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RÉSUMÉ
Introduction. La fracture diaphysaire du fémur (FDF) occupe le 2ème rang dans l’épidémiologie locale des fractures, derrière les fractures de jambe. Le but de notre étude était d’étudier les aspects épidémiologiques, cliniques et thérapeutiques des fractures diaphysaires du fémur à Yaoundé. Méthodologie. Il s’agissait d’une étude de cohorte rétrospective multicentrique menée sur la période de janvier 2015 à décembre 2020 à l’Hôpital Général, l’Hôpital Central, Le Centre des Urgences, Hôpital Militaire et Centre Hospitalier Universitaire de Yaoundé et portant sur tous les patients âgés de 18 ans ou plus, opérés pour une FDF. Résultats. Nous avons enregistré 308 patients avec un âge moyen de 34,6 ± 13,6 ans pour un sex ratio de 2,58. La FDF était ouverte dans 16,6% cas. La fracture était de type A dans 67,5% cas. L’intervention s’est déroulée à foyer ouvert dans tous les cas. Les techniques de fixation fréquemment utilisées étaient l’enclouage centromédullaire (69,5%) cas, la plaque vissée (19,2%) cas et le fixateur externe (11,3%) cas. Le pourcentage de patients ayant évolué jusqu’à consolidation normale sans complication était de 71.4%. Le recul moyen était de 34,7±19,9 mois. Le délai moyen de consolidation était de 5,48 ±2,56 mois. Les patients avaient retrouvé une marche parfaitement normale, sans boiterie dans 53,4% des cas. Les infections du site opératoire et les faillites de l’implant/démontage du construit (23,7%), étaient significativement plus fréquents en cas de plaque vissée (0,034). Conclusion. L'enclouage centromédullaire est la technique de fixation la plus fréquemment utilisée pour le traitement des FDF avec un faible taux de complications post-opératoires.
ABSTRACT
Introduction. The diaphyseal femur fracture (DFF) ranks second in local fracture frequency, behind leg fractures. The aim of our study was to describe the epidemiological, clinical, and therapeutic aspects of diaphyseal femur fractures in Yaoundé. Methodology. This was a multicenter retrospective cohort study conducted from January 2015 to December 2020 at the General Hospital, Central Hospital, Emergency Center, Military Hospital, and University Hospital of Yaoundé, involving all patients aged 18 years and older who underwent surgery for a DFF. Results. We recorded 308 patients with a mean age of 34.6 ± 13.6 years and a sex ratio of 2.58. The DFF was open in 16.6% of cases. The fracture was type A in 67.5% of cases. The intervention was done via open reduction in all cases. The most frequently used fixation techniques were intramedullary nailing (69.5% of cases), plate and screws (19.2% of cases), and external fixator (11.3% of cases). 71.4% of patients achieved normal consolidation without complications. The average follow-up was 34.7 ± 19.9 months. The average time to consolidation was 5.48 ± 2.56 months. Patients regained perfectly normal gait without limping in 53.4% of cases. Surgical site infections and implant failures/removal of the construct (23.7%) were significantly more common with plate and screws (0.034). Conclusion. Intramedullary nailing is the most frequently used fixation technique for DFF treatment, with a low rate of postoperative complications.

Keywords

femoral shaft fracture complications Yaoundé Fracture diaphysaire fémur foyer ouvert complications Yaoundé

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Fonkoué Loïc, Muluem Kennedy, Lamane Axel, Ngongang Olivier, Tambekou Ulrich, Mohamadou Guiemse, Mebouinz Ferdinand, Ngo Yamben MA, Savom Eric Patrick, Mbaga Claude, Kaldakak, Guifo Leroy, & Handy Daniel. (2024). Epidemiological, Clinical, and Therapeutic Aspects of Femoral Diaphyseal Fractures in Yaoundé. HEALTH SCIENCES AND DISEASE, 25(4). https://doi.org/10.5281/hsd.v25i4.5537
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