There is a tendency to treat humeral fractures with the use of splintage in resource poor countries due to a perceived high rate of complications with operative fixation. The Surgical Implant Generation Network (SIGN)...There is a tendency to treat humeral fractures with the use of splintage in resource poor countries due to a perceived high rate of complications with operative fixation. The Surgical Implant Generation Network (SIGN) intra medullary nail has provided an alternative in the management of humeral shaft fractures. Due to the paucity of research work in this area, our study evaluated factors that influence the time to fracture union in humeral shaft fractures. Fifty-eight humeral Diaphysial fractures were treated over six years. It is a retrospective study. Case notes and the database were analysed. The statistical analysis was done using the SPSS 24 software. The time to fracture healing was the primary outcome variable and how it was influenced by patient and implant variables was studied. The mean time to fracture healing was 17.38 weeks. All 58 fractures united. The mean time to fracture healing in the 20 - 29 years was 16.00 weeks which was lower than in older age groups. Fractures in males healed at 16.33 weeks and in females at 18.76 weeks. Patients with Diabetes Mellitus had a mean healing time of 29.00 weeks, while third proximal fractures healed in a mean time of 15.25 weeks. Age and sex had no significant influence on the time to fracture healing while Diabetes Mellitus, longer duration of antibiotic use, open fractures, and presence of fracture gap post fixation and third middle fractures had increased time to fracture healing.展开更多
BACKGROUND: Low back pain is a major cause of referral to the Spine clinic. In the adult population 50% - 90% may present with low back pain at least once in their life time. Currently, the gold standard for diagnosin...BACKGROUND: Low back pain is a major cause of referral to the Spine clinic. In the adult population 50% - 90% may present with low back pain at least once in their life time. Currently, the gold standard for diagnosing the etiology of low back pain is MRI. The protocol at NOHE is to request MRI for patients whose clinical patterns are indicative for invasive intervention. OBJECTIVE: To determine the pattern of MRI findings in patients with low back pain attending spine clinic at NOHE. METHODS: This is a retrospective study of 60 MRI of adult patients with low back pain with clinical need for invasive intervention. The scan was carried out with A Basda BTI 0.35T MRI System using the standard protocol, with sagital and axial T1 and T2-weighted and STIR. Images were from Onis 2.5 digital co. limited. RESULT: Thirty five (58.3%) were males while 25 (41.7%) were females with majority aged between 40 - 59 years. About 90% of the images had disc prolapse while 73% had disc height reduction. The commonest cause of spinal canal stenosis was disc prolapse, thickened ligamentum flavum, spondylolisthesis and osteophytes. Six (10%) of the patient did not have any lesion on MRI. L4/5 was the commonest affected segment while 90% of abnormal cases had multilevel involvement. CONCLUSION: There is high yield of diagnosis with MRI scan among low back pain patients with clinical need for invasive intervention, hence an excellent navigating tool. L4/L5 disc level remains the commonest culprit.展开更多
Background: Spinal cord injury represents one of the most physically and psychologically devastating trauma. Before modern medicine, it was considered an ailment not to be treated. In incomplete spinal cord injury (SC...Background: Spinal cord injury represents one of the most physically and psychologically devastating trauma. Before modern medicine, it was considered an ailment not to be treated. In incomplete spinal cord injury (SCI), there is residual sensory and/or motor function. Method: This was to determine the epidemiology, treatment options and outcome of incomplete SCI at National Orthopedic Hospital Enugu, Nigeria, over a 5 year period. This was a descriptive retrospective study of patients managed for incomplete spinal cord injury between January 2011 and December 2015. This was to determine the epidemiology, various treatment options and their outcome in patients with incomplete SCI managed in our center. The patients’ biodata, mechanism of injury, time of presentation, pattern of injury, level of injury, type of treatment, associated injuries, complications, duration of treatment and American Spinal Injury Association (ASIA) assessment at presentation and at discharge were collected. Data analysis was done using statistical package for social sciences (SPSS) version 20.0. All tests were regarded as significant at P-values Results: A total of 57 patients (49 males and 8 females) were included and analyzed showing a male to female ratio of 6.3:1. Incomplete traumatic SCI forms about 44.2% of all traumatic SCI in Enugu. This represents 0.09% of all patients and 0.9% of all trauma patients seen. The cervical spine (59.6%) is the most commonly affected isolated anatomic region. Road traffic accident (52.6%) was the most common aeteology. Compression fracture was the commonest injury (33.3%). Majority of the patients (57.9%) had ASIA C at presentation while 47.4% and 33.3% of the patients had ASIA D and E respectively at discharge. Most of the patients (91.2%) had conservative treatments. Conclusion: The significant ASIA grade improvement of majority of the patients suggests good functional outcome of incomplete SCI treated conservatively at our hospital.展开更多
