First – Line Papineau Technique and Honey for Late Leg Open Fractures in Mbujimayi
DOI:
https://doi.org/10.47941/ijhmnp.3169Keywords:
Open Fracture, Leg Bone, Papineau Technique, First line, Honey, MbujimayiAbstract
Purpose: To provide evidence of the benefit of treating open fractures of moderate and complex severity using the protocol combining the Papineau technique as first-line treatment with honey, in terms of post-operative results.
Methods: This quasi-experimental study was carried out in three hospitals in Mbujimayi, Democratic Republic of Congo; from January 1, 2017 to March 30, 2025. It involved 91 patients admitted to the trauma department for open fractures of the leg bones and divided into three groups according to the therapeutic protocols used.
Results: The mean wound healing time was 46.8 ± 11.1 days for the group of patients treated with the experimental protocol combining the Papineau technique as first intention with honey, compared to the other methods (Papineau technique as first intention without honey and classical Papineau technique) whose respective wound healing times were 62.5 ± 13.1 days and 72.2 ± 9.5 days. This experimental protocol proved effective in terms of reducing the average partial weight-bearing times (9.6 ± 1.9 weeks), and obtaining sufficient bone consolidation (7.7 ± 1.0 months) as well as the average length of hospital stay of patients (5.5 ± 1.7 months). Results which are much better, compared to the other therapeutic methods under study.
Unique Contribution to Theory. Practice and Policy: The protocol combining the Papineau technique as a first-line treatment with honey has better post-operative results and significantly reduces the duration of patient inactivity after fracture of the leg bones, compared to other methods studied.
Downloads
References
Barsorti J, Robert C, Cance J. Leg Fractures: A Practical Guide to Trauma. 6th Edition. Paris: Elsevier Masson SAS, 2010.
Mohamad J, Halawi MD, Michael P, Morwood MD. Acute Management of Open Fractures: An Evidence-Based Review. Duke University Medical Center-Durham North Carolina. Feature Article. 2015; 38(11): 1025-9
Pollak N, Jones AL, Castillo RC, Bosse MJ, Mackenzie EJ. The relationship between time to surgical debridement and incidence of infection after open high emergy. The Journal of Bone and Joint surgery 2010; 92-A: 7-15.
Kim PH, Leopold SS. Gustilo-Anderson Classification[corrected]. Clin Orthop Relat Res. 2012; 47(11): 3270-4
Zalavras CG, Patzakis MJ. Open fractures: assessment and management. J Am Acad Orthop Surg. 2003; 11(3): 212-9
Court BM, Bugler KE, Clement ND, Duckworth AD, MacQueen MM. The epidemiology of open fractures in adults: a 15 year review. Injury. 2012; 43(6): 891-7
Kohlprath R, Assal M, Uçkay I, Holzer N, Domizio S, Hoffmeyer P. Open fractures of the tibial shaft in adults. Surgical management and complications. Rev Med Suisse 2011; 322(6): 2482-4
Giannoudis PV, Faour O, Goff T. Masquelet technique for the treatment of bone defects. Tips-tricks and future injury directions, 2011; 42(6): 591-8
Romouldis P, Karargyris O, Morassi LG. Distraction over nail using circular external fixation for septic osteoarthrosis of the tibia. J Long Term Eff Med Implants. 2012; 22(2): 137-43
Scott E, Sexton MD. Open fractures-Lower extremity. Clin Podiatr Med Surg. 2014; 31(14): 461-86
Handy ED, Samba K, Bang GA, Toure S, Emile JB, Ngo Nonga B et al. Osteosynthesis by intramedullary nailing in late open leg fractures: procedure, results and indications. Yaounde Central Hospital-Cameroon, Revintsc méd-RISM-2017; 19(3): 206-2011.
Sidi YI, Meziane N, Benyoure DJ, Nekrouf A, Snoussi AK. Classification of fractures. Algeria: AbouBelkaid University-Tlemcen; 2014.
Karagyris O, Polyzois VD, Krabinas P. Papineau method, lizaroy bone transport and negative pressure wound closure for septic bone defects of the tibia. Eur J Ortho Surg Traumatol. 2014; 24(6): 1013-7
Attipouk, Guerzou M, Nadji N. Comparative study between some local and imported honeys. Ziane Achour University, 2023.
Crispin MM, Claris MM, Séraphin BK, Trésor KK, Hervé MT, Anaclet TK et al. Efficacy of honey in the treatment of infected open lesions in Mbujimayi. RIMC. 2025;2(3):10-20.http://doi.org/10.70602/rimc.25.2.3.10.20
Therapeutic applications of honey in pathologies of the oral mucosa. [Online]. February 2022 [Accessed 04/09/2025] Available at the URL: https://dumas.ccsd.cnrs.fr.
