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Papers by Olayinka Oladiran Adegbehingbe

Archives of Orthopaedic and Trauma Surgery, Apr 1, 2008

The ideal specimen for identification of the etiologic agents in chronic osteomyelitis for best a... more The ideal specimen for identification of the etiologic agents in chronic osteomyelitis for best antibiotic decision remains controversial. To assess the concordance of sinus track culture (STC) with that of intraoperative bone culture (IBC) to guide antibiotic therapy in chronic osteomyelitis. A prospective comparative study of chronic osteomyelitis patients seen in our centre from January 2004 to December 2006. Specimens from the depths of sinus track and intraoperative bone biopsy were obtained from each patient and subjected to microbiologic examination and their concordance determined. In STCs Staphylococcus aureus has the highest sensitivity (60.5%), specificity (45.0%) and positive predictive value (72.2%). The overall sensitivity (50.9%), specificity (20%) and predictive value (47.5%) of sinus track specimens were very low. Antibiotic decision based on IBC showed 106 patients (82.8%) had resolution of chronic osteomyelitis at mean of 2 years follow-up. IBC appears to predict more reliably the complete etiologic organisms than STCs in chronic osteomyelitis.

African Journal of Paediatric Surgery, Feb 1, 2007

Birth trauma is a significant cause of neonatal morbidity and mortality. This prospective study d... more Birth trauma is a significant cause of neonatal morbidity and mortality. This prospective study determined the predictive factors for birth trauma as seen in a Nigerian university teaching hospital. This was a prospective descriptive evaluation of birth trauma at Wesley Guilds Hospital, Ilesa over three years. Semi-structured questionnaire was used to collect data on the age, gender, pattern of presentation, place and mode of delivery, level of birth attendants, and treatment offered. Outcome measures were factors predisposing to birth trauma. A total of 137 neonatal hospital admissions with birth related complaints were recorded between 10th December, 2002 and 9th December 2005, out of which 119(86.8%) patients had 121 birth injuries (Males: Females= 1.4: 1). The mean age was 6 ± 4.1 (range: 1-31) day. Non skeletal injuries included cephalohaematoma 30(24.8%), genital bruises/abrasion 4(3.3%), subconjuctiva haemorrhage 2(1.7%), subdural haemorrhage 1 (0.8%), nasal necrosis 1(0.8%), Erb`s`palsy 31(25.6%) and Klumpke`s palsy 2(1.7%). Skeletal injuries were mainly bone fractures 50(41.3%)with 2(1.7%)mortality. Ante natal care/delivery, level of birth attendants, mode of delivery, fetal distress, and emergency caesarian section were among the factors that determined birth trauma. The prevalence of birth trauma is high in southwestern Nigeria. The predictive factors are easily identifiable in the perinatal period; early recognition could reduce significantly birth trauma. Keywords : Birth Trauma, Predictive factors, Prevalence, Nigeria. African Journal of Paediatric Surgery Vol. 4 (1) 2007: pp. 20-25

Sahel Medical Journal, Feb 9, 2004

ABSTRACT The practice of traditional bone setters can no longer be denied in this environment as ... more ABSTRACT The practice of traditional bone setters can no longer be denied in this environment as some of the complications resulting from their treatment are still seen commonly in orthopaedic surgical practice. This study was undertaken at the Federal Medical Centre, Owo, Ondo State, Nigeria to find out about knowledge, attitude and practice about the traditional bone setters (TBS) among health workers. A pre-tested questionnaire was distributed among the health workers through their heads of departments for ease of collection. The response rate was 88.2% with a male to female ratio of 1:1.7. 88.1% were aware of the TBS practice in our environment and 32.7% got to know about them through the mass media; constituting the greatest percentage proportion. Only 19.6% of the respondents claimed the knowledge of how traditional bone setters acquired their skills, 73.6% of these responded that it was innately acquired. While most of the respondents assessed their care as inadequate and that they should not be allowed to treat patients with fractures; 12.9% believed that the TBS possessed special powers to treat fractures that is lacking in orthopaedic surgeons. Health assistants were the most likely to be believe in the possession of such powers. It was recommended that the TBS should be banned from unvented access to the use of the mass media. Within the hospital environment, there is need to organize regular update or instructional lectures for health workers, especially the health assistants who are most likely to give wrong interpretations to events surrounding the patient treatment by the orthodox practitioners. (Key words: Chronic suppurative otitis media, Pseudomonas aerugi nosa, Hearing loss). Sahel Med. J. Vol.6(3) 2003: 79-82

PubMed, 2015

Background: Clubfoot has been evaluated in many ways, including the most common classifications o... more Background: Clubfoot has been evaluated in many ways, including the most common classifications of clubfoot, described by Caterrall and Piraniis based on six clinical signs. The purpose of this study was to gain better understanding of the heel pad in relation to the term "empty heel", and to propose modification of clubfoot severity scoring system based on "empty heel". Methods: A combination of prospective study of 79 clubfoot patients treated with Ponseti method and literature review of heel pad anatomy and biomechanics. The setting was a university teaching hospital. The ethical research committee approved study protocol and informed consent of patients' parent obtained. The selection criteria included patients' diagnosed congenital idiopathic clubfoot, age < 2 years, no history of previous treatment and tenotomy indicated. An evaluation of patient was assessed by orthopaedic surgeons trained on Ponseti method and has above 5 years experience. Data analysis performed on the age, sex, Pirani scores at onset of treatment, tenotomy, and 6 month after initial full correction. Results: One hundred and thirty-two clubfeet in 79 patients (56 males, 23 females) completed Ponseti protocol. The median age at presentation was 5.2 months (range 0.1-23.7 months). The mean right foot abduction after correction 57.30 (S.D. 9.20), and for the left foot, was 56.30 (S.D. 9.40). The mean right foot dorsiflexion was -13.70 (S.D. 18.40) before correction while after correction, it was 20.00 (S.D. 4.50) and for the left, the mean was -8.50 (S.D. 9.60) before correction and 21.00 (S.D. 4.30) after correction. Eighteen (22.8%) patients (10 bilateral, 9 unilateral) had clubfeet with empty heel score above zero point at initial full correction (p<0.001). Clinic anatomy shows the heel pad is a solid complex structure existing in normal, moderate and severe atrophied form. Heel pad is attached tightly to calcaneus without a cavity for the calcaneus to drop. Conclusions: Heel pad probably could replace "empty heel" in modify Pirani scoring system. Clinical indication for repeat tenotomy should be based on equinus, not on the feeling of an empty heel, and families can be advised that the heel pad has a tendency to remodel over time to a normal shape. Level of evidence: Level II. Clinical relevance: Empty heel feeling at initial full correction of congenital idiopathic clubfoot based on Ponseti protocol is not indication for repeat tenotomy.

