Aneurysmal Bone Cyst: A Case Report Demonstrating the Role of Curettage, Bone Grafting and Prophylactic Screw Fixation

Aneurysmal bone cyst (ABC) is a rare osteolytic bone tumour characterized by several sponge-likeblood or serum filled, non-endothelialized spaces of  various diameters. When it is located in the proximal femur it is associated with increased risk of pathological fracture. Different treatment modalities have been reported for the management of aneurysmal bone cysts, including surgical excision with or without adjuvants, intralesional injection of sclerosing agents, radiation therapy, cryotherapy, systemic calcitonin therapy, and selective arterial embolization. We present a young man with a proximal femoral ABC who was treated successfully with curettage, cancellous bone grafting and prophylactic cancellous screw fixation.Keywords: Aneurysmal bone cyst, prophylactic fixation, bone graft

Indications and outcome of Open Reduction and Internal Fixation of Long Bones in Benue State North Central Nigeria

Background: Open reduction and internal fixation (ORIF) is a  well-established surgical treatment of fractures worldwide. However, the indications and modes of stabilization of long bone fractures vary and are evolving .The general trend now is towards fixation with locked intramedullary nail (i.m nail) rather than plate and screws.Objective: To identify the common indications for ORIF in our  environment, the implant commonly used and ascertain the outcome of such fixations.Materials and Methods: A four year retrospective review of all the patients who had ORIF at NKST Rehabilitation Hospital Mkar Benue State between January 2007 and December 2010 was done. The data obtained included the age, sex, diagnosis, implant used (plate and screws or i.m nail), outcome (united or failed implant), complications and bones involved. Allcase notes with incomplete data were excluded from the study. Follow up was for 24 months. The data was analyzed using SPSS 16.Results: There were 361 ORIF done on 355 patients, 245(66.4%) males and 124(33.6%) females giving a male to female ratio of 2:1. The age range was 3 to 82 years with mean age of 36.4 years (SD 14.7). The indications for ORIF were closed fractures 187(50.7%), Nonunion  103(27.9%), Malunion 57 (15.4%), Failed implant 13(3.5%), Delayed union 4(1.1%), open fracture 4(1.1%), and congenital pseudoarthrosis of the tibia 1(0.3%). The commonest bone involved was the femur  205(55.6%) followed by the tibia and fibula 78(21.1%) and humerus 58(15.7%) then others 28(7.6%). Plate and screws were used in  354(95.1%), i.m nail in 15(4.1%). The fractures that united were  357(96.7%), 12(10 plates and screws, 2 i.m nails) (3.3%) had failed implant. Infection was documented in 8(2.2%), joint stiffness in 4(1.1%) and limb length discrepancy in 4(1.1%).Conclusion: The study shows that plates and screws are the commonest implants used at NKST Rehabilitation Hospital. Closed fractures are the commonest mode of presentation, and the femur is the commonest bone fractured that requires ORIF. The fracture union rate is also acceptable but might be better if intramedullary nails are used where indicated.Key words: Plates and screws, nails, implant closed fracture, fracture union, Benue

Alkaliphiles : The Emerging Biological Tools Enhancing Concrete Durability

Concrete is one of the most commonly used building materials ever used. Despite it is a very important and common construction material, concrete is very sensitive to crack formation and requires repair. A variety of chemical-based techniques and materials have been developed to repair concrete cracks. Although the use of these chemical-based repair systems are the best commercially available choices, there have also been concerns related to their use. These repair agents suffer from inefficiency and unsustainability. Most of the products are expensive and susceptible to degradation, exhibit poor bonding to the cracked concrete surfaces, and are characterized by different physical properties such as thermal expansion coefficients which are different to that of concrete. Moreover, many of these repair agents contain chemicals that pose environmental and health hazards. Thus, there has been interest in developing concrete crack repair agents that are efficient, long lasting, safe, and benign to the environment and exhibit physical properties which resemble that of the concrete. The search initiated by these desires brought the use of biomineralization processes as tools in mending concrete cracks. Among biomineralization processes, microbially initiated calcite precipitation has emerged as an interesting alternative to the existing chemical-based concrete crack repairing system. Indeed, results of several studies on the use of microbial-based concrete repair agents revealed the remarkable potential of this approach in the fight against concrete deterioration. In addition to repairing existing concrete cracks, microorganisms have also been considered to make protective surface coating (biodeposition) on concrete structures and in making self-healing concrete. Even though a wide variety of microorganisms can precipitate calcite, the nature of concrete determines their applicability. One of the important factors that determine the applicability of microbes in concrete is pH. Concrete is highly alkaline in nature, and hence the microbes envisioned for this application are alkaliphilic or alkali-tolerant. This work reviews the available information on applications of microbes in concrete: repairing existing cracks, biodeposition, and self-healing. Moreover, an effort is made to discuss biomineralization processes that are relevant to extend the durability of concrete structures