A comparison of intralesional verapamil and triamcinolone monotherapy in the treatment of keloids in an African population.

BACKGROUND: Keloid is a fibroproliferative disorder of dermal origin, common and severe in the dark-skinned individuals. The patients suffer from pain and pruritus with poor body image. AIMS: We compared the efficacy and side effects of intra-lesional verapamil and triamcinolone in patients with keloids. As most treatments are cumbersome, recurrence is a major problem despite the many treatment modalities. There is need for effective monotherapy with minimal complications. MATERIALS AND METHOD: This is a prospective, randomized study of intralesional injection of verapamil and triamcinolone in keloids conducted in the Burns and Plastic unit of a tertiary hospital. There were two groups; triamcinolone treatment group (TTG) and verapamil treatment group (VTG). A total of 115 patients with keloids <10 cm were diagnosed, 37 (32.2%) were excluded, and 78 were included into the study. There were 40 patients in the TTG and 38 patients in the VTG. Eventually, 70 patients completed the study. Triamcinolone 40 mg and 2.5 mg of verapamil were used for TTG and VTG respectively. The changes in the dimensions of keloids were measured using an electronic caliper. The symptoms were assessed using the visual analog score for pain and the pruritus score was adapted from the 5-D pruritus score. RESULTS: Triamcinolone completely resolved pain and pruritus in 6 and 12 weeks, respectively, while there was no complete resolution among VTG patients. However, verapamil injection was comparably effective to triamcinolone for small-size keloids. CONCLUSION: Verapamil as monotherapy is less efficaceous in the resolution of symptoms of keloids but is comparable to triamcinolone in reducing the size of small-sized keloids.

Cooking Gas Explosions As Cause Of Burns Among Patients Admitted To A Regional Burn Centre In Nigeria.

Burn injury has become a major source of mortality and morbidity in countries with low socioeconomic status. World energy consumption is mainly based on fossil fuels. This source of energy, if not properly handled, can be a source of major accident to lives and properties. The aim of this study is to highlight cases and the outcome of management of burns from cooking gas explosions in Lagos, Nigeria. The study involved all patients who sustained burns following cooking gas explosion within the study period. The parameters considered included demography, spread, anatomical locations and presence of inhalational injury, and outcome of management. A total of 347 patients were treated for burns during the study period, and 49 had burns from cooking gas explosion. Male to female ratio was 1.04:1. Patients between the ages of 21-40 years were the most affected. Extremities were involved in nearly all the patients. The presence of inhalational injury and larger burn surface area were found to be poor prognostic indices. Mortalities occurred within the first two weeks of injury. Cooking gas is becoming increasingly popular in Nigeria. Prevalence of burns from gas explosion is also on the increase. People are however not aware of its safe handling. More public enlightenment is required.

Les brûlures représentent une cause de morbidité et de mortalité considérables dans les pays à IDH faible. L'énergie consommée dans le monde est principalement d'origine fossile et son mésugeage est la cause d'accidents aux conséquences humaines et matérielles graves. Cette étude s'est penchée les caractéristiques et l'évolution de 49 patients (sur 347) hospitalisés dans le CTB de Lagos après explosion de réchaud à gaz. Nous avons relevé la démographie des patients, la surface et la localisation des brûlures, l'existence éventuelle d'une inhalation de fumées et le devenir. Le sex-ratio M/F était de 1,04/1, la tranche d'âge 21-40 ans était la plus fréquemment touchée. Les extrémités de presque tous les patients étaient brûlées. L'augmentation de la surface brûlée et la présence d'une inhalation de fumées étaient des facteurs de mauvais pronostic. En cas de décès, la mort survenait dans la première quinzaine. L'augmentation de la prévalence des brûlures lors d'une explosion de réchaud à gaz est parallèle à l'augmentation de leur utilisation, ce qui montre que des campagnes d'information sont nécessaires.

Demographic and clinical characteristics of keloids in an urban center in Sub-Sahara Africa.