PubMed, 2010

Purpose: To evaluate the intraocular pressure (IOP) lowering efficacy of Garcinia kola 0.5% aqueo... more Purpose: To evaluate the intraocular pressure (IOP) lowering efficacy of Garcinia kola 0.5% aqueous solution eye drops in patients with newly diagnosed primary open-angle glaucoma or ocular hypertension (POAG/OH). Materials and methods: A randomized, double-masked, multicenter, active-controlled prospective study. Patients who met the inclusion criteria were randomly assigned in equal numbers to receive Timolol 0.5% eye drops as a control medication (A = Group 1 eyes) or Garcinia kola 0.5% eye drops as the study medication (B = Group 2 eyes). All drops were instilled at 6 am and 6 pm daily. Goldman applanation tonometry was performed at 9 am, 12 pm and 3 pm at baseline, week-6, week-12 and week-24 visits. Voluntary and actively elicited reports of adverse events were documented. The mean change in IOP over 24 weeks was the primary outcome measure. Both groups were compared for statistically significant differences at all visits. A P < 0.05 was considered statistically significant. Results: A total of 178 patients were randomly assigned to G. kola and Timolol groups. At baseline there were no differences in mean IOP between groups, based on age, sex, or diagnosis. At the end of the study period (24(th) week), the mean (+/- SD) reduction in IOP was 12.93 +/- 2.3 mmHg (47.8% +/- 0.8% reduction) in G. Kola group and 13.09 +/- 2.8 mm Hg (48.2% +/- 1.03% reduction) in the Timolol group (P > 0.05). Adverse events were mild in nature with no statistically significant differences between groups (P > 0.05). Conclusions: Garcinia kola ophthalmic solution significantly reduces IOP as compared to baseline. The IOP lowering effect of both treatments was equivalent.

Annals of medicine and surgery, Dec 1, 2017

Introduction: Ponseti method has become the main treatment modality for the management of clubfoo... more Introduction: Ponseti method has become the main treatment modality for the management of clubfoot producing good long-term results. However, variation in cast application post tenotomy has not been evaluated. Methods: A prospective cohort study involving 40 patients with 67 clubfeet were randomized into two groups: 32 above knee cast (AKC) and 35 below knee cast (BKC) after percutaneous tenotomy. All had foot abduction brace after post tenotomy cast. The median age was 21 weeks (range: 1-104 weeks) and 1.9:1 male/female ratio. 27 (67.5%) patients had bilateral clubfoot and unilateral in 13 (32.5%). Patients were followed-up for 6 months with documentation of the Pirani Score and the cost of treatment. Results: No significant difference between AKC and BKC mean Pirani score before treatment (p = 0.550) and after treatment (p = 0.702). However, mean Pirani score at 6 months was significantly different (p = 0.038). Overall mean number of casting was 6.4 in AKC group and 4.7 in BKC group (p = 0.003). There was recurrence in 2 feet before completion of treatment (6.3%) among AKC and none among BKC group. However, there was no recurrence at 6 months after treatment in both groups. The mean cost for AKC and BKC were ₦10,427.34 (52.33 US dollars) and ₦7021.54 (35.24 US dollars) respectively (p = 0.002). Conclusion: Early results of below knee cast after tenotomy were comparable to the classical above knee cast after tenotomy in Ponseti treatment protocol for clubfoot. There was also reduction in cost of treatment in the modified Ponseti compared to the classical Ponseti. Long-term result will be desirable.

Oncology, 2009

completeness of treatment courses, duration of hospital stay and mortality. The reproducibility o... more completeness of treatment courses, duration of hospital stay and mortality. The reproducibility of the methodology was reappraised at the Federal Medical Center. Kruskal-Wallis analysis was used, and an alpha error of ! 0.05 at a CI of 95% was taken to be significant. Results: A total of 112 cases of MMST were managed during the study period. Seventy-one (63.4%; 37 WGHFA; 34 WGHFB) met the inclusion criteria. Age, sex, tribe, religion, comorbid factors and mean weekly income were not significant factors influencing improved MMST care among the WGHFB patients. 32 WGHFB versus 7 WGHFA patients accepted the treatment plan. The mean duration of hospital stay before surgery (p ! 0.001), discharge against medical advice (p ! 0.000), limb salvage (21 vs. 2, p ! 0.001), limb amputation (3 vs. 12, p ! 0.05, 95% CI 8.3-37.9), completeness of treatment (33 vs. 7, p ! 0.05), mean duration of hospital stay, in days (23 vs. 39, p ! 0.05) and mortality at 1-year follow-up (13 vs. 28, p ! 0.02) were significant. Conclusion: The cost of cancer care is a challenge for patients with MMST in a resource-constrained country such as Nigeria. Direct integration of the government and family into MMST care will serve as a link between the cancer patient and the source of funds. It raises the possibility of an effective psychosocial approach to improve patient outcome through enhanced treatment acceptability and completion, and so reduce morbidity and short-term mortality.

PubMed, Apr 4, 2007

Background: Most reports on amputations in Nigeria have been on adults. Few published data exist ... more Background: Most reports on amputations in Nigeria have been on adults. Few published data exist on the causes of amputations in children. Methods: A retrospective analysis of all children who had limb amputations from January 1998 to December 2004 at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife was made. Results: Thirty five (32.7%) out of 107 patients who had major limb amputations were children. The mean age was 9.9 years. Trauma accounted for 74.3% of the amputations, 92.3% of which had developed gangrene from treatment of simple fractures by traditional bone setters. Fifty one point four percent of the amputations were in the upper limbs. The most common complications were anaemia (88.6%) and wound infection (68.6%). One patient had tetanus while one died from septicaemia. Only two patients had prosthetic fitting following amputation. Conclusion: Most amputations in Nigerian children are due to traditional bone setters who manage simple, straight forward fractures in children causing gangrene of the limbs.

