Determinants of good oral hygiene among pregnant women in Ibadan, south-western Nigeria.

Background and objectives: The need to attain and maintain good oral hygiene among pregnant women cannot be over emphasized as periodontal diseases in pregnancy have been linked with poor pregnancy outcomes. This study assessed the variables that affect oral hygiene status among pregnant women in a south-western Nigerian locality. Methodology: Four hundred and five pregnant Nigerian women were assessed for their oral hygiene status using the Oral Hygiene Index-Simplified. Demographic and pregnancy statistics were also obtained and the relationships between these and oral hygiene status were determined. Results: The mean age was 25.35 ± 5.02 years. Most of the women (96.0%) had never visited a dentist or any other oral health care provider and only 12.5% of those who had been attended by dental care givers have ever had professional dental cleaning. The oral hygiene status appeared to worsen as parity increased (p=0.047) while the use of the toothbrush and paste was associated with good oral hygiene (p=0.007). Higher education was associated with use of the tooth brush and paste (p=0.046) and good oral hygiene (p=0.001). Conclusion: The positive effect of education on oral hygiene practices is highlighted in this study. However there is still need for proper health enlightenment in this population with regards to use of the available oral health care facilities.Keywords: Oral hygiene, Pregnancy, Nigeria

Results of Operative Fixation of Fractures of the Ankle at a Tertiary Hospital in a Developing Country

Background: Operative fixation of ankle fractures is becoming popular in developing countries. The concern however is the outcome of care. The objective was to evaluate the results of open reduction and internal fixation (ORIF) of fractures of the ankle in our hospital.Methods: All cases ORIF of fractures of the ankle at the University College Hospital (UCH), Ibadan between March 2010 and December 2012 were recruited into the study. The indications for surgery, techniques of fixation, time interval between injury and presentation as well as outcome  measures like time to union, complications and functional outcomes were evaluated.Results: Seventy patients who had ORIF of ankle fractures were studied. Twenty-one (30%) were open fractures while forty-nine (70%) were closed. Sixty (85.7%) patients presented within the first week of injury, 4 (5.7%) after 4 weeks, 4 (5.7%) after 6 weeks and 2 (2.9%) after 52 weeks. Time to union averaged 12.6±4.1weeks. Complications included wound infection 14.3%, wound dehiscence with exposed implants 2.9%, malunion 8.6% and non union 5.7%. Good to excellent functional outcomes were achieved in 77.1% of the patients.Conclusion: ORIF is a viable option in the treatment of ankle fractures

Results of Lateral Condylar Blade Plate Fixation of Supracondylar Fractures of the Femur in an African Tertiary Hospital in Nigeria

Background: The concerns about operative stabilization of supracondylar femoral fractures are complications, especially hardware infection and disturbance of normal knee function. We reviewed the results of operative fixation of supracondylar femoral fractures using the lateral condylar blade plate device in our centre.Methods: All patients operatively treated using a lateral condylar blade plate device within a 13-year period were reviewed.Results: There were thirty two fractures. Mean age was 47.3±21.5 years. There were 22 AO type 33-A, 4 type 33-B and 6 type 33-C fractures.Traffic crashes accounted for 15 cases (46.9%). Six were open (Gustilo type IIIa). Surgery was delayed for an average of 21.3 days. Length of hospitalization was 69.7±43.5 days. Follow up averaged 23.6 weeks and average time to fracture union was 17.8±1.0 weeks. All fractures unitedduring follow up with an excellent outcome in 22 (68.8%), good in 5 cases (15.6%), moderate in 4 (12.5%) and a poor outcome in one patient using the Schatzker and Lambert criteria. Complications included knee stiffness (15.6%), bone infection (9.4%) and loosening of an implant. The infections subsided after removal of the hardware.Conclusions: Treatment of supracondylar femoral fractures with the lateral condylar plate usually promises good results. However, high energy injuries are often prone to complications.Keywords: Supracondylar femur, fracture, operative treatment, injuries, Nigeria

Comparison of Chlorhexidine - Alcohol and Providone Iodine Skin Preparation Skin Preparation Solutions in Orthopaedic and Trauma Surgery at An African Tertiary Hospital

