A V Dansokho

Cheikh Anta Diop University, Dakar, Dakar, Dakar, Senegal

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Publications (28)4.19 Total impact

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    ABSTRACT: Evaluate the technique of Bristow-Latarjet in the treatment of the recurrent dislocation of the shoulder. It was a continuous retrospective study on 46 cases selected in the CHU of Dakar over 11 years. From our criteria of inclusion, 41 patients were retained. There were 37 men for 4 women, whose average age at the time of the intervention was 29 years (extreme: 20 - 44 years). The management of the first episode was unsuited in 25 times. The average time of the first repetition was 10 months and its number varied between 5 and 36 episodes. The treatment of the recurrences was also misfit in 23 times. All our patients were treated according to the technique of Bristow-Latarjet. A standard immobilization Mayo clinic during 3 weeks was made with a systematic rehabilitation. The evaluation was done according to the scale of Constant with 45,6 months an average retreat. We found: 7 excellent cases (17%); 14 very good cases (34%); 9 good cases (22%); 6 average cases (15%); 5 bad cases (12%). Five cases of omarthrosis (3 types II and 2 types III of Samilson-Prieto) were found like two surface cases of sepsis. There was neither post-operative recurrence nor iatrogenic nervous attack. The recurrent anterior dislocation of the shoulder represents a frequent complication of primary dislocations of the shoulder touching especially young subjects. Stabilization by the anterior coracoid abutment according to the technique of Bristow-Latarjet led well represents one of the best techniques for its treatment.
    Le Mali médical 01/2011; 26(4):39-43.
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    ABSTRACT: Extension-type supracondylar fractures of the humerus in children are frequent lesions whose orthopaedic treatment remains under debate in Rigault and Lagrange type III fractures and highly controversial in type IV fractures. The objective of this study was to extend the Blount method to fractures with substantial displacement even in patients presenting significant swelling and to evaluate the results. We conducted a prospective continuous study from December 2005 to August 2007 on 67 children: 49 boys and 18 girls with a mean age of 6 years (range, 3-14 years). The mean time lapsed from consultation to treatment was 30 h. The mean hospital stay was 72 h. In 50 children, the limb was elevated preoperatively for a mean 48 h. The fracture was reduced under fluoroscopy-guided general anesthesia with mask and immobilized with 5-cm cloth banding padded with foam. The follow-up was clinical and radiological. The mean follow-up was 16 months (range, 6-26 months). Assessment followed the 1969 SOFCOT guidelines. At union, mean flexion was 124 degrees , the mean extension lag was 26 degrees . At last follow-up, the mean flexion was 146 degrees , the extension lag was 0.5 degrees , and pronation and supination were free. Immediately after surgery, the mean Baumann and anteflexion angles were 75 degrees and 43 degrees , respectively; at union they were 76 degrees and 44 degrees and at follow-up 79 degrees and 42 degrees . We found no vascular or nerve lesions. According to the SOFCOT criteria, at follow-up we obtained 80.6% very good results and 19.4% good results. Level IV. Therapeutic study.
    Orthopaedics & Traumatology Surgery & Research 05/2010; 96(3):276-82. · 1.06 Impact Factor
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    ABSTRACT: Introduction Les fractures supracondyliennes en extension de l’humérus de l’enfant sont des lésions fréquentes dont le traitement orthopédique reste discuté dans les types III, et très controversé dans les types IV. Le but de notre travail est d’étendre l’indication de la méthode de Blount aux fractures à grand déplacement même chez des patients présentant une tuméfaction importante, et d’en évaluer les résultats. Patients et méthodes Nous avons mené une étude prospective continue de décembre 2005 à août 2007 concernant 67 enfants, 49 garçons et 18 filles, âgés en moyenne de six ans (3–14 ans). Le délai moyen de consultation était de 30 heures. La durée moyenne d’hospitalisation était de 72 heures. Chez 50 enfants, une surélévation de 48 heures en moyenne était effectuée en préopératoire. La réduction était faite sous anesthésie générale au masque et sous contrôle scopique, la contention effectuée avec du Jersey 5 cm rembourré avec de la mousse. Le suivi était clinique et radiologique. Le recul moyen était de 16 mois (6–26 mois). L’évaluation était faite selon la cotation de la Sofcot de 1969. Résultats À la consolidation, la flexion moyenne était de 124°, le déficit d’extension de 26°en moyenne. Au recul, la flexion moyenne était de 146°, le déficit d’extension de 0,5° et la pronosupination libre. En postopératoire immédiat, les angles de Baumann et d’antéflexion moyens étaient respectivement de 75° et 43° ; à la consolidation, ils étaient de 76° et 44° et au recul de 79° et 42°. Nous n’avions pas retrouvé de lésions vasculonerveuses. Ainsi, selon les critères de la Sofcot, nous avions obtenu au recul, 80,6 % de très bons résultats et 19,4 % de bons résultats. Niveau de preuve IV étude thérapeutique.