PubMed, 2010

Background: Congenital clubfoot treatment continues to be controversial particularly in a resourc... more Background: Congenital clubfoot treatment continues to be controversial particularly in a resource-constrained country. Comparative evaluation of clubfoot surgery with Ponseti methods has not been reported in West Africa. Objectives: To determine the effects of Ponseti techniques on clubfoot surgery frequency and patterns in Nigeria. Methods: This was a prospective hospital-based intention-to-treat comparative study of clubfoot managed with Ponseti methods (PCG) and extensive soft tissue surgery (NPCG). The first step was a nonselective double-blind randomization of clubfoot patients into two groups using Excel software in a university teaching hospital setting. The control group was the NPCG patients. The patients' parents gave informed consent, and the medical research and ethics board approved the study protocol. Biodata was gathered, clubfoot patterns were analyzed, Dimeglio-Bensahel scoring was done, the number of casts applied was tallied, and patterns of surgeries were documented. The cost of care, recurrence and outcomes were evaluated. Kruskal-Wallis analysis and Mann-Whitney U technique were used, and an alpha error of < 0.05 at a CI of 95% were taken to be significant. Results: We randomized 153 clubfeet (in 105 clubfoot patients) into two treatment groups. Fifty NPCG patients (36.2%) underwent manipulation and extensive soft tissue surgery and 55 PCG patients (39.9%) were treated with Ponseti methods. Fifty-two patients of the Ponseti group had no form of surgery (94.5% vs. 32%, p<0.000). Extensive soft tissue surgery was indicated in 17 (34.0%) of the NPCG group, representing 8.9% of the total of 191 major orthopaedic surgeries within the study period. Thirty-five patients (70.0%) from the NPCG group required more than six casts compared to thirteen patients (23.6%) of the PCG (p<0.000). The mean care cost was high within the NPCG when compared to the Ponseti group (48% vs. 14.5%, p<0.000). The Ponseti-treated group had fewer treatment complications (p<0.003), a lower recurrence rate (p<0.000) and satisfactory early outcome (p<0.000). Conclusion: Major clubfoot surgery was not commonly indicated among patients treated with the Ponseti method. The Ponseti clubfoot technique has reduced total care costs, cast utilization, clubfoot surgery frequency and has also changed the patterns of surgery performed for clubfoot in Nigeria.

PubMed, Jun 1, 2011

Introduction: Brodie's abscess is not a common variant of subacute osteomyelitis; however, when i... more Introduction: Brodie's abscess is not a common variant of subacute osteomyelitis; however, when it does occur, the presentation is atypical and usually late. This study aimed to describe the mode of presentation of Brodie's abscess and evaluate the results of surgical treatment in a resource-poor setting. Method: Over a five-year period, we retrospectively reviewed 20 patients who presented to two tertiary health institutions in south western Nigeria with clinical and radiological features of Brodie's abscess. Results: Brodie's abscess accounted for just 2 percent of all patients with osteomyelitis. Most patients were adults (mean age 21.5 +/- 7.8 years) and males (75 percent). In the series, the tibia was involved in 50 percent of the cases, the femur in 30 percent, and the radius and fibula each in 10 percent. The diaphyseal part of the long bones was affected in 65 percent of the patients and the metaphysis, in the remaining patients. The average size of the cavities was 3.0 +/- 0.8 cm. 65 percent of the isolates yielded Staphylococcus aureus. All patients were treated by curettage of the abscess cavities, cancellous bone grafting and antibiotics. All patients had satisfactory outcomes, with complete incorporation of the grafts and new bone formation in the cavities. No patient reported any recurrence. Conclusion: Patients with Brodie's abscess respond well to surgical curettage of the abscess, cancellous bone grafting and antibiotic therapy.

Journal of Clinical and Diagnostic Research, 2021

Introduction: Orthopaedic emergency department commonly receives paediatric fractures, of which f... more Introduction: Orthopaedic emergency department commonly receives paediatric fractures, of which forearm fractures constitute a larger proportion with the burden greatest in low-middle income countries. Studies done in the temperate region found an association between forearm fractures in children and low serum vitamin D3. Some studies in our environment have shown low levels of 25-hydroxy vitamin D3 {25(OH)D} in normal Nigerian children, but the association with forearm fractures has not been studied. Aim: To determine if serum vitamin D3 level can predict the occurrence of forearm fractures in children. Materials and Methods: This was a case control study conducted over a year from January 2018 to December 2018 at a tertiary health facility in South-West Nigeria among paediatric patients. Thirty children with forearm fractures and thirty children with no forearm fractures were recruited for the study. Socio-demographic data, mechanisms of fracture, anthropometric measurements and serum 25(OH)D levels were determined. Univariate and multivariate analyses were done for the variables concerning the presence or absence of forearm fractures (dependent variable is the presence or absence of forearm fractures; independent variables include the age, sex, mechanism of injury, outdoor playing time, serum vitamin D3 level). Results: The mean serum 25(OH)D levels in the study group were significantly lower than the controls; (60.751±15.041 ng/mL and 95.506±19.489 ng/mL, respectively). There was a statistically significant relationship between the serum level of 25(OH)D and the presence of forearm fracture in children (p=0.002 and OR of 0.838). Conclusion: Children with forearm fracture have relatively lower serum vitamin D3 compared with age matched ones without fracture and they have correspondingly increased odd risks of sustaining forearm fracture.

Orient Journal of Medicine, Apr 18, 2006

Results: A total of 189 patients with congenital defects were seen during the study period, of wh... more Results: A total of 189 patients with congenital defects were seen during the study period, of which 31(16.4%) had congenital eye defects {male 16(51.6%), female 15 (48.4%)} with a male to female ratio of 1:1. Their ages at presentation ranged from 1 day to 23 years with mean ...

East and Central African Journal of Surgery, 2015

Background: Major limb amputation is a serious but usually preventable public health problem that... more Background: Major limb amputation is a serious but usually preventable public health problem that is often associated with profound social, psychological and economic impacts on the patient and family. The objective of this study was to evaluate the trend, indications and short term complications of major limb amputations and to compare our experience with that of other published data. Methods: A retrospective study of medical records of all patients who underwent major limb amputations at a Nigeria teaching hospital between 2006 and 2013. Information about age, sex, indications, level of amputation, facilities where patients had initial care before presenting in our centre, complications and outcomes of care were studied. Results: One hundred and sixty-five major limb amputations were done in 158 patients with bilateral lower limb amputations in seven of them. 60.8% of these were due to severe extremity trauma with irreversible vascular damage while diabetic foot gangrene accounted for 30.4%. Complications included wound infections (24.2%), flap necrosis (3.6%), phantom limb pain (2.4%) and knee flexion deformity (0.6%). Mortality was 0.2%. Conclusion: Trauma with irreversible vascular damage is still the leading indication for major limb amputation in our hospital.

