Azhar Salim Mohamed

Traumatic posterior sternoclavicular joint dislocation in a child: a case report

Sternoclavicular joint dislocation is a rare event. It occurs most often in a violent trauma. The authors report the case of a10 years old child, received at emergencies for right shoulder blunt trauma after been punched by another child. He presented with right shoulder pain, right upper limb functional impairment and right sternoclavicular joint depression. Standard chest radiographs were normal. Chest CT scan showed posterior dislocation and allowed us to determine its variety. Twelve hours after the trauma, a closed reduction has been done under general anesthesia. A control CT scan showed a restoration of normal joint anatomy. After 18 months, the shoulder was painless and mobile in all directions. It is an isolated recent posterior sternoclavicular joint dislocation in a child. With this observation the authors emphasizeon the unusual mechanism of such a dislocation occurrence, the primary role of CT scan in the diagnosis and early closed reduction.

Caractéristiques des accidents du travail et devenir des victimes: à propos de 133 cas déclarés auprès de la Caisse de Sécurité Sociale de Dakar (Sénégal)

Introduction Les accidents du travail (AT) ont des répercussions sur le système de sécurité social du pays, sur les victimes elles-mêmes ainsi que leurs proches. L’objectif de notre étude est de décrire les différentes caractéristiques des AT déclarés auprès de la Caisse de Sécurité Sociale (CSS) de Dakar et le devenir socio-professionnel des victimes. Méthodes Etude rétrospective et transversale sur une période de 5 ans, de 2002 à 2006. Ont été colligés 133 cas sur 9.308 AT déclarés à la CSS. Divers paramètres ont été étudiés: caractéristiques socio-professionnelles des victimes et aspects lésionnels des accidents. Les victimes ont été interrogées pour recueillir leur vécu socio-professionnel, la situation professionnelle. Résultats L’âge moyen des sujets était de 37,55 ans avec une prédominance masculine (99,22%). Les secteurs du BTP (22,6%) et de la pêche (15%) étaient les plus touchés. Près des deux tiers des accidents survenaient au lieu du travail (77,4%). Ces accidents entrainaient des fractures dans 51,7% des cas et touchaient la main dans 30,1% des cas. Près de deux tiers des accidentés (60,9%) avaient repris la même profession. On notait 31 cas de licenciement et 12 cas de reclassement professionnel. La durée d’incapacité temporaire totale moyenne était de 236,7 jours. Le montant annuel moyen de la rente était de 1.640.329 Francs CFA (2 504,31 Euros). Conclusion Les AT au Sénégal ne présentent pas de grandes particularités comme décrites partout ailleurs. Les faibles ressources allouées aux victimes et l’absence de politique d’accompagnement social expliquent les différentes souffrances des victimes et leurs familles.

