromedillaire nail (in 56.25% of the cases), screwed sheets (31.25% of the cases), the external fixator (6.25%), nailing (6.25 %). The consolidation is obtained in all the cases at about means within of 5.74 months. The results are satisfying in 86.95% concerning the femur; then bad in 13.05% cases.
[show abstract][hide abstract] ABSTRACT: From January 2000 to december 2006, 40 club foot have been collected to the service of the frequency of the inveterate equin varus club foot is 0.3%. The average age is 12.13 years with extremes of 3 years to 20 years. The masculine sex is predominate with sex ratio of 1.08. Most patients come from the farming zones either 86.2% of the sample with parents to 93.1% without level of instruction. The bilateral attack predominates in 55% of the cases. On the therapeutic plan, ours patients benefited from the surgical technique of postero medical soft tissue release and lateral ostestomy in one time. A case of skin necrosis has been noted in our set. The middle receding is of 49 months with extremes of 14 months to 84 months. Our results were satisfactory in 95% of the cases.
[show abstract][hide abstract] ABSTRACT: This retrospective and prospective study over 49 months has permitted us to count 43 cases of pathologic fractures: the population concerned is a population of adults whose average age is 43.5 years old. The social groups, which are more affected, are these having poor economical revenue. The male sex is predominating lightly with 22 cases (51.2%). Within 16 cases (37.2%) the pathologic fracture has revealed the causal affection and 27 cases (62.8%) where the affection was already known before the occurrence of pathologic fracture. Pain, tumefaction and functional impotence constitute the main reason (motive) for consultation. Femur is the most affected bone with 26 cases over 43 cases. The principal etiologies are represented by malignant bone tumors 37.2%, osteoporosis 23.2%, and osteomyelitis 23.2%. Imperfect osteogenosa 6.9%, ricket 6.2%. The standard face and profile radiography and biopsy are the principal complementary exams. The treatment is surgical in 81.4% of cases and orthopedic in 18.6% of cases.
[show abstract][hide abstract] ABSTRACT: The authors present the results of a retrospective study performed during 12 months; about 50 open fractures of tibia, treated by Hoffmann external fixation entirely or partially. The mean age was 33 years (6 years to 60 years). Forty (80%) patients had sustained the fracture in road traffic. According to Cauchoix system: 30 (60%) tibia open fracture was type I, 8 (16%) type II, and type III 12 (24%). 20 patients treated by external fixation following by internal fixation (plate), 10 patients treated by external fixation following by cast; 20 patients treated by external fixation only. The mean bone healing time was 7.5 month Complications: infections 6%, non-union 5 patients. Hoffmann external fixation is an excellent and safe method for the management of tibial open fractures.
[show abstract][hide abstract] ABSTRACT: From January 2001 to June 2003, 66 cases of osteomyelitis in sickle cell disease were collected in the two (2) main hospitals of Niamey (the HNN and the HNL). The sex ratio is 1.27 in favor of the masculine sex. Children payed the heaviest tribute to this. An effect 63.6% patients belong to the group of 0 to 5 years. The consultation is related in 71.21% of cases. This situation would explain itself by the weak level of instruction and income at the more part of families investigated. A door of entrance is identified positively that in 9.09% of cases. The vaso-occlusive crisis is the main factor encouraging and represents 31.57% of antecedents in report with cases of osteomyelitis. Multiple focal localization are observed at 15.15% of patients. Diaphysis are more frequent involved (31.70% of cases).. Staphylococci are the most frequent germs (35.71%) follow salmonellas (14.28%). The medical treatment is used very extensively, notably in the acute osteomyelitis where 100% of patients benefited some with 63.15% of good results.
[show abstract][hide abstract] ABSTRACT: Complete absence of acute compartment syndrome was observed in a consecutive series of 966 tibial fractures in African patients of diverse ethnic groups, reviewed retrospectively at our institution. Considering the incidences reported in the literature, we should have experienced between 22 and 86 cases of acute compartment syndrome. The purpose of this prospective study was to confirm these findings and at the same time to look for possible explanations for this unexpected observation. During a period of one year and four months, 257 tibial fractures were prospectively analyzed for clinical signs and late sequelae of acute compartment syndrome. In 156 of these patients, presenting 158 fractures of the tibia, the pressure in the anterior compartment was systematically measured. No single case of compartment syndrome was diagnosed in this series, and no late sequelae of acute compartment syndrome were noted. The hypothesis we forward for total absence of acute compartment syndrome is the favourable effect of the continuously high surrounding temperatures on safeguarding the arteriovenous pressure gradient and lowering the vascular resistance. We suggest that further investigation should be carried out to study this hypothesis.