Tanzania health research bulletin, Jun 4, 2009

This descriptive cross-sectional community-based study was carried out in Ile-Ife, Nigeria to ass... more This descriptive cross-sectional community-based study was carried out in Ile-Ife, Nigeria to assess the knowledge of mother's on the aetiology of rickets associated knee deformities and the cultural perception of its treatment. Data collection was done using interviewer based semi structured questionnaires. A total of 464 questionnaires were administered with a response rate of 86.9%. Over half (59.8%; N=241) and 36.5% (147) of the mothers were aware of children with knee deformity and rickets, respectively. Ninety-one (22.6%) mothers had the correct knowledge and perception of the true meaning of rickets. Rickets associated knee deformity aetiology was wrongly perceived to be mainly hereditary (53.8%), cancer (50.9%) and bone infection (48.1%). Very low proportions of mothers had correct knowledge on the causes of rickets such as inadequate exposure to sunshine (21.3%) or inadequate intake of calcium (21.1%). The knowledge of aetiology of rickets was influenced by education (P<0.02), skilled occupation (P<0.0001) and the previous birth of a child with knee deformity from rickets (P<0.001). The mother's cultural perceptions of treatment for childhood rickets associated knee deformities was significantly affected by age (P<0.001), education, (P<0.001), skilled occupation (P<0.000), history of knee deformity (P<0.04) and mothers with children diagnosed to have knee deformity (P<0.004). Lack of finance, poor compliance to treatment, too long treatment periods, lack of information on where to seek for treatment and unaffordable treatment were among the important factors affecting completeness of treatment of knee deformity due to rickets. In conclusion, the awareness of mothers about rickets in Nigeria is still very low. It is a major reason for late presentation or complete failure to seek for adequate treatment of the knee deformity due to rickets. Increase and sustain public health enlightenment programmes are necessary for prevention. Health policy should incorporate free surgical fees for the established knee deformity to encourage community participation in the management of the condition.

East and Central African Journal of Surgery, 2013

The aim of this study was to find out the reasons why trauma victims with Orthopaedic injuries ta... more The aim of this study was to find out the reasons why trauma victims with Orthopaedic injuries take their discharge against medical advice. Methods: This was a prospective study conducted on Trauma victims presenting to the Wesley Guild Hospital Ilesha who took their discharge against medical advice (DAMA) over a 2 year period. A questionnaire was designed that was used to retrieve information on the patients biodata, their injuries and the reasons why they DAMA. Results: A total of 49 patients were interviewed over this period. The mean age of the patients was 36.7 years. Students (22.4%), traders (20.4%) and artisans (24.5%) were commonly involved in this practice. Eighteen (36.7%) of the respondents claimed to have taken DAMA due to hospital cost, 18 (36.7%) also DAMA because of their believe in Traditional Bone Setters. Eleven patients (22.4%) simply said they want treatment near home while one patient each gave the fear of amputation and hospital protocol as their reasons for DAMA. Conclusion: Cost of treatment and believe in traditional bone setters were the 2 main reasons why most patients with fracture DAMA. Measures to reduce the cost of treatment and patient's education about the dangers with unorthodox treatment of fractures and dislocations should help to reduce this behaviour.

International Journal of Injury Control and Safety Promotion, Nov 6, 2014

In developing countries, most motorcycles are ridden with more than one occupant. The objective o... more In developing countries, most motorcycles are ridden with more than one occupant. The objective of this study was to establish the relative vulnerability of riders and co-riders to injury and determine the injury risk factors in multi-occupant motorcycle crashes. Between January and December 2010, we collected crash and injury data from victims of multi-occupant motorcycle. It is a hospital-based study. The probability of sustaining injuries was similar for co-riders and riders, but co-riders were more likely to sustain severe injuries. Occupants of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;2-occupant motorcycles were also more likely to be involved in risky behaviours like not wearing helmet and speeding than those on 2-occupant motorcycles. Occupants of motorcycles on which there were more than two occupants were at an increased risk of sustaining injuries compared with occupants of motorcycles with only two occupants (OR: 2.1, 95% CI: 1.1-4.3). Motorcycle co-riders were more vulnerable to severe injuries than riders. The significance of the study finding to prevention was discussed.

General Hospital Psychiatry, 2009

Objective: The study compares psychological symptoms between amputees and other orthopedic patien... more Objective: The study compares psychological symptoms between amputees and other orthopedic patients. Method: Forty-two consecutive amputees were interviewed between 7 and 28 days after amputation, and an equal number of other orthopedic patients matched for age, sex, marital status, and occupation were used as controls. Each respondent completed a sociodemographic questionnaire, while clinical variables were obtained from the case notes. Respondents also completed the General Health Questionnaire, State Trait Anxiety Inventory, and the Zung Self-Rating Depression Inventory. Results: The mean age of amputees in this study was 42.33 years (S.D.=15.89 years), and the average weekly income is #3500.00 ($29.00). Anxiety and depressive symptoms were high among amputees (64.3% and 59.5%, respectively) compared to other orthopedic patients (14.3% and 12.0%, respectively). Correlation analysis showed that there was significant correlation between anxiety and age (negative), marital status, and level of education, while depressive symptoms significantly correlated significantly with age (negative) and marital status. Conclusion: Psychological symptoms are high in this sample of amputees, indicating the importance of social and emotional support for these patients.

Journal of Foot & Ankle Surgery, Jul 1, 2011

It is customary to administer prophylactic antibiotics before exsanguination of the limb and infl... more It is customary to administer prophylactic antibiotics before exsanguination of the limb and inflation of a tourniquet in extremity surgery. To compare the clinical outcome in lower limb operations when prophylactic antibiotics were administered before versus after limb exsanguination and tourniquet inflation, we randomized patients to the administration of prophylactic antibiotics 5 minutes before exsanguination and inflation of the tourniquet (ABT) and administration of prophylactic antibiotics 1 minute after inflation of the tourniquet (AAT). A total of 106 patients completed the study, including 76 males (71.7%) and 30 females (28.3%). Of the 106 patients, 54 (50.9%) received antibiotics before tourniquet inflation (ABT) and 52 (49.1%) after tourniquet inflation (AAT). Most of the operations (71.7%) involved open reduction and internal fixation of fractures. In the ABT group, 8 wounds (14.8%) developed postoperative infection. In the AAT group, 2 (3.9%) developed wound infection (P = .031). The mean period to wound healing in the ABT group was 4.0 ± 2.3 weeks and was 3.0 ± 0.5 weeks in the AAT group (P = .002). Overall, 100% of the patients in the AAT group were satisfied compared with 85.2% in the ABT group. The difference was statistically significant (P = .005). The results of our study suggest that administration of prophylactic antibiotics before exsanguination and inflation of a lower extremity tourniquet does not give better results than administration of the antibiotic shortly after inflation of the tourniquet.