    Revue de Chirurgie Orthopédique et Traumatologique. 05/2010; 96(3).
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    ABSTRACT: The floating elbow in the child is rare and serious. The authors report a traumatic case of floating elbow without vascular and nervous lesions associated in a 6-year-old child. We treated these both fractures of the distal forearm and the supracondylar humeral by respectively cast plaster and a collar and cuff with an anatomical reduction. The radiological and clinical results were excellent with the 29 months follow-up.
    Chirurgie de la Main 04/2010; 29(2):135-7. · 0.30 Impact Factor
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    ABSTRACT: The floating elbow in the child is rare and serious. The authors report a traumatic case of floating elbow without vascular and nervous lesions associated in a 6-year-old child. We treated these both fractures of the distal forearm and the supracondylar humeral by respectively cast plaster and a collar and cuff with an anatomical reduction. The radiological and clinical results were excellent with the 29 months follow-up.
    Chirurgie De La Main - CHIR MAIN. 01/2010; 29(2):135-137.
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    ABSTRACT: The authors report a case of apophysial fracture of the odontoid process in association with paresis of the upper extremities in a 5-year-old child. The fracture was treated by gradual guided self-reduction without anaesthesia, followed by a Minerva jacket cast immobilisation. Reduction was anatomical, and the neurological problems regressed within 48 hours.
    Orthopaedics & Traumatology Surgery & Research 05/2009; 95(3):234-6. · 1.06 Impact Factor
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    ABSTRACT: Les auteurs rapportent un cas de décollement apophysaire de l’odontoïde associé à une parésie des membres supérieurs chez un enfant de cinq ans. Ce décollement apophysaire a été traité par autoréduction sans anesthésie suivie d’une contention par minerve plâtrée. La réduction a été anatomique et les troubles neurologiques ont régressé en 48 heures.
    Revue de Chirurgie Orthopédique et Traumatologique. 05/2009; 95(3).
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    ABSTRACT: Osteotomy of the olecranon is commonly used to gain exposure for reconstruction of bi-condylar fractures of the distal humerus (type 13-C of classification AO), but there is controversy because of the considerable complications inherent in this technique. The aim of our study is to examine the anatomical and functional consequences of this technique of exposure on the elbow. This is a retrospective study over a continuous 7-year period. We confined ourselves to patients more than 15 years old who had presented with a bi-condylar fracture (type C of the AO) of the distal humerus, internally fixed through an osteotomy of the olecranon. We reexamined and evaluated 14 treated patients who had been operated in our service. There were nine men and five women with an average age of 34 years (range 17 to 70 years). According to the AO classification, we found 14 fractures distributed in the following way: three type C1, seven type C2 and four type C3; the fracture was open in two cases. The osteotomy was carried out in all the cases using an osteotome, extra-articular in six cases and intra-articular way in eight cases. Repair was always performed using tension band wiring. The evaluation was based on anatomical and functional criteria (Mayo Elbow Performance Score). No case of radial and ulnar paralysis was found. Thirty-six percent of the olecranon fixations were of bad quality and we found one case of olecranon pseudarthrosis. No case of heterotypic calcification was found, on the other hand, there was a case of post-traumatic osteoarthritis of the elbow. On the functional level, we obtained 36% of excellent results, 28.5% of good results, 7% of average results and 28.5% of bad results. Osteotomy of the olecranon is one of the techniques for exposure of the articular surface during reconstruction of fractures of the distal humerus. A rigorous technique allows one to avoid complications.
