Bilateral gluteal abscesses and myofibrosis complicating intramuscular pentazocine abuse: a case report

BACKGROUND: There is paucity of reports on the musculoskeletal complications of pentazocine abuse in Nigeria.The aim was to report a case of bilateral gluteal abscesses and myofibrosis as a consequence of parenteral pentazocine abuse.CASE SUMMARY: We report a case of a 39 year old housewife who presented with bilateral gluteal pyomyositis and myofibrosis following intramuscular pentazocine abuse.The patient had received parental pentazocine for pain relief for about 3 weeks seven years ago.She gradually developed dependence on this drug and received increasing doses of this drug by self injection on both buttocks. She subsequently developed bilateral gluteal abscesses and myofibrosis that was treated by surgical drainage,debridement,wound dressing and antibiotics.CONCLUSION: Pentazocine abuse should be considered a differential diagnosis in cases of multiple gluteal abscesses.Clinicians should be cautious in the use of pentazocine as routine painkillers.KEYWORDS: Pentazocine abuse,gluteal abscesses,Nigeria

A scoping review comparing two common surgical approaches to the hip for hemiarthroplasty

Hemiarthroplasty for hip fracture is a common surgical procedure. A number of distinct approaches are used to access the hip joint. The most commonly used are the direct lateral approach (DLA), and the posterior approach (PA). Internationally there is little consensus on which of these approaches to use. Current guidance is based on a limited selection of evidence and choice of approach is frequently based on surgeon preference. Historically, recommendations have been made based on dislocation rates. In light of technical advancements and greater recognition of patient priorities, outcomes such as post-operative function and pain may be considered more important in the modern context. The aim of this scoping review was to summarise the literature pertaining to the comparison of common surgical approaches to the hip for hemiarthroplasty.This article is freely available via Open Access. Click on the Additional Link above to access the full-text via the publisher's site.Publishe

Compartment Syndrome Complication Acute Osteomyelitis of the Radius in a Neonate: A Case Report

No Abstract

Musculoskeletal Complications of Sickle Cell Disease in Enugu, Nigeria

No Abstrac

Knowledge and Attitude of Healthcare Workers Towards Traditional Bone Setters In Benue State

Introduction: Traditional bone setting (TBS) is an art that is still flourishing to the detriment of patients. Some healthcare workers are aiding the practice, thus calling for reasons. This study ascertained the opinions of healthcare workers on TBS and the contention of incorporation into Modern Orthopaedic Services (MOS).Method: A self-explicit questionnaire with sociodemography and impressions of healthcare workers on TBS was administered across the various health institutions in a rural and an urban community of Benue State.Result: Three-hundred healthcare workers responded with 266 (88.7%) and 34 (11.3%) from urban and rural communities respectively. In all, 167 (55.6%) had not heard of any form of TBS advertisement. Advertisement by orthodox practitioners was never allowed in the last one year while majority 190 (63.3%) were not supporting TBS advertisement. However, 144 (48.1%) support incorporation into MOS. TBS was believed to have more patronage (70.3%) than MOS, mainly because it was cheaper. Significantly, 147(49.0%) disapproved TBS practice, 112 (37.3%) approved and 41 (13.7%) not sure. Majority 183 (61.0%) declined TBS treatment in case of any fracture. Educational status has no correlation with approval and patronage of TBS. Acceptance of TBS and opinion on incorporation into MOS were based on the outcome of their relations who had patronized TBS.Conclusion: As TBS has come to stay, strict ethical monitoring should be enforced. Both practices should be allowed to advertise (their services). Incorporation of TBS into MOS, if approved, should be steered by moral philosophy from the medical council. Government needs to adequately equip all secondary healthcare centres with basic facilities for effective initial management of patients with musculoskeletal lesions.Keywords: Traditional Bone Setters. Healthcare Workers. Knowledge, Attitud

Impact of overweight and obesity on the musculoskeletal system using lumbosacral angles

Ndubuisi OC Onyemaechi,1,2 Godson E Anyanwu,3 Emmanuel N Obikili,3 Okechukwu Onwuasoigwe,1,2 Okechukwu E Nwankwo1,2 1Department of Surgery, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria; 2University of Nigeria Teaching Hospital, Enugu, Nigeria; 3Department of Anatomy, College of Medicine, University of Nigeria, Enugu, Nigeria Background: Overweight and obesity have been identified as independent risk factors for musculoskeletal disorders. However, the association between obesity and low back pain remains controversial. Little is known about the effects of overweight and obesity on the angles of the lumbosacral spine. The objective of this study was to evaluate the effects of body mass index (BMI) and waist–hip ratio (WHR) on lumbosacral angles. Methods: The effects of BMI and WHR on the lumbar lordosis angle (LLA), lumbosacral angle (LSA), sacral inclination angle (°°), and lumbosacral disc angle (LSDA) of 174 overweight and obese subjects (test group) and 126 underweight and normal-weight subjects (control group) were analyzed. Results: The test group had a significantly higher mean LSA, LLA, sacral inclination angle (SIA), and LSDA (P=0.001). A significant correlation was noted between BMI and LSA (P=0.001), LLA (P=0.001), SIA (P=0.001), and LSDA (P=0.03). There was also a positive relationship between WHR and LSA (P=0.012), LLA (P=0.009), SIA (P=0.02), and LSDA (P=0.01). Conclusion: There was an increase in lumbosacral angles in individuals with raised BMI and WHR. This may result in biomechanical changes in the lumbosacral spine, which increase the incidence of low back pain. Keywords: body mass index, waist–hip ratio, lumbosacral angle

Aetiological Factors in Limb Amputation: The Changing Pattern!

Background: Limb amputation is a common ablative procedure in orthopaedic practice in Nigeria. Trauma and traditional bonesetters' gangrene have remained the leading indications for amputation in Nigeria. However, recent studies show that diabetic foot gangrene is becoming an important cause of limb amputation in Nigeria.Objectives: The aim of this study is to describe the demography, indications and problems of major limb amputation surgery in Makurdi, North-central Nigeria.Methodology: A retrospective review of all patients that had major limb amputations at the Federal Medical Centre Makurdi from March 2009 to March 2011 was undertaken. The data collected and analyzed were the demographic profile, indications for amputation, levels of amputation, traditional bonesetters' (TBS) treatment, complications and method of rehabilitation.Results: A total of sixty (60) patients had major, limb amputation. Four (4) patients with incomplete data were excluded and 56 patients were analyzed. The age range was 2-85 years with a mean age of 40.9 ±20.5 years. The male to female ratio was 3:1. Diabetic foot gangrene was the commonest cause of limb amputation in 22 (39.3%) patients. Above-knee amputation was the commonest level of amputation (48.2%). Wound infection was the commonest complication (12.5%). Only 4 patients (7.1%) used prosthesis and the mortality rate was 8.9%.Conclusion: Diabetic foot gangrene was the leading cause of amputation in this series. Above-knee amputation was the commonest level of amputation. Mortality rate was 8.9%. Education of diabetic patients on compliance to medication and foot care will help to reduce the incidence of diabetic foot gangrene.Keywords: Limb amputation, indications, diabeticgangrene