BACKGROUND: Keloid is a major complication of wound healing. The clinical spectrum ranges from unaesthetic lesions minimally invading the adjacent skin to large grotesque lesions sometimes associated with contractures. SUBJECTS AND METHODS: The patients were seen over 2 years in a tertiary hospital setting. The following information was obtained with a proforma: the biodata, etiology of keloid, region affected, symptoms, and treatment prior to presentation. The keloids were examined and the sizes were grouped into small, medium, and large keloids; the severities of symptoms were determined using the visual analog scale. RESULTS: 159 patients with 224 keloids were seen over 2-year period with male-to-female ratio of 1:1.24. The most common causes of keloid were trauma and acne (27.0% and 20.1%, respectively). The trunk had a statistically significant higher number of symptomatic keloid compared with other regions keloids. The larger keloids were more symptomatic compared with the smaller ones, P = 0.000. There were more pruritic keloids than painful ones. About 25% of patients had positive family history in first-degree relative, 16% in second-degree relative, and their keloid are more symptomatic than those without family history. CONCLUSION: In view of the burden of keloids, early treatment is advised. Unnecessary trauma and extra piercing should be avoided; elective surgeries that are deferrable should be postponed until when necessary.

Does open guide suture technique improve the patency rate in submillimeter rat artery anastomosis?

OBJECTIVE: The anastomosis of sub-millimeter vessels is fraught with significant technical challenges even for the experienced microsurgeon. The supermicrosurgery era is increasing the demand for repair of very small vessels. Our study aims to ascertain whether the open guide suture technique provides a superior patency rate compared with conventional technique when anastomosing rat artery less than a millimeter. METHODS: Anastomosis of transected rat femoral, superficial femoral and central tail arteries were done in 24 in bred albino rats. The external diameters ranged from 0.4 mm to 0.8 mm. The repair was assigned into the Open guide suture technique group or the conventional group (n=12 in each group). The duration of repair, grade of leakage, patency of the repair at 30 min were noted and compared between the groups. RESULTS: The patency rate was 92.7% in each group. There was no statistically significant difference between the 2 groups with respect to anastomotic times, grade of leakage external diameter and type of vessel repaired (p-values >0.05). CONCLUSION: It appears open guide suture -technique simplifies repair but may not offer a better patency rate in rat arterial anastomosis under 1 mm when compared to the conventional technique.

Prevalence of orofacial clefts in Nigeria.

Orofacial clefts are the most common malformations of the head and neck. In Africa, orofacial clefts are underascertained, with little or no surveillance system in most parts for clefts and other birth defects. A Nigerian craniofacial anomalies study, NigeriaCRAN, was established in 2006 to support cleft research specifically for epidemiological studies, treatment outcomes, and studies into etiology and prevention. We pooled data from seven of the largest Smile Train treatment centers in the six geopolitical zones in Nigeria. Data from September 2006 to June 2011 were analyzed and clefts compared between sides and genders using the Fisher exact test. A total of 2197 cases were identified during the study period, with an estimated prevalence rate of 0.5 per 1000. Of the total number of orofacial clefts, 54.4% occur in males and 45.6% in females. There was a significant difference (P = .0001) between unilateral left clefts and unilateral right clefts, and there was a significant difference (P = .0001) between bilateral clefts and clefts on either the left or right side. A significant gender difference (P = .03) was also observed for cleft palate, with more females than males. A total of 103 (4.7%) associated anomalies were identified. There were nine syndromic cleft cases, and 10.4% of the total number of individuals with clefts have an affected relative. The significant difference between unilateral clefts and the gender differences in the proportion of cleft palate only are consistent with the literature. The present study emphasizes the need for birth defects registries in developing countries in order to estimate the exact prevalence of birth defects including orofacial clefts.

Acceptance and perception of Nigerian patients to medical photography.

