Machinery penile injuries associated with traditional trousers of the Yoruba of South-western Nigeria: A consideration for proper work clothes

AbstractAppropriateness of garments for different vocations to avoid unintended injury to the worker has always been recognized. This report of two cases of machinery penile injuries in patients wearing the traditional trousers of the Yoruba tribe of south-western Nigeria emphasizes the need for wearing appropriate clothes when operating machines

Chronic osteomyelitis: Comparison of outcome following the use of antibiotic impregnated beads and gentamycinsaline solution after sequestrectomy

Background: Chronic osteomyelitis (COSM) is a common disease in developing countries. Complete cure of the disease is difficult due to its high  recurrent rate. Sequestrectomy and debridement in addition to parenteral antibiotics is essential in the treatment of the disease. Local deposition of antibiotics has been shown to be effective in eradicating residual bacteria. The aim of this study was to compare the outcome of treatment following the use of antibiotic beads vs gentamycin-saline solution as local antibiotic delivery after sequestrectomy.Method: A prospective study carried out between April 2014 and March 2016. Each patient was followed up for a year.Results: Sixty-seven patients were recruited during the study period, 46 males and 21 females (M:F=2.2:1). The mean age was 22 ± 8.2 years, (range = 4 to 72 years). COSM was most common in the age group 11-20 years, n=37 (55.2%), the disease was commonest among patient with genotype SS, n=25 (37.3%). The commonest aetiology was acute haematogenous osteomyelitis, n=43 (64.2%). Tibia was the commonest bone involved, n=34 (50.7%). The commonest organism isolated from the sinus tract and sequestrum was Staphylococcus aureus, n=32 (56.2%), and n=34(56.7) respectively. Antibiotic beads were used in 27 (40.3%) patients after sequestrectomy with one recurrence, while 40 (59.7%) patients had gentamycin-saline instillation after sequestrectomy with two recurrences.Conclusion: Chronic osteomyelitis is still common in Nigeria, the organism cultured from sinus tract and the sequestrum is the same in most cases. Instillation of gentamycin-saline solution after sequestrectomy is as good as using antibiotic beads after sequestrectomy

Clinical outcomes after open locked intramedullary nailing of closed femoral shaft fractures for adult patients in a Nigerian hospital

Background: Femoral shaft fractures are common injuries in adults. Closed locked intramedullary nailing is the recommended treatment for femoral shaft fractures due to its high union rate. Objective: The objective of this study is to determine the outcome of management of closed femoral shaft fractures in adult patients, using open locked intramedullary nailing. Patients and Methods: This is a  prospective study which was carried out on all adult patients aged 16 years and above who presented within 2 weeks of sustaining closed femoral shaft fractures to the accident and emergency unit of a University  Teaching Hospital in Nigeria from January 2013 to December 2013. Pathological fractures were excluded from the study. The procedure was carried out using standard techniques, and each patient was followed up for a minimum of 1 year. Results: Forty‑three patients were recruited into the study. They had a mean age of 36.9 ± 11.7 years, with a male to female ratio of 2.9:1. The most common cause of closed femoral shaft fractures was road traffic crashes (95.3%), with   motorcycle‑related injuries found to be the highest type (56.1%). The rate of union in the study was 95.3%. The average time to radiological union was 14.0 ± 1.2 weeks while the mean time to painless full weight bearing was 14.2 ± 1.2 weeks. Among the complications encountered were broken nails (4.7%), infection, loosening of the distal screw, and limb length discrepancy (2.3% each). Using Thoresen’s criteria, excellent results were obtained in 93% and poor results in 4.7% of patients. Conclusion: Open locked intramedullary nailing gives excellent clinical outcomes with high union and low complication rates in the management of closed femoral shaft fractures in adult patients.Keywords: Clinical union, femoral shaft fracture, open locked intramedullary nail, radiological union, Thoresen’s criteri