Biomedical subjects

A V Dansokho

Publications and source records attributed to A V Dansokho.

8 recordsLinked to original sources

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↗

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↗

PubMed2000

[Recent traumatic peroneal tendon dislocation: a case report].

Peroneal tendons dislocation describes a permanent or intermittent displacement of these tendons out of the retro malleolar sucket to its lateral side. It was described in fist in 1803 by Monteggia. It remains a rare affectation, dominantly of traumatic causes, mostly by passed in emergency situation. Also in its rarity, it remains remarkable for its diagnostic interest but also for its management which remains only surgical. This case concerned an adult of 24 years old, victim of closed trauma of the right ankle, the ankle was forced in varus and supine position. Ths initial diagnosis was a benign sprain which was later rectified 14 days after for a diagnosis of peroneal tendons dislocation. During the operation, a rupture of the retinaculum like type II of Eckert and Davis was noticed. A simple suture technique using Exner method give a good result 14 months later. The authors insist after this case indifferential diagnosis with sprain and recommended a surgical repair in recent lesions.

Adult↗

PubMed1999

[Deep onchocerciasis of the left thigh. An unusual case].

INTRODUCTION: Commonly onchocercoma has been presented as superficial and multiple nodules. When it's unique and deeply situated, its clinical diagnosis is difficult. An uncommon form of onchocercoma is reported. CASE REPORT: A 37 years old man presented a big tumor at the inferior third of the left thigh like lipoma or liposarcoma because of microcalcifications. The tumor was removed. It was a cyst containing a liquid like an "mango juice". The histological examination was performed. Degenerated microfilariae of Onchocerca volvulus was found. DISCUSSION: A big and deep onchocerma of the thigh is uncommon and diagnosis before operation is very difficult. Histological examination have eliminate filarial infections like Dracunculus medinensis and have given the right diagnosis. Radiological microcalcifications and absence of microfilariae at the parasilogical and ophthalmological examinations recall an "aged" onchocercoma. For this reason, we didn't realise a chemotherapy. CONCLUSION: This tumor in Sahel areas is very difficult to diagnose before operation. The histological examination is very important in this case. We don't use chemotherapy because this onchocercoma looks old without alive microfilariae.

Adult↗

PubMed1999

[Fibrodysplasia ossificans progressiva or Munchmeyer disease apropos of 2 cases].

Fibrodysplasia ossificans progressiva or myositis ossificans progessiva or still Munchmeyer disease is a genetic ailment with dominant autosomic transmission. It includes a high rate of change and doesn't appear any race. The authors gave an account of two remarks about it on a causal and late discovery upon two young black Africans. The first observation is a nine year-old-boy, without any similar family previous history and who has been hospitalized in maxillo-facial milieu for a mandible osteitis staphiloccocus. It showed some muscular ossifications of paravertebral, cervical, dorsal and lumbar nature--from a spontaneous appearance and evolving progressively since the age of three months. The radiographic results displayed some specific bones disorders which enable to retain the diagnosis above. The second observation is the case of a twenty four-year-old-woman who has previously benefitted from a surgical exploration a non-inflammatory muscular tumefication at the right arm which occurred at the age of twenty one. Three years later, she took surgery for the restriction of the oral gap and a right hand side lumbar paravertebral tumefaction which was thus restricting the mobility of the rachis. The radiological results have found some specific bone disorder++ at the hands and the feet which enable to link the paravertebral ossifications to their fibrodysplasic origin. Munchmeyer disease remains a affection of easy radio-clinical diagnosis. The essential point is to precociously think of it before the specific osseous anomalies occurring at the level of the feet and the hands. The functional or even vital prognosis remains closely linked to both the important and the topography of conjunctivo-muscular ossifications.

Adult↗

PubMed1998

[Scapulo-thoracic mycetoma. A rare localization, a particular form].

INTRODUCTION: An uncommon form and a rare localization of mycetoma is reported. The aim of this report was to distinguish this inhabitual form of mycetoma from some tropical diseases like onchocerca and other fungal diseases. CASE REPORT: A 55 year old man was admitted 10 years after a septic worm-hole for a scapulo-thoracic tumor. This encapsulated mass was a bending and rounded polyfistular one attached to the dorsal aspect of left shoulder. The fistula discharge a serosanguineous or purulent exudate. The characteristic red granule was not visible. The tumor was removed and histological examination was performed. A typical granuloma of red granule of streptomyces pelletieri was found. A good result was obtained with associated cotrimoxazole treatment. DISCUSSION: Scapulo-thoracic form included: scapular, axillary and chest form of mycetoma. All these localizations are rare. One of them can be complicated by osteitis or pleuro-pulmonary localization. Streptomyces pellitieri is the actinomycetic causal agent. This encapsulated form is uncommon. CONCLUSION: Scapulo-thoracic mycetoma is rare. Encapsulated and pedicular form is uncommon. Around Sahel areas, differential diagnosis must be evoked such as parasitic and mycobacterial infections.

Dermatomycoses↗

PubMed1996

[Early evaluation of surgical treatment for patella fractures].

From mars 1989 to mars 1992, 26 fractures of the patella were treated surgically in the "Orthopaedic and Traumatological center in Dakar". We have evaluated the functional and the anatomical results. The mean age of the patients was 45 years. The most common mechanism was direct trauma (24 cases). We have registered 12 opened fractures, 24 displaced fractures and 13 comminutive fractures. Surgical methods were modified tension band internal fixation (18 cases), tension band wiring for fixation (5 cases) and circumferential wire loop fixation (3 cases). The mean follow-up was ten months. Only eight patients have adequate post-operative kinesitherapy. So functional results was poor in 50% of cases. The anatomical reconstruction of the patella were achieved in 18 cases. We have observed a relation between: anatomical results and inadequate indications; excellent functional results and adequate kinesitherapy. So the authors recommend modified tension band internal fixation in transversal fractures and fracture with central communication. Tension band wiring for fixation is used in others comminutive fractures. Post operative kinesitherapy must be realized in a adequate center and criteria of functional evaluation be wider theses.

Adult↗

PubMed1993

[Osteosynthesis of displaced fractures of the acetabulum with Letournel plate. Apropos of 14 cases].

Up to 1989, conservative treatment was used for fractures of the acetabulum at the Dakar teaching hospital, with in previous study, of poor result. The same authors present here their first experience of surgical treatment of displaced fractures of acetabulum using LETOURNEL plate at the "Centre de Traumatologie" of Dakar for three years. Fourteen patients (12 men and 2 women) presented after traffic road accident: fracture of posterior wall: 7 cases transversal fracture: 1 case complex fractures: 6 cases. Those displaced fractures were associated with hip dislocation in 8 cases. The initial emergency treatment by reducing the dislocation, associated with transfemoral pin traction was realized. At the day 7 through a posterior surgical approach in 11 cases and through a combined anterior and posterior approach in three cases. The anatomical reconstruction of the acetabulum was achieved in 12 cases. It's still early to make a final clinical assessment, but the early functional results using MERLE D'AUBIGNE's criteria (pain, lamenliss, mobility) are very good in 10 cases and poor in 2 cases. The reliability of the procedure, and the adequate post operative kinesitherapy is according to the authors the main indication for displaced fractures of the acetabulum.

Acetabulum↗