Biomedical subjects

A Ndiaye

Publications and source records attributed to A Ndiaye.

At least 19 recordsLinked to original sources

PubMed2005

[Retrograde intramedullary nailing for humeral shaft fractures in adults. Evaluation of anatomical and functional results in 63 cases].

PURPOSE OF THE STUDY: Many methods have been proposed for treatment of displaced humeral shaft fractures in adults. This study was designed to evaluate the anatomical and functional results of patients treated by retrograde intramedullary nailing through the lateral condyle. MATERIALS AND METHODS: Sixty-three fresh traumatic fractures of the humerus were treated between January 2000 and January 2003. Five patients were lost to follow-up. The AO classification and the Hackethal classification modified by De La Caffinière were used. Outcome was assessed according to the modified Stewart and Hundey classification. RESULTS: We had 23 very good results, 26 good results, five passable results and four bad results. The bad results were three cases of non-union and one case with poor function (stiffness of elbow and shoulder). Mean delay to union was ten weeks four days. There were no cases of iatrogenic radial nerve palsy or pin migration. CONCLUSION: Retrograde intramedullary nailing is a reliable method, easy to perform and of low economic cost. We propose it for all types of displaced shaft humeral fractures.

Adolescent↗

PubMed2005

[Femoral neck fracture complicating orthopedic reposition of a dislocated hip: four cases].

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.

Accidents, Traffic↗

PubMed2005

[Surgical management of landmine foot injuries in the orthopedic and trauma clinic of Ziguinchor regional].

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.

Adolescent↗

PubMed2004

[Sciatic nerve in gluteal portion: application of sciatic nerve post injection lesion].

In our regions malaria is endemic and intraguteal injection is a common procedure. One unfortunate complication of that procedure appeared to be a sciatic nerve injury. The purpose of our study was to set up the anatomical feature and basis of this post injection lesion. We performed sciatic nerve gluteal dissection on 10 adults black African fresh cadavers on both side. The pathway of the nerve was 19 times in the subpiriformis canal. Only in one cadaver, the outlet of the nerve was above the piriformis muscle. In each case the pathway is identical with an oblique and vertical portion running down through the ischio-trochanteric channel. The nerve was crossed between its two portions by an arteriole coming from the inferior gluteal artery. The cutaneous projection of the sciatic nerve is distant from the upper lateral quadrant of the buttock. Intra-gluteal injections in this area doesn't damage the nerve. The anatomical variations of this nerve pathway are almost nonexistent. So, other hypothesis of sciatic nerve post injection lesion should be considered. We think that the local toxicity of quinine and its diffusion in the neurovascular gluteal area might explain the nerve lesion. Thus, the intramuscular injections should be replaced by the intravenous or rectal administration in children.

Buttocks↗

PubMed2004

[The superficial temporal artery: anatomical type and clinical application to the flap of the fascia temporal superficialis].

The goal of our study is to assess the anatomical type of the superficial temporal artery (STA) in the black population using the classification of Ricbourg et al.. Forty-seven fresh cadavers and three extracted and frozen heads were included in this study. The external carotid artery was isolated in the neck and injected by Rhodopas stained with Congo Red. The superficial temporal artery was dissected using a Y-shaped skin incision. The last step of the procedure was to remove the flap of the fascia superficialis temporis. The third segment of the superficial temporal artery and its terminal branches were studied. This segment courses cephalad and wraps the zygomatic arcade. It splits into two terminal branches: the temporo-frontal and the temporo-parietal ones. The most important of its collaterals, the zygomato-maleus artery, plays a crucial role for distinguishing the subtypes of STA according to the classification of Ricbourg et al.. Indeed, this branch can be subdivided into two types: --type I: the zygomato-malar artery arises from the trunk of the STA; it courses perpendicular and with a slightly ascending direction; this type accounts for 93% of the cases. --type II: the zygomato-malar artery originates from the branch of the temporo-frontal artery. Its course is either horizontal or caudad. This type accounts for 3% of the cases. Our results confirm those of Ricbourg et al.. Thus, we could not CONFIRM the notion of a racial predominance of typology of the STA in our context. We did not study the dimensions of STA and also the level of its bifurcation. Indeed, it has been largely reported in the literature. These elements constitute the anatomic basis of the surgical use of temporal flaps. The vessel-containing tissue in which travels the STA forms the so-called fascia temporalis superficialis whose plasticity and polyvalency are critical during the procedures of plastic and reconstructive surgeries.

