Perioperative considerations in orthopaedic patients with diabetes mellitus: a review.

Patients with diabetes mellitus are predisposed to a host of orthopaedic problems which may require surgery and many patients with orthopaedic conditions may have unrecognised hyperglycaemia presenting for the first time at surgery. This group of patients are also prone to adverse surgical outcomes like post-operative infections and poor wound healing. The control of hyperglycaemia in orthopaedic patients with diabetes mellitus is the key in optimising surgical outcome in these patients. Peri-operative insulin is the main antihyperglycaemic agent of use. The risk of hypoglycaemia with tighter peri-operative glucose control outweighs its potential benefits. Blood glucose control with insulin infusion is better than sliding scale insulin. Control of infections and promotion of wound healing are necessary adjuncts in the management to optimise surgical outcome.

Deep calf cavernous haemangioma in a 10 year- old girl: a case report.

Haemangiomas are abnormal proliferation of blood vessels in any vascularised tissue. They can be capillary or cavernous varieties. Cavernous are either of cutaneous or deep types. Cavernous when compared with the capillary haemangioma is rare. Rarer still is the deep type of cavernous haemangioma. This is a report of a 10 year old Nigerian girl who presented with a right posterior leg swelling of 8 year duration, size initially was that of a peanut but increased to fill the entire calf region causing pain to the patient as well as cosmetic and anxiety concern to the parents. No preceding history of trauma, no associated systematic symptoms. She had exploratory laparatomy at 1 year of age at a private hospital for an abdominal mass which was excised. Pre-operative plain radiograph, Magnetic Resonance Imaging(MRI), Abdominopelvic ultrasound scan (USS) were done, fine needle aspiration cytology (FNAC) though done was not helpful. Histo-pathology result of excised leg mass confirmed diagnosis; there was a free margin of excision. Post-operatively, clinical improvement was marked.

A review of obesity and orthopaedic surgery: the critical issues.

Obesity is a growing concern in the health community because of the morbidities associated with it. There is a higher occurrence of many orthopaedic conditions among obese individuals than their non-obese counter parts. Obesity also worsens the progression of many of these orthopaedic conditions. Studies have shown that obesity may have negative impact on bone metabolism and may be implicated in the pathophysiology of some orthopaedic conditions like osteoporosis, fractures, osteoarthritis and many soft tissue ailments by both reduction in bone mass and elaboration of proinflammatory cytokines. These contribute to preponderance of musculoskeletal co-morbidities among obese patients. Critical peri-operative issues which include increased cardiopulmonary risks, issues of special equipment, instrumentation, surgical approach, patients' positioning and adjustments in medication should be acknowledged and meticulously addressed in operative management of orthopaedic conditions in obese patients. Surgeries in obese patients are fraught with operative challenges and post-operative complications than in the non-obese and a good knowledge of the critical issues in surgical management of obese patients is necessary to facilitate decision making as well as rendering of effective and efficient orthopaedic care.

Chronic recurrent multifocal osteomyelitis: a case report and review of literature.

BACKGROUND: Chronic recurrent multifocal osteomyelitis (CRMO) is a rare condition of largely unknown aetiology and pathogenesis with variable clinical and radiological features. There are no reports on CRMO to the best of our knowledge; in the West African sub region. OBJECTIVE: To present a case and review the literature on chronic recurrent multifocal osteomyelitis. METHODS: A 13-year-old male presented with a three-year history of recurrent discharging right thigh sinus and an 11-day history of a left shoulder swelling with discharging sinus. Detailed history was obtained and physical examination and radiological and microbiological tests carried out before treatments. RESULTS: There were periodic exacerbations of pain, swelling and discharge over affected areas. He had a short limb gait and shoulder asymmetry. His left shoulder was warm, erythematous and there was decreased range of movement in all directions. Investigations revealed an erythrycyte sedimentation rate (ESR) of 150mm/hr. Wound swabs taken at different times from the right thigh and shoulder sinuses revealed no growth. Radiographs of the left arm, right thigh and hip showed features consistent with chronic osteomyelitis. There were associated destruction of the left hip and soft tissues welling in the left shoulder. He was principally treated with non-steroidal anti-inflammatory drugs (NSAIDs) , antibiotics and dressing of sinuses for three months and had only mild relief of clinical features but no improvement in radiological picture. CONCLUSION: Chronic recurrent multifocal osteomyelitis is a diagnosis of exclusion which is usually under diagnosed because amongst other things, not much is known about it. Successful treatment is difficult to achieve, though some authors have reported good results with combined medical and surgical treatment.