文摘There is a tendency to treat humeral fractures with the use of splintage in resource poor countries due to a perceived high rate of complications with operative fixation. The Surgical Implant Generation Network (SIGN) intra medullary nail has provided an alternative in the management of humeral shaft fractures. Due to the paucity of research work in this area, our study evaluated factors that influence the time to fracture union in humeral shaft fractures. Fifty-eight humeral Diaphysial fractures were treated over six years. It is a retrospective study. Case notes and the database were analysed. The statistical analysis was done using the SPSS 24 software. The time to fracture healing was the primary outcome variable and how it was influenced by patient and implant variables was studied. The mean time to fracture healing was 17.38 weeks. All 58 fractures united. The mean time to fracture healing in the 20 - 29 years was 16.00 weeks which was lower than in older age groups. Fractures in males healed at 16.33 weeks and in females at 18.76 weeks. Patients with Diabetes Mellitus had a mean healing time of 29.00 weeks, while third proximal fractures healed in a mean time of 15.25 weeks. Age and sex had no significant influence on the time to fracture healing while Diabetes Mellitus, longer duration of antibiotic use, open fractures, and presence of fracture gap post fixation and third middle fractures had increased time to fracture healing.
文摘BACKGROUND: Low back pain is a major cause of referral to the Spine clinic. In the adult population 50% - 90% may present with low back pain at least once in their life time. Currently, the gold standard for diagnosing the etiology of low back pain is MRI. The protocol at NOHE is to request MRI for patients whose clinical patterns are indicative for invasive intervention. OBJECTIVE: To determine the pattern of MRI findings in patients with low back pain attending spine clinic at NOHE. METHODS: This is a retrospective study of 60 MRI of adult patients with low back pain with clinical need for invasive intervention. The scan was carried out with A Basda BTI 0.35T MRI System using the standard protocol, with sagital and axial T1 and T2-weighted and STIR. Images were from Onis 2.5 digital co. limited. RESULT: Thirty five (58.3%) were males while 25 (41.7%) were females with majority aged between 40 - 59 years. About 90% of the images had disc prolapse while 73% had disc height reduction. The commonest cause of spinal canal stenosis was disc prolapse, thickened ligamentum flavum, spondylolisthesis and osteophytes. Six (10%) of the patient did not have any lesion on MRI. L4/5 was the commonest affected segment while 90% of abnormal cases had multilevel involvement. CONCLUSION: There is high yield of diagnosis with MRI scan among low back pain patients with clinical need for invasive intervention, hence an excellent navigating tool. L4/L5 disc level remains the commonest culprit.
文摘Background: Spinal cord injury represents one of the most physically and psychologically devastating trauma. Before modern medicine, it was considered an ailment not to be treated. In incomplete spinal cord injury (SCI), there is residual sensory and/or motor function. Method: This was to determine the epidemiology, treatment options and outcome of incomplete SCI at National Orthopedic Hospital Enugu, Nigeria, over a 5 year period. This was a descriptive retrospective study of patients managed for incomplete spinal cord injury between January 2011 and December 2015. This was to determine the epidemiology, various treatment options and their outcome in patients with incomplete SCI managed in our center. The patients’ biodata, mechanism of injury, time of presentation, pattern of injury, level of injury, type of treatment, associated injuries, complications, duration of treatment and American Spinal Injury Association (ASIA) assessment at presentation and at discharge were collected. Data analysis was done using statistical package for social sciences (SPSS) version 20.0. All tests were regarded as significant at P-values Results: A total of 57 patients (49 males and 8 females) were included and analyzed showing a male to female ratio of 6.3:1. Incomplete traumatic SCI forms about 44.2% of all traumatic SCI in Enugu. This represents 0.09% of all patients and 0.9% of all trauma patients seen. The cervical spine (59.6%) is the most commonly affected isolated anatomic region. Road traffic accident (52.6%) was the most common aeteology. Compression fracture was the commonest injury (33.3%). Majority of the patients (57.9%) had ASIA C at presentation while 47.4% and 33.3% of the patients had ASIA D and E respectively at discharge. Most of the patients (91.2%) had conservative treatments. Conclusion: The significant ASIA grade improvement of majority of the patients suggests good functional outcome of incomplete SCI treated conservatively at our hospital.
