ARTHROSCOPIC PARTIAL MENISCECTOMY - SHORT-TERM CLINICAL OUTCOME IN AN ORTHOPAEDIC CENTER IN SOUTHWESTERN NIGERIA.

BACKGROUND: Meniscal tears are one of the common causes of knee pain. AIM: To evaluate the early clinical results of arthroscopic partial meniscectomy in the treatment of meniscal tears. STUDY DESIGN: This was a prospective study in which consecutive patients presenting with meniscal injury, who met the inclusion criteria were recruited for the study. SETTING: National Orthopaedic Hospital, Lagos. METHODOLOGY: Biodemographic data and clinical findings were obtained. The visual analogue pain score and WOMET score were computed pre-operatively and at least 6-months post-operatively and these values compared using the Wilcoxon's signed rank. The level of significance was set at 0.05. RESULTS: A total of 19 patients with 19 knees were included. Degenerative longitudinal tears were the commonest findings in 15 (79%), complex tears in 3 (16%) and radial tear in 1 (5%). The medial meniscus was more affected (52%) than lateral meniscus (48%). The red-white zone was involved in 12 (63%) cases and the white-white zone in 5 (37%). The median duration of follow up was 7 months while the median (IQR) WOMET score decreased from 59 (IQR =22) to 26.5(IQR=23), (Z= -3.409, P=001 ) and the visual analogue pain rating scale improved from 5 (IQR=1.5) to 3 (IQR=2.5) (Z= -3.346, P=001 ). CONCLUSION: Arthroscopic partial meniscectomy offers a good short term clinical outcome for patients with knee pain secondary to meniscal injury.

Trauma during pregnancy in a Nigerian setting: Patterns of presentation and pregnancy outcome.

CONTEXT: Trauma is an important health concern during pregnancy in developing nations though it is under-reported. AIMS: The aim of this study was to determine the patterns of presentation and feto- maternal outcomes of trauma during pregnancy in a Nigerian setting. SETTINGS AND DESIGN: A hospital-based retrospective analysis of database of entire patient population who presented in Ebonyi State University Teaching Hospital, Abakaliki, with trauma during pregnancy. MATERIALS AND METHODS: The data on demographics, obstetrics, and injury characteristic in addition to the outcome of all injured pregnant women hospitalized from January 2002 to December 2010 were analyzed. STATISTICAL ANALYSIS: SPSS version 16 and quantitative skills software SISA were used in data analysis. RESULTS: Trauma-necessitated hospitalization in 12 per 1000 pregnant women admitted in antenatal ward and was a complication of pregnancy in 4.7 per 1000 live birth in the hospital. Physical assault was the predominant causative factor and accounted for 46% of injuries whereas road traffic accident (motorcycle injury related in over 80%) was involved in 30.2% of the patients. The parity of the patients was significantly related to the trimester of pregnancy at the time of injury - 73% of grand-multiparae and about 60% of primigravida involved presented with injury in the 3(rd) and 2(nd) trimester, respectively (P < 0.017). Preterm delivery (7.9%), abruptio placentae (4.8%), and stillbirth (4.8%) were common obstetric complications observed. Maternal mortality of 1.6% and fetal loss of 7.9% were associated with trauma. CONCLUSIONS: Injury prevention measures during pregnancy deserve a place in any policy response aimed at reducing feto-maternal morbidity and mortality in developing countries.

Outcome of road traffic injuries received in the emergency room of a teaching hospital, Southeast Nigeria.

Road traffic injuries (RTI) are a rapidly growing public health problem in developing countries. This study was aimed at assessing the early outcome of RTIs received in our hospital emergency room. Understanding this will help to achieve optimum injury outcome. A prospective study was conducted on all patients presenting with RTIs to the emergency room of the Ebonyi University Teaching Hospital, Abakaliki, from 1 March 2007 to 29 February 2008. Out of 363 patients: 72.45% were treated in the emergency unit and discharged; 12.7% left against medical advice; 10.9% were admitted to the ward; and 4.7% died. Self-discharge against medical advice was significantly related to the type of injury (78.3% had fracture/dislocation) and gender (P = 0.001). The patronage of traditional bone setters, because of cultural belief that they have supernatural ability to treat fractures, was the major reason given by those who left against medical advice. The morbidity and mortality rate was significantly related to the road type (P = 0.005 - a higher rate was observed for RTIs received on intercity roads than intracity ones) and the type of crash (P = 0.03 - more than half from head on collisions). Although the mortality rate was within the expected range, the preventable death rate was high, and the majority of deaths occurred within the 'golden hour' . Improvement in pre-hospital and emergency room care of patients with RTIs, as well as public awareness of the availability and efficacy of orthodox orthopaedic trauma care, are needed in the developing countries.

Machete injuries as seen in a Nigerian teaching hospital.

BACKGROUND: The morbidity and mortality of machete-related injuries is rather appreciable in Nigeria although it is under-reported. Machetes are multipurpose tools in the farm, home and construction sites. Machetes may also be used as a close-range weapon. In Nigeria, there is no legislation guiding their Acquisition, so they are readily available in many homes. Injuries from machetes could be as detrimental as fatal or non-fatal with long-term morbidity. METHODS: We performed a retrospective study to assess the pattern and outcome of patients presenting with machete injuries in Ebonyi State University Teaching Hospital, Abakaliki, from January 2003 to December 2007. RESULTS: Of 76 patients, 74 met the criteria for the study. The male:female ratio was 10:1. The youth were commonly affected and the average age was 27.86 years. Assaults accounted for 96% of cases whilst accidental injuries accounted for 4% of cases. Early presentation, multiple machete wounds and involvement of head and upper extremities were common. Peripheral nerve palsy was the most common complication and haemorrhagic shock the most common cause of death. Sixty-one patients (87.14%) had complete recovery, and six patients (8.51%) recovered with morbidity. Death occurred in three patients (4.29%). CONCLUSIONS: Management of machete injuries in a developing nation can be quite challenging. Assault with homicidal intention was the major aetiological factor in our own environment and may be a very important and under-recognised aspect of the injuries. Appropriate injury-prevention mechanisms and other aspects of trauma care are recommended.