Aetiology and Patterns of Implant Failure Following Fracture Fixation in a Developing Country

Background: Implant failure is traumatic for patient as it increases the cost of treatment and may negatively affect the confidence of patients in the superior outcome of operatively treated fractures. Hence the objectives for this study were to determine the proportion of implant fixations that fail, types and causes of implant failure in our practice.Methods: A retrospective study conducted at a tertiary health institution, South west, Nigeria. Data of patients who presented with implant failure following fracture management between 2006 and 2011 were reviewed. Outcome measures were type and causes of implant failure. Data wereanalyzed using SPSS 16.Results: A total of 349 patients had implant fixation done following fracture during the study period of which 19 (5.4%) had failure of their implant. The commonest type of failure was a broken implant while the commonest cause for implant failure was non union 9 (47.4%) which resulted in fatigue failure of implant.Conclusions: We recommend adherence to principles of internal fixation. Education of our patients with regards to compliance with instruction will also go a long way in reducing the rate of failure.Keywords: Internal fixation; Fractures; Implant failur

Factors influencing the outcome of elective paediatric orthopaedic operations in Ile-Ife, Nigeria

There is a paucity of published data on the types of paediatric orthopaedic conditions that require surgery and factors infl uencing their outcome in most parts of Sub-Saharan Africa. This is a necessary audit to improve paediatric orthopaedic practice. We carried out an audit of all elective orthopaedic operations performed in children at Awolowo University Teaching Hospitals Complex in Ile-Ife, Nigeria from January 2000 through December 2005. The aim was to document the clinical outcomes and the factors that infl uence them. This is with a view to instituting necessary measures to improve paediatric orthopaedic practice in the area. A total of 146 children who had elective operations on 210 limbs were included in the study. Their mean age was 75.6±66.8 months (range 0.3-396 months). The commonest indications for surgery were angular knee deformities (from Blount\'s disease and rickets) and club foot. The mean hospital stay before surgery was 12±8.8 days (range 1-38days). The mean duration of operation was 78.4±36min. (range 30-195 min). The total length of hospitalization was 34.97±19.91 days in males and 41.97±25.15 days in females. Wound infection was the commonest postoperative complication (8.2%). The patient\'s age (P=0.002), indication for surgery (P=0.008), length of preoperative hospital stay (P=0.048), length of operation (

Predictive factors for primary amputation in trauma patients in a Nigerian university teaching hospital

No Abstract.The East African Medical Journal Vol. 83 (10) 2006: pp. 539-54

Outcome of non-operative management of femoral shaft fractures in children

Background: Femoral shaft fractures are common injuries in childhood. There is paucity of information on their presentation and outcome of the available treatment methods in the African population. Thisstudy evaluated the outcome of non-operative methods of treatment of femoral shaft fractures in our centre.Patients and Methods: A retrospective review of the database of children aged 14 years and below with femoral shaft fractures treated nonoperatively over a 10-year period.Results: A total of 134 patients with 138 fractures met the study criteria.This consisted of 71 boys (mean age = 6.1 years ± SD) and 63 girls (mean age = 6.5 years ± SD). Pedestrian vehicular accident was the most common cause of femoral shaft fractures in the study population. Themidshaft was the most common site of fractures. There were associated injuries to other parts of the body (especially head injury) in 34.3% of the patients. The commonest mode of treatment was skin traction only (87.7%). The mean time to fracture union was 4.9 weeks ± SD (range = 3–15 weeks). The mean length of hospitalisation was 6.7 weeks ± SD (range = 5 days–11 weeks). There was a fairly strong positive correlation between the length of hospitalisation and the presence of associated injuries, especially head injury, upper limb fractures and bilaterality ofthe fractures. The mean total cost of treatment was #7685 (Naira) or $51.2 (range =$14.2–$190). At the last follow up, 97.8% of the fractures united without significant angulation or shortening.Conclusion: The outcome of non-operative treatment of femoral shaftfractures in our setting is comparable to the results of other workers. Methods of treatment that shorten the length of hospitalisation without unduly increasing cost should be encouraged