Usage of Complementary and Alternative Medicine (CAM) among osteoarthritis patients attending an urban multi-specialist hospital in Lagos, Nigeria.

BACKGROUND: Osteoarthritis (OA), a chronic degenerative disease of synovial joints is characterised by pain and stiffness. Aim of treatment is pain relief. Complementary and alternative medicine (CAM) refers to practices which are not an integral part of orthodox medicine. AIMS AND OBJECTIVES: To determine the pattern of usage of CAM among OA patients in Nigeria. PATIENTS AND METHODS: Consecutive patients with OA attending orthopaedic clinic of Havana Specialist Hospital, Lagos, Nigeria were interviewed over a 6- month period st st of 1 May to 31 October 2007 on usage of CAM. Structured and open-ended questions were used. Demographic data, duration of OA and treatment as well as compliance to orthodox medications were documented. RESULTS: One hundred and sixty four patients were studied.120 (73.25%) were females and 44(26.89%) were males. Respondents age range between 35-74 years. 66(40.2%) patients used CAM. 35(53.0%) had done so before presenting to the hospital. The most commonly used CAM were herbal products used by 50(75.8%) of CAM users. Among herbal product users, 74.0% used non- specific local products, 30.0% used ginger, 36.0% used garlic and 28.0% used Aloe Vera. Among CAM users, 35(53.0%) used local embrocation and massage, 10(15.2%) used spiritual methods. There was no significant difference in demographics, clinical characteristics and pain control among CAM users and non-users. CONCLUSION: Many OA patients receiving orthodox therapy also use CAM. Medical doctors need to keep a wary eye on CAM usage among patients and enquire about this health-seeking behaviour in order to educate them on possible drug interactions, adverse effects and long term complications.

Surgical consideration for benign bone tumors.

BACKGROUND: The surgical management of symptomatic benign bone tumor has been described in various manners in medical literature. However, there are few published reports on the presentation and surgical management of benign bone tumors in black African patients. OBJECTIVES: To determine the pattern of presentation of benign bone tumors and evaluate the common indications for surgery in a Nigerian Orthopedic Center. MATERIALS AND METHODS: This is a prospective study of 67 patients, surgically treated for benign bone tumors, over a three-year period, at the National Orthopedic Hospital, Lagos, Nigeria. RESULTS: The common histological types include, osteochondroma, giant cell tumor, and the simple bone cyst. These tumors have varying anatomic locations, but are more commonly located around the knee joint. In this series, most of the patients have presented with an active or aggressive stage of the disease. The most common indication for surgery is painful swelling; other indications include a pathological fracture, restricted range of movement, and peripheral nerve compression. The surgical procedures performed are simple excision, curettage, and stabilization; and 1-stage and 2-stage wide resection with reconstruction. Patients with significant bone defects have autologous bone grafting or methylmethacrylate cement application. Further stabilization is achieved with intramedullary or compression plate and screw fixation. Amputation has only been necessary in one patient with a huge aneurysmal bone cyst. At the average follow-up period of 28.6 months, five patients showed recurrence. All were with a histological diagnosis of giant cell tumor. CONCLUSIONS: The mode of presentation of benign bone tumors in this group of black African patients is heterogenous, demanding various surgical options. Limb sparing is a largely feasible option, but the recurrence rate is particularly higher for giant cell tumors. Increase in the number of patients presenting with giant cell tumors raises the possibility of an increase in the incidence of this condition in the black African population. Larger multicenter studies in the black African population may shed more light on the actual incidence of giant cell tumors and other bone tumors in this group of patients.

Multicentre study of bone tumours.

