Management of Limb Lesions of Ballistic Trauma at Sominé DOLO Hospital of Mopti

Résumé fourni par la source

Background: Mali is a west African country which has been going through armed conflict, insecurity and socio-political instability since 2012.This multidimensional crisis has led to an avalanche of violence with health repercussions, including ballistic trauma to limps.Sominé DOLO hospital is a second reference hospital located in the center of Mali where the war wounded are referred.The objective of this work was to describe the characteristics and the management of limb lesions du to ballistic trauma. Patients and Methods:This was a prospective study from January 1 to December 31, 2019 in the surgery department.Our study focused on 170 limb-injured patients out of the 250 patients admitted to the emergency department for ballistic trauma.The study population consisted of patients of all ages presenting a ballistic injury to the limbs.Data was captured and analyzed on Epi-info 7.2.4.0.Proportions and means were calculated for qualitative and quantitative variables, respectively.Results: Out of the 250 cases of ballistic lesions, 170 cases (68%) of limb injuries were found.The average age was 41 years.The sex-ratio was 9. Isolated wounds without fracture were the most frequently lesions in the limbs, 108 cases (63.5%) followed by fractures 62 cases (36.5%).Out of the 179 cases, surgery was performed twice in 83.6%.Patients with open fractures accounted for 54 (31.8%) and had been operated on more than 3 times.We resorted to orthopedic treatment, 30 cases (48.4%) received a plaster splint, 14 (22.6%) an external fixator and in 6 cases (9.7%) limb amputation was performed.The evolution was favorable in 90.8% of cases, however some cases of complications was noted such as surgical site infection (6.3%) and 5 cases of death (2.9%).Conclusion: It appears that the majority of patients affected by ballistic trauma to the limbs were civilians with a predominance of the male sex.Lesions of the lower limbs were the most frequent.Surgical trimming and delayed closure well conducted reduced the risk of complications.

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