    Chirurgie de la Main 02/2009; 28(2):93-8. · 0.30 Impact Factor
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    ABSTRACT: Two cases of hip snapping in its external or lateral variety are presented. The authors review the pathogenesis of this affliction. They underline the fact that the diagnosis is primarily clinic. Further, they discuss the different therapeutic options and they propose a crosswise section of the ilio-tibial band with fixation to the great trochanter. Deux observations de ressaut de hanche dans la variété externe sont décrites. Les auteurs étudient la pathogénie de cette affection. Ils insistent sur le diagnostic qui est essentiellement clinique. Enfin ils discutent les différentes méthodes thérapeutiques et proposent la section en croix de la bandelette ilio-tibiale et sa fixation sur le grand trochanter.
    European Journal of Orthopaedic Surgery & Traumatology 01/2007; 17(4):377-379. · 0.18 Impact Factor
  • European Journal of Orthopaedic Surgery and Traumatology - EUR J ORTHOP SURG TRAUMATOL. 01/2007; 17(4):377-379.
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    ABSTRACT: Le but de ce travail est d’évaluer notre technique d’arthrodèse talocrurale et son retentissement sur les articulations sous-jacentes dans la prise en charge des arthroses de la cheville secondaire à un traumatisme négligé ou à une arthrite septique. De janvier 1996 à juin 1999, 26 arthrodèses talocrurales avaient été réalisées. Les critères d’inclusion étaient une étiologie arthrosique par traumatisme négligé ou séquellaire d’ostéoarthrite, une évaluation clinique et radiologique complète effective, une articulation sous-talienne normale, une fixation interne par vissage en X et un recul supérieur à six mois. La série présentait alors 11 cas avec une prédominance masculine (sept hommes pour quatre femmes) et un âge moyen de 46 ans à la date de l’arthrodèse. Le recul moyen était de 23 mois avec des extrêmes de 6 et 54 mois. Notre technique d’arthrodèse consistait, après un abord antérieur de la cheville, un avivement des surfaces articulaires, en une fixation par des vis à os spongieux croisées en X. La cheville était en position neutre dans les trois plans. Une contention plâtrée complétait cette synthèse pendant douze semaines. L’appui total était autorisé vers la dixième semaine. Nos patients avaient été évalués cliniquement selon la cotation de Duquennoy et radiologiquement sur la fusion osseuse et l’aspect de l’articulation sous-talienne. Nos résultats étaient bons dans 81,8 % des cas avec une fusion osseuse dans neuf cas dans un délai moyen de 12,4 semaines. Deux cas de pseudarthrodèse ont été observés. Nous avons observé au bout de 12 mois environ la survenue dans 45,4 % des cas d’une arthrose sous-talienne postérieure. L’arthrodèse talocrurale semble représenter, dans le cadre de la prise en charge de l’arthrose posttraumatique et postarthritique de la cheville, un traitement de choix malgré la survenue dans les suites lointaines d’une arthrose sous-talienne postérieure. The aim of our work was to evaluate our tibiotalar arthrodesis technique and its effects on distal joints in treating ankle arthrosis secondary to a neglected injury or septic arthritis. From January 1996 to June 1999, we performed 26 tibiotalar arthrodeses. The inclusion criteria were arthrosis caused by a neglected injury or sequelae of osteoarthritis, a complete clinical and radiological evaluation, a normal subtalar joint, internal fixation by X cancellous bone screws and follow-up greater than six months. The series presented 11 cases (7 men and 4 women). The average age was 46. The average follow-up was 21 months (6 to 54 months). Using an anterior approach to the ankle, our arthrodesis technique consisted of joint surface resection and fixation by X cancellous bone screws. We maintained the ankle in neutral position. A plaster cast was applied for 12 weeks, with weight bearing allowed at week 10. Our patients were clinically evaluated according to the Duquennoy scoring system, the radiological determination of bone fusion and the appearance of the subtalar joint. The outcomes were good in 81.8% of the cases, with fusion in 9 cases obtained over on average period of 12.4 weeks. Two cases of pseudarthrodesis were observed. Posterior subtalar arthrosis occurred in 45.4% of the cases after an average of 12 months. Tibiotalar arthrodesis is a safe alternative for the treatment of neglected injuries and septic arthritis of the ankle after the occurrence of subtalar arthrosis in the long-term.
