International Olympic Committee consensus statement on pain management in elite athletes.

Pain is a common problem among elite athletes and is frequently associated with sport injury. Both pain and injury interfere with the performance of elite athletes. There are currently no evidence-based or consensus-based guidelines for the management of pain in elite athletes. Typically, pain management consists of the provision of analgesics, rest and physical therapy. More appropriately, a treatment strategy should address all contributors to pain including underlying pathophysiology, biomechanical abnormalities and psychosocial issues, and should employ therapies providing optimal benefit and minimal harm. To advance the development of a more standardised, evidence-informed approach to pain management in elite athletes, an IOC Consensus Group critically evaluated the current state of the science and practice of pain management in sport and prepared recommendations for a more unified approach to this important topic.

Normal Q-angle in an adult Nigerian population.

The Q-angle has been studied among the adult Caucasian population with the establishment of reference values. Scientists are beginning to accept the concept of different human races. Physical variability exists between various African ethnic groups and Caucasians as exemplified by differences in anatomic features such as a flat nose compared with a pointed nose, wide rather than narrow faces, and straight rather than curly hair. Therefore, we cannot assume the same Q-angle values will be applicable to Africans and Caucasians. We established a baseline reference value for normal Q-angles among asymptomatic Nigerian adults. The Q-angles of the left and right knees were measured using a goniometer in 477 Nigerian adults (354 males; 123 females) in the supine and standing positions. The mean Q-angles for men were 10.7 degrees +/- 2.2 degrees in the supine position and 12.3 degrees +/- 2.2 degrees in the standing position in the right knee. The left knee Q-angles in men were 10.5 degrees +/- 2.6 degrees in the supine position and 11.7 degrees +/- 2.8 degrees in the standing position. In women, the mean Q-angles for the right knee were 21 degrees +/- 4.8 degrees in the supine position and 22.8 degrees +/- 4.7 degrees in the standing position. The mean Q-angles for the left knee in women were 20.9 degrees +/- 4.6 degrees in the supine position and 22.7 degrees +/- 4.6 degrees in the standing position. We observed a difference in Q-angles in the supine and standing positions for all participants. The Q-angle in adult Nigerian men is comparable to that of adult Caucasian men, but the Q-angle of Nigerian women is greater than that of their Caucasian counterparts.

Plating of Femoral Shaft Fractures: the Experience in an African Teaching Hospital.

BACKGROUND: Femoral shaft fractures are common presentation in our trauma units. It is obvious that all these fractures cannot be treated conservatively due to the pressure on trauma beds and thus a suitable method of internal fixation that is feasible in the environment has had to be adopted. OBJECTIVE: This study is a report of our experience with plate fixation of femoral shaft fracture in our environment. DESIGN: A retrospective hospital based study. PATIENT AND METHOD: All patients with femoral shaft fractures stabilized with plates and screws between 1997 and 2004 at the University College Hospital were reviewed. The case notes were retrieved and data extracted from them; all case notes entry gave sufficient information. RESULTS: The fracture pattern showed 56 cases (35.4%) of Type 32-A, 45 cases (28.5%) of Type 32-B and 57 cases (36.1%) of Type 32-C using AO classification. The outcome of treatment was excellent to good in 125 fractures (77.2%). The average time of healing was 20 weeks (range 16-48). Fracture related complications occurred in nine fractures (5.7%) which included deep infection in four fractures (2.5%) and implant failure in five fractures (3.2%). CONCLUSION: Femoral shaft plating gives good result if the principles of fixation is carefully followed and in developing countries where initial cost of procurement of equipments for closed nailing may not be forth coming, it thus provide a safe efficient and low cost method of fixation of femoral shaft fracture.

Normal values of knee angle, intercondylar and intermalleolar distances in Nigerian children.

There is little data on the range of variation of knee angle, intermalleolar and intercondylar distances in African children. Such measurements are needed to assist determining whether a child legs are normal or not. Knee angle intermalleolar and intercondylar distances were measured in 2166 Nigerian children aged one year to 10 years to establish normal values for these measurements. In the study we discovered that knees were maximally bowed at ages 1-3 years and reduced to neutral of 0 degrees at age five (5 years) in girls and age seven (7) in boys. Both sexes had no bowing after age (7 years) in boys. Both sexes had no bowing after age of 7 years. The valgus angle was found to be constant at about 11 degrees between ages 1-10 years in both sexes. Mean intercondylar distance was 0.2 cm at 1 year of age and did not vary significantly at 10 years of age. The greatest intermalleolar distances of 2.5 cm and 2.2 cm were noted between the ages of 2 and 4 years. Normograms of these measurements are presented as diagnostic aids in clinical settings.