Les accidents de la vie courante chez l’enfant à Dakar: à propos de 201 cas

Les accidents de la vie courante (AcVC) sont fréquents chez l’enfant et peuvent être à l’origine de lésions handicapantes et de décès. L’objectif de notre travail était d’étudier les aspects épidémiologiques et lésionnels des AcVC à Dakar. C’est une étude transversale descriptive menée du 1er Janvier 2013 au 30 juin 2013. Les enfants victimes d’accidents domestiques, d’accidents de sport et de loisirs ou d’accidents scolaires ont été inclus. Nous avons étudié des paramètres généraux et des paramètres ayant trait à chaque type d’AcVC. Deux cent et un enfants ont été inclus, ce qui représentait 27% des consultations aux urgences. Il y avait 148 garçons et 53 filles. Les enfants de moins de 5 ans étaient les plus touchés (37,8%). Le football et le jeu de lutte étaient les grands pourvoyeurs d’AcVC. Les AcVC survenaient principalement à domicile (58,2%) et dans les aires de sport et de loisirs (31,8%). Les fractures prédominaient dans les différents types d’AcVC: 54,9% des accidents domestiques, 68,8% des accidents de sport et de loisirs et 40% des accidents scolaires. Au plan épidémiologique, nos résultats sont superposables à la littérature. Les fractures prédominent à l’opposé de la littérature où les contusions sont prépondérantes. Le jeu de lutte est le plus grand pourvoyeur de ces fractures après le football. La connaissance des aspects épidémiologiques et lésionnels permet de mener des campagnes de prévention des AcVC à Dakar.Accidents of everyday life (AcVC) are common in children and can led to disabling injuries and death. This study aimed to analyze the epidemiological aspects of AcVC and the related injury mechanisms in Dakar. We conducted a descriptive, cross-sectional study conducted from 1 January 2013 to 30 June 2013. All the children victims of domestic accidents, sport and leisure accidents or school accidents were included. We studied some general parameters and some parameters related to each type of AcVC. Two hundred and one children were included, accounting for 27% of emergency consultations. There were 148 boys and 53 girls. Children less than 5 years of age were most affected (37.8%). Football and wrestling game were the main causes of AcVC. AcVC occur mainly at home (58.2%) and in the areas of sport and recreation (31.8%). The fractures predominated in the different types of AcVC: 54.9% of domestic accidents, 68.8% of sport and recreation accidents and 40% of school accidents. From an epidemiological perspective, our results are superimposable to literature. Fractures predominated contrary to literature where bruises were preponderant. Wrestling game is the main cause of these fractures, after football. The acquisition of knowledge about the epidemiological aspects of AcVC and the related injury mechanisms will allow for prevention campaigns in Dakar.

Wrestling game injuries among children in Dakar: a report on 172 cases

Introduction The objective was to report epidemiological and lesional features among children practicing wrestling as a game in Dakar, Senegal. Methods It was a retrospective study including all patients under 16, victims of wrestling game injuries. We studied epidemiological and lesional aspects in children: frequency of wrestling game injuries among all games, age, sex, geographic origin, place of injury, parent’s socioeconomic status, nature of the injury and location. Results Wrestling game injuries represented 19.9% injuries in all games. Sex-ratio was 33.4. The most affected age group was the 6-10 years old age group. The majority of children are from suburban Dakar (64%). Injuries occurred most often at home and in the street. Most children are from low socioeconomic status (64%). Fractures predominated and were localized almost exclusively on the elbow. Conclusion Wrestling game injuries in Dakar occur among older children from the suburbs, living in the neighborhood of great wrestling champions’ districts of residence. Wrestling game cause injuries, consisting mostly of elbow fractures.

[Scooter accidents in children at Aristide Le Dantec, Unversity Hospital of Dakar: a study of 74 cases].

INTRODUCTION Scooter accidents are becoming more frequent in Dakar. The purpose of this study is to report the epidemiological and lesional aspects of these accidents on children in Dakar. MATERIALS AND METHODS A retrospective and descriptive study was conducted in Pediatric Surgery Unit of the Aristide Le Dantec Hospital in Dakar from January 1st, 2009 to December 31, 2011. Various parameters were studied. These parameters include: frequency, sociodemographic and lesional aspects. RESULTS Scooter accidents represent 12% of highway accidents. They were more frequent in the day, from 12 am to 2 pm (27%) and in the night, from 6 pm to 8 pm (28.4%). They might occur every day but were more frequent during April (17.6%) and June (13.5%). They occurred mainly in the suburban district of Dakar (78%). The age group most affected was the one from 3 to 8 years (60.8%). Male gender was predominant (sex ratio 1.5). Pedestrians are the most vulnerable (93.2%). The fall was the dominant mechanism (98.7%). Lesions affected mainly the lower limb (51.1%) and were essentially constituted by fracture. CONCLUSION The frequency of scooter accidents in children is related to the galloping urbanization and to the increase of the number of cars on the roads in the peninsula. Victims are essentially pedestrians and present most of the time fractures.

Umbilical hernia in children in a developing country: Does the season have an effect on the occurrence of strangulation?

To the Editor : Umbilical hernia in a child is considered benign in developed countries, as complications seldom occur. In Africa, complications related to umbilical hernia, such as strangulation, are frequent. Strangulation often occurs if the hernia has a diameter of 0.5 - 1.5 cm. The theory of a foreign body in the hernial sac was raised by Papagrigoriadis et al. in London, and Brown et al. in South Africa. However, the actual causes of strangulation are unknown.