No Abstract

Case Report: Proximal focal femoral deficiency in Ibadan a developing Country's perspective and a review of the literature

Proximal focal femoral deficiency (PFFD) is a rare but often severe abnormality of the lower limb which poses a significant challenge to effective treatment. We reviewed 21 patients with 23 cases of PFFD treated in our centre in the 14-year period from 1997 to 2010. The male:female ratio was 1:2 and the right femur was more commonly involved. Coincident congenital malformations were identified in four patients (19%), all involving the limbs. Conservative management was Employed for all our patients due to nonavailability of limb lengthening facilities. The cultural aversion to amputation in our environment makes it difficult to employ that option of treatment. Proximal focal femoral deficiency in Ibadan a developing country's perspective and a review of the literature.Keywords: Proximal focal femoral deficiency, congenital malformations, limb malformations, lower limb anomalies, Nigeria

Non-syndromic multiple supernumerary teeth among patients seen in a Nigerian Teaching Hospital

Background: The global prevalence of multiple supernumerary teeth for permanent and primary dentition in various populations is between 0.05- 5.3% and 0.2-0.8%. A previous study in Nigeria reported a very low prevalence of multiple supernumeraries. Aim: To ascertain any variation in the prevalence and presentation of multiple supernumeraries in Ibadan, Nigeria.Methodology: Demographic data was obtained from the patients’ data extraction form. Panoramic radiographs of 100 patients seen in the orthodontic clinic of the University College Hospital were assessed for presence, site, side and clinical characteristics of multiple supernumeraries. Data was analysed using SPSS version 18 and Chi square test was used to determine any significant relationship between the assessed variables. Results: More than half of the study population were females. The age range of the Study population was 5-40 years  (mean age 13.58±6.5 years).  Seventy-one  percent had Angle’s  class I molar relationship, 17% had  Angle’s class II and 5% had Angle’s class III. The prevalence of supernumerary teeth was 9%. Most presented as a combination of supplemental (premolars) and conical/tuberculate teeth. Most (69.2%) of the supernumerary teeth were unerupted. There was no significant variation in the presence of multiple supernumeraries with respect to sex and molar relationship.Conclusion: This study showed a higher prevalence of multiple supernumeraries than previously reported. There is need for a national survey  to present a true population prevalence of multiple supernumeraries.Keywords: Non-syndromic, Multiple, Supernumerary teeth, Nigeri

Skeletal birth injuries: presentation, management and outcome at the University College Hospital, Ibadan

No Abstract. Nigerian Journal of Paediatrics Vol. 32(1) 2005: 12-1

The burden of open fractures of the tibia in a developing economy

Background and purpose of study: Open fractures are difficult to treat particularly because of the risk of infective complications. The rudimentary emergency rescue services in a developing country like ours with attendant delays in presentation of patients amongst other factors would suggest a dismal outcome for open tibial fractures in Nigeria.Patients and methods: Ninety two patients with 98 open tibial fractures who presented to the University College Hospital(UCH), Ibadan over a 12-month period were reviewed. The aetiology and severity of these fractures were explored as well as thetreatment outcomes.Result: The mean age was 33.3 years (peak 21-40 years) with men being 2.4 times at risk. Eighty three percent were from roadtraffic injuries; pedestrian crashes led other traffic injuries with 32% of cases. A quarter of the patients presented after 8 hours of injury. Three quarters of the fractures occurred in the shaft. Gustilo type IIIb injuries was the commonest (36.7%). The methods of treatment included plaster cast (71.5%), external fixation (15.7%), plating and primary amputation (5.7% each), and  intramedullary nailing (1.4%). Average time to union was 26.2 ± 12.7 weeks. Forty six late complications occurred in 32 fractures (there were 6 cases of chronic osteomyelitis).Conclusion: The incidence and severity of open fractures in our environment calls for urgent steps geared towards reducing theincidence of road crashes. The provision of standard, prompt and affordable emergency as well as definitive health care facilitiesfor the victims should be a priority