Laredy H, Rezzay W. Microbiological and Physicochemical Characterization of Honeys from the Tiared Region of Algeria. Asian Journal of Pharmaceutical Research and Health Care; 2017 9.3.85-91
Said Z, Richard D, Ossama E, Kamal L, Amine M, Fawzi B. Intramedullary nailing in bifocal fractures of the leg: a report of 16 cases. PAMJ. 2017; 28:139 Doi:10.11604
Omar M, Jalal B, Hicham S, Ouahb A, Mohamed D, Khalid K. Value of intramedullary nailing in fractures of the distal quarter of the leg: a report of 30 cases. PAMJ. 2017;28:176. Doi:10.11604
Kevin PBP, Pierlesky EO, Elodie JLMO, Zifa PZ, Paul YI, Marc FN. Management and Evolution of SurgicalBoneCoverage for Open Leg Fractures in Brazzaville. HealthSci. Say. 2024; 25 (4):54-9.
Layes T, Terna T, Kalifa C, Dadé BSH, Aboubacar Sidiki S, Mahamadou TD et al. Treatment of open diaphyseal leg fractures with Ender nails in a second-referral hospital. HealthSci Dis 2020;21(7):47-51.
Laigle M, Rony L, Pinet R, Lancigu R, Steiger V, Hubert L. Intramedullary nailing of open leg fractures in adults. France (Angers University Hospital: Department of Bone Surgery), Elsevier, 2019; 11 pages. Available on:https://www.elsevier.com/open-access/userlicense/1.0/Accessed on 06/20/2023
Enweluzo GO, Adekoya-cole TO, Mofikoya BO, Giwa SO, Badmus OO. Morbidity of open tibia fractures in Lagos, Nigeria. East cent Af J Surg 2015; 20:37-43.
Touré L, Diallo M, Traore T, Sidibé O, Dembélé M, Hans MA. Treatment of open leg fractures in a second referral hospital. J AfrChirOrthop Traumato 2018; 3(1): 8-14.
Camara T, Bah ML, Madjirabe NH, Keita K, Diallo MM, Youla M. Open leg fractures treated with external fixator at the orthopedic -traumatology department of the Ignace Deen Conakry Teaching Hospital. HealthSci. Say. 2022; 23 (12):16-19.
Ghosh S, Sirdar BK, Chaudhuri A, Datta S, Ghosh PK, Kumar A. Interlocking nail and ender'snail in management of diaphyseal fracture of tibial in a rural population of a developing country. Saudi J Sports Med 2015; 15:238-43.
Kikobya S, Kabinda JM, Munyanga M. Epidemiological profile and factors associated with complications of open limb fractures by firearm. Apropos of 184 cases admitted to the Bukavu Regional Hospital. Dem. Rep. Congo: International Review of Armed Forces Health Services, 2016; 89(2): 8-14.
Kortam K, Bezstarosti H, Metsemakers WJ, Esther MM, Michael HJ, Michael J et al. Risk factors for infectious complications after open fractures: a systematic review and meta-analysis. Int Orthop 2017;41(10):1965-82.
Obremskey W, Molina C, Collinge C, et al. current practice in the management of open fractures among orthopedic trauma surgeons. part a: initial management. A survey of orthopedic trauma surgeons. J Orthop Trauma 2014; 28:198-202
Hallouz M, Mamoum N. Physicochemical study and evaluation of the biological activities of jujube honey. [Online]. 2020 [Accessed 08/04/2025]. Available at the URL: https://dspace.univ-tiaret.dz].
Ms. Boukaaba Hind. Results of surgical treatment of type C tibial pilon fractures [Online]. 2021 [Accessed 09/04/2025]. Available at the URL:https://toubkal.Imist.ma
Bénié AC, Yaokreh JB, Kouamé YGS, Lohourou GF, Traoré I, Kpangni AJB et al. Results of Delayed Treatment of Open Leg Fractures in Children in Yopougon. HealthRes. Afr. 2025; 3(1): 63-67.
Monka M, MboutolMandavo C, Zengui ZF, Moyikoua A. External fixator treatment of open limb fractures in Brazzaville HealthSci. 2017;18(1):39-42
Therapeutic applications of honey in pathologies of the oral mucosa. [Online]. February 2022 [Accessed 04/09/2025] Available at the URL: https://dumas.ccsd.cnrs.fr.
Laredy H, Rezzay W. Microbiological and Physicochemical Characterization of Honeys from the Tiared Region of Algeria. Asian Journal of Pharmaceutical Research and Health Care; 2017 9.3.85-91
Noel L, Di Mascio L. Classification and management of ocute wounds and open fractures. London (Royal London Hospital), 2014
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Crispin Muamba Mukendi, Claris Mpingiyabu Musangu, Trésor Kabuya Kabamba, Roger Kamwema Shamuana, Séraphin Binene Katulondi, Alidor Mbangila Yombo, Pierre Tangila Tangila, Anaclet Tshinyangu Kandanda, André Mutombo Kabamba, Joseph Ngandu Tshilunda, Gabriel Wakunga Warach, Séverin Uwonda Akinja
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution (CC-BY) 4.0 License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