Global Journal of Health Science, Jul 12, 2020

Background: According to the literature, long bone fractures are not common in the elderly, with ... more Background: According to the literature, long bone fractures are not common in the elderly, with fractures occurring as a result of low energy and trivial falls. While epidemiological studies of long bone fractures in elderly patients in developed countries are scarce, it is almost non-existent in resource-poor location. Hence, this study of the patterns and presentation of long bone fractures amongst the elderly population in an African poor resource setting and their short-term outcomes following operative intervention Methodology: This was a retrospective study involving 48 patients who were 60 years and above and had intramedullary nailing for their long bone fractures. Biodata and other variables of interest such as fracture aetiology, level, type, infection, union and further surgeries were extracted. Collected data were analyzed using the SPSS version 20. Statistical significance was inferred at p<0.05. Result: Forty-eight interlocking nailings done in the elderly patients who were 60 years old and above over a 15-year period (February 2004-January 2019) were retrieved. The average age was 70.0 ± 7.51 years, with 56.3% as females. Closed fractures accounted for 75%, while the mechanism of injury was mostly Road Traffic Accident {RTA} (70.8%). Non-union was significantly related to the level of fracture, p = 0.04. While the infection rate was related to the type of fracture (open fractures), p = 0.02. Conclusion: Elderly long bone fractures followed majorly Road traffic accident (motorcycle-pedestrian) in resource-poor setting. for which most of the fractures united. The adverse outcome was associated with open fractures and proximal fractures.

The Internet Journal of Orthopedic Surgery, 2008

Introduction: There is paucity of literature on exposed bone (EB) classification. We aimed at cla... more Introduction: There is paucity of literature on exposed bone (EB) classification. We aimed at classification and scoring of exposed long bones of limb. Patients and Methods: A clinical based observational prospective non-randomized three years study of EB was evaluated at tertiary teaching hospitals. Patient's informed consent and institutions ethical clearance were obtained. Research question was EB's are not the same. The type I (AEB) and type II (CEB) were EB occurring for less than six weeks or more respectively. The type I and II EB patients constituted what we coined "Exposed Bone Syndrome" (EBS). One major symptom and one major sign with two or more symptoms and two or more minor signs constituted diagnostic EBS criteria. The measuring instrument was Ile-Ife EBS protocol. Outcome measures were duration of hospital stay and mortality. Data was analyzed with SPSS version 11.0 software using Pearson correlation, Yates's coefficient, Spearman correlation, Mantel-Haenszel odd ratio package. The alpha error level was p<0.05. Results: A total of 155 EB patients (111 males=71.6%; 44 females= 28.4%) with 74.2% in lower limb and 25.8% in upper limb met the inclusion criteria's. Trauma was the main predisposing factor to EB (p<0.000). The age, sex, religion, location of EB, body side involvement, blood use, genotype, fever and blood chemistry were not significant. The presence and number of EB, bone viability ,length of bone exposed, haemogram, microorganism, pain, bleeding, recurrent discharge ,deformity ,sinuses, joint exposure, putrefying odor , hyper pigmentation, hypo pigmentation ,exuberant hair growth ,puckered scar, rocking detachment and limb length discrepancy were significant symptoms and signs (p<0.05) in EB classification. A preliminary scoring of the significant clinical features of EB that ranged from 9-44 was documented. Conclusion: Exposure of bones is often seen in clinical orthopedics practice. Management of exposed bone portends a great challenge to the surgeons. Exposed bone syndrome is a distinct clinical entity that could be classified into two types using Ile Ife diagnostic protocol. Mclanre Exposed Bone Scoring System (MEBSS) is simple to apply and reproducible for epidemiology and management of exposed bone.

Archives of Orthopaedic and Trauma Surgery, Apr 1, 2008

The ideal specimen for identification of the etiologic agents in chronic osteomyelitis for best a... more The ideal specimen for identification of the etiologic agents in chronic osteomyelitis for best antibiotic decision remains controversial. To assess the concordance of sinus track culture (STC) with that of intraoperative bone culture (IBC) to guide antibiotic therapy in chronic osteomyelitis. A prospective comparative study of chronic osteomyelitis patients seen in our centre from January 2004 to December 2006. Specimens from the depths of sinus track and intraoperative bone biopsy were obtained from each patient and subjected to microbiologic examination and their concordance determined. In STCs Staphylococcus aureus has the highest sensitivity (60.5%), specificity (45.0%) and positive predictive value (72.2%). The overall sensitivity (50.9%), specificity (20%) and predictive value (47.5%) of sinus track specimens were very low. Antibiotic decision based on IBC showed 106 patients (82.8%) had resolution of chronic osteomyelitis at mean of 2 years follow-up. IBC appears to predict more reliably the complete etiologic organisms than STCs in chronic osteomyelitis.

African Journal of Paediatric Surgery, Feb 1, 2007

Birth trauma is a significant cause of neonatal morbidity and mortality. This prospective study d... more Birth trauma is a significant cause of neonatal morbidity and mortality. This prospective study determined the predictive factors for birth trauma as seen in a Nigerian university teaching hospital. This was a prospective descriptive evaluation of birth trauma at Wesley Guilds Hospital, Ilesa over three years. Semi-structured questionnaire was used to collect data on the age, gender, pattern of presentation, place and mode of delivery, level of birth attendants, and treatment offered. Outcome measures were factors predisposing to birth trauma. A total of 137 neonatal hospital admissions with birth related complaints were recorded between 10th December, 2002 and 9th December 2005, out of which 119(86.8%) patients had 121 birth injuries (Males: Females= 1.4: 1). The mean age was 6 ± 4.1 (range: 1-31) day. Non skeletal injuries included cephalohaematoma 30(24.8%), genital bruises/abrasion 4(3.3%), subconjuctiva haemorrhage 2(1.7%), subdural haemorrhage 1 (0.8%), nasal necrosis 1(0.8%), Erb`s`palsy 31(25.6%) and Klumpke`s palsy 2(1.7%). Skeletal injuries were mainly bone fractures 50(41.3%)with 2(1.7%)mortality. Ante natal care/delivery, level of birth attendants, mode of delivery, fetal distress, and emergency caesarian section were among the factors that determined birth trauma. The prevalence of birth trauma is high in southwestern Nigeria. The predictive factors are easily identifiable in the perinatal period; early recognition could reduce significantly birth trauma. Keywords : Birth Trauma, Predictive factors, Prevalence, Nigeria. African Journal of Paediatric Surgery Vol. 4 (1) 2007: pp. 20-25

