Centro-Medullary Nailing of Open Leg Fractures in N’djamena (CHAD)
Open fractures are any disruption of continuity where the fracture site communicates with the outside. The aim of this study was to evaluate the treatment of open leg fractures by intramedullary nailing. This was a single-center, cross-sectional, retrospective study carried out over a continuous period of 4 years, from January 2020 to December 2023. Open fractures were classified according to Gustillo/Anderson, and anatomical and functional outcomes were evaluated using the modified Ketenjian criteria. Twenty-eight patients, including 3 women aged 18 to 60 years (mean 38.14 years), were collected. They represent 6.15% of open leg fractures and 0.96% of all fractures in the orthopedic and trauma surgery department. The etiologies were dominated by road traffic accidents (88%). We recorded 15 cases (53.6%) of type I, 6 cases (21.4%) of type II, 6 cases (21.4%) of type IIIa, and one case of type IIIb (3.6%). The average time to management was 35.5 hours, with extremes ranging from one hour to 240 hours. Thorough debridement plus antibiotic prophylaxis was performed in all our patients. The complications consisted of one case of surgical site infection, one case of osteitis and joint stiffness, and one malunion. The average consolidation time was 4.75 months. Functional and anatomical results were satisfactory in 82.2%.Immediate intramedullary nailing in open leg fractures allows for good results.
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Bilateral open distal radius epiphyseal separation fracture: A rare case and literature review at the La Renaissance University Hospital Center
Epiphyseal separation fractures of the distal radius represent the most common injury in children, but the open, bilateral form remains rare. We report the case of a 15-year-old right-sided adolescent with no known medical history who was the victim of a road traffic accident resulting in bilateral open wrist trauma. Clinical and paraclinical investigations led to the diagnosis of a bilateral open epiphyseal separation fracture (Gustillo type II on the left and type I on the right; Salter/Harris type II on the left and type I on the right). Careful debridement and reduction were performed, followed by double pinning on the right and quadruple pinning on the left. The anatomical and functional results were excellent.
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