Over the past decades, cancer has become one of the toughest challenges for health professionals. The epidemiologists are increasingly directing their research efforts on various malignant tumor worldwide. Of note, incidence of cancers is on the rise more quickly in developed countries. Indeed, great endeavors have to be made in the control of the life-threatening disease. As we know it, pancreatic cancer (PC) is a malignant disease with the worst prognosis. While little is known about the etiology of the PC and measures to prevent the condition, so far, a number of risk factors have been identified. Genetic factors, pre-malignant lesions, predisposing diseases and exogenous factors have been found to be linked to PC. Genetic susceptibility was observed in 10% of PC cases, including inherited PC syndromes and familial PC. However, in the remaining 90%, their PC might be caused by genetic factors in combination with environmental factors. Nonetheless, the exact mechanism of the two kinds of factors, endogenous and exogenous, working together to cause PC remains poorly understood. The fact that most pancreatic neoplasms are diagnosed at an incurable stage of the disease highlights the need to identify risk factors and to understand their contribution to carcinogenesis. This article reviews the high risk factors contributing to the development of PC, to provide information for clinicians and epidemiologists.

<p class="abstract"><strong>Background:</strong> The objective of this study was to describe the epidemiological, clinical presentation, management and prognosis of classic floating elbows at the Brazzaville University hospital.     </p><p class="abstract"><strong>Methods:</strong> This is retrospective descriptive study conducted in the Trauma-Orthopedics Department at Brazzaville University Hospital between January 2013 and December 2018. Four patients meeting the inclusion criteria underwent surgery. Open fractures were classified according to the classification of Gustilo and Anderson. Anatomical evaluation was based on the quality of fracture reduction and bone healing. The functional results were assessed according to the Mayo Clinic score. <strong></strong></p><p class="abstract"><strong>Results:</strong> The functional results were assessed according to the Mayo Clinic score of the 4 patients in our study, there were 3 men and 1 woman. The average age was 31 (28 and 34). They were all victims of traffic accidents. Three floating elbows were closed and one open at the humeral level with paralysis of the radial nerve. The closed fractures were treated by screwed plates and the open fracture by external fixator. Bone healing was achieved in 3 patients and we observed 1 case of aseptic nonunion of the radius. According to the Mayo Clinic score, 2 patients had a very good functional result, 1 patient an average result and 1 patient a poor result.    </p><p class="abstract"><strong>Conclusions:</strong> Classic floating elbows are rare and their prognosis remains unpredictable, especially when they involve musculo-cutaneous or neurovascular damages. Their treatment must be surgical in the adult to avoid a prolonged immobilization which may lead to stiffness of the elbow. A multidisciplinary approach should then be taken into consideration. </p>

Introduction: Homolateral combined fractures of Monteggia and Galeazzi are very rare. Their treatment is exclusively surgical and should be proposed early in order to restore the anatomy of the antebrachial skeleton, pronosupination, and the flexion-extension of the elbow and wrist. Observation: We reported the case of a 45-year-old woman who presented a homolateral fracture of Monteggia and Galeazzi following a road accident. This combination of fractures posed a problem of diagnosis and management. Surgical follow-up presented functional issues. Conclusion: The association of Monteggia and Galeazzi fracture is very rare and poorly reported in the literature. This observation reminds us of the importance of performing a complete clinical and paraclinical assessment before any therapeutic decision.

<p class="abstract"><strong>Background:</strong> The objective of the study was to evaluate the functional and anatomical results of the surgical treatment of fractures of the distal humerus at Brazzaville University Hospital using non-anatomical plates.</p><p class="abstract"><strong>Methods:</strong> This was a retrospective study of patients operated by screwed plates for fracture of the distal humerus at Brazzaville University Hospital between January 2014 and December 2017. The study included 11 patients operated by non-anatomical plates and responding the inclusion criteria. Fractures of the distal humerus were distributed according to the AO classification of Müller and Nazarian. The functional results were evaluated according to the Mayo Clinic score based on 4 criteria: pain, mobility bow, stability and functional capacity.<strong></strong></p><p class="abstract"><strong>Results:</strong> There were 8 men and 3 women. The average age was 35 years (range 23 to 50 years). Causes of the trauma were a road accident in 7 patients and a fall in 4 patients. The site involved in the trauma was lateral right in 7 patients and left in 4 patients. The average time to surgery was 7 days (range 5 to 12 days). All our patients have consolidated in first intention. The average time to consolidation was 3 months (range 3 to 4 months). Results at the average follow-up of 9 months were considered excellent in 3 patients, good in 6 patients and average in 2 patients.</p><p class="abstract"><strong>Conclusions:</strong> Osteosynthesis of fractures of the distal humerus remains a challenge in developing countries. Our experience shows that surgical treatment of fractures of the distal humerus by non-anatomic plates can give good results when bone stabilization is satisfactory and rehabilitation is undertaken early.</p>

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