Purpose: The multifidus muscle is an important extensor muscle of the lumbar spine. It plays a major role in the stability and realization of axial rotation movements of the thoraco-lumbar spine. Its atrophy by fatty ...Purpose: The multifidus muscle is an important extensor muscle of the lumbar spine. It plays a major role in the stability and realization of axial rotation movements of the thoraco-lumbar spine. Its atrophy by fatty degeneration would be at the origin of the occurrence of chronic low back pain which constitutes a public health problem in Senegal. Taking into account its anatomy is essential for the etiopathogenic analysis and the treatment of low back pain. The purpose of our work was to investigate the impact of multifidus muscle morphometry on the anatomy-clinical evolution of low back pain. Material and method: this was a prospective study over a period of 30 months from November 2019 to May 2022. It involved 100 patients seen in the neurology department of Fann Hospital for chronic low back pain and who had already had a scanner falling within the criteria for low back pain. We used 3D Slicer, SPSS 20, Excel 2016 software to model and analyze the morphometric data of the multifidus muscle after physiotherapy and control lumbar scans. Results: The sex ratio was 2.23. The average age of the patients was 45 ± 7 years. On the initial CT scan, according to the Hadar classification, we noted a predominance of grade 2 with 56% in L5/S1, followed by grade 1 with 32% and grade 3 with 14%. In L4/L5, the majority of patients, 67%, had grade 1. A conflicting circumferential disc bulge with the roots predominating in L5/S1 was present in 94% of men (p-value = 0.02). Before physiotherapy, the average volume of the multifidus was 193 mm<sup>3</sup> ± 39, after physiotherapy it was 203 mm<sup>3</sup> ± 42 with a progression rate of 5.2%. Clinically, severe type pain had regressed from 86% before physiotherapy to 0% after physiotherapy (p-value = 0.03). Conclusion: Taking into account the morphometry of the multifidus is an essential element in the management of chronic low back pain.展开更多
This study examined neglected hip fracture-dislocations in developing countries, focusing on five cases in Dakar. The research adopted a prospective method, assessing epidemiological, clinical, radiological, and thera...This study examined neglected hip fracture-dislocations in developing countries, focusing on five cases in Dakar. The research adopted a prospective method, assessing epidemiological, clinical, radiological, and therapeutic aspects, utilizing the Postel Merle d’Aubigné scoring system for functional assessment. Results demonstrated that total joint replacement surgery, predominantly following traffic accidents, significantly improved mobility and reduced limb length disparity, with most patients achieving independent walking post-operation. The study concludes that early diagnosis and total hip arthroplasty are critical for optimal outcomes.展开更多
Introduction: The progressive osseous lengthening on a single site corticotomy such as described by Ilizarov is a reliable but difficult method in the treatment of limb length discrepancies. The objective of this stud...Introduction: The progressive osseous lengthening on a single site corticotomy such as described by Ilizarov is a reliable but difficult method in the treatment of limb length discrepancies. The objective of this study was to appreciate the results of the recent application of this method in a low-income country such as Senegal. Material and Method: It was a retrospective study on 32 patients among whom 19 were men (people) and 13 were women over one continuous period of 7 years. The mean age was of 19 years with extremes of 10 and 36 years. Etiologies were dominated by osteoarthritis of the hip in 77.8%, traumatic sequela in 16.7% and the aseptic osteonecrosis of femoral head in 5.6%. The average duration of treatment was of 232 days with extremes of 110 and 363 days. Results: On the anatomical plan, the average lengthening was 55.89 mm that is 12.03% of the initial length with extremes of 35 and 110 mm. The equalization, in terms of length of the members, was obtained in 33.3% of the cases. The average index of cure was of 56.29 days, six patients, which are 18.75% of the cases, complained about pain at the end of treatment and walking without crutches was possible in 83.33%. The complications, in the phase of lengthening, were either mechanics, with 5 subluxations (3 at the level of the hip and 2 at the level of the knee), or biological with 7 infections (superficial 5 and 2 deep), 2 premature consolidations and 1 bleeding. The complications in the consolidation phase were also mechanical with 32 articular stiffness, 8 plastic deformations, 7 subluxations, a fracture and a collapse of the regenerate, or biological with 8 infections among which an osteitis and bleeding. Conclusion: Despite a strong rate of complications and sometimes not reached objectives, the results of this first series of lengthening are encouraging and rich in education and do not seem to be a limiting factor for the implementation of the method in developing countries.展开更多