Black People↗

PubMed2004

[Sternoclavicular dislocations: clinical and therapeutic study. A report of 9 cases].

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.

Adolescent↗

PubMed2004

[Spiral CT in aortic dissection].

Patients with suspected dissection of the thoracic aorta require immediate diagnostic evaluation so that urgent therapeutic interventions can begin. Two women with suspected aortic dissection and one man with abdominal aortic aneurysm underwent color-flow Doppler echocardiography and CT angiography with multiplanar reconstructions. Spiral CT showed ascending aortic dissection (type A Stanford) in two cases and descending aortic dissection (type B Stanford) in one case. It also access the visualization of the intimal flap, the extent of dissection, the size of the aorta, and the presence of pericardial fluid. CT angiography is an accurate diagnostic procedure for patients with suspected aortic dissection and possesses several advantages over other modalities such as transthoracic echocardiography, transesophageal echocardiography and aortography.

Adult↗

PubMed2004

[Trichobezoard revealed by intestinal perforation. A case report].

This paper presents a case of gastric and ileal trichobézoard on a 12 years-old girl. It was revealeds by ileal perforation which was confirmed by abdominal X-ray. Trichobézoard diagnosis was not performed before surgery despite two contradictory/abdominal ultrasound scans. The trichobézoard was removed surgicaly by ileotomy and gastrotomy. The patient had an satisfactory post-operative convalescence after a follow-up of six months.

Bezoars↗

PubMed2003

[Vascular dysplasia in vascular surgery in an African area: 28 cases at the Dakar teaching hospital].

This retrospective study was conducted to analyze the anatomic and clinical data concerning vascular dysplasia in vascular surgery patients seen in an African hospital and to assess its role in treatment. Twenty-eight patients (14 women and 14 men) were treated for vascular dysplasia between 1994 and 1998. There were 8 cases of hemangioma and 20 cases of vascular malformation. Average age of patients with hemangioma was 3.23 years, with a sex ratio of 0.33. There were 4 cases of mixed hemangioma, 3 of cutaneous hemangioma, and 1 of subcutaneous hemangioma. Cervicocephalic (n=4) and limb (n=3) localizations were the most frequent. Duplex Doppler did not reveal any signs of muscle disease. Four patients underwent surgery, for an early indication in 3 and a late indication in 1. Resection suture was performed in 3 cases and resection graft in one. Mean follow-up was 85.90 days. There was one case of early suppuration. There were no cases of recurrence or late complications and the operative wounds healed well. Vascular malformations concerned 20 patients (sex ratio 1.5, average age 15.55 years) with 16 cases of venous malformation including 4 patients with Klippel Trenaunay syndrome, three with arteriovenous malformation and one with capillary angioma. CT and arteriography were obtained in all cases. Limb localizations predominated (14 patients). In-depth extension was found in 6 cases of venous malformation. Sixteen patients underwent surgery for functional indications in 7. Resection suture was performed in 11 cases. Mean follow-up was 85.90 days. There were 4 early and 2 late postoperative complications. There has been no recurrence. Anatomic and clinical polymorphism of vascular dysplasia requires multidisciplinary collaboration in which vascular surgery plays an important role in complex or complicated forms of the disease in patients attending facilities with limited resources.

Adolescent↗

PubMed2003

[Results of emergengy colectomy in the management of the colon volvulus in Dakar hospital].

PURPOSE: The aim of this study was to evaluate the results of emergency colectomies for the management of colon volvulus. PATIENTS AND METHODS: This retrospective study was undertaken on 50 cases of colon volvulus operated in the Surgical Department of the Aristide Le Dantec teaching hospital of Dakar from January 1994 to December 2000. It concerned 42 men and 8 women with an mean age of 42 years. All patients presented an occlusive syndrome suggestive of colon volvulus, which required a laparotomy, through a xypho-pubic incision. The patients were divided into two groups. Group I concerned 13 patients who underwent an ideal colectomy and group II, 37 patients in whom we performed a colectomy associated with a temporary colostomy with either Bouilly-Volkman procedure (n = 23) or Hartman procedure (n = 14) followed one month later by intestinal continuity restoration. Mortality and morbidity were compared in the two groups. RESULTS: The overall mortality rate was 12% (6/50). The mortality rate was 31% (4/13) in group I and 5 % (2/37) in group II. The overall morbidity rate was 14%. In group I, the morbidity rate was 15 % (2/13) and 13,5% (5/37) in group II. CONCLUSION: In our study the mortality rate was higher after colectomy with primary anastomosis than after colectomy with temporary colostomy followed by secondary anastomosis. We recommend colectomy without anastomosis for the emergency management of the colon volvulus in Africa.

