Predictive factors of malunion and nonunion at the Aristide le Dantec hospital

Background: Malunion and nonunion are late complications that can occur during the fracture healing process. The aim of this study was to determine the predictive factors for malunion and nonunion Methods: This was a retrospective study over a period of 43 months. Predictive factors were sought from patient, fracture and initial management data Results: We recorded 72 consolidation disorders in 69 patients. malunion accounted for 54.1% and nonunion for 45.9%. The study population was divided as follows: 53 men and 16 women. The average age was 37.8 years. The patients lived in urban areas in 81.2% of cases. Comorbidities were present in 14.5%. The circumstances of fracture occurrence were dominated by traffic accidents, especially for 39 patients. The initial fracture was closed in 91.3%. Long bones were involved in 97.2% of cases, with a diaphyseal location in 52.8%. The fracture was simple in 79.1%, with 84.7% of the fractures being transverse. The tibia was the bone most affected by malunion (53.8%). Nonunion occurred in the humerus, femur and tibia in 27.3% each. Initial treatment was undertaken in 91.3% of patients. Conclusions: Malunion and nonunion are a reality in our daily practice. These consolidation problems occur in young patients who are victims of road traffic accidents. Diaphyseal fractures of long bones with a transverse line have been the most frequently incriminated. conservative treatment and traditional practice have favoured the development of these complications

Acetabular fractures: epidemiological, lesional, therapeutic and evolutionary aspects

Background: Fractures of the acetabulum are serious because they affect a deep, load-bearing joint that is difficult to repair surgically at first. They occur in a context of polytrauma. The aim of our work is to study the epidemiological, lesional, therapeutic and evolutionary aspects of acetabulum fractures.Methods: This is a 5-year retrospective study from January 2012 to December 2016 including 45 patients treated for acetabulum fracture.Results: 45 patients including 38 men and 7 women with a mean age of 36 years (extremes 18 and 74). The circumstances of occurrence were dominated by road traffic accidents with 42 cases (93.3%).According to the Judet-Letournel classification, we observed 28 elementary fractures (16 posterior wall fractures, 11 posterior column fractures, 1 anterior column fracture) and 17 complex fractures (7 posterior column and posterior wall fractures, 6 transverse and posterior wall fractures, 3 posterior and anterior column fractures, 1 anterior column and posterior hemi-transverse fracture). The association of a dislocation with an acetabulum fracture was found in 32 cases. Associated lesions (fractures) were observed in 23 patients. One case of associated TCE was noted. Treatment was orthopedic in 18 patients, surgical in 18 patients and functional in 9 patients. According to the Matta criteria we obtained after treatment 46.7% good reduction, 51.1% satisfactory and 2.2% unsatisfactory reduction. According to the Postel-Merle D'Aubigné rating, 16 patients obtained excellent results with overall 93.3% satisfactory results. The complications found were coxarthrosis (15 cases), para-articular ossification (2 cases) and vicious callus (1 case).Conclusions: The treatment of acetabulum fractures depends on the type of fracture, the age and activities of the patients. Orthopedic, surgical as well as functional treatment can give good acetabular reconstructions and functional results