The aim of the study was to determine the acceptance and perception of Nigerian patients to medical photography. A self-administered questionnaire was distributed among Nigerian patients attending oral and maxillofacial surgery and plastic surgery clinics of 3 tertiary health institutions. Information requested included patients' opinion about consent process, capturing equipment, distribution and accessibility of medical photographs. The use of non-identifiable medical photographs was more acceptable than identifiable to respondents for all purposes (P = 0.003). Most respondents were favourably disposed to photographs being taken for inclusion in the case note, but opposed to identifiable photographs being used for other purposes most especially in medical websites and medical journals. Female respondents preferred non-identifiable medical photographs to identifiable ones (P = 0.001). Most respondents (78%) indicated that their consent be sought for each of the outline needs for medical photography. Half of the respondents indicated that identifiable photographs may have a negative effect on their persons; and the most commonly mentioned effects were social stigmatization, bad publicity and emotional/psychological effects. Most of the respondents preferred the use of hospital-owned camera to personal camera/personal camera-phone for their medical photographs. Most respondents (67.8%) indicated that they would like to be informed about the use of their photographs on every occasion, and 74% indicated that they would like to be informed of the specific journal in which their medical photographs are to be published. In conclusion, non-identifiable rather than identifiable medical photography is acceptable to most patients in the studied Nigerian environment. The use of personal camera/personal camera-phone should be discouraged as its acceptance by respondents is very low. Judicious use of medical photography is therefore advocated to avoid breach of principle of privacy and confidentiality in medical practice.

Clinical and proctosigmoidoscopic findings in patients with anorectal sepsis in a private health facility in Lagos, Nigeria.

BACKGROUND: Anorectal sepsis is a distressing condition which is sometimes inadequatelytreated. OBJECTIVES: To determine the clinical and prostosigmoidoscopic findings in patients with anorectal sepsis seen by the authors over a 5 year period as well as identifying the commonly performed procedures. METHOD: A review of all the records of patients seen by the authors over a 5 year period was carried out. The demographic pattern was determined including the age, sex, mode of presentation, and associated co-morbidities. The detailed perianal and protosigmoidoscopic findings were also noted RESULTS: 45 males and 10 females were seen during the study period. The mean age incidence was 43.4 years. The commonest mode of presentation was perianal discharge and pain in over 85% of the patients seen. The low anal fistula was the commonest pathology on proctosigmoidoscopy while abscesses and external haemorrhoids were the other commonly occurring lesions found . Fistulotomy was the most commonly perfomed procedure while diabetes was the most common comorbidity. CONCLUSION: Anorectal sepsis most commonly affects males in the fifth decade of life. Thorough evaluation and adequate operative treatment appear to result in satisfactory early outcome.

An overview of biological basis of pathologic scarring.

AIMS AND OBJECTIVES: To review the current mechanisms and biologic processes leading to the formation of pathologic scars. MATERIALS AND METHODS: A computerised literature search was carried out using MEDLINE for all published articles on ''pathologic scarring''. The medical subject headings ''scarring'' were combined with ''mechanisms''. A review of selected relevant literature was then undertaken. RESULTS: Scarless embryonal healing tends to be characterised by minimal inflammatory reaction mediated by reduced IL6,IL8 and hyaluronidase while there are elevated levels of hyaluronic acid MMP1to3, as well as IL10.The multifunctional cytokine TGF-B, its several isoforms as well as its postreceptor signalling mechanisms appears to play the key role in the scarring process . There is also evidence to show that PDGF, IGF and other cytokines regulate scarring . While conventional antiscarring agents target the fibroplasia phase, others such as tamoxifen ,calcium channel blockers, and imidazolaquinolines targets various phases of the scarring process . CONCLUSION: It appears that multiple mechanisms are involved in the phenotypical appearance of abnormal scarring. A deeper understanding of these mechanisms is pivotal to the development of better antiscarring therapies in the very near future .