Adult↗

PubMed2003

[Topographic anatomy of the tibial nerve in the medial malleolus: application to the effect of nerve block anesthesia].

To better understand the anatomical variations and pathogeny of tarsal tunnel syndrome, the tibial nerve were dissected in 20 ankles of fresh black African cadavers. The tibial nerve located to 1.75 cm on average from the posterior side of the malleolus and to 2 cm from medial side of the calcaneus tendon. The nerve always ended according to dichotomic method. 90% cases of bifurcation were noted under the flexor retinaculum at 1 cm from the malléolo_calcaneus line; in 10% of dissections, we found proximal bifurcation at 5 cm from this line. The medal calcaneus branch which is a collateral branch of tibial nerve was constant, unique in 80% of cases and double in 20% of cases. The anatomical constatations allow a more precise anesthesia of tibial nerve block. We use constant anatomical marks formed by calcaneus tendon and internal malleolus tip. Olso we more understand the possibility of lesion of tibial nerve at the ankle during the synovites, or ossifications of flexor rétinaculum.

Black People↗

PubMed2003

[Purulent pleurisy at the surgical emergency service: retrospective study of 34 cases at Dakar Teaching Hospital].

The empyema thoracis remain a current pathology in under developed countries. The aim of this study was to evaluate the incidence of empyema thoracis in the Surgical Emergency Unit, to analyze their causes, therapeutic procedures and their results. Between 1997 and 1998, 54 patients were received in urgency for empyema thoracis; 34 of them had a complete and exploitable file. Mean age was 20 years (3 weeks and 83 years) with 64.70% of children (0 to 15 years) and the sex ratio 3.25. Fever (85.70%) and cough (73.52%) were the most frequent symptoms. Twenty nine patients (85.3%) had pleural empyema and 5 a hydropneumothoracic image. Empyemas were related to pneumonia in 11 cases, associated to tuberculosis in 5 cases and were primitive in 18 cases. Bacteriological exam of the pus performed in only 18 patients had revealed a pneumococcus in 4 cases (22.23%) and was negative in 9 cases (50%). Closed chest drainage associated with antibiotics, pleural washing and respiratory kinesitherapy was done in all the cases. The average duration of hospitalisation was 24.56 days (1 to 55 days). Five deaths (14.70%) occurred. Two cases of recurrence were noted requiring a second drainage. Three cases of pachypleuritis had required a thoracotomy for pleural decortication in average time of 6 months. The duration of follow-up was 1 year. For the other 24 patients (70.58%) the evolution was good. Urgent closed chest drainage of empyema thoracis combined with antibiotics, pleural washing and respiratory kinesitherapy allows a good evolution and reduces the risk of pachypleuritis.

Adolescent↗

PubMed2002

[Anatomical and surgical study of the medial calcaneus branch of the tibial nerve].

To better understand the anatomical variations of the medial calcaneus branch, the tibia nerve were dissected in 20 ankles of fresh black African cadavres. The medial calcaneus branch which is a collateral branch of tibial nerve was constant. It was unique in 80% of cases and was detaching itself from the trunck of the tibial nerve ot the entrance of the calcaneal sulcus. It was in the form of two small nerves with point of departure from the common tibial nerve trunk. These anatomic constatations confronted with those published in literature permits us to understand the etiopathogenic aspects of certain neuropathies of the ankles. To add this they impose a certain order if precaution in the operational surgnical route of the posterior section of the ankle.

Ankle↗

PubMed2002

[Penetrating wounds of the abdomen. Evaluation of conservative treatment in 40 cases].