Recurrent haemarthrosis after total knee arthroplasty - A case report

No Abstract

Pelvic fractures management in a teaching hospital in Nigeria

BACKGROUND: Significant external forces are required to fracture a normal pelvis. The forces usually result from rapid deceleration or crushing injuries. Associated injuries are common as the energy is delivered to multiple anatomical sites. AIMS/OBJECTIVE: The aim of this study was to highlight the pattern of presentation of pelvic injuries, causes, types of the pelvic fracture and outcome of the treatment of these injuries in a teaching hospital in a developing country. SETTING: Department of Orthopaedic Surgery and Traumatology, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State, Nigeria. DESIGN: A seven-year retrospective study was done from January 1995 to December 2001. RESULTS: The mean age of the patients at presentation was 35.0+14.8 (SD) with 42 males and 11 females. The mean injury severity score was 20.1. Motor vehicular accident remains the most common cause of pelvic fractures in 37(69.8%) patients, fall from height in 8(15.1%) patients, collapsed walls of dilapidated building in 4(7.6%) patients, motor vehicle pedestrian accident and motorbike pedestrian accidents in 2(3.8%) patients each. The type of pelvic fracture was classified according to Tile. Types A, B, and C were found in 24(45.3%), 17(32.1%), and 12(22.6%) patients respectively. In three patients, the fractures were open. Directly associated injury was diagnosed in 9 patients, these were mainly urogenital system, 2 had bladder injuries, 4 had urethral injuries and 3 had vagina laceration. All the patients were managed without recourse to open operative reduction. The outcome was adjudged excellent, good, fair and poor in 18(34%), 20(37.4%), 9(17%), and 6(11.3%) patients respectively. CONCLUSION: It was concluded that most types of pelvic fractures could be managed with satisfactory results in this environment using the facilities available. KEY WORDS: Pelvis fracture, motor vehicle accidents, falls. Nigerian Journal of Orthopaedics and Trauma Vol.3(1) 2004: 10-1

Femoral Diaphyseal Fractures in Adults: Pattern of Presentation and Outcome

Background: Fractures of the femoral shaft are among the common fractures seen by orthopaedic surgeons. The relative distribution of these fractures depends on multiple factors including the geographic location (urban vs. rural) and country of study. The aim of this paper is to re-evaluate the aetiology, severity and mechanisms of injuries responsible for femoral fractures.Study design: A prospective review of patients presenting at the Accident and Emergency (A/E) Department of the Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife between February 2011 and January 2012 was carried out.Results: Fifty-six femoral diaphyseal fractures in fifty-five patients with a mean age of 37.4±15.9years were seen. The male to female ratio was 1.7:1. The causes of injury were motor vehicular accidents (39.3%), motorcycle accidents (37.3%), pedestrian injuries (16.1%), fall from height (3.6%), gunshot injury (1.8%) and falling timber (1.8%). All were managed operatively with interlocking intramedullary nailing. Mean time to union was 16.4 ± 4.8 weeks and the complications included missed distal screws, delayed union, superficial and deep wound infection.Conclusions: Motor vehicular and motorcycle crashes still remain the top causative factors of femoral diaphyseal fractures. More intense efforts should be directed towards reducing the menace of road accidents and provision of affordable health care for victims.Key words: Femur, fractures, vehicular crashes, interlocking nai

Pattern of Congenital Musculoskeletal Abnormalities in South West, Nigeria: A Hospital Based Study

Background: Published data on congenital musculoskeletal anomaly in subsaharan Africa are few.Aim: To review the pattern of congenital musculoskeletal abnormalities seen at the Obafemi Awolowo University Teaching Hospitals' Complex (O.A.U.T.H.C) Ile-Ife.Materials and Methods: The clinical records of patients who presented to the O.A.U.T.H.C, Ile-Ife, with congenital musculoskeletal abnormalities over 7 years (July 2000 to June 2007) were reviewed. Comprising patients delivered in the hospital, referred patients seen in the Orthopaedic clinics and those admitted to the hospital Orthopaedic, Paediatric and Postnatal wards. The following data were extracted; age, gender, diagnoses, description of the abnormality and the presence of associated congenital deformities. The side of the body involved and bilaterality were noted.Result: Over this period, 123 patients met the criteria. Eighty one were males while 42 were females with a M:F= 2:1 Congenital talipes equinovarus(CTEV) deformity was the most common congenital musculoskeletal anomaly in 64(52.0%) patients. Others were Polydactyly 16 (13.0%) and syndactyly 11(8.9%). Other common congenital orthopaedic anomalies encountered include: Arthrogryposis multiplex congenital 7(5.7%), congenital knee dislocation 6(4.9%), Calcaneovalgus deformity 5(4.1%) and absent radius 5(4.1%). Among the patients with clubfoot, there was a predominance of bilateral involvement of both foot with 63.4% of the idiopathic variety showing bilaterality and 60.9% of the non-idiopathic variety having bilateral involvement. The idiopathic Variety constituted 64.1% of the club foot deformities. Spina bifida cystica was the most common associated deformity among the patients with nonidiopathic clubfoot.Conclusion: Congenital talipes equinovarus was the most common congenital Musculoskeletal anomaly seen at the Obafemi Awolowo University Teaching Hospital Ile-Ife, with a high incidence of bilaterality. Spina bifida cystica was the most associated anomaly in the non-idiopathic club foot in this centre.Keywords: Congenital, Musculoskeletal, anomaly, Tertiary, Referral, Centre