The Use of Negative Pressure Therapy for the Treatment of Gunshot Wounds in a limited resource setting in Eastern part of the Democratic Republic of Congo: case series.Paul Munguakonkwa Budema 1,2, Jean de Dieu Tumusifu Manegabe 1,2, Gauthier Murhula Bahizire 1,2, Fabrice Cikomola Gulimwentuga 1,2, Georges Kuyigwa Toha 1,2, Olivier Mukuku 3, Zacharie Kibendelwa Tsongo 4, Theophile Barhwamire Kabesha 5, Stanislas Okitotsho Wembonyama 6.Department of Surgery, Provincial General Reference Hospital of Bukavu, Bukavu, Democratic Republic of Congo.Faculty of Medicine, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo.Institut Supérieur de Techniques Médicales de Lubumbashi, Lubumbashi, Democratic Republic of Congo.Faculty of Medecine, Université de Kisangani, Kisangani, Democratic Republic of Congo.Faculty of Medecine, Université Officielle de Bukavu, Bukavu, Democratic Republic of Congo.Faculty of Medecine, Université de Lubumbashi, Lubumbashi, Democratic Republic of Congo.Mails addressPaul Munguakonkwa Budema :paulbdma@yahoo.frJean de Dieu Tumusifu Manegabe :tumusifujeandedieu7@gmail.comGauthier Murhula Bahizire:b ahiziregauthierm@gmail.comFabrice Cikomola Gulimwentuga:cikomolafab@gmail.comGeorges Kuyigwa Toha:kuyigwa2002@yahoo.frOlivier Mukuku:oliviermukuku@yahoo.frZacharie Kibendelwa Tsongo:tsongo.kibendelwa@unikis.ac.cdTheophile Barhwamire Kabesha:thkabesha@gmail.comStanislas Okitotsho Wembonyama :wembostanislas@yahoo.fr

Introduction The elbow is a complex joint consisting of ulnohumeral, proximal radioulnar, and radiocapitellar articulation. The elbow joint is the second most commonly dislocated joint in adults after dislocation of the shoulder. The annual incidence of simple and complex elbow dislocations is 6.1 per 100,000 (1) and they are classified as pure or complex as they are associated with fracture.Diverse mechanisms are reported as causes of elbow dislocation such as hyperextension, direct impact, axial varus-supination-compression, and axial valgus-supination-Compression. (2). Radial head fractures are the most frequent ones in the elbow (3). They are caused by axial mechanisms with the upper limb in extension and the forearm in pronation (posture in which pressure is more strongly transmitted through the radius). In divergent dislocations, the proximal radius and ulna are wedged apart by the humerus.The severity of radial head fractures is the presence of associated injuries. Most common injuries associated with radial head fractures into 5 patterns: a)fracture of the radial head and rupture of the interosseous ligament of the forearm (Essex-Lopresti) (4); b) Fracture of the radial head and rupture of the medial collateral ligament (MCL) or capitellar fracture; c) Fracture of the radial head and posterior dislocation of the elbow; d) Terrible triad injuries (posterior dislocation of the elbow with fractures of the radial head and coronoid process); and e) posterior olecranon fracture dislocations (posterior Monteggia pattern injuries) (5).Mason’s classification divides radial head fractures into: type I: non-displaced or <2mm-displaced fractures; type II: displaced fractures; type III: comminute fractures; and type IV: fractures associated with dislocation (6).We present a patient who suffered an elbow dislocation associated with fracture of the radial head

CASE REPORT

Lumbosacral agenesis is a rare and complex malformation characterized by a total or partial absence of the lumbosacral vertebrae. It is often associated with other malformations. Its etiology is poorly understood but factors such as gestational diabetes, genetic abnormalities and environmental factors are incriminated.

Bladder exstrophy is a rare and complex malformation. Often associated with diverse deformations, an accurate diagnosis is a must for adequate management. In the African setting, especially in a remote area, delivery rarely occurs within a healthcare structure thus reducing the chance of an early diagnosis.