Introduction
Avulsion-fractures of the tibial tubercle apophysis are a rare lesion of active adolescent. They are relatively uncommon injuries that occur in the active adolescent. We described cases of tibial tubercle apophysis avulsion-fractures in two Cameroonian adolescents.
Cases
We observed 2 cases which occurred in boys after contraction of the quadriceps during sports activity (high jump and football). The lesions were classified as Type IV by Ryu and Debenham (case 1) and type IA by Ogden (Case 2). The treatment was surgical by double screwing (case 1) and orthopedic by plaster knee brace (Case 2). The functional result was excellent without complications.
Discussion
Non-displaced fracture of the anterior tibial tubercle I type IA Ogden has good prognosis and responding very well to non-surgical treatment. It should be considered as a separate entity. The other cases of displaced fracture generally require surgery which enables an assessment of often associated lesions. Type IV can required supplemental plate fixation to stabilize the proximal tibia. The prognosis of displaced fractures is poor due to the associated lesions and potential complications. Functional results are excellent despite a few cases of previous pain limiting sports activity.
Conclusion
Avulsion fractures of the anterior tuberosity in adolescents remain rare in Africa and worldwide. The circumstances of the occurrence are stereotypical. If treated properly, the outcome is usually good.
Background: An open fracture is an injury in which the fracture site and/or hematoma communicates with the external environment. It is associated with significant morbidity and disability and is a challenge to the surgical team. The lower extremities are the most often exposed to traumatic injuries compared to other anatomical parts of the body. Patterns of open fractures differ with different mechanisms of injury and the segment of the long bone affected. The correct and timely management of open fractures is beneficial to the patients and leads to a more favorable outcome. This study aimed at describing the pattern of open fractures of long bones of the lower limb treated in 3 major hospitals of the south west region, Cameroon. Methodology: This was a hospital-based retrospective review of files of patients with open fractures of long bones of the lower limb managed at the surgical units of three secondary health facilities in the South-West region of Cameroon from the 1 st of January 2015 to the 31 st of December 2019. The socio-demographic characteristics, clinical presentation, treatment modalities, and outcomes were recorded. The data was stored and analyzed using Epi info version 7.0 and SPSS version 23.0 respectively. Results: A total of 195 files of patients aged 8 to 80 years were studied. The main age group affected was between 20 -40 years. There were 147 (75.4%) males and 48 (24.6%) females giving a sex-ratio of 3.1:1. The most common cause was road traffic crashes 142 (72.8%). In 98 cases (50.3%), the left side was more involved. The tibia was the most common long bone affected in 75 (38.5%) cases. Comminuted fracture was the most common fracture pattern encountered in 126 cases (64.6%). A total of 76 (39%) fractures were graded Gustilo-Anderson IIIA.
Introduction
closed static interlocking nailing with c-arm guidance is the standard procedure for the treatment of closed diaphyseal leg fractures. It is still very difficult to carry out such procedures in a low-income setting because of few or absent image intensifiers (c-arm) despite the necessity. The aim of this study was to describe the outcomes of patients with tibial fractures treated with closed interlocking intramedullary nails without c-arm guidance in a Cameroonian population.
Methods
this was a prospective study including adult patients treated for tibial fractures without a c-arm in two regional hospitals.
Results
finally, 22 patients were included. The mean age was 34 ± 12.6 years with a male predominance (16 males and 6 females). Ninety percent of the fracture lines were simple or with a wedge fragment grade 42A or 42B respectively according to the AO classification. The mean surgery time was 1 hour 26 ± 34 minutes. The various aspects evaluated were the nail entry point which was good in 19 (86.4%) cases; proper nail driving which was considered good in 15 (68%) cases; the distal locking which was missed in 6 (27.3%) cases. Bone consolidation was obtained in an average of 4 ± 1.2 months in all 22 cases.
Conclusion
in resource constraints settings where c-arm are not always available, closed interlocked nail of tibia without c-arm guidance still gives overall good results. Nevertheless, there is a need to improve equipment in sub-Saharan African hospitals to make trauma surgery with c-arm a gold standard as currently recommended.
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