Glomus Tumours of the Hand in Lagos; Nigeria

"Background: Glomus tumours of the hand are uncommon intriguing tumours which cause significant morbidity. Few reports have documented the epidemiology and presentation in the West African subregion. The aim of this review is to identify the common baseline demographics; the presentation; evaluation; diagnosis and treatment outcome of glomus tumours of the hand in Lagos; Nigeria Methods: A 10 year retrospective review of the records of all patients seen with histopathologically diagnosed glomus tumor of the hand at the Lagos University teaching hospital was carried out noting the biodata; demographics; method of presentation and treatment of this condition.Results: 11 patients were seen over the study period .There were nine females and 2 males seen.The mean age of the patients was 41 years. The symptoms had been on for between 3 and 40 months .All patients seen had a positive Love test.Only one patient had associated bony erosion.All had complete excision with no recurrence at 6 months.Conclusion: Glomus tumor of the hand is an uncommon tumour often occurring in adult women. Clinical test (Love ""test"") will correctly identify the diagnosis.Surgical treatment was curative in all our cases. High index of suspicion is needed to make earlier diagnosis"

Detecting Nosocomial Intrinsic Infections through Relating Bacterial Pathogens of Incision

Surgical procedures often lead to both intrinsic and extrinsic infections. In order to improve on recovery of patients; investigations were carried out on samples collected from patients during and after surgery. Laboratory analysis was performed on wound swabs from incision; colon segments; scrapes; tissues; pus and catheter specimen urine. The samples were cultured on MacConkey and Blood agar and incubated aerobically at 370C for 16-24 hours. Thereafter; isolates were identified using standard microbiological methods. Results showed that isolates from wound were also found on endogenous indicators of surgery. Klebsiella species from incision was 15 (18.75) while those from colon segment was 30(37.6); scrapes 8(16) and pus 3(7.5). Acinetobacter species found on incision was 15(7.5) and pus 7(2.3). Pseudomonas species was distributed on incision 5(2.5); colon segment 4(5); tissue 3(1.6); scrapes 5(10) and pus was 5(12.5). Staphylococcus aureus which was isolated from incision was 2(1); while scrapes and pus were 5(10) and 7(17.5) respectively. Catheter associated urinary tract infections yielded significant bacteriuria (64.7); almost twice the rate of non-significant bacteriuria (35.3); indicating the need to remove all catheters as soon as possible. Antibiogram of isolates of Klebsiella pneumoniae with resistance pattern: ApGnNaNt; Escherichia coli (ApCtNaTtCm) and S. aureus (ApChCxErPn) with plasmid sizes in the range (30.2-52.51Kb) were common to both indicators and wound; showing that the pathogens were the same clusters. This study demonstrated surgical procedures as precursory to intrinsic infections and that bacterial pathogens found on wounds and endogenous indicators of surgery are links to intrinsic infection. The study therefore emphasizes the need to culture wounds promptly to effect speedy recovery of patients who have undergone surgery

Pattern of breast masses in Lagos: a private health facility review of 189 consecutive patients.

BACKGROUND: The increasing awareness concerning breast cancer has led to significant interest in breast masses in general. As a result there is considerable interest in the clinicopathologic studies of breast masses in various populations. OBJECTIVE: To study the clinicopathologic pattern of breast masses at a private health facility in Lagos, Nigeria. METHOD: The records of all patients who presented between January 1993 and December 2002 with breast lumps at the Lagoon Hospital Apapa were reviewed. Their biodata, clinical presentation and histopathological diagnosis were retrieved. RESULTS: 189 consecutive patients were studied comprising of 180 females and nine males. The peak age incidence for benign disease was 21-30 years while it was 31-40 years for those with malignant masses. Majority (66.1%) presented with painless solitary lumps. 46 (77.2%) patients had benign lumps while 43 (22.8%) had malignant lesions. The commonest benign lesion was fibrocystic disease (47.9%) while infiltrating ductal carcinoma was the commonest pathological diagnosis in the malignant group (83.1%). CONCLUSION: From this study benign breast masses outnumber malignant ones by more than 3:1 in this population. The commonest pathological diagnosis was fibrocystic disease in benign lesions and infiltrating ductal carcinoma for malignant masses.

Genito-urinary system injuries in Lagos: pattern and general treatment outcome.

