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OBJECTIVE: Improve the quality of life of patients with severe hand trauma. MATERIALS AND METHOD: A retrospective study was carried out from August, 1st, 2017, to May 31st, 2020, at the emergency department of a private clinic in Abidjan. Were included in this study all patients with severe hand trauma who had undergone emergency surgery with a quality-of-life assessment time of over six months after surgery. The data were reported on a structured and standardized survey form. RESULTS: We analyzed 36 patients, with average age of 38.6 years (min. 8, max. 71 years). The population study was predominantly male with a sex ratio of 17. 92% of patients were right-handed, and in 53% of cases, the trauma involved the dominant hand. 64.2% of the patients were manual workers. In 83.3% of the cases, the patients had no difficulty in writing. Patients had no difficulty in washing or drying their hair 88.9% of the time. Eighty-nine percent of the patients no longer felt pain. The patients didn't feel any weakness in the hand in 72.2% of the cases and in 63.9% of the cases there was no stiffness in the hand. Only 5.6% of the injured felt their health was poor and 83.3% of patients strongly disagree with feeling less valuable, less confident, or even less capable because of the trauma. 72% of patients were incapacitated for work between 5 and 15 weeks. 80.6% of trauma victims had no loss of income, and 88.9% of patients kept their previous jobs. 83.3% of patients did not experience any social discomfort. CONCLUSION: The patients had a good quality of life despite the severity of hand injuries they had due to early and adequate management combined with good physiotherapy.

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Evaluation of the levels of function, disability and quality of life of 23 patients with an unstable fracture of the distal radius treated with an angle-stable volar T-plate. During the period from 24/10/2004 to 01/02/2006 we carried out a prospective study including 23 patients. The fractures were 23A22 (n = 5), 23C11 (n = 4), 23C12 (n = 4) and 23C13 (n = 6). Impairment, disability and quality of life were evaluated 6 months after the injury. The evaluation of impairment included assessment of mobility of the wrist, global hand strength, key pinch strength and sensibility. There was an average loss of 0.715 for the Zscore of the grip strength and 0.531 for the Z-score of the key pinch strength. For sensibility, there was no significant difference between the fractured side and the uninjured side. The radiographs demonstrated a correction of volar tilt from -11.2 degrees to 4.9 degrees, of ulnar inclination from 14.3 degrees to 22.9 degrees, of radial shift from 19.9 mm to 16.8 mm, of radial length from 5.7 mm to 11.2 mm and of the RUI from -1.9 mm to 0.6 mm. The global DASH score was 55.7. The level of pain was 1.3 on the VAS. The mental SF-12 score was 48.4 and the physical SF-12 score 46.4. Treatment of unstable distal radius fractures with volar fixed-angle plates without additional bone graft led to good reduction of the fractures without significant secondary displacement.

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BACKGROUND: To evaluate the incidence and the risk of transmitting a virus through a bone allograft from a living donor. MATERIAL AND METHODS: A total 7032 femoral heads have been collected from 24 Belgian institutions. The tissue along with the screening blood tests were systematically sent to the bank. Serological screening included: for HIV, a HIV1-2 antibody test; for HBV, a HBS antigen and HBS and Hbcore antibodies; for HCV, a HCV antibody test. Syphilis was also screened with a non-specific and a specific assays. HTLV1-2 screening was recommended but not obligatory. RESULTS: From the 7032 femoral heads, 1066 (15.2%) implants were definitively excluded. Hundred forty-six femoral heads, representing 2.1% of all grafts and 13.9% of the excluded ones, were discarded for positive serological testing associated with a risk of disease transmission. There were 2 donors who tested positive for HTLV1-2. The prevalence of HIV in the femoral head donor population was six times lower than in the general one. The prevalence of hepatitis B and C was similar but far higher than HIV. The risk was computed to be 0.54 out of 1 × 10(5) for HIV and HCV without quarantine or tissue processing. For HBV, the risk was 0.77 out of 1 × 10(5). CONCLUSION: Current standards of tissue banking incorporated safety and quality as their main features. This policy is now regulated at the European level. With a multi-step screening-policy, stringent donor selection guidelines, the risk of viral transmission trough a tissue is minimized.

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A case of avascular necrosis of the lunate bone in a 6-year-old boy is reported. This is the youngest child reported in literature with Kienböck's disease. Clinical and radiological healing was obtained with conservative treatment. Non-operative management is recommended in children with avascular necrosis of the lunate bone.

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