Stabbed penetrating abdominal wounds are becoming more and more frequent in our emergency surgical unit due to increase of aggressions. The goal of our study is to evaluate the conservative treatment of these wounds. This concerns a study carried out between January 1997 and October 1998. Exploratory laparotomy was proposed at each time when one or more of the following criteria was noticed: choc, evisceration of intestines, digestive hemorrhagy or hematuria, outlet of digestive fluids, sign of peritoneal irritation, wounds by gunshots or wounds at the frontal regions. In the other cases, the conservative treatment with wound dressing following an antibiotic and serovaccination therapy of tetanus was the therapeutic option. Our study was carried out on 40 patients of whom were 37 males and 3 females of average age 24.9 years with extremities of 7 to 52 years. It arrived to the following results: 32 of the patients (80%) were victim of aggression and 29 cases were stabbed wounds. The wounds were in the central region (umbilicus 29.5%) and superior to the abdomen and were associated with outlet of the omentum (50%) outlet of the intestines (12.5%), peritoneal irritation (27.5%), digestive hemorrhagy (10%), hematuria (2.5%) outlet of faeces (2.5%). 17 patients (42.5%) underwent exploratory laparotomy on the basis of criteria afor mentioned and the 23 others (57.5%) underwent medical surveillance and 3 of them developed peritonitis and underwent surgery. The rate of negative laparotomy was 5% and retarded interventions was 13%. The morbidity was also 13% and mortality 2.5%. The average period of internship in hospital was 11,4 days with extremities of 1 to 101 days. The conservative treatment of penetrating stabbed abdominal wounds out of the criteria mentioned were quite satisfactory.

Abdominal Injuries↗

PubMed2002

[Anatomical and surgical study of the medial calcaneus branch of tibial nerve].

To better understand the anatomical variations of the medial calcaneus branch, the tibia nerve were dissected in 20 ankles of fresh black African cadavers. The medial calcaneus branch which is a collateral branch of tibial nerve was constant. It was unique in 80% of cases and was detaching itself from the trunk of the tibial nerve at the entrance of the calcaneal sulcus. It was in the form of two small nerves with point of departure from the commun tibial nerve trunk. These anatomic constatations confronted with those published in literature permits us to understand the etiopathogenic aspects of certain neuropathies of the ankle. To add this they impose a certain order if precautions in the operational surgical route of the posterior section of the ankle.

Duplicate Publications as Topic↗

PubMed2002

[Treatment of chronic anal fissures: report of 31 cases].

A prospective study evaluating the surgical technique used in the treatment of chronic anal fissures, which is fissurectomy, partial sphincterotomy and anoplasty, was carried out in University Teaching Hospital Dakar. Thirty one patients with chronic anal fissures (20 males and 11 females) with average age 38 years and mean consultation period of 3 years, were treated with this technique. The delay of healing was between 4 to 12 weeks for a mean period of six weeks with 27 cases healed before 2 months and 4 cases after. One patient developed transitory faecal incontinence, recurrences, anal stenosis, haemorrhoidal relapses. noticed after simple lateral sphincterotomy were not found in our study as written in the medical literature. The surgical treatment of chronic anal fissures by fissurectomy, partial sphincterotomy and anoplasty is an important corner stone in this pathology. However lately healing may be a source of discomfort for the patient.

Adult↗

PubMed2001

[Descriptive study of complicated hypertension. Experience of the Principal Hospital of Dakar].

We included in a six month-period 85 patients concerned about complicated high blood pressure. Hypertension represented 33% of 276 admissions for cardiovascular cases. Among the 55 men and 30 women concerned, average age was 57 years-old. Male to female ratio was 1,8. Cardiovascular risk factors were determined as follows: obesity: 18 cases (21%), cigarette smoking: 27 cases (32%), diabetes mellitus: 11 cases (13%), hypercholesterolaemia: 44 cases (52 %). Kidney was damaged in 36 patients (42%). Seventy patients (82%) with systolic dysfunction in 21 cases (30%) presented a left ventricular hypertrophy. Malignant hypertension was noted in 13 cases (15%). Eighteen patients (21%) had stroke and 9 died (10,5%). Drugs association was needed to control hypertension. As for everywhere in Africa, complicated hypertension is the main cause to admission for cardiovascular disease in our day-to-day practice. National preventive measures should help for systematic detection process and adequate management.

Adult↗

PubMed2001

[Trochanteric fractures in elderly patients: management and prognosis of 68 cases].

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.

Aged↗