    Médecine et Chirurgie du Pied 01/2007; 23(1):28-34. · 0.06 Impact Factor
  • Medecine Et Chirurgie Du Pied - MED CHIR PIED. 01/2007; 23(1):28-34.
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    ABSTRACT: Posterior dislocation of the femoral head with fracture is an exceptional hip injury. Emergency reduction is required. Reposition into the acetabular cavity of the dislocated femoral head may not be feasible. Irreducibility, instability, and more rarely accidental fracture of the femoral neck may also occur. We encountered this latter complication in four patients and report here its frequency and mechanism and propose preventive therapeutic measures. Seventy dislocations and fracture-dislocations of the hip were treated in our unit from March 1997 to February 2003. Among these cases, fourteen hip dislocations were complicated by femoral head fractures. Fracture of the femoral neck occurred during reduction in four. All four cases occurred in men, mean age 49.7 years, who were traffic accident victims (drivers or passengers). There were two Pipkin IV fracture-dislocations and two Pipkin II. The first reduction, achieved under general anesthesia in an emergency setting, was performed by an orthopedic surgeon in one patient and a general surgeon in three patients. Arthroplasty was used to treat the femoral neck fracture in three patients and pinning in one. We reviewed retrospectively the clinical and imaging data before and after reduction. Sub-capital fracture situated 4.0 cm (mean, range 3.5-4.5 cm) from the lesser trochanter occurred in all four cases. The head remained attached above and posteriorly to the acetabulum and was rotated less than 90 degrees . The fragment remaining in the acetabulum was displaced in two cases. In one patient, the fracture-dislocation of the head was associated with a fracture of the posterior rim of the acetabulum. This complication appears to result from an abrupt inappropriate reduction movement. The neck fracture would occur when capsulomuscular retention of the femoral head is associated with a head defect which catches on the rim of the acetabulum during the reduction movement. Neck fracture during reduction of traumatic hip dislocation is a serious complication. Prevention of this iatrogenic event requires a slow, progressive reduction limiting the trauma to a minimum; first intention open surgery may be required in selected cases.
    Revue de Chirurgie Orthopédique et Réparatrice de l Appareil Moteur 05/2005; 91(2):173-9. · 0.37 Impact Factor
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    ABSTRACT: Posterior dislocation of the femoral head with fracture is an exceptional hip injury. Emergency reduction is required. Reposition into the acetabular cavity of the dislocated femoral head may not be feasible. Irreducibility, instability, and more rarely accidental fracture of the femoral neck may also occur. We encountered this latter complication in four patients and report here its frequency and mechanism and propose preventive therapeutic measures.Seventy dislocations and fracture-dislocations of the hip were treated in our unit from March 1997 to February 2003. Among these cases, fourteen hip dislocations were complicated by femoral head fractures. Fracture of the femoral neck occurred during reduction in four. All four cases occurred in men, mean age 49.7 years, who were traffic accident victims (drivers or passengers). There were two Pipkin IV fracture-dislocations and two Pipkin II. The first reduction, achieved under general anesthesia in an emergency setting, was performed by an orthopedic surgeon in one patient and a general surgeon in three patients. Arthroplasty was used to treat the femoral neck fracture in three patients and pinning in one. We reviewed retrospectively the clinical and imaging data before and after reduction.Sub-capital fracture situated 4.0 cm (mean, range 3.5-4.5 cm) from the lesser trochanter occurred in all four cases. The head remained attached above and posteriorly to the acetabulum and was rotated less than 90̊. The fragment remaining in the acetabulum was displaced in two cases. In one patient, the fracture-dislocation of the head was associated with a fracture of the posterior rim of the acetabulum.This complication appears to result from an abrupt inappropriate reduction movement. The neck fracture would occur when capsulomuscular retention of the femoral head is associated with a head defect which catches on the rim of the acetabulum during the reduction movement.Neck fracture during reduction of traumatic hip dislocation is a serious complication. Prevention of this iatrogenic event requires a slow, progressive reduction limiting the trauma to a minimum; first intention open surgery may be required in selected cases.
