Malick Diallo1, Massadiami Soulama2, Alexander E Hema2, Adama Sidibé2, Emile Bandré3, Patrick W H Dakouré2. 1. Orthopedics and Trauma Surgery Department, University Hospital of Bobo-Dioulasso, Bobo-Dioulasso, Burkina Faso. malikijallo@yahoo.com. 2. Orthopedics and Trauma Surgery Department, University Hospital of Bobo-Dioulasso, Bobo-Dioulasso, Burkina Faso. 3. Pediatrics Surgery Department, University Hospital of Bobo-Dioulasso, Bobo-Dioulasso, Burkina Faso.
Abstract
INTRODUCTION: Neglected epiphyseal fracture-separations of the distal femur are rare. Still reported in developing countries, they lead to therapeutic issues. The objective of the study is to describe their characteristics and to propose treatment options. MATERIALS AND METHODS: Ten years of ongoing study was held in our orthopedics department. All patients with a neglected epiphyseal fracture-separations of the distal femur after a knee trauma were included in the study. Pre-operative and post-operative data were collected and analyzed. RESULTS: A total of 13 cases of neglected traumatic epiphyseal fracture-separations of the distal femur were found among 8616 in-patients of the department. It was mainly boys (9M/4F) around 16 years that were received 14 weeks after knee trauma. Most of the injuries were an AO-type 33-E/2.1 (Simple Salter-Harris' type II) (n=12) distal femur malunion (n=10). Associated complications were cutaneous opening (n=7), superficial infection (n=4), deep infection (n=4). Fractures were management surgically (n=12) by an open osteoclasis procedure (n=9), debridement (n=7) and a thigh amputation (n=1). The outcome was better if an open osteoclasis procedure was early performed in closed distal femur mal-union with a complementary rehabilitation program. CONCLUSION: Specialized trauma care facilities must be increased, and trauma education programs must be undertaken to avoid neglected epiphyseal fracture-separations of the distal femur in developing countries.
INTRODUCTION: Neglected epiphyseal fracture-separations of the distal femur are rare. Still reported in developing countries, they lead to therapeutic issues. The objective of the study is to describe their characteristics and to propose treatment options. MATERIALS AND METHODS: Ten years of ongoing study was held in our orthopedics department. All patients with a neglected epiphyseal fracture-separations of the distal femur after a knee trauma were included in the study. Pre-operative and post-operative data were collected and analyzed. RESULTS: A total of 13 cases of neglected traumatic epiphyseal fracture-separations of the distal femur were found among 8616 in-patients of the department. It was mainly boys (9M/4F) around 16 years that were received 14 weeks after knee trauma. Most of the injuries were an AO-type 33-E/2.1 (Simple Salter-Harris' type II) (n=12) distal femur malunion (n=10). Associated complications were cutaneous opening (n=7), superficial infection (n=4), deep infection (n=4). Fractures were management surgically (n=12) by an open osteoclasis procedure (n=9), debridement (n=7) and a thigh amputation (n=1). The outcome was better if an open osteoclasis procedure was early performed in closed distal femur mal-union with a complementary rehabilitation program. CONCLUSION: Specialized trauma care facilities must be increased, and trauma education programs must be undertaken to avoid neglected epiphyseal fracture-separations of the distal femur in developing countries.
Authors: Malick Diallo; Théodore Ouédraogo; Jean-Louis Debiesse; Jean Philippe Fayard; Paul-Henri Hulin; Joseph Millon; Wendpanga Rodrigue Lucas Douamba; Alidou Porgo; Patrick Wendpouiré Hamed Dakouré Journal: Pan Afr Med J Date: 2022-03-14