BACKGROUND: Bone tumours are associated with high morbidity and mortality, especially in Lagos where late presentation, lack of diagnostic and therapeutic facilities as well as cultural and religious beliefs/practices constitute a formidable challenge to appropriate management. OBJECTIVE: To study the clinico-pathologic pattern of primary bone tumours in Lagos. METHODS: A 2.5 decade retrospective review of cases of primary bone tumours at National Orthopaedic Hospital, Lagos (NOH), Lagos University Teaching Hospital (LUTH), and Havana Specialist Hospital (HSH) was done. Data such as age, gender, tumour type were extracted from the medical records and analysed. RESULTS: Six hundred and ninety-eight (698) cases were reviewed. 364 cases were from NOH, 242 from LUTH and 92 from HSH. There were 10 cases in 1981, 13 in 1985, 19 in 1990, 30 in 1995, 38 in 2000 and 46 in 2005. The age range of cases was 6 to 85 years with a mean of 25.8 years and peak frequency in the 11-20 year age group. 423 patients (60.6%) were males and 275(39.4%) were females giving a male to female ratio of 1.5: 1. Three hundred and fifty-six (51.0%) were of benign while 342 (49.0%) were malignant. The commonest types were osteosarcoma 197 cases (28.2%), osteochondroma 106 cases (15.2%) and osteoclastoma 78 cases (11.2%) CONCLUSION: Primary bone tumours presenting to hospitals in Lagos are on the rise. They are common amongst males and teenagers. Majority are benign and comprise osteochondroma, osteosarcoma, osteoclastoma, aneurysmal bone cysts and chondrosarcoma.

Clinico-pathologic patterns of extremity liposarcoma.

BACKGROUND: Liposarcoma is a tumour derived from primitive cells that undergo adipose differentiation. OBJECTIVE: To describe the clinico-pathological pattern of extremity liposarcoma in Lagos, Nigeria. METHODS: This is a descriptive study of patients with histologically established liposarcoma affecting the extremities seen at the Oncology unit of the National Orthopaedic Hospital, Lagos Nigeria. Demographic and clinical data ( including age, gender, presenting complaints anatomic location of lesions ), histologic type, clinical stage and treatment outcome were collected using a prepared proforma and analysed. RESULTS: Liposarcoma accounted for 6 [27.3%] of 22 cases of soft tissue sarcomas seen within the study period. All 6 were males with a M:F of 6:0. The age range was 36- 59 years. Lesions were mostly located in the thigh 5/6 (83.3%). The most common histologic type was myxoid seen in 3/6 [50%]. All presented at stage T2bNoMo. Five (83.3%) had limb salvage surgery with adjuvant radiotherapy while one had ablative surgery. Survival and recurrent rates could not be determined as all patients were lost to follow-up soon after surgery. CONCLUSION: Liposarcoma is the commonest extremity soft tissue sarcoma seen in our centre, the myxoid type being the commonest histologic subtype.

Concerns, attitudes, and practices of orthopaedic surgeons towards management of patients with HIV/AIDS in Nigeria.

The increasing number of people living with HIV/AIDS is causing concern among surgeons over risk of occupationally acquired HIV infection. This may influence their attitude to such patients. The purpose of this study was to develop a cross-sectional survey of orthopaedic surgeons to assess their concerns, attitudes, and practices towards management of HIV-positive patients in Nigeria. All respondents were males, 55 (73.3%) of them indicated concern over the risk of occupational acquisition of HIV infection and 37 (49.3%) had examined or operated on at least one HIV/AIDS patient. Sixty (79.9%) were willing to be tested for HIV and 51 (67.9%) were previously tested. Fifty-seven (75.9%) would order preoperative HIV screening of high risk patients, and 67 (89.3%) would operate on HIV-positive patients. Most orthopaedic surgeons in Nigeria would operate on HIV-positive patients.

Challenges in the diagnosis and management of musculoskeletal tumours in Nigeria.

The management of musculoskeletal tumours is important because of the high mortality rates associated with the available treatment modalities. A 5-year prospective study of bone and soft-tissue tumours is presented, along with the difficulties encountered in diagnosis and treatment. There were 71 patients (male:female ratio of 1.7:1, age range 5-85 years, mean age 32 years) with an average duration of 24.7 weeks (range 1 day to 34 years) before presentation. No patient had computed tomography (CT) scanning or magnetic resonance imaging (MRI) due to financial constraints, 95% had biopsies and X-rays, 15% could afford chemotherapy/ror chemotherapy is a sad consequence. 50% agreed to amputation. In the soft-tissue sarcoma group, only one of three patients could pay for limb-sparing surgery. In the benign group, 65% had limb-sparing surgeries and 15% had amputation. Fifty percent (50%) of patients were lost to follow up within 3 months and 39% of the malignant group died within the same period. Musculoskeletal tumours are a reality in our environment and a significant portion of our population have financial limitations. Ignorance and cultural beliefs promote late presentation to our hospitals, which are poorly equipped to give optimal care, despite the presence of trained personnel.

Lower limb amputations at a Nigerian private tertiary hospital.