    Revue de Chirurgie Orthopédique et Réparatrice de l'Appareil Moteur. 04/2005; 91(2):173-179.
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    ABSTRACT: Les auteurs dcrivent un chondrosarcome msenchymateux de la phalange distale de lhallux chez un adolescent de 15 ans. La tumeur tait lytique avec une destruction complte de la phalange et un envahissement des parties molles. Lamputation de la tumeur emportant une partie de la tte de la phalange proximale a t ralise. Lhistologie a permis le diagnostic et apprcie le degr de malignit de la tumeur. La raret de cette localisation et la survenue inhabituelle de la tumeur chez ladolescent sont soulignes par les auteurs. Il apparat que la rcidive locale est fonction du type de chirurgie effectu.The authors describe a mesenchymal chondrosarcoma of the distal phalanx of the first toe in a fifteen-year old boy. The tumour was lytic with a complete destruction of the phalanx and an extension in soft tissues. A large resection of the tumour and the head of the proximal phalanx was made. The histological study permits the diagnostic and evaluates the degree of malignancy. The site of this tumour is uncommon in the foot and unusual in an adolescent. The recovery depends on the type of surgery.
    Médecine et Chirurgie du Pied 03/2005; 21(1):31-33. · 0.06 Impact Factor
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    ABSTRACT: The aim of this work was to discribe the lesions caused by the use of blasting landmines among civilians in south Senegal, and to evaluate their surgical management. The prospective study, which was conducted from February 2001 to September 2002, took place in the orthopedics and trauma clinic of the Ziguinchor regionle hospital. The average age of the patients was 22, and they included 13 men and 2 women. In 12 cases, the lesions were unilateral and bilateral in 3 cases. Surgical management began with an assessment of the lesions using the classification of Coupland and De Wind. Treatment was based on a pre-established protocol in order to end up with a stump of good quality. The major lesion would consist in one or both lower limbs crushed or amputated. It would be open and of the I- type according to Coupland and De Wind. Lesions as a result of several shrapnel impact and burns were considered as associated lesions with the main lesion. Six patients presented an infection of the stump. Some stumps healed completely after about 15 days, and some took no more than 75 days before closing up. Only one stump needed grafting. All our patients had the advantage of a casting off. The young and rural people were the most vulnerable. Lesions were rather distal-based. Infection delayed healing. No matter what the form of the lesion, there was always a partial loss of a limb. Landmine feet injuries as serious lesions. The objective of the surgical treatment is to facilitate the further use of a prosthesis.
    Bulletin de la Société médicale d'Afrique noire de langue française 02/2005; 50(1):11-6.
  • Medecine Et Chirurgie Du Pied - MED CHIR PIED. 01/2005; 21(1):31-33.