Sahel Medical Journal, Feb 9, 2004

ABSTRACT The practice of traditional bone setters can no longer be denied in this environment as ... more ABSTRACT The practice of traditional bone setters can no longer be denied in this environment as some of the complications resulting from their treatment are still seen commonly in orthopaedic surgical practice. This study was undertaken at the Federal Medical Centre, Owo, Ondo State, Nigeria to find out about knowledge, attitude and practice about the traditional bone setters (TBS) among health workers. A pre-tested questionnaire was distributed among the health workers through their heads of departments for ease of collection. The response rate was 88.2% with a male to female ratio of 1:1.7. 88.1% were aware of the TBS practice in our environment and 32.7% got to know about them through the mass media; constituting the greatest percentage proportion. Only 19.6% of the respondents claimed the knowledge of how traditional bone setters acquired their skills, 73.6% of these responded that it was innately acquired. While most of the respondents assessed their care as inadequate and that they should not be allowed to treat patients with fractures; 12.9% believed that the TBS possessed special powers to treat fractures that is lacking in orthopaedic surgeons. Health assistants were the most likely to be believe in the possession of such powers. It was recommended that the TBS should be banned from unvented access to the use of the mass media. Within the hospital environment, there is need to organize regular update or instructional lectures for health workers, especially the health assistants who are most likely to give wrong interpretations to events surrounding the patient treatment by the orthodox practitioners. (Key words: Chronic suppurative otitis media, Pseudomonas aerugi nosa, Hearing loss). Sahel Med. J. Vol.6(3) 2003: 79-82

PubMed, 2015

Background: Clubfoot has been evaluated in many ways, including the most common classifications o... more Background: Clubfoot has been evaluated in many ways, including the most common classifications of clubfoot, described by Caterrall and Piraniis based on six clinical signs. The purpose of this study was to gain better understanding of the heel pad in relation to the term "empty heel", and to propose modification of clubfoot severity scoring system based on "empty heel". Methods: A combination of prospective study of 79 clubfoot patients treated with Ponseti method and literature review of heel pad anatomy and biomechanics. The setting was a university teaching hospital. The ethical research committee approved study protocol and informed consent of patients' parent obtained. The selection criteria included patients' diagnosed congenital idiopathic clubfoot, age < 2 years, no history of previous treatment and tenotomy indicated. An evaluation of patient was assessed by orthopaedic surgeons trained on Ponseti method and has above 5 years experience. Data analysis performed on the age, sex, Pirani scores at onset of treatment, tenotomy, and 6 month after initial full correction. Results: One hundred and thirty-two clubfeet in 79 patients (56 males, 23 females) completed Ponseti protocol. The median age at presentation was 5.2 months (range 0.1-23.7 months). The mean right foot abduction after correction 57.30 (S.D. 9.20), and for the left foot, was 56.30 (S.D. 9.40). The mean right foot dorsiflexion was -13.70 (S.D. 18.40) before correction while after correction, it was 20.00 (S.D. 4.50) and for the left, the mean was -8.50 (S.D. 9.60) before correction and 21.00 (S.D. 4.30) after correction. Eighteen (22.8%) patients (10 bilateral, 9 unilateral) had clubfeet with empty heel score above zero point at initial full correction (p<0.001). Clinic anatomy shows the heel pad is a solid complex structure existing in normal, moderate and severe atrophied form. Heel pad is attached tightly to calcaneus without a cavity for the calcaneus to drop. Conclusions: Heel pad probably could replace "empty heel" in modify Pirani scoring system. Clinical indication for repeat tenotomy should be based on equinus, not on the feeling of an empty heel, and families can be advised that the heel pad has a tendency to remodel over time to a normal shape. Level of evidence: Level II. Clinical relevance: Empty heel feeling at initial full correction of congenital idiopathic clubfoot based on Ponseti protocol is not indication for repeat tenotomy.

PubMed, 2010

Purpose: To evaluate the intraocular pressure (IOP) lowering efficacy of Garcinia kola 0.5% aqueo... more Purpose: To evaluate the intraocular pressure (IOP) lowering efficacy of Garcinia kola 0.5% aqueous solution eye drops in patients with newly diagnosed primary open-angle glaucoma or ocular hypertension (POAG/OH). Materials and methods: A randomized, double-masked, multicenter, active-controlled prospective study. Patients who met the inclusion criteria were randomly assigned in equal numbers to receive Timolol 0.5% eye drops as a control medication (A = Group 1 eyes) or Garcinia kola 0.5% eye drops as the study medication (B = Group 2 eyes). All drops were instilled at 6 am and 6 pm daily. Goldman applanation tonometry was performed at 9 am, 12 pm and 3 pm at baseline, week-6, week-12 and week-24 visits. Voluntary and actively elicited reports of adverse events were documented. The mean change in IOP over 24 weeks was the primary outcome measure. Both groups were compared for statistically significant differences at all visits. A P < 0.05 was considered statistically significant. Results: A total of 178 patients were randomly assigned to G. kola and Timolol groups. At baseline there were no differences in mean IOP between groups, based on age, sex, or diagnosis. At the end of the study period (24(th) week), the mean (+/- SD) reduction in IOP was 12.93 +/- 2.3 mmHg (47.8% +/- 0.8% reduction) in G. Kola group and 13.09 +/- 2.8 mm Hg (48.2% +/- 1.03% reduction) in the Timolol group (P > 0.05). Adverse events were mild in nature with no statistically significant differences between groups (P > 0.05). Conclusions: Garcinia kola ophthalmic solution significantly reduces IOP as compared to baseline. The IOP lowering effect of both treatments was equivalent.

