Comparative Study of Epidemiology, Clinical Presentation and Management of Leg Fracture Due to Road Traffic Accidents in Hospitals of Cameroon and France
DOI :
https://doi.org/10.5281/hra.v2i1.5110Mots-clés :
Fracture, jambe, AVP, Cameroun, FranceRésumé
RÉSUMÉ
Introduction. La fracture de jambe est une lésion fréquente, souvent due aux accidents de la voie publiques (AVP), mais dont les caractéristiques varient selon la situation géographique de survenue. L’objectif de ce travail est de comparer les caractéristiques épidémiologiques, cliniques et thérapeutiques des fractures des os de la jambe associée aux AVP dans des hôpitaux du Cameroun et de France. Méthodologie. Il s’agit d’une étude multicentrique transversale rétrospective à visée prospective. Elle a eu lieu dans quatre structures hospitalières dont l’hôpital Général de Douala, l’hôpital Laquintinie de Douala au Cameroun et l’hôpital de Meaux, l’hôpital de Marne la vallée en France. Nous avons inclus tous les patients âgés de 18 ans et plus, victimes d’AVP avec fractures des os de la jambe et un dossier complet. Résultats. Sur une période de deux ans, nous avons recruté 220 cas dont 164 au Cameroun et 56 en France. L’âge moyen des sujets était de 37,3±13,3 ans au Cameroun et 45,1 ± 18,8 ans en France. Les patients étaient de sexe masculin dans 77,4% des cas au Cameroun et dans 69,6% en France. Les mototaxis étaient la principale activité au Cameroun (25,6%) et en France, il s’agissait des ouvriers (30,4%). Au Cameroun, on notait un retard à l’admission (70,9%) et à la prise en charge (79,2%). Toujours au Cameroun, la prise en charge sur le lieu de l’accident était absente et le transport était non médicalisé. Les fractures ouvertes étaient significativement plus fréquentes au Cameroun (61%) par rapport à la France (12.5%). Le traitement chirurgical était le moyen thérapeutique le plus employé dans les deux pays, mais alors que le fixateur externe était la modalité principale au Cameroun (44,6%), c’est la plaque vissée qui était la principale en France (49,1%). Au Cameroun, 33,5% des patients ont eu des complications contre 10,7% en France. Conclusion. La fracture de jambe pose des problèmes plus sérieux au Cameroun qu’en France. En effet, au Cameroun, il y a absence de prise en charge préhospitalière, les fractures sont plus souvent ouvertes et les complications sont trois plus fréquentes.
ABSTRACT
Introduction. The leg fracture is a common injury, often due to road traffic accidents (RTA), but whose characteristics vary according to the geographical situation of occurrence. The objective of this work is to compare the epidemiological, clinical and therapeutic characteristics of PVA-associated leg bone fractures in hospitals in Cameroon and France. Methodology. This is a retrospective cross-sectional multicentre prospective study. It took place in four hospital structures including the General Hospital of Douala, the Laquintinie Hospital of Douala in Cameroon and the Meaux Hospital, the Marne la Vallée Hospital in France. We included all patients aged 18 years and older with AVP with broken leg bones and a complete record. Results. Over a two-year period, we recruited 220 cases, 164 in Cameroon and 56 in France. The average age of subjects was 37.3 years in Cameroon and 45.1 years in France. The patients were male in 77.4% of cases in Cameroon and in 69.6% in France. Mototaxis were the main activity in Cameroon (25.6%) while in France, it was workers (30.4%). In Cameroon, there was a delay in admission (70.9%) and treatment (79.2%). Also in Cameroon, coverage at the accident site was absent and transportation was not medicalized. Open fractures were significantly more frequent in Cameroon (61%) compared to France (12.5%). Surgical treatment was the most common treatment modality in both countries, but while the external fixative was the main modality in Cameroon (44.6%), it was the screwed plate that was the main in France (49.1%). In Cameroon, 33.5% of patients had complications compared to 10.7% in France. Conclusion. Leg fracture raises more serious issues in Cameroon than in France. Indeed, in Cameroon, there is no pre-hospital management, fractures are more often open and complications are three times more common.
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