PurposeTo study the management and evaluate anatomical and functional outcomes of patients with ipsilateral proximal and shaft femoral fractures.MethodsA retrospective, descriptive and analytic study lasted for ten years and a half ranging from January 1, 2005 to June 30, 2015. The following parameters were studied: epidemiology, fracture characteristics, therapeutic, anatomical and functional outcomes. The correlation between different parameters was analyzed with Fischer test. The significant threshold was defined for p value <0.05.ResultsTen medical files were registered. There were 7 men and 3 women, with a sex ratio of 2.33. The average age was 46 years (range: 29–62 years). It was about traffic road accidents in all cases. Motorcycle–motorcycle and motorcycle–car collision were most frequent. Average admission delay was 7 h (range: 1.5–24 h). Left side was most reached in 8 cases. According to Garden classification, there was type III cervical fracture in 2 cases, type II in 1 case and type IV in 1 case. According to Ender classification, there was type I trochanteric fracture in 3 cases, type VI in 2 cases and type VII in 1 case. According to AO classification, there was type A shaft fracture in 6 cases (A2 in 4 cases and A3 in 2 cases), type B in 2 cases (B1 in 1 case and B2 in 1 case) and type C in 2 cases (C1 in 1 case and C2 in 1 case). Average surgical delay was 28.7 days (range: 11–61 days). For proximal femoral fracture, Moore prosthesis was used in 1 case, blade plate 130° in 2 cases, long Gamma nail in 4 cases, double screwing in 2 cases and dynamic hip screw in 1 case. For shaft femoral fracture, blade plate 95° was used in 3 cases, low compressive plate in 2 cases. Osseous contention was achieved in 4 cases with long Gamma nail and in 1 case with long blade plate 130°. Nonunion of cervical fracture was achieved in 2 cases. The average osseous healing delay was 5.14 months (range: 3–12 months) for proximal femoral fracture and 5 months (range: 3–8 months) for shaft femoral fractures. According to Friedman and Wyman criteria, functional results were good in 4 cases, average in 4 cases and bad in 2 cases. Regarding implants, healing delay showed no statistic difference between one-implant group and two-implant group (p = 0.52), and among the patients with different functional outcomes (p = 0.52). Functional outcomes showed no statistic difference between one-implant group and two-implant group (p = 0.46).ConclusionIpsilateral proximal and shaft femoral fractures are relatively uncommon in our daily activities. It is difficult to recognize proximal femoral fractures which are unnoticed. Results are generally good if the doctors take the two fractures into account in the management.

Abstract:We report herein the case of 19-year-old female farmer who suffered a double snakebite on the right foot. After an unsuccessful traditional treatment, she consulted a health center, 48 hours after the bite. Upon arrival at the hospital, she showed signs of severe damage, including hemorrhagic syndrome, extensive gangrene of the bitten limb and severe acute renal failure. Due to financial constraints, neither antivenom nor the scheduled amputation was performed. After 35 days of hospitalization, she returned home, against the advice of medical personnel. Our case summarizes the daily challenges of patients and practitioners that suffer snakebite envenomation in Bobo-Dioulasso, western Burkina Faso.

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A 27-year-old presented a complete dislocation of the talus with a missing medial malleolus through a lateral wound after a motorcycle accident. Only extruded contaminated talus was found, debrided, and reimplanted, and pinned within two hours. The outcome was good at 14 months without infection and MRI-confirmed talus revascularization.

Background: Upper limbs amputations disturb relational life. Outcomes of upper limb amputees were studied, functional outcomes and quality of life were analyzed. Objectives: The purpose of this study was to examinate the outcomes of an upper limb amputation on a functional, social and economic level, and to investigate the epidemiological and clinical factors that bear the functional outcomes and quality of life of these patients. Methods: an analytical prospective study over seven years which included 37 patients managed at the referral hospital in Benin was performed. They were mean aged of 36.3 years and 22 were in couple. The mean time of follow-up was 3.0 ± 2.1 years. The rate of fitting prosthesis, relateralization, presence of bi-manual activity, Disabilities of the Arm, Shoulder and Hand (DASH) score, handicap imposed by the amputation, and its socio-economic impact were recorded. Quality of life of amputees evaluated using Nottingham Health Profile (NHP) score was also studied. Statistical analysis was performed with Chi 2 and Kruskal-Wallis tests. A p-value ≤0.05 was established as statistically significant. Results: No patient had been fitted; one had been able to re-lateralize; 24 patients demonstrated bi-manual activity. The mean DASH score was 40.1 ± 13.7. Thirteen patients were able to dress themselves and 10 needed an additional help to go to the toilet. Socially, 21 patients had given up their hobbies, and 5/22 were no longer in a couple. Economically, 27 patients had a decreased monthly income. Factors influencing functional outcomes were the level of amputation and gender (p of 0.005 and 0.006, respectively). The mean NHP score was 5.8 ± 0.2. There was a statistically significant relationship between quality of life, age and level of amputation (p of 0.02 and 6x10-4, respectively). Conclusion: Upper limb amputations strongly affect quality of life. A better social reintegration policy for upper limb amputees should be contemplated in Benin.