Annals of medicine and surgery, Dec 1, 2017

Introduction: Ponseti method has become the main treatment modality for the management of clubfoo... more Introduction: Ponseti method has become the main treatment modality for the management of clubfoot producing good long-term results. However, variation in cast application post tenotomy has not been evaluated. Methods: A prospective cohort study involving 40 patients with 67 clubfeet were randomized into two groups: 32 above knee cast (AKC) and 35 below knee cast (BKC) after percutaneous tenotomy. All had foot abduction brace after post tenotomy cast. The median age was 21 weeks (range: 1-104 weeks) and 1.9:1 male/female ratio. 27 (67.5%) patients had bilateral clubfoot and unilateral in 13 (32.5%). Patients were followed-up for 6 months with documentation of the Pirani Score and the cost of treatment. Results: No significant difference between AKC and BKC mean Pirani score before treatment (p = 0.550) and after treatment (p = 0.702). However, mean Pirani score at 6 months was significantly different (p = 0.038). Overall mean number of casting was 6.4 in AKC group and 4.7 in BKC group (p = 0.003). There was recurrence in 2 feet before completion of treatment (6.3%) among AKC and none among BKC group. However, there was no recurrence at 6 months after treatment in both groups. The mean cost for AKC and BKC were ₦10,427.34 (52.33 US dollars) and ₦7021.54 (35.24 US dollars) respectively (p = 0.002). Conclusion: Early results of below knee cast after tenotomy were comparable to the classical above knee cast after tenotomy in Ponseti treatment protocol for clubfoot. There was also reduction in cost of treatment in the modified Ponseti compared to the classical Ponseti. Long-term result will be desirable.

Oncology, 2009

completeness of treatment courses, duration of hospital stay and mortality. The reproducibility o... more completeness of treatment courses, duration of hospital stay and mortality. The reproducibility of the methodology was reappraised at the Federal Medical Center. Kruskal-Wallis analysis was used, and an alpha error of ! 0.05 at a CI of 95% was taken to be significant. Results: A total of 112 cases of MMST were managed during the study period. Seventy-one (63.4%; 37 WGHFA; 34 WGHFB) met the inclusion criteria. Age, sex, tribe, religion, comorbid factors and mean weekly income were not significant factors influencing improved MMST care among the WGHFB patients. 32 WGHFB versus 7 WGHFA patients accepted the treatment plan. The mean duration of hospital stay before surgery (p ! 0.001), discharge against medical advice (p ! 0.000), limb salvage (21 vs. 2, p ! 0.001), limb amputation (3 vs. 12, p ! 0.05, 95% CI 8.3-37.9), completeness of treatment (33 vs. 7, p ! 0.05), mean duration of hospital stay, in days (23 vs. 39, p ! 0.05) and mortality at 1-year follow-up (13 vs. 28, p ! 0.02) were significant. Conclusion: The cost of cancer care is a challenge for patients with MMST in a resource-constrained country such as Nigeria. Direct integration of the government and family into MMST care will serve as a link between the cancer patient and the source of funds. It raises the possibility of an effective psychosocial approach to improve patient outcome through enhanced treatment acceptability and completion, and so reduce morbidity and short-term mortality.

PubMed, Apr 4, 2007

Background: Most reports on amputations in Nigeria have been on adults. Few published data exist ... more Background: Most reports on amputations in Nigeria have been on adults. Few published data exist on the causes of amputations in children. Methods: A retrospective analysis of all children who had limb amputations from January 1998 to December 2004 at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife was made. Results: Thirty five (32.7%) out of 107 patients who had major limb amputations were children. The mean age was 9.9 years. Trauma accounted for 74.3% of the amputations, 92.3% of which had developed gangrene from treatment of simple fractures by traditional bone setters. Fifty one point four percent of the amputations were in the upper limbs. The most common complications were anaemia (88.6%) and wound infection (68.6%). One patient had tetanus while one died from septicaemia. Only two patients had prosthetic fitting following amputation. Conclusion: Most amputations in Nigerian children are due to traditional bone setters who manage simple, straight forward fractures in children causing gangrene of the limbs.

PubMed, 2010

Background: Congenital clubfoot treatment continues to be controversial particularly in a resourc... more Background: Congenital clubfoot treatment continues to be controversial particularly in a resource-constrained country. Comparative evaluation of clubfoot surgery with Ponseti methods has not been reported in West Africa. Objectives: To determine the effects of Ponseti techniques on clubfoot surgery frequency and patterns in Nigeria. Methods: This was a prospective hospital-based intention-to-treat comparative study of clubfoot managed with Ponseti methods (PCG) and extensive soft tissue surgery (NPCG). The first step was a nonselective double-blind randomization of clubfoot patients into two groups using Excel software in a university teaching hospital setting. The control group was the NPCG patients. The patients' parents gave informed consent, and the medical research and ethics board approved the study protocol. Biodata was gathered, clubfoot patterns were analyzed, Dimeglio-Bensahel scoring was done, the number of casts applied was tallied, and patterns of surgeries were documented. The cost of care, recurrence and outcomes were evaluated. Kruskal-Wallis analysis and Mann-Whitney U technique were used, and an alpha error of < 0.05 at a CI of 95% were taken to be significant. Results: We randomized 153 clubfeet (in 105 clubfoot patients) into two treatment groups. Fifty NPCG patients (36.2%) underwent manipulation and extensive soft tissue surgery and 55 PCG patients (39.9%) were treated with Ponseti methods. Fifty-two patients of the Ponseti group had no form of surgery (94.5% vs. 32%, p<0.000). Extensive soft tissue surgery was indicated in 17 (34.0%) of the NPCG group, representing 8.9% of the total of 191 major orthopaedic surgeries within the study period. Thirty-five patients (70.0%) from the NPCG group required more than six casts compared to thirteen patients (23.6%) of the PCG (p<0.000). The mean care cost was high within the NPCG when compared to the Ponseti group (48% vs. 14.5%, p<0.000). The Ponseti-treated group had fewer treatment complications (p<0.003), a lower recurrence rate (p<0.000) and satisfactory early outcome (p<0.000). Conclusion: Major clubfoot surgery was not commonly indicated among patients treated with the Ponseti method. The Ponseti clubfoot technique has reduced total care costs, cast utilization, clubfoot surgery frequency and has also changed the patterns of surgery performed for clubfoot in Nigeria.