BACKGROUND: Genitourinary injuries (GUI) are relatively uncommon. Even though mortality from isolated injuries is rare, they are commonly associated with significant and life long morbidity. OBJECTIVE: This study is to assess the pattern of the injuries and the overall short term treatment outcome in our environment. METHODS: Fifty consecutive patients diagnosed with genitourinary injuries seen by the Urology Unit through the Accident and Emergency, emergency referrals (or consultations) from the ward or theatre between June 2004 to February 2006 were included in the study. Information collected included demographic data, pattern of presentation, aetiology of injury, type of injury the type of treatment and the immediate outcome. RESULTS: There was a total of 61 injuries in 50 patients. Road traffic accidents was the commonest cause of GUI (58%) followed by straddle injuries (18%) and iatrogenic causes (12%) and miscellaneous (12%). The male- female ratio was 6:1. The urethral was also the most commonly injured organ (60.6%), followed by the kidney (11.5%). The testes were the least injured organs (1.6%). The blunt renal injuries and extraperitoneal bladder injuries were managed by non operative means while most other injuries were managed by surgical intervention. Immediate treatment outcome was satisfactory in most patients. There was one mortality. CONCLUSION: Most cases of GUI are preventable. Improved safety on the roads,'proper training of surgeons and attention to clinical and surgical details will go a long way in preventing GUI. Early intervention significantly reduces the morbidity and mortality.

Challenges in the organisation of a microsurgery laboratory in a low resource country.

OBJECTIVES: To highlight the problems encountered in the set up, organisation and operations of a microsurgery laboratory in a low resource tertiary care hospital in Lagos, Nigeria. METHODS: The basic infrastructural deficiencies of this setting were encountered. Significant administrative, logistic and technical obstacles needed to be overcome. The need for improvisation and flexibility in the organisation and operations of such a laboratory is highlighted. The use of locally available, cheaper variety of instruments and consumables in the microsurgery laboratories of developing countries with limited resources was demonstrated by our experience . CONCLUSION: We conclude that even in the setting of low resource tertiary centres found in many developing countries, challenges could be overcome and standard acceptable patency rates obtained in the microsurgery laboratory .

Profile of amputations in Lagos University Teaching Hospital, Lagos, Nigeria.

BACKGROUND: Amputation is a common surgical procedure for which there are several indications. There are few research works on the profile of amputation in Lagos. OBJECTIVE: The study is to determine the pattern of amputation at the Lagos University Teaching Hospital, Lagos, and to identify the indications, types, morbidity and mortality associated with amputation. METHODS: This was a retrospective study carried out at the Lagos University Teaching Hospital between Jan.2007 and Dec. 2009. All records of patients were retrieved and selected data collated. RESULTS: A total of 127 patients presented between Jan. 2007 and Dec. 2009 with various indications for amputation. The mean age was 43.0 +/- 19.4 years. Male: female ratio was 1.7 to 1. Diabetic foot gangrene was the leading cause of amputation occurring in 55.14% of patients studied. Other major indications were trauma and malignancies. Below-knee amputation was the commonest type done (46.6%). Sepsis was the commonest complication (11.8%). The mortality rate of 11.8% was mainly due to co-morbidities. CONCLUSION: Amputation in our centre is more likely to be done on males and diabetics. Majority was below knee and was associated with significant mortality. Increasing public enlightenment and early presentation are needed to reduce morbidity and mortality as well as improve limb salvage in our population.

Knowledge and perceptions of facial plastic surgery among a selected group of professionals in Lagos, Nigeria.

