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Paediatric fractures in a sub-saharan tertiary care center: a cohort analysis of demographic characteristics, clinical presentation, therapeutic patterns and outcomes.

Abstract Paediatric fractures are often of good prognosis due to auto-correction of insufficient fracture reduction by bone remodeling. In sub-Saharan Africa, traditional healers are renowned for managing fractures and there is a neglect for specialized pediatric fracture care. We aimed to determine the demographic characteristics, clinical presentation, treatment patterns and outcomes of paediatric fractures in a tertiary health care centre in Yaoundé.
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Authors

Mayor MeshTerms
Keywords

Paediatric fractures

clinical presentation

manipulation under anaesthesia

Journal Title the pan african medical journal
Publication Year Start




PMID- 28819468
OWN - NLM
STAT- In-Process
DA  - 20170818
LR  - 20170821
IS  - 1937-8688 (Electronic)
VI  - 27
DP  - 2017
TI  - Paediatric fractures in a sub-saharan tertiary care center: a cohort analysis of 
      demographic characteristics, clinical presentation, therapeutic patterns and
      outcomes.
PG  - 46
LID - 10.11604/pamj.2017.27.46.11485 [doi]
AB  - INTRODUCTION: Paediatric fractures are often of good prognosis due to
      auto-correction of insufficient fracture reduction by bone remodeling. In
      sub-Saharan Africa, traditional healers are renowned for managing fractures and
      there is a neglect for specialized pediatric fracture care. We aimed to determine
      the demographic characteristics, clinical presentation, treatment patterns and
      outcomes of paediatric fractures in a tertiary health care centre in Yaounde.
      METHODS: We conducted a prospective cohort study of all consenting consecutive
      cases of fractures in patients younger than 16 years managed between January 2011
      and June 2015 at the University Teaching Hospital, Cameroon. We analysed
      demographic data, injury characteristics, fracture patterns, treatment details,
      therapeutic challenges and outcome of treatment at 12 months of follow-up.
      RESULTS: We enrolled 147 fractures from 145 children with a mean age of 7 years
      and male-to-female sex ratio of 2.5:1. The main mechanisms of injury were games
      (53%) and accidental falls (20.7%). Forearm fractures were the most common
      fractures (38%). The mainstay of management was non-operative in 130 (88.5%)
      fractures, with 29.3% manipulations under anesthesia and 17 (11.5%) open
      reductions with internal fixation. The most surgically reduced fractures were
      supracondylar humeral fractures. Major difficulties were long therapeutic delay, 
      lack of diligent anaesthesia and the lack of fluoroscopy. The outcome of
      treatment was favorable in 146 (99.3%) paediatric fractures. CONCLUSION: With the
      growing population of sub-Saharan Africa and the objective of becoming an
      emergent region, public policies should match the technical realities.
FAU - Guifo, Marc Leroy
AU  - Guifo ML
AD  - Department of Surgery, University Teaching Hospital of Yaounde, Yaounde,
      Cameroon.
AD  - Department of Surgery and specialties, Faculty of Medicine and Biomedical
      Sciences, University of Yaounde, Yaounde, Cameroon.
FAU - Tochie, Joel Noutakdie
AU  - Tochie JN
AD  - Department of Surgery and specialties, Faculty of Medicine and Biomedical
      Sciences, University of Yaounde, Yaounde, Cameroon.
FAU - Oumarou, Blondel Nana
AU  - Oumarou BN
AD  - Department of Surgery and specialties, Faculty of Medicine and Biomedical
      Sciences, University of Yaounde, Yaounde, Cameroon.
AD  - National Social Insurance Fund Health Center of Yaounde, Yaounde, Cameroon.
FAU - Tapouh, Jean Roger Moulion
AU  - Tapouh JRM
AD  - Department of Surgery and specialties, Faculty of Medicine and Biomedical
      Sciences, University of Yaounde, Yaounde, Cameroon.
AD  - Department of Radiology and Medical Imaging, University Teaching Hospital of
      Yaounde, Yaounde, Cameroon.
FAU - Bang, Aristide Guy
AU  - Bang AG
AD  - Department of Surgery and specialties, Faculty of Medicine and Biomedical
      Sciences, University of Yaounde, Yaounde, Cameroon.
FAU - Ndoumbe, Aurelien
AU  - Ndoumbe A
AD  - Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala,
      Cameroon.
FAU - Jemea, Bonaventure
AU  - Jemea B
AD  - Department of Surgery, University Teaching Hospital of Yaounde, Yaounde,
      Cameroon.
AD  - Department of Surgery and specialties, Faculty of Medicine and Biomedical
      Sciences, University of Yaounde, Yaounde, Cameroon.
FAU - Sosso, Maurice Aurelien
AU  - Sosso MA
AD  - Department of Surgery and specialties, Faculty of Medicine and Biomedical
      Sciences, University of Yaounde, Yaounde, Cameroon.
LA  - eng
PT  - Journal Article
DEP - 20170518
PL  - Uganda
TA  - Pan Afr Med J
JT  - The Pan African medical journal
JID - 101517926
PMC - PMC5554657
OTO - NOTNLM
OT  - Paediatric fractures
OT  - clinical presentation
OT  - manipulation under anaesthesia
EDAT- 2017/08/19 06:00
MHDA- 2017/08/19 06:00
CRDT- 2017/08/19 06:00
PHST- 2016/12/24 [received]
PHST- 2017/04/27 [accepted]
AID - 10.11604/pamj.2017.27.46.11485 [doi]
AID - PAMJ-27-46 [pii]
PST - epublish
SO  - Pan Afr Med J. 2017 May 18;27:46. doi: 10.11604/pamj.2017.27.46.11485.
      eCollection 2017.