BACKGROUND: Lower Limb amputation remains one of the commonest surgical procedures. The incidence is on the rise in Nigeria due mainly to increasing motorcycle accidents and increased prevalence of uncontrolled diabetes complicated by neuropathy, vasculopathy and diabetic foot gangrene. OBJECTIVE: To determine the pattern and outcome of lower limb amputations in a private tertiary setting. METHODS: This was a 10-year retrospective review of lower limb amputations done at Havana Specialist Hospital (HSH), a multi-specialist private hospital in Lagos, Nigeria. Utilizing theatre and ward records, case notes of patients that had lower limb amputations in the hospital between 1997 and 2006 were studied. RESULTS: A total of 68 lower limb amputations performed on 64 patients were studied. All were closed amputations. Ages 2 to 76 years were affected with a mean of 36.0 +/- 16.2 years and peak age in the 21-30 year group. There were 44 (68.8%) males and 20 (31.2%) females, showing a male to female ratio of 2:2.1. Trauma was the most common indication accounting for 42 (61.8%). Motorcycle related accidents were implicated in 26 (61.9%) of the trauma related cases followed by 8 (19.0%) pedestrians involved in road traffic accidents, while 30 (71.4%) of the patients with trauma had visited traditional bone setters before presenting at the hospital. Below knee amputation was done in 51 (75.0%) of cases and stump wound infection was found in 18 (26.5%). Three (4.7%) patients died. Fifty-five (77.9%) amputation stumps healed by primary intention. Postoperative hospital stay ranged from 21 to 72 days. CONCLUSION: Most lower limb amputations were done on young adult males and were mostly due to trauma, predominantly from motorcycle accidents. Majority of the stumps healed by primary intention. Mortality was highest in diabetic related amputations.

Deep vein thrombosis: risk factors and prevention in surgical patients.

BACKGROUND: Deep vein thrombosis (DVT) is a cause of preventable morbidity and mortality in hospitalized surgical patients. The occurrence of the disease is related to presence of risk factors, which are related primarily to trauma, venous stasis and hyper-coagulability. DVT seems not to be taken seriously by many surgeons in Nigeria. This is despite comprehensive studies that show no real differences in racial demography of the disease. OBJECTIVE: To highlight the importance of physician awareness about DVT especially its risks and prevention methods. METHODS: A detailed literature search was completed to extrapolate articles that described DVT risks and prevention. This involved hand and online searches. Specific search terms used included DVT/risk factors/prevention. The searches generated 468 papers. Of these 57 papers were included in the review. RESULTS: Predominant risk factors for DVT include middle or old age, prolonged surgery, trauma, confinement, presence of malignancy and insertion of deep venous catheters. In women, contraceptive use, hormone replacement therapy, pregnancy and the puepernum are a additional risk factors. Prophylactic measures include those directed at eliminating venous stasis and those directed at changes in blood coagulability. CONCLUSION: Deep Venous Thrombosis is a common disease with fatal and serious long term burdensome complications. We must target primary and secondary prophylaxis to improve survival and reduce morbidity from this preventable disease.

Management of long bone fractures and associated injuries from gunshots at a nigerian tertiary hospital.

BACKGROUND: Globally, management of gunshot injuries (GSI) encompasses resuscitation, evaluation and treatment. Wound debridement is mandatory, while definitive treatment of any associated fracture varies from one part of the world to another. In developed countries aggressive modalities of early operative fixation of such fractures have produced good results. In the Nigerian environment, the approach to such fractures is controversial and cautious, with secondary operative and even non-operative methods still being predominant. OBJECTIVE: To compare operative versus non-operative methods of treatment of long bone fractures and associated injuries from gunshots in our centre. METHODS: This is a prospective study of long bone fractures and associated injuries from civilian gunshots presenting at Lagos University Teaching Hospital (LUTH), Lagos, Nigeria between 1st January 2000 and 31st December 2003. LUTH, one of the tertiary hospitals in Nigeria receives most of the multi-system trauma referrals in Lagos State, Nigeria. RESULTS: Three hundred and sixty patients with GSI were studied, 322 (89.4%) were males while 38 (10.6%) were females, giving a male: female ratio of 8.5:1. One hundred and thirty-six patients (37.8%) had long bone fractures, 94 (69.1%) on the lower limbs. All wounds were debrided and 198 (55.0%) had serial debridement. Eighty-two (60.3%) of 136 patients with fractures from G.S.I had operative treatment done secondarily and 87.5% of them achieved union. Also 42 (77.8%) of 54 patients treated non-operatively achieved union. Two hundred and thirty-four (65.0%) of the gunshot wounds healed by secondary intention, 81 (22.5%) had split thickness skin grafting and 18 (5.0%) had flap cover. CONCLUSION: This study showed that secondary operative treatment of long bone fractures in GSI produces good outcome.