This was a questionnaire-based study among a selected group of professionals in Lagos, Nigeria to assess their knowledge, attitude and perceptions to facial plastic surgery. A well-structured questionnaire was administered to a group of professionals in the banking industry and the civil service. The respondents were asked if they had heard of 'facial plastic surgery' before and if they were familiar with some selected facial plastic surgery procedures. They were also asked if they had ever considered undergoing facial plastic surgery for any real/perceived facial abnormalities; if they knew any close relatives/friends who had undergone facial plastic surgery and if they considered the result satisfactory or not. A total of 130 respondents participated in the study; of these, 102 (78.5%) respondents had some knowledge of 'facial plastic surgery' while 28 (21.5%) respondents had no prior knowledge of facial plastic surgery. Fifty-five of the 102 respondents had some knowledge of liposuction of the face and neck. Nineteen of the 130 respondents expressed willingness to undergo facial plastic surgery for removal of facial wrinkles and excess fat on the cheeks and neck. Only 17 (13%) of the respondents had ever thought of undergoing facial plastic surgery; of these 17 respondents, nine claimed that their facial appearance was the main reason. Respondents with perceived facial abnormalities were more likely to undergo plastic surgery than those without perceived abnormalities (P=0.000). Twenty-four (18.5%) of the 130 respondents knew of a friend/close relative who had undergone facial plastic surgery before, and the majority (19 of the 24) considered the result of the surgery satisfactory. We conclude that most of the study participants had some knowledge of facial plastic surgery; however, only a few expressed willingness to undergo facial plastic surgery for removal of facial wrinkles and folds/fat on the cheeks and neck. The fact that only a few of the respondents knew someone who had undergone facial surgery may reflect the low level of availability of facial plastic surgery procedures in Nigeria.

Genito-urinary system injuries in Lagos: pattern and general treatment outcome

BACKGROUND: Genitourinary injuries (GUI) are relatively uncommon. Even though mortality from isolated injuries is rare; they are commonly associated with significant and life long morbidity. OBJECTIVE: This study is to assess the pattern of the injuries and the overall short term treatment outcome in our environment. METHODS: Fifty consecutive patients diagnosed with genitourinary injuries seen by the Urology Unit through the Accident and Emergency; emergency referrals (or consultations) from the ward or theatre between June 2004 to February 2006 were included in the study. Information collected included demographic data; pattern of presentation; aetiology of injury; type of injury the type of treatment and the immediate outcome. RESULTS: There was a total of 61 injuries in 50 patients. Road traffic accidents was the commonest cause of GUI (58) followed by straddle injuries (18) and iatrogenic causes (12) and miscellaneous (12). The male- female ratio was 6:1. The urethral was also the most commonly injured organ (60.6); followed by the kidney (11.5). The testes were the least injured organs (1.6). The blunt renal injuries and extraperitoneal bladder injuries were managed by non operative means while most other injuries were managed by surgical intervention. Immediate treatment outcome was satisfactory in most patients. There was one mortality. CONCLUSION: Most cases of GUI are preventable. Improved safety on the roads;'proper training of surgeons and attention to clinical and surgical details will go a long way in preventing GUI. Early intervention significantly reduces the morbidity and mortality

Pattern of Breast Masses in Lagos: A Private Health Facility Review of 189 Consecutive Patients

BACKGROUND:The increasing awareness concerning breast cancer has led to significant interest in breast masses in general. As a result there is considerable interest in the clinicopathologic studies of breast masses in various populations. OBJECTIVE: To study the clinicopathologic pattern of breast masses at a private health facility in Lagos; Nigeria. METHOD: The records of all patients who presented between January 1993 and December 2002 with breast lumps at the Lagoon Hospital Apapa were reviewed. Their biodata; clinical presentation and histopathological diagnosis were retrieved. RESULTS: 189 consecutive patients were studied comprising of 180 females and nine males. The peak age incidence for benign disease was 21-30 years while it was 31-40 years for those with malignant masses. Majority (66.1) presented with painless solitary lumps. 46 (77.2) patients had benign lumps while 43 (22.8) had malignant lesions. The commonest benign lesion was fibrocystic disease (47.9) while infiltrating ductal carcinoma was the commonest pathological diagnosis in the malignant group (83.1). CONCLUSION: From this study benign breast masses outnumber malignant ones by more than 3:1 in this population. The commonest pathological diagnosis was fibrocystic disease in benign lesions and infiltrating ductal carcinoma for malignant masses

Paediatric hand injuries at the Lagos University teaching hospital.