PubMed, Jun 1, 2011

Introduction: Brodie's abscess is not a common variant of subacute osteomyelitis; however, when i... more Introduction: Brodie's abscess is not a common variant of subacute osteomyelitis; however, when it does occur, the presentation is atypical and usually late. This study aimed to describe the mode of presentation of Brodie's abscess and evaluate the results of surgical treatment in a resource-poor setting. Method: Over a five-year period, we retrospectively reviewed 20 patients who presented to two tertiary health institutions in south western Nigeria with clinical and radiological features of Brodie's abscess. Results: Brodie's abscess accounted for just 2 percent of all patients with osteomyelitis. Most patients were adults (mean age 21.5 +/- 7.8 years) and males (75 percent). In the series, the tibia was involved in 50 percent of the cases, the femur in 30 percent, and the radius and fibula each in 10 percent. The diaphyseal part of the long bones was affected in 65 percent of the patients and the metaphysis, in the remaining patients. The average size of the cavities was 3.0 +/- 0.8 cm. 65 percent of the isolates yielded Staphylococcus aureus. All patients were treated by curettage of the abscess cavities, cancellous bone grafting and antibiotics. All patients had satisfactory outcomes, with complete incorporation of the grafts and new bone formation in the cavities. No patient reported any recurrence. Conclusion: Patients with Brodie's abscess respond well to surgical curettage of the abscess, cancellous bone grafting and antibiotic therapy.

Journal of Clinical and Diagnostic Research, 2021

Introduction: Orthopaedic emergency department commonly receives paediatric fractures, of which f... more Introduction: Orthopaedic emergency department commonly receives paediatric fractures, of which forearm fractures constitute a larger proportion with the burden greatest in low-middle income countries. Studies done in the temperate region found an association between forearm fractures in children and low serum vitamin D3. Some studies in our environment have shown low levels of 25-hydroxy vitamin D3 {25(OH)D} in normal Nigerian children, but the association with forearm fractures has not been studied. Aim: To determine if serum vitamin D3 level can predict the occurrence of forearm fractures in children. Materials and Methods: This was a case control study conducted over a year from January 2018 to December 2018 at a tertiary health facility in South-West Nigeria among paediatric patients. Thirty children with forearm fractures and thirty children with no forearm fractures were recruited for the study. Socio-demographic data, mechanisms of fracture, anthropometric measurements and serum 25(OH)D levels were determined. Univariate and multivariate analyses were done for the variables concerning the presence or absence of forearm fractures (dependent variable is the presence or absence of forearm fractures; independent variables include the age, sex, mechanism of injury, outdoor playing time, serum vitamin D3 level). Results: The mean serum 25(OH)D levels in the study group were significantly lower than the controls; (60.751±15.041 ng/mL and 95.506±19.489 ng/mL, respectively). There was a statistically significant relationship between the serum level of 25(OH)D and the presence of forearm fracture in children (p=0.002 and OR of 0.838). Conclusion: Children with forearm fracture have relatively lower serum vitamin D3 compared with age matched ones without fracture and they have correspondingly increased odd risks of sustaining forearm fracture.

Orient Journal of Medicine, Apr 18, 2006

Results: A total of 189 patients with congenital defects were seen during the study period, of wh... more Results: A total of 189 patients with congenital defects were seen during the study period, of which 31(16.4%) had congenital eye defects {male 16(51.6%), female 15 (48.4%)} with a male to female ratio of 1:1. Their ages at presentation ranged from 1 day to 23 years with mean ...

East and Central African Journal of Surgery, 2015

Background: Major limb amputation is a serious but usually preventable public health problem that... more Background: Major limb amputation is a serious but usually preventable public health problem that is often associated with profound social, psychological and economic impacts on the patient and family. The objective of this study was to evaluate the trend, indications and short term complications of major limb amputations and to compare our experience with that of other published data. Methods: A retrospective study of medical records of all patients who underwent major limb amputations at a Nigeria teaching hospital between 2006 and 2013. Information about age, sex, indications, level of amputation, facilities where patients had initial care before presenting in our centre, complications and outcomes of care were studied. Results: One hundred and sixty-five major limb amputations were done in 158 patients with bilateral lower limb amputations in seven of them. 60.8% of these were due to severe extremity trauma with irreversible vascular damage while diabetic foot gangrene accounted for 30.4%. Complications included wound infections (24.2%), flap necrosis (3.6%), phantom limb pain (2.4%) and knee flexion deformity (0.6%). Mortality was 0.2%. Conclusion: Trauma with irreversible vascular damage is still the leading indication for major limb amputation in our hospital.

Tanzania health research bulletin, Jun 4, 2009

This descriptive cross-sectional community-based study was carried out in Ile-Ife, Nigeria to ass... more This descriptive cross-sectional community-based study was carried out in Ile-Ife, Nigeria to assess the knowledge of mother's on the aetiology of rickets associated knee deformities and the cultural perception of its treatment. Data collection was done using interviewer based semi structured questionnaires. A total of 464 questionnaires were administered with a response rate of 86.9%. Over half (59.8%; N=241) and 36.5% (147) of the mothers were aware of children with knee deformity and rickets, respectively. Ninety-one (22.6%) mothers had the correct knowledge and perception of the true meaning of rickets. Rickets associated knee deformity aetiology was wrongly perceived to be mainly hereditary (53.8%), cancer (50.9%) and bone infection (48.1%). Very low proportions of mothers had correct knowledge on the causes of rickets such as inadequate exposure to sunshine (21.3%) or inadequate intake of calcium (21.1%). The knowledge of aetiology of rickets was influenced by education (P<0.02), skilled occupation (P<0.0001) and the previous birth of a child with knee deformity from rickets (P<0.001). The mother's cultural perceptions of treatment for childhood rickets associated knee deformities was significantly affected by age (P<0.001), education, (P<0.001), skilled occupation (P<0.000), history of knee deformity (P<0.04) and mothers with children diagnosed to have knee deformity (P<0.004). Lack of finance, poor compliance to treatment, too long treatment periods, lack of information on where to seek for treatment and unaffordable treatment were among the important factors affecting completeness of treatment of knee deformity due to rickets. In conclusion, the awareness of mothers about rickets in Nigeria is still very low. It is a major reason for late presentation or complete failure to seek for adequate treatment of the knee deformity due to rickets. Increase and sustain public health enlightenment programmes are necessary for prevention. Health policy should incorporate free surgical fees for the established knee deformity to encourage community participation in the management of the condition.

East and Central African Journal of Surgery, 2013

The aim of this study was to find out the reasons why trauma victims with Orthopaedic injuries ta... more The aim of this study was to find out the reasons why trauma victims with Orthopaedic injuries take their discharge against medical advice. Methods: This was a prospective study conducted on Trauma victims presenting to the Wesley Guild Hospital Ilesha who took their discharge against medical advice (DAMA) over a 2 year period. A questionnaