Anatomical Measurements of the Distal Clavicle in a Kenyan Population

Anatomical measurements of the distal clavicle are important in the design of clavicular implants for fixing clavicular fractures and reconstruction of the coraco-clavicular complex in acromio-clavicular joint dislocations. These measurements show population variations however, little data exists from the African population and none for the Kenyan one. One hundred and eighty unpaired dry adult human clavicles were obtained from the Department of Human Anatomy, University of Nairobi. The length of clavicle and distance of conoid and trapezoid tuberosities from the distal end were measured using a ruler. The superoinferior thickness of the distal end was measured using a vernier caliper. The mean clavicle length was  148.57±12.63mm. The left clavicle was longer (150.4mm) than the right one (146.8mm). Conoid tubercle (CT) and trapezoid tuberosity (TT) were 39.52±5.93mm and 17.96±3.42mm respectively from the lateral edge of clavicle. These distances correlated positively with the  length of clavicle and occupied 0.3 and 0.15 of total clavicular length respectively. The supero-inferior thickness of the lateral edge was 10.09±2.36mm. The distance of CT and TT positively correlated with clavicular length. The CT lies at a junction of lateral one third and medial 2/3 while the TT is midway between CT and lateral end. Designers of clavicular implants should consider these measurements and surgeons involved in fixation of acromoclavicular joints fractures.Key words: Clavicle, conoid tubercle, trapezoid tuberosity

Variations in the formation of supraclavicular brachial plexus among Kenyans

Objective: To describe the pattern and prevalence of variations that occur in the supraclavicular part of the brachial plexus in a Kenyan population. Study design: Descriptive cross-sectional study. Materials and methods: Ninety-four brachial plexuses from forty-seven formalin fixed cadavers were displayed by gross dissection. Results: The presence of at least one variation from the classical anatomy was observed in 73 (77.7%) of the 94 plexuses. The roots and trunks were involved in 32 (34%) of the plexuses . Preand postfixed roots were present in 23 (24.7%) and 3 (3.2%), respectively. The presence of four trunks, and trunks passing between the scalene medius and posterior were also noted. The long thoracic nerve was variant in 51 (54.3%) of the plexuses. Unusual relations of the phrenic nerve to scalene muscles and the subclavian vein were encountered. Conclusion: The presence of four trunks and an accessory phrenic nerve passing through the subclavian vein are probably described and reported for the first time. However, most of the variations of the BP among Kenyans are similar to those reported in the other populations

Variant Branching of the Common Femoral Artery in a Black Kenyan Population: Trifurcation is Common

Branching pattern of common femoral artery is important during artery catheterization, orthopaedic, plastic and general surgery in the proximal thigh. Frequency of variant branching shows ethnic variation but there are no data for black African populations. Since atherosclerotic diseases are increasing and femoral artery catheterization is rising, variation in  branching of common femoral artery was studied by dissection in a black Kenyan population. 208 femoral arteries in 104 limbs were studied. Bifurcation occurred in only 72.1% of cases. Trifurcation into superficial femoral, profunda femoris and lateral circumflex femoral arteries occurred in 27.9% of cases. Trifurcation of common femoral artery is a common variation in the black Kenyan population. Pre – operative ultrasonic evaluation of the femoral arterial system is recommended to minimize inadvertent arterial injury during catheterization or surgery

Variant Anatomy of the External Jugular Vein

Variant anatomy of the external jugular vein is important when performing invasive procedures in the neck. Although there are a number of case reports on some of these variations, there are few descriptive cross-sectional regarding the same. This study therefore aimed at describing the variant anatomy of the external jugular vein as seen in a sample Kenyan population. One hundred and six (106) sides of the neck from 53 cadaveric specimens (70 males and 36 females) in the Department of Human  Anatomy, University of Nairobi, Kenya, were used. Pattern and level of  formation, course, communications and termination were studied by dissection. The vein was absent in 14.2% of cases, all males. It was formed within the substance of the parotid gland in 44%, and did not receive posterior auricular vein in 6.6%. Variant communications noted included facial vein, internal jugular, and a presence of a large anastomotic vein connecting it to the anterior jugular. It was duplicated in 2.2% cases and terminated into internal jugular vein in 7.7% of cases. The most common variations were in origin, course, communications and termination. These may limit its clinical utilization, and their awareness is important when considering the vein for any invasive procedure. This may avoid unnecessary time wastage and complications of device malposition.Key Words: External Jugular Vein; Variations; Communications; Absence; Terminatio

Characteristics of women undergoing induced abortion in a Kenyan tertiary referral hospital

Background: Data on characteristics of women who undergo abortion is important to inform reproductive health education strategies. Such data from  sub-Saharan African countries is incomplete and inconsistent.Objective: The characteristics of women undergoing abortion at Kenyatta National Hospital, Nairobi, Kenya.Methods: This was a prospective study. A structured questionnaire was administered to all women who had attended follow-up outpatient gynecology clinics. The questionnaire examined age, socioeconomic status, highest level of education, marital status and religion. Data obtained were analysed for  frequencies and means using SPSS version 17.0 and presented in tables, pie charts and graphs.Results: The most commonly affected age group was 20-30 years (57.8%) while the least was 34-39 years. Majority (64.3%) of the victims were unemployed. Of these, 23.5% were students. The most commonly affected were those with secondary level of education (59.3%). Unmarried women comprised 66.9%. Eighty eight percent of the victims were Christians with 47.4% being Roman Catholics. Muslims comprised only 6.8%.Conclusion: Abortion occurs in women aged 15-40 years, peaking at 20-29 years, who are the  unemployed or students. Majority are single and had attained at least secondary education. More Catholics than Protestants were affected. Most of these characteristics differ from those reported in earlier studies from the region, suggesting changing characteristics.Key words: Abortion, Age, Socioeconomic status, Education, Keny