Introduction: Soft tissue tumors of the musculoskeletal system are uncommon. They include a large heterogeneous group of extraskeletal mesenchymal neoplasm lesions. The aim of this work was to establish their epidemiological and clinical profile in Cotonou

Methodology: This is a retrospective study of all the patients admitted to the traumatology-orthopedics department of Benin reference hospital. For tumors of the soft tissues of the musculoskeletal system over a period of thirteen years (2009-2021). Only complete files were considered.

Results: 55 patients were selected. The average age was 39.7 years. The predominance was slightly male with a sex ratio of 1.2. Reasons for consultation, included swelling (52cases), pain (18cases), aesthetic (8cases) or functional discomfort (3cases). Ulcerations were noted in 8 cases. The tumors were less than 5 cm in 40 cases and greater than 5 cm in 15cases. Tumors were more common in the head (8cases), wrist (8cases), foot (7cases), hand (6cases) or knee (6cases). The radiological assessment included standard radiography (36cases), ultrasound (14cases), computed tomography (4cases) and MRI (2cases). There were 51 cases of benign tumors and 04cases of malignant tumors. Benign tumors were dominated by lipomas (24cases) and cysts (15cases). As malignant tumors, we found, a liposarcoma, a rhabdomyosarcoma, a melanoma, a squamous cell carcinoma.

Conclusion: Tumors of the soft tissues of the musculoskeletal system are infrequent in Cotonou. They present a varied epidemiological profile and clinical aspects. The low MRI completion rate in imaging evaluation remains a real challenge in our working conditions. Ulcerated tumors are potentially malignant tumors.

Background: Bipolar sealer technology provides a continuous saline flow effectively maintaining tissue temperatures below 100°C and theoretically leading to decreased charring of soft tissue. We investigate whether this results in less pain and reduced narcotic consumption in patients following Total Knee Arthroplasty (TKA).

Methods: A retrospective review of prospectively collected data of 100 primary unilateral TKAs were divided into two historical cohorts. Each Cohort consisted of 50 consecutive patients before and after switching from a monopolar Bovie to the bipolar sealer. All other perioperative variables such as multimodal protocols, no use of tourniquet, surgical technique or perioperative mobilization were identical. All patients were discharged the next day 24 hours within surgery. Pain measurements using a Visual Analog Scale (VAS) and narcotic consumption were retracted from the longitudinal medical records and analyzed for the day of surgery, day of discharge and in total.

Results: Bipolar sealer patients reported significantly lower pain scores and narcotic usage. Day of surgery pain levels were comparatively reduced from a VAS of 4.1 to 2.7 (p < .05) and day of discharge pain levels were reduced from 4.5 to 3.1 (p < .0001), reductions of 33% and 31% respectively. Total ME administered was reduced from 35.9 mg to 26.2mg (p < .05). The preclinical characteristics of each patient cohort were not associated with the pain outcomes nor ME consumption.

Conclusion: Our preliminary trial revealed a significant reduction in pain levels and narcotic consumption in patients following unilateral TKAs with bipolar sealing technology compared to the use of the standard Bovie. This study suggests that this technology may decrease pain and narcotic consumption in patients using the exact same perioperative management. The future will show whether the increased cost of this technology will lead to a more widespread use.

Summary: Introduction. Bimalleolar fractures are fractures that combine a fracture of the external malleolus and a fracture of the internal malleolus. They are very common. It is an entity that occurs in a context of high energy secondary to a road accident. Our study aims to determine the epidemiological, lesional, therapeutic and evolutionary aspects of bimalleolar fractures at the National Hospital of Niamey.

Patients and methods: This was a retrospective study of patients with a bimalleolar fracture treated in the orthopedic surgery and traumatology department of the National Hospital of Niamey from January 1, 2010 to December 31, 2015. Recruitment concerned patients of both sexes aged 18 years or older. From their files we collected epidemiological data and those relating to etiologies, clinical presentation, type of treatment as well as complications observed during their follow-ups. The data are entered on Word 2013 and Microsoft office Excel 2013 software.

Results : 251 cases of bimalleolar fractures had met our inclusion criteria. The average age of our patients was 48.5 years. The sex ratio (M/F) is 3.92. The bimalleolar fracture had affected more young active people with 35.06% of cases. The consultation was early in the majority of cases, i.e. 71.31% of cases. The circumstances of the trauma were predominated by the AVP, i.e. 75.30%. The indirect mechanism predominated with 186 patients, i.e. 74.10% of cases. The right sides were affected in 114 cases, or 57% in men, and 2 bilateral cases, or 1%, compared to 26 cases on the right side, 25 cases on the left side, and 0 cases on the bilateral side. Pain and functional impotence were found in all our patients, or 100% of cases. Weber C supraligamentary fractures are the most common in many of our patients with a percentage of 44% of cases, skin opening was found in 115 cases of our patients, or 45.82%, and stage III of the Gustillo classification was the most represented. 67 patients were treated orthopedically, or 26.69%, compared to 184 patients treated surgically, or 73.31% of cases. 28.29% of our patients had complications. Conclusion

Keywords: Bimalleolar Fracture; Epidemiology; Lesions; Treatment; Niamey-Niger.