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    ABSTRACT: Posterior dislocation of the femoral head with fracture is an exceptional hip injury. Emergency reduction is required. Reposition into the acetabular cavity of the dislocated femoral head may not be feasible. Irreducibility, instability, and more rarely accidental fracture of the femoral neck may also occur. We encountered this latter complication in four patients and report here its frequency and mechanism and propose preventive therapeutic measures.Seventy dislocations and fracture-dislocations of the hip were treated in our unit from March 1997 to February 2003. Among these cases, fourteen hip dislocations were complicated by femoral head fractures. Fracture of the femoral neck occurred during reduction in four. All four cases occurred in men, mean age 49.7 years, who were traffic accident victims (drivers or passengers). There were two Pipkin IV fracture-dislocations and two Pipkin II. The first reduction, achieved under general anesthesia in an emergency setting, was performed by an orthopedic surgeon in one patient and a general surgeon in three patients. Arthroplasty was used to treat the femoral neck fracture in three patients and pinning in one. We reviewed retrospectively the clinical and imaging data before and after reduction.Sub-capital fracture situated 4.0 cm (mean, range 3.5-4.5 cm) from the lesser trochanter occurred in all four cases. The head remained attached above and posteriorly to the acetabulum and was rotated less than 90̊. The fragment remaining in the acetabulum was displaced in two cases. In one patient, the fracture-dislocation of the head was associated with a fracture of the posterior rim of the acetabulum.This complication appears to result from an abrupt inappropriate reduction movement. The neck fracture would occur when capsulomuscular retention of the femoral head is associated with a head defect which catches on the rim of the acetabulum during the reduction movement.Neck fracture during reduction of traumatic hip dislocation is a serious complication. Prevention of this iatrogenic event requires a slow, progressive reduction limiting the trauma to a minimum; first intention open surgery may be required in selected cases.
    Revue De Chirurgie Orthopedique Et Reparatrice De L Appareil Moteur - REV CHIR ORTHOP REPARAT APP. 01/2005; 91(2):173-179.
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    ABSTRACT: Sterno-clavicular dislocations represent an uncommon pathology in shoulder trauma. The authors describe the anatomical and clinical forms observed between January 1999 and December 2002, and evaluate the treatment process. The retrospective study addressed 9 patients (men only) with an average age of 26.6. Based on the duration of the consulting period, one could distinguish old forms from more recent ones. Diagnosis would help to see anterior forms from posterior forms. Evaluation criteria were: pain, mobility of the shoulder, visibility of the deformation of the sterno-clavicular joint. Six types of anterior dislocations were listed, including 4 recent and 2 old ones. There were 3 recent posterior forms. The anterior recent forms, which were treated in orthopedics, showed a positive evolution. As there was no functional disability, it was wiser to refrain from any treatment of the anterior old forms. The posterior forms, two of them were operated (osteosynthesis) revealed no functional deficit after treatment. However, one of the patients had a broken implant. Scanner facilitated the diagnosis of sterno-clavicular dislocations. The anterior forms, which are more frequent and benign, are different from the posterior forms, which are emergency cases due to the proximity of the aero-digestive and cardiovascular elements. Their surgical stabilization requires techniques related to ligamentoplasty rather than using osteo-synthesis equipment which may move away or break off.
    Bulletin de la Société médicale d'Afrique noire de langue française 02/2004; 49(3):211-4.
  • J Senghor, M H Sy, A Ndiaye, A V Dansokho, S I Seye
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    ABSTRACT: The authors studied restrospecively their cases of trochanteric fractures to evoluate the frequency, the mortality, the morbidity and the results according to the diferent types of osteosynthesis used. 68 cases were collected in a 45 months. Mean age was 75 with 33 men and 35 women. 28 patients were sick before the accident. Using the A.O. classification, the patients were divided in three groups: 19 type A1, 37 type A2 and 12 type A3. 28 patients were operated an emergency basis. An A.O. nail plaque was used in the 43 cases and a staca screw plaque was used in the 11 remaining cases. Early in hospital mobilisation and weigh bearing with assistant was used and continued after discharge. After 17 months of follow up and according to Merle d'AUBIGNE'S, criteria, 91. 42% of the patients showed satisfactory results--16 patients died 8 of them had another desease. Anatomically, bone consolidation was gained after a mean period of 97 days and 40 % of Coxa-vara was reorganised. The frequency of trochanteric fracture inthe elderly is 69,3% in our experience. The patients operated on in emergency for whom a stacca nail plate had a better results with an earlier walking autonomy. In mean follow up there was no different in the two groups.
    Bulletin de la Société médicale d'Afrique noire de langue française 02/2001; 46(2):102-4.