Bone cement in the management of cystic tumour defects of bone at National Orthopaedic Hospital, Igbobi, Lagos.

BACKGROUND: Cystic bony defects are characteristics of bone tumours especially benign ones e.g. Giant cell tumours of bone [GCT] and some metastatic tumours to bone. These patients present late with significant cystic cavities at a time the cost and availability of prosthetic implants to replace these defects sometimes precludes resection. The objective of this study is to evaluate the outcome of filling these defects with bone cement augmented with plate and screw for stability. METHOD: A seven year prospective study was carried out in patients presenting with large cystic bony defects secondary to bone tumours at the oncology unit of the National Orthopaedic Hospital, Igbobi, Lagos. Data such as age, sex, anatomic location of lesions, histological type of tumours, x-ray findings, operation performed with the number of packets of bone cement used to fill the resultant bony defects were retrieved from prepared proforma. The average follow-up was 36 months. RESULT: The proximal tibia and distal femur accounted for 42.9% and 28.6% respectively of the 14 patients studied. Giant cell tumour was the most common histological diagnosis 78.6%. Bone cement was effective in meeting the local requirements of limb salvage, early functional recovery and as a temporising measure until the patients can avail themselves of better options. The complication encountered was that of anaphylactic reaction in 2 scrub nurses. CONCLUSION: Bone cement augmented with appropriate implants has proven valuable as a stop gap in filling large cystic bony defects resulting from tumours.

Primary bone tumours in a tertiary hospital in Nigeria: 25 year review.

BACKGROUND: Primary bone tumors remain a daunting challenge to orthopaedic surgeons. The challenge is heightened in developing countries due to limited diagnostic and therapeutic facilities and ignorance. The published literature on the subject is sparse in our environment. OBJECTIVE: To describe the pattern of primary bone tumors seen in a tertiary hospital in Nigeria. METHODS: This is a retrospective review of all the histologically confirmed primary bone tumours seen at Lagos University Teaching Hospital (LUTH) over a 25 year period. RESULTS: A total of 242 patients (aged 7.5 to 62 years) with a mean of 25.3 years were studied. One hundred and forty four patients (59.5%) were males and 98 (40.5%) were females. The peak age incidence was in the age group 11-20 years. One hundred and thirty (53.7%) of the tumors were benign. Among these Osteochondroma was the commonest accounting for 36 cases (27.7%) followed by Osteoclastoma, 28 cases (21.5%). Osteosarcoma accounted for 66 cases (58.9%) of all primary malignant tumours in the study. CONCLUSION: This study showed that primary bone tumours were mainly benign, occurred predominantly in the second decade of life with a male preponderance. Osteochondroma and Osteosarcoma were the most common benign and primary malignant bone tumours respectively.

Morbidity and mortality associated with polytrauma at a Nigerian tertiary hospital.

BACKGROUND: Polytrauma which is a leading cause of morbidity and mortality world-wide is associated with long hospital stay and loss of productivity. OBJECTIVE: To determine the morbidity and mortality associated with polytrauma in an urban African tertiary hospital. METHODS: This prospective study was carried out at the Lagos University Teaching Hospital (LUTH) between 1st November 2004 and 31st October 2006 All surviving patients with significant multiple injuries that presented at LUTH over the period were studied. Data were collected and analysed included age, gender, complications and outcomes. RESULTS: Two hundred and ninety-one patients with multiple trauma were studied excluding those brought in dead. Most (75.3%) of the patients were males. Ages were affected ranged from two years to 76 years with a mean of 32.2 +/- 16.4 years. The commonest complication was wound infection 24 (32.0%) followed by bedsores 12 (16.0%). Forty-two (14%) patients died. These deaths were associated with average high injury severity score of 37.2 +/- 12.0. Six patients had amputation and all of them had mangled extremity severity score greater than seven. Prolonged hospital stay was recorded among patients with fractures and spinal injuries, who had average stay of 71 days. CONCLUSION: Wound infection and high death rates among patients with high injury severity scores are the commonest complications in polytrauma as seen in this African teriary hospital.

Pattern of extremity injuries in polytrauma in Lagos, Nigeria.

BACKGROUND: Extremity injuries are common in polytrauma, which remains a leading cause of death, long hospitalisation and disability for all ages. There are few research works on the pattern of these extremity injuries in Lagos, Nigeria. OBJECTIVE: To describe the pattern of extremity (limb) injuries in polytraumatised patients. PATIENTS AND METHODS: This was a prospective study carried out at the Lagos University Teaching Hospital, between 1st November 2004 and 31st October 2006. RESULTS: A total of 291 patients presented with multiple injuries between November 2004 and October 2006. All of them had extremity injuries. The studied patients were aged 2 to 76 years with a mean of 31.2 +/- 16.4. Two hundred and twenty two (76.3%) of the patients were aged 40 years or less. There were 219 males and 72 females showing a male to female ratio of 3:1 Road traffic accident was the most common aetiology (73.2%). The most frequently seen fractures were tibia 27.8%, femur and fibula 24.7% each. An overwhelming majority (88.8%) had multiple fractures. The commonest fracture combinations were tibia/ fibula 24.7% and radius/ulna 19.6%. The most frequently associated injury was head injury 26.8%. Others were spinal and abdominal injuries 13.4% each. Hip dislocation accounted for a majority (56%) of all dislocations seen in this study. CONCLUSION: Lower extremity injuries were commoner than upper extremity injuries in polytrauma. Majority of them had multiple fractures especially among bones that have close anatomical location. Head injury was the most commonly associated injury.

Indications for ablative surgery in extremity musculoskeletal tumours.

BACKGROUND: Surgical options for treatment of extremity musculoskeletal tumours include excision [limb sparing] surgery or amputation [limb ablation]. Ablative surgery is for advanced extremity musculoskeletal tumours when limb salvage surgery is not feasible. OBJECTIVE: To determine the indications for ablative surgery in extremity musculoskeletal tumours in our centre. METHOD: This is a 6 year prospective study of patients presenting with extremity musculoskeletal tumours at National Orthopaedic Hospital Lagos. Data such as age, gender, presenting complaints, anatomic location of the tumour, clinical stage, type of ablative surgery and adjuvant treatment offered, histologic type of tumour, and treatment outcome were documented. RESULTS: Nineteen patients had ablative surgery as a mode of treatment. 11 were male while 8 were female with a M:F of 1.3:1. The age range was 3 - 69 years. Seven patients [6 males and 1 female] refused ablative surgery and voluntarily discontinued treatment. Most tumours were located in the lower limb and all patients that had ablative treatment presented with stage 3 or 4 disease. Osteogenic sarcoma was the most common diagnosis, accounting for 4 cases [21.1%]. Six patients [31.6%] with non-malignant tumours had ablative surgery due to either late presentation or inaccurate preoperative diagnosis. Trans-femoral amputation was the most common level of amputation and this was done in 9 patients [47.4%]. Adjuvant chemotherapy was prescribed for all patients. The recurrence and survival rates could not be determined for each tumour as the patients were lost to follow-up soon after surgery with average post operative follow up of 5.5 months. CONCLUSION: Late presentation with locally advanced disease remains the dominant indication for ablative surgery in extremity musculoskeletal tumours.

Profile of spinal injuries in Lagos, Nigeria.

STUDY DESIGN: Retrospective study. OBJECTIVE: To describe the pattern and outcome of spinal cord injuries in Lagos, Nigeria. SETTING: Nigeria, Lagos. METHODS: This retrospective review of cases was conducted at Lagos University Teaching Hospital (LUTH), Lagos, between January 1992 and December 2006. RESULTS: A total of 468 cases of spinal cord injury over the 15-year period were studied. Three hundred and twelve of them (66.2%) were aged 40 years and below, with the peak age incidence as 21-30 years. There were 328 males (70.1%) and 140 females (29.9%) showing a male to female ratio of 2.34:1. Road traffic accident accounted for 362 (77.4%) patients. At presentation, 430 (91.9%) of the injuries were of ASIA (American Spinal Injury Association) class A. Lumbar spine was affected in 278 (59.4%) of patients, whereas cervical spine accounted for 142 (30.3%). The most frequently seen complication was bedsore, seen in 163 (59.9%) of 272 patients that had complications. On discharge, 230 patients (49.1%) were in ASIA class A and 34 (7.5%) in ASIA E. Eighty-two patients (17.5%) died. CONCLUSION: Spinal injuries in Lagos occurred mostly in young adult males affecting mainly the lumbar spine. Traffic-related incidents were the leading cause and bedsore the most common complication.