Kibadi K, Portaels F, Pichot Y, Kapinga M, Moutet F
Rev Med Brux. 2015 Nov-Dec;36(6):468-74.
Democratic Republic of Congo (DRC), a particular form of juvenile delinquency and insecurity intensifies in the city of Kinshasa. This is the phenomenon Kuluna. It is organized gangs equipped with machetes and other weapons. The main objective of this study is to know the phenomenon Kuluna and describe the upper limb injuries caused by machetes, while insisting on the specifics of the management of these lesions in our communities. This retrospective descriptive study examines 14 cases of wounds of the hand and forearm due to stab phenomenon Kuluna, in Kinshasa. It covers the period from 1 November 2010 to 1 November 2013. Among the 14 patients with lesions in the hand and forearm admitted and treated at the Unit of Plastic Reconstructive and Aesthetic Surgery, Hand Surgery and Burns, University Clinics of Kinshasa to attacks due to the phenomenon Kuluna. We have 11 men and 3 women. The average age was 33, 5 years (extremes of 21 and 56 years). The right upper limb is reached that the left upper limb, respectively 12 patients and 2 patients. The lesions are localized to the wrist in the majority of cases (10 patients) in the palm of hand and in 3 patients in the fingers in 1 patient. The palmar surface is reached (10 cases) and the dorsal (4 cases). Zone 5 of the International Classification of flexor and Zone 8 topographic classification extensors at hand are the predilection sites of lesions respectively the palmar surface (6 out of 10) and the dorsal (2 case 4). The median nerve at the wrist is cut in half the cases. On bone lesions localized to the forearm, we observed a high incidence of fracture of the ulna (62.5%). The treatment begins with the stabilization of bone pieces, gestures revascularization and nerve sutures and suture tendon and finally skin coverage. Rehabilitation was mandatory, she supervises the actions of repair and it continues until the recovery of function.
刚果民主共和国（DRC），金沙萨市一种特殊形式的青少年犯罪和不安全状况加剧。这就是“库卢纳”现象。它是由配备大砍刀和其他武器的有组织团伙构成。本研究的主要目的是了解“库卢纳”现象，并描述大砍刀所致上肢损伤，同时强调我们社区对这些损伤的管理细节。这项回顾性描述性研究调查了金沙萨市14例因“库卢纳”刺伤现象导致的手部和前臂伤口病例。研究涵盖2010年11月1日至2013年11月1日期间。在金沙萨大学诊所的整形重建与美容外科、手外科和烧伤科收治并治疗的14例手部和前臂损伤患者中，均因“库卢纳”现象袭击所致。其中有11名男性和3名女性。平均年龄为33.5岁（年龄范围为21岁至56岁）。右侧上肢受伤的有12例，左侧上肢受伤的有2例。大多数情况下（10例患者）损伤位于腕部，3例位于手掌，1例位于手指。手掌面受伤的有10例，手背面受伤的有4例。国际手部屈肌分类的第5区和伸肌地形分类的第8区分别是手掌面（10例中的6例）和手背面（4例中的2例）损伤的好发部位。腕部正中神经在半数病例中被切断。在前臂的骨损伤方面，我们观察到尺骨骨折的发生率很高（62.5%）。治疗首先是固定骨碎片、进行血管再通手术和神经缝合以及肌腱缝合，最后进行皮肤覆盖。康复治疗是必不可少的，它监督修复行动并持续到功能恢复。
