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Abstract

RÉSUMÉ
Introduction. La drépanocytose est l'une des hémoglobinopathies les plus fréquentes en Afrique subsaharienne et s'accompagne souvent de complications ostéoarticulaires, en particulier infectieuses, qui augmentent la morbidité et le handicap fonctionnel. Au Gabon, où la prévalence du trait drépanocytaire est élevée, ces complications restent mal décrites en milieu chirurgical. L'objectif de ce travail était de décrire les caractéristiques épidémiologiques, cliniques, microbiologiques et thérapeutiques des manifestations ostéoarticulaires chez les patients drépanocytaires hospitalisés en chirurgie. Méthodologie. Nous avons mené une étude rétrospective descriptive multicentrique dans trois services de chirurgie et d'orthopédie du Gabon, du 1er mai 2023 au 1er mai 2025. Nous avons inclus tous les patients drépanocytaires homozygotes SS hospitalisés pour une complication ostéoarticulaire avec dossier complet. Résultats. Vingt-quatre dossiers ont été retenus, dont 15 patients de sexe masculin (sex-ratio 1,5). L'âge moyen était de 12 ans (4–25 ans) et 12 patients étaient régulièrement suivis en pédiatrie. Les complications étaient dominées par les infections ostéoarticulaires (20/24, 83 %), principalement les ostéomyélites chroniques (11 cas, soit 46 %), les ostéomyélites aiguës (3 cas) et les arthrites septiques (genou, hanche, épaule). Les localisations les plus fréquentes étaient le fémur distal, le tibia proximal et l'humérus proximal. Une ostéonécrose de la tête fémorale a été observée chez 2 patients (8 %). Un prélèvement bactériologique était positif chez 12 patients, avec prédominance de Staphylococcus aureus. Douze patients ont bénéficié d'un traitement médico-chirurgical (curetage, séquestrectomie) associé à une antibiothérapie ciblée, avec évolution globalement favorable. Conclusion. Dans notre contexte, les complications ostéoarticulaires de la drépanocytose prises en charge en chirurgie sont largement dominées par les infections osseuses. Un diagnostic précoce et une prise en charge médico-chirurgicale adaptée semblent permettre de limiter les séquelles fonctionnelles.
ABSTRACT
Introduction. Sickle cell disease is one of the most common genetic hemoglobinopathies in sub-Saharan Africa and is frequently associated with osteoarticular complications, particularly infectious ones, which increase morbidity and functional disability. Methodology. In Gabon, where the prevalence of the sickle cell trait is high, these complications remain poorly described in surgical settings; therefore, this multicenter retrospective descriptive study was conducted in three surgical and orthopedic departments from May 1, 2023, to May 1, 2025, including all homozygous SS patients hospitalized for osteoarticular complications with complete records. Results. Twenty-four cases were reviewed, involving 15 male patients (sex ratio 1.5) with a mean age of 12 years (range 4–25 years), half of whom received regular pediatric follow-up. Complications were dominated by osteoarticular infections (20/24, 83%), primarily chronic osteomyelitis (11 cases, 46%), acute osteomyelitis (3 cases), and septic arthritis of the knee, hip, and shoulder, with the most frequent locations being the distal femur, proximal tibia, and proximal humerus. Additionally, femoral head osteonecrosis was observed in 2 patients (8%), and bacteriological cultures were positive in 12 cases—predominantly Staphylococcus aureus—leading to combined medico-surgical treatment (curettage, sequestrectomy) and targeted antibiotic therapy for 12 patients, resulting in generally favorable outcomes. Conclusion. In our context, osteoarticular complications of sickle cell disease managed surgically are largely dominated by bone infections, suggesting that early diagnosis and adapted medico-surgical management can help limit functional sequelae.

Keywords

Drépanocytose, Infections Osseuses, Osteonecrose Drépanocytose, Infections Osseuses, Osteonecrose

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Abiome R, Mikiela A, Nkole M, Mba Mba C, Djembi YR, Koussou R, & Sane AD. (2026). Osteoarticular Complications in Sickle Cell Patients in Surgical Settings in Gabon: A Multicentre Retrospective Study : Complications Ostéoarticulaires chez le Drépanocytaire en Milieu Chirurgical au Gabon : Une Étude Rétrospective Multicentrique . HEALTH SCIENCES AND DISEASE, 27(4), 158–162. https://doi.org/10.5281/zenodo.19219731
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