Introduction: Lesions of the humerus are relatively frequent and pose no diagnostic problem with the help of radiography. The real controversies concern the therapeutic indications, pitting the advocates of orthopaedic treatment against those of surgical treatment. Despite the risk of complications, surgery is an effective treatment for humeral damage. The aim of this work is to study the indications, techniques and results of osteosynthesis of humerus fractures and to share the results of our experience.

Methodology: This was a descriptive cross-sectional study collected retrospectively over a period of 4 years and 6 months in the Orthopaedic Traumatology Department of the CHU Yalgado Ouedraogo (Ouagadougou - B.F). It concerned all patients aged at least 15 years who had undergone osteosynthesis of the humerus for a proven injury, whether recent or long-standing. Anatomical results were assessed on the basis of radiographs. Functional results were assessed using the modified Constant, Stewart and Hundley scores, the MEPS and the patient’s subjective assessment. Ninety-three (93) patients were selected. Results: The average age was 37.86, with a sex ratio of 2.1. Road traffic accidents were the most frequent cause of death. The indications for osteosynthesis were dominated by recent fractures in 78.49% of cases. The majority of lesions were diaphyseal, accounting for 58.06% of cases (54 patients). The average operating time was 4.5 days. General anaesthesia was used in 83 patients. The screw plate was used in 60 cases. Forty-seven patients were able to undergo rehabilitation sessions. We recorded 31 cases of complications. Consolidation was achieved in 82 patients with an average consolidation time of 3.5 months. The anatomical result in our analysis was good in 78 cases, acceptable in 11 cases and poor in 4 cases.

Conclusion: The indications for osteosynthesis are becoming increasingly frequent. In our study, osteosynthesis of the humerus demonstrated its effectiveness, with appreciable anatomical and functional results.

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.

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.

 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.

The present systematic review determined the effects of physical activity/exercise added to Denosumab, Romosozumab, Abaloparatide or Teriparatide-therapy on bone strength and fall incidence in middle-aged and older people with osteopenia/osteoporosis. A systematic literature search of five electronic databases and two registers (up to 30/05/2023) without language restrictions included studies with (a) postmenopausal women and men ≥45 years, with low bone mass that compared study arms with (b) combined interventions of physical activity/exercise and Denosumab or Romosozumab or Abaloparatide or Teriparatide versus (c) isolated pharmaceutical therapy on (d) Bone Mineral Density (BMD) and prospective fall and/or fracture events (e) applying a randomized controlled study design. Finally only one study that compared the effect of Teriparatide and whole-body vibration versus isolated Teriparatide therapy on bone strength parameters was eligible. This trial reported a significant effect of combined vs. isolated therapy for lumbar spine BMD however not for total hip-, radius- and tibia-BMD, bone microarchitecture or bone turnover biomarkers. Thus, reviewing the literature there is rather limited data on additive effects of exercise on novel pharmaceutic therapy for osteoporosis. Nethertheless, considering age, bone status and physical function of most people under corresponding therapies might already justify the recommendation of exercise programs dedicated to reduce number and impact of falls and fall impact that complement the effects of pharmacological therapy on bone strength. Due to the enormous socioeconomic importance of osteoporosis-induced low trauma fractures more studies should focus on the dissection of the impact of individualized exercise programs when combined with medical treatment.

Osteoblastoma-like osteosarcoma (OBLOS), is a rare malignant lesion with risks of both local recurrence and distant metastasis. It is considered a rare variant of osteosarcoma. The distinction between (OBLOS), and aggressive osteoblastoma is still debatable and challenging. Based on the initial clinical, radiological, and histological findings, a definitive diagnosis might only sometimes be achievable. On the other hand, the significance of a proper diagnosis must be accomplished because the approach to treatment varies greatly depending on the type of lesion. Sufficient tissue sampling is essential to provide the proper diagnosis. In clinicopathological and radiological discordance cases, a high index of suspicion and significant experience are requirements for an appropriate diagnosis. The OBLOS is categorized as a conventional (high-grade) osteosarcoma in the World Health Organization (WHO) classification system. However, several cases that have been published have been identified as low-grade malignant tumors. There are no precise morphological criteria to discriminate between low- and high-grade lesions. We describe a case of osteoblastoma-like osteosarcoma in an 11-year-old boy involving the right proximal humerus. We provide a brief review of the pertinent literature including diagnosis, differential diagnosis, debatable grading of this type of tumors, management, and prognosis.

Introduction: The purpose of our study was to describe the epidemiological and therapeutic aspects of the proximal humerus fractures and to evaluate their functional results.

Materials and methods: This was a retrospective study about all patients operated for proximal humerus fracture at the South-Essonne Dourdan-Étampes Hospital Center between January 2016 and December 2017.

