Introduction: The objective of this work was to evaluate the clinical and radiological results; and the quality of life of patients with THA at final follow-up. Patients and Method: This was a prospective, multicenter, multi-operator study, which was carried out in patients with THA, between January 1, 2014 and December 31, 2022. The clinical evaluation was carried out with the PMA, Devane and WOMAC activity scores. Radiologically, the analysis focused on the inclination of the cup, the peri-prosthetic lines and the bony integration of the implants. Results: 85 patients were re-evaluated out of 145; 60 were lost to follow-up including 16 due to death, the average follow-up was 5.85 years. The average age was 51.81 years (39-85). The functional scores were generally satisfactory at the last follow-up with a mean PMA, Devane, and WOMAC score of 15.8 respectively; 2 and 76.54 and a rate of resumption of sexual intercourse after THA of 54.11%. The mechanical complications were: 8 revisions for prosthetic loosening, 4 wear and osteolysis, 02 periprosthetic margins. The patients were much more optimistic than the surgeon: 94.73% of the patients judged their results to be excellent or good while the surgeon only accepted 85.96%. Conclusion: Degenerative hip joint pathologies seem to be increasing due to the incidence of complications of sickle cell disease. The need for joint replacement is growing despite the still expensive cost. At the last follow-up, the overall results are satisfactory and a rate of resumption of sexual intercourse after THA of 54.11%. Chronic pain and muscle atrophy have had a significant impact on quality of life and sexual activity. Our study confirms the medium-term reliability of dual mobility with a survival rate of 90.60%. These results must be tempered because of the occurrence of long-term complications, linked to the risk of dual mobility in young subjects.

Introduction: The aim of this study was to evaluate the anatomical and functional results of locked condylar plate osteosynthesis in distal femur fractures in elderly Togo patients.Patients and Method: It was a continuous prospective study with descriptive and analytical aims, conducted over a period of 4 years 6 months, from 1 January 2019 to July 2023. The AO/OTA classification was used for the radiological classification of fractures. The walk was measured by the Parker score. Functional outcome of the knee was evaluated using the MEGY functional score. The population of study was 32 cases. The mean age of the patients was 74.25 years, and the most affected group was 35-45 age. Both sexes were equally represented. Fall at home were responsible of 43.8% distal femoral fracture in patients aged over 60 years old. Fractures were open in 18.8%. In 15.6% cases, these lesions were associated to polyfractures and/or polytrauma and in 3 cases we found

The purpose of this study is to present our surgical strategy and describe the advantages and outcomes of the Ilizarov method in the treatment of bilateral tibia nonunion in an adult with OI. The major of bone fracture fixation drawback is the difficult placement of nails due to abnormal bony anatomy, non-linear and imperforate canals, marked bowing and unusually short limbs. A female adult aged 18yo with bilateral tibia nonunion affected with OI type V was treated with the Ilizarov method. The tibia was in varus (15° at left, 14° at right) and recurvatum (18° on the left, 27° on the right). Surgical technic was same for both tibia in one-time procedure and it's compounded: primary fibula osteotomy, tibia and osteotomy taking out interfragmentary fibrosis, reduction and fixation by Ilizarov frame. Full weight-bearing was allowed at 3 months. The complications that occurred were minors. Bone's consolidation was obtained at 5 months and the frames were removed at 6 months in the office without anesthesia. At the follow-up visit 5 months after removal, the ASAMI functional and radiological score was excellent on the left side and good on the right side. The use of the Ilizarov method for treating a tibia bilateral nonunion in an adult patient with moderate OI provides good stability. This technique ensures early weight full bearing, above joint motion, and recovery functional necessary to normal bone tissue regeneration. This is an alternative to avoid difficulties and complications due to internal fixation in deformities correction in adults with acquired bone-weakening conditions.

English Title: Interest of circular external fixator in orthopaedic in low-income country Objectif : Cette etude avait pour but de decrire les indications de la technique d’Ilizarov en orthopedie traumatologie et leurs resultats.Materiel et methode. Il s’agissait d’une cohorte retrospective multicentrique. Elle avait inclus les patients traites par la technique d’Ilizarov entre juillet 2014 et septembre 2019 et suivi jusqu’a la guerison. L’analyse avait porte sur les types de lesions, les complications, le taux de guerison et d’echec.Resultats : quarante-sept patients ont ete traites. L’âge moyen etait de 37,4 ans. Les hommes representaient 63,8%. Les diagnostics principaux etaient : fractures du tibia (n=31 ; 65,9%), dont 14 fractures du plateau tibial ; les cals vicieux de cheville (3 ; 6,4%) ; les pertes de substances osseuses (3 ; 6,4%). Les interventions principales realisees etaient : l’osteosynthese (n=34 ; 72,3%) ; l’arthrodese de cheville (n=5 ; 10,6%) ; correction de pied varus equin (n=4 ; 8,5%). La duree moyenne d’une intervention etait de 130,5min. le delai moyen d’ablation etait de 98,7 jours. Le taux de guerison etait de 95,6%. Les complications principales etaient : l’infection sur broche (n=11 ; 23,4%) ; la douleur (n=6 ; 12,8%), la raideur du genou (n=7 ; 15,9%).Conclusion : le taux de resultat positif est similaire a celui observe dans la litterature. Le fixateur externe d’Ilizarov a permis d’obtenir des resultats satisfaisants pour des lesions complexes de jambe et cheville avec un cout reduit. Mots cles : technique d’Ilizarov, Afrique, resultats positifs

Les fractures-luxations de hanche rentrent frequemment dans le cadre des polytraumatismes avec cinetique lesionnelle importante. Les associations lesionnelles sont variees avec une morbi-mortalite elevee. Les fractures-luxations bilaterales de hanche sont rares et leurs prises en charge en urgence et au stade de sequelles sont difficiles et constituent un challenge sur le plan fonctionnel. Nous rapportons un cas de fracture-luxation de hanche negligee associee a une fracture de la diaphyse femorale : une luxation posterieure droite associee a une fracture de la tete femorale droite type III et une fracture-luxation centrale type 3 A associee a une fracture du femur ipsilaterale. Au dernier recul postoperatoire, elles ont evolue vers une coxarthrose polaire superieure gauche et une osteonecrose secondaire de la tete femorale droite.Mots cles : Luxation de hanche bilaterale, fracture, osteonecrose, arthrose.