Radial nerve injuries in displaced extension-type supracondylar humeral fractures in children are well known. Entrapment in fracture of radial nerve is uncommon and rarely evocated in literature. We report two similar...Radial nerve injuries in displaced extension-type supracondylar humeral fractures in children are well known. Entrapment in fracture of radial nerve is uncommon and rarely evocated in literature. We report two similar cases in the mechanism of injury, the clinical findings and the treatment and propose therapeutic guidelines.展开更多
文摘Purpose: The multifidus muscle is an important extensor muscle of the lumbar spine. It plays a major role in the stability and realization of axial rotation movements of the thoraco-lumbar spine. Its atrophy by fatty degeneration would be at the origin of the occurrence of chronic low back pain which constitutes a public health problem in Senegal. Taking into account its anatomy is essential for the etiopathogenic analysis and the treatment of low back pain. The purpose of our work was to investigate the impact of multifidus muscle morphometry on the anatomy-clinical evolution of low back pain. Material and method: this was a prospective study over a period of 30 months from November 2019 to May 2022. It involved 100 patients seen in the neurology department of Fann Hospital for chronic low back pain and who had already had a scanner falling within the criteria for low back pain. We used 3D Slicer, SPSS 20, Excel 2016 software to model and analyze the morphometric data of the multifidus muscle after physiotherapy and control lumbar scans. Results: The sex ratio was 2.23. The average age of the patients was 45 ± 7 years. On the initial CT scan, according to the Hadar classification, we noted a predominance of grade 2 with 56% in L5/S1, followed by grade 1 with 32% and grade 3 with 14%. In L4/L5, the majority of patients, 67%, had grade 1. A conflicting circumferential disc bulge with the roots predominating in L5/S1 was present in 94% of men (p-value = 0.02). Before physiotherapy, the average volume of the multifidus was 193 mm<sup>3</sup> ± 39, after physiotherapy it was 203 mm<sup>3</sup> ± 42 with a progression rate of 5.2%. Clinically, severe type pain had regressed from 86% before physiotherapy to 0% after physiotherapy (p-value = 0.03). Conclusion: Taking into account the morphometry of the multifidus is an essential element in the management of chronic low back pain.
文摘This study examined neglected hip fracture-dislocations in developing countries, focusing on five cases in Dakar. The research adopted a prospective method, assessing epidemiological, clinical, radiological, and therapeutic aspects, utilizing the Postel Merle d’Aubigné scoring system for functional assessment. Results demonstrated that total joint replacement surgery, predominantly following traffic accidents, significantly improved mobility and reduced limb length disparity, with most patients achieving independent walking post-operation. The study concludes that early diagnosis and total hip arthroplasty are critical for optimal outcomes.
文摘Introduction: The progressive osseous lengthening on a single site corticotomy such as described by Ilizarov is a reliable but difficult method in the treatment of limb length discrepancies. The objective of this study was to appreciate the results of the recent application of this method in a low-income country such as Senegal. Material and Method: It was a retrospective study on 32 patients among whom 19 were men (people) and 13 were women over one continuous period of 7 years. The mean age was of 19 years with extremes of 10 and 36 years. Etiologies were dominated by osteoarthritis of the hip in 77.8%, traumatic sequela in 16.7% and the aseptic osteonecrosis of femoral head in 5.6%. The average duration of treatment was of 232 days with extremes of 110 and 363 days. Results: On the anatomical plan, the average lengthening was 55.89 mm that is 12.03% of the initial length with extremes of 35 and 110 mm. The equalization, in terms of length of the members, was obtained in 33.3% of the cases. The average index of cure was of 56.29 days, six patients, which are 18.75% of the cases, complained about pain at the end of treatment and walking without crutches was possible in 83.33%. The complications, in the phase of lengthening, were either mechanics, with 5 subluxations (3 at the level of the hip and 2 at the level of the knee), or biological with 7 infections (superficial 5 and 2 deep), 2 premature consolidations and 1 bleeding. The complications in the consolidation phase were also mechanical with 32 articular stiffness, 8 plastic deformations, 7 subluxations, a fracture and a collapse of the regenerate, or biological with 8 infections among which an osteitis and bleeding. Conclusion: Despite a strong rate of complications and sometimes not reached objectives, the results of this first series of lengthening are encouraging and rich in education and do not seem to be a limiting factor for the implementation of the method in developing countries.
文摘Radial nerve injuries in displaced extension-type supracondylar humeral fractures in children are well known. Entrapment in fracture of radial nerve is uncommon and rarely evocated in literature. We report two similar cases in the mechanism of injury, the clinical findings and the treatment and propose therapeutic guidelines.