BACKGROUND: Paediatric hand trauma represents a subset of hand injury that can be quite challenging to manage. Local studies on this injuries are few therefore a 4 year retrospective study at the Trauma and hand rehabilitation unit of the Lagos University teaching hospital was carried out. OBJECTIVES: To determine the percentage of hand trauma occurring in the paediatric age group, the predominant age group involved, place of injury, the major injury types occurring as well as the most common surgical procedure required. METHODS: The case records of all cases that presented at the hand rehabilitation clinic or the emergency center of the Lagos University teaching hospital over a 4 year period were reviewed. Those below the age of 12 years were studied. Their biodata, type of injury, place of injury and other details were obtained. RESULTS: 634 patients were seen over the study period, 61 cases of hand injuries were in the paediatric age group. Hand trauma constituted less than a third of all paediatric hand cases. The commonest age group affected was 2-6 years. Most of the injuries occurred around the home. Burns injury, blunt trauma, glass and knife cuts were the commonest causes of hand trauma. Soft tissue reconstruction was commonest procedure done. CONCLUSION: Infants and toddlers were the most vunerable groups while burns injury was the commonest cause of hand trauma seen at the Lagos university teaching hospital.

Paediatric Hand Injuries at the Lagos University Teaching Hospital

Background: Paediatric hand trauma represents a subset of hand injury that can be quite challenging to manage. Local studies on this injuries are few therefore a 4 year retrospective study at the Trauma and hand rehabilitation unit of the Lagos University teaching hospital was carried out. Objectives: To determine the percentage of hand trauma occurring in the paediatric age group; the predominant age group involved; place of injury; the major injury types occurring as well as the most common surgical procedure required. Methods: The case records of all cases that presented at the hand rehabilitation clinic or the emergency center of the Lagos University teaching hospital over a 4 year period were reviewed. Those below the age of 12 years were studied. Their biodata; type of injury; place of injury and other details were obtained. Results: 634 patients were seen over the study period; 61 cases of hand injuries were in the paediatric age group. Hand trauma constituted less than a third of all paediatric hand cases. The commonest age group affected was 2-6 years. Most of the injuries occurred around the home. Burns injury; blunt trauma; glass and knife cuts were the commonest causes of hand trauma. Soft tissue reconstruction was commonest procedure done. Conclusion: Infants and toddlers were the most vunerable groups while burns injury was the commonest cause of hand trauma seen at the Lagos university teaching hospital

Experience with prosthetic reconstruction of ear defects at LUTH, Lagos, Nigeria.

AIM: The aim of the article is to report our experience with prosthetic reconstruction of ear defects in Nigerians. MATERIALS AND METHODS: A review of all consecutive cases of alloplastic (prosthesis) reconstruction of auricular defects was conducted at the Department of Oral and Maxillofacial Surgery of the Lagos University Teaching Hospital. Data collected included age and sex of patients, aetiology of defects, site of defects (left or right), lost tissue (partial or total), material used for the fabrication, and mode of retention of the prosthesis. RESULTS: A total of 33 consecutive patients who had prosthetic reconstruction of auricular defects during the period were included. The male-to-female ratio was 3.7: 1. Six cases (18.2%) were congenital defects and 27 (81.8) cases were acquired defects. Three (50%) of the congenital cases were microtia. Majority (63%) of the acquired cases were due to road traffic crashes. Total loss of the auricle was recorded in 22 (66.7%) patients. Of the patients with partial loss of the auricle, pinna was the major structure lost in 5 patients while pinna +lobe were lost in another 5 patients. Silicone elastomers was the most frequently used material for the fabrication of auricular prostheses (29 patients). The most frequently used retention method was silastic medical grade adhesive. CONCLUSIONS: Prosthetic option is a valuable technique for the reconstruction of ear defect. The primary indication for prosthetic reconstruction of ear defect in the present study is acquired ear deformity; mainly due to road traffic crashes.