Introduction : La morbidite des pseudarthroses diaphysaires de membres n’est pas negligeable. L’objectif de cette etude retrospective, etait de repertorier les etiologies et d’evaluer resultats radiologique et fonctionnel.Patients et Methodes : Nous avons analyse retrospectivement une serie monocentrique de patients traites pour une pseudarthrose diaphysaire aseptique de membre (48 hypertrophiques et 9 atrophiques) entre janvier 2001 et decembre 2012. Il s’agissait de 57 patients (17 femmes et 40 hommes) d’âge moyen au moment de l’intervention de 37,40 ans (17 – 88). Le cote gauche etait atteint de facon preponderante 43 fois. Lemecanisme lesionnel initial etait essentiellement traumatique. Tous les patients ont subi au moins une intervention chirurgicale. Les methodes de fixation ont varie et etaient couplees a une decortication avec adjonction d’autogreffe. L’evaluation a ete faite selon les criteres clinique et radiographique.Resultats : Recul moyen etait de 22,8 mois (8 a 91 mois). Le delai moyen de prise en charge a ete de 18 mois (8 - 36). La consolidation a ete obtenue en premiere intention chez 44 (77,20 %) patients. Treize (22,80 %) cas de pseudarthroses iteratives ont ete observes. Le taux d’infection du site operatoire etait retrouve chez 5 patients (08,77 %). Les sequelles etaient constituees par les cals vicieux et les raccourcissements. Les raideurs de chevilles, fonctionnellement peu genantes et de genoux ont ete observes respectivement dans 3 et 7 cas.Conclusion : Le traumatisme routier et la qualite du traitement initial ont constitue les facteurs pseudarthrogenes dans notre serie. Les resultats fonctionnels apres la reconstruction osseuse avec apport de greffons autologues ont ete satisfaisants. Le meilleur traitement des pseudarthroses est celui de la prise en charge initiale. Le concept de la membrane induite est une alternative dans les pseudarthroses iteratives.Mots cles: Pseudarthrose, aseptique, diaphyse, traitement, Autogreffe.

Resume : Introduction - Les fractures du Processus Coronoide sont rares et pourvoyeuses de lesions associees. L’utilisation de fragment provenant de la tete radiale comme une butee dans la reconstruction du Processus coronoide, lorsque l’osteosynthese s’avere impossible est une alternative therapeutique au remplacement prothetique, en permettant aux patients de retrouver un coude fonctionnel. Le but de cette etude etait d’evaluer les resultats fonctionnels a court terme de cette technique. Materiels et methodes – il s’agit d’une etude retrospective d’une serie monocentrique de 6 cas, constituee de 4 hommes et 2 femmes, operes entre 2009 et 2015. L’âge moyen etait de 37,5 ans. La technique chirurgicale consistait en une reconstruction du processus coronoide par une butee au moyen du fragment de la tete radiale non reconstructible. Resultats – Tous les patients ont ete revus avec un recul moyen de 25,5 (4 -52 mois). Aucune complication n’a ete retrouvee ni de subluxation. La valeur  moyenne du score de performance de Mayo Clinic etait de 91 (81 - 105). Les mobilites moyennes en flexion, extension, pronation et supination etaient respectivement de 132,5°; 12,5°; 80°; 78,33°. Tous les patients etaient satisfaits ou tres satisfaits du resultat. Conclusion – La reconstruction du processus coronoide par une butee au moyen du fragment de la tete radiale dans les lesions associees non reconstructibles donne un resultat fiable. Elle est une alternative therapeutique lorsque le plateau technique est limite dans la prise en charge des lesions instables du coude.

The aim of this study was to report the results of our experience in the treatment of proximal fractures with distal radius plate. This prospective study was conducted between January 2010 and December 2014. It took into account patients with a body mass index (BMI) not more than 25 kg/m2 in which the indication of conservative surgical treatment was decided and who did not have enough financial means to fulfill the required implants. The Neer classification was used to characterize fracture. To assess treatment outcomes, we used UCLA (University of California in Los Angeles) slightly modified score. There were 17 patients including 10 men and 7 women with a mean age of 32 years. According to Neer classification, six patients (35,29%) had stage I lesions, 5 others (29,42%) stage II and 6 patients (35,29%), stage III. There was no open fracture. There were three cases (17, 66%) of fracture-dislocations with one posterior variety. The average time of care was 13, 7 days (with a range of 2 to 29 days). The average time of healing was 117, 4 days with extremes of 81 days and 4 months 10 days. All patients were consolidated. The results at a mean of 15.31 months revealed excellent results in 29.41% and 29.41% poor results. In young patients whose treatment should be as conservative as possible, the distal radius plate could be an alternative if patient BMI does not exceed 25 kg/m2 and the epiphyseal screws are not too long. In case of comminuted fracture, it seems more desirable to postpone the osteosynthesis of weeks. However, only other subsequent studies on larger samples and longer followup, may lead to some conclusions about the usefulness of the distal radius plate in these lesions.