Results: 58 patients were operated. Women represented 65.5% with a female / male sex ratio of 1.9. The mean age was 67.3 years (17-95 years). Fracture following a fall in 86% and 60% concern the left side. according to the Neer classification, 65.5% were 2-parts fractures, 22.4% 3-parts fractures and 12% 4 or over 4 parts. In 19% were operated after orthopedic treatment failure. The telegraph nail represents 62% of used materials. 12% of the patients had benefited a total shoulder arthroplasty. At the last follow-up of 14 months (8-22 months) consolidation was achieved in 98% of osteosynthesis. The abduction average was 145 ° (45 ° - 180 °). Mean Constant score was 79 (64 - 95). 1 case of humeral head necrosis was noted and 5 cases of shoulder stiffness in abduction.

Discussion: We believe, as many authors, that many factors seem to influence functional evolution. The type of fracture influences the therapeutic choice and is the main predictor of functional outcome, failure, complications and re-intervention.

Conclusion: There is certainly no consensus in the management of the proximal humerus fracture, but many choices are currently available for surgeons. “Every age group is served”

Bone health is one of the important parts of healthy-life and longevity. In the current scenario, due to indiscriminate uses of pesticides in agriculture, there is a high abundance of toxins and contaminants in the environment and food chain. For this consequence, the present study has investigated the effect of the Biofield Energy Healing (The Trivedi Effect®) Based test formulation on bone health parameters using the human bone osteosarcoma cells - MG-63(ATCC® CRL-1427™). A proprietary formulation was designed that consisted of eight ingredients viz. zinc chloride, ferrous sulfate, sodium selenate, nanocurcumin, copper chloride, magnesium gluconate, vitamin C (ascorbic acid), and vitamin D3 (cholecalciferol). The test formulation was divided into two parts. One part was denoted as the untreated test formulation without any Biofield Energy Treatment, while the other part was defined as the Biofield Energy Treated sample, which received the Biofield Energy Healing Treatment by renowned Biofield Energy Healer, Mahendra Kumar Trivedi. The cell viability assay data of the test formulation showed more than 70% cell viability at the concentration ranges from 0.001 to 10 µg/mL, which indicated its safe and non-cytotoxic nature. Alkaline phosphatase enzyme (ALP) was significantly increased by 80.16%, 292.91%, 200.36%, 22.24%, and 690.35% in the Biofield Energy Treated test formulation group (G4) at 0.0008, 0.001, 0.0033, 0.052, and 10.41 µg/mL, respectively as compared to the untreated test formulation group (G3). As a result of that phosphorus absorption and deposition in bone cells can be increased which can help to make stronger bone. The data demonstrated that the Biofield Treatment has the strong potential for the treatment of patients with arthritis, osteoporosis, and other bone disorders. Thus, Consciousness Energy Healing can be useful as a bone cells growth promoter for different bone-related disorders like low bone density, osteogenesis imperfecta, osteoporosis, etc.

The subacromial impingement syndrome is a collective cause of shoulder pain it takes place due to the soft tissue reside in the subacromial space. This occurs by mechanical compression of the soft issues predominantly on the supraspinatus, long head of biceps tendon, subacromial bursae and superior portion of the articular capsule between the greater tuberosity and the under surface of the anteroinferior edge of the acromion. The root cause of this condition has been contested over the last couple of decades nowadays, many studies agree that this condition is multifactorial and management includes physiotherapy, injections, and surgery in some selected patients. This article aims to provide an overview of the clinical features and pathogenesis of subacromial impingement syndrome also discuss the widely accepted non-invasive physiotherapy interventions approach for recovering the subacromial impingement syndrome effectively and efficiently based on other studies.

Aim of the Study: To find association between clinical features of systemic sclerosis and esophageal dysmotility disorder based on high resolution manometry (HRM) findings according to the 3rd version of Chicago classification.

Methods: In a cross-sectional study in Firozgar hospital we recruited 150 consecutive SSc patients. All patients fulfilled the 2013 ACR/EULAR classification for SSc criteria. We used water-perfused esophageal high resolution manometry (HRM) having 26-channel silicone-customized catheter.

Results: From all 150 SSc patients who were included in the study, forty-nine (46%) had dcSSc subset of disease with mean age (SD) 47.0 (12.1) years. According to the 3rd version of the Chicago classification, 135 (90%) patients had ineffective peristalsis [weak peristalsis in 24 (16.0%) and failed peristalsis in 111 (74.0%) of patients]. Hypotensive Esophagogastric junction pressure (hEGJP) presented in 47 (31.3%) patients. Two (1.3%) patients had achalasia in HRM. Age, gender, and duration of disease were not different in the above two groups of patients. In multivariate model FVC%, [OR (CI95%): 1.055(1.025-1.086), p<0.001] showed significant association with failed peristalsis.Comparison between average rank of FVC% in peristalsis status groups showed significant difference between average rank of FVC% in patients with failed peristalsis and weak peristalsis p=0.001, and average rank of FVC% in those with failed peristalsis and normal peristalsis p=0.020.

Conclusions: Our findings showed that esophageal dysmotility is a frequent finding in systemic sclerosis patients. The results demonstrated that FVC%, tendon friction rub kept significant concordance with failed peristalsis. Moreover, we noticed a concordance between HRM results and severity of FVC.