创伤与治疗杂志

A Four Year Study of Complex Fractures around the Knee in Laquintinie Hospital of Douala

Abstract

Arabo Saidou Mohamadou, Atemkeng Tsatedem Faustin*, Tsiagadigui Jean Gustave, Ndando Polle Richard and Bayiha Alphonse

Introduction: Complex fractures around the knee are really challenging. They are caused by a direct high-energy mechanism and can be either opened or closed. The main objective of this work was to do a preliminary study of these injuries in our setting.

Materials and Methods: This was a prospective and descriptive study carried out from January 2010 to December 2013, in the orthopaedics and traumatology service of the Laquintinie hospital in Douala. Were included, all patients with around knee fractures, classified 33-A3, 33-C, 41-A3 or 41-C according to the Swiss orthopaedic association (OA) classification.

Results: We had 18 male patients. No female. All were victims of road traffic accidents involving at least one motorbike. The average time of occurrence of the accident was 11 pm. Seventeen lesions were opened with a predominance of the types 1 and 2 of Gustillo and Anderson’s classification. AO Type 33-C3 (5 cases) were more frequent on the femur, while AO type 41-A3 (4 cases) dominate the tibia fractures. Seven patients presented floating knees (above and below knee fractures). The most common associated injurie was the patella fracture (2 cases). Twelve patients including 6 floating knees were treated surgically. Condylar blade plate (7 cases) was the most used at the distal femur whereas in the proximal tibia it was the OA plate (6 cases); four cases were treated conservatively and two fractures were complicated by complex vascular injury imposing amputation at the thigh level.

Discussion: Our study showed that these lesions were not rare; they represented around 2.5% of serious injuries observed during highway accidents caused by the two-wheeled vehicles in our milieu. We had complex lesions in terms of anatomoclinical, therapeutic and functional aspects.

Conclusion: Complex fractures around the knee are becoming frequent in our milieu. They are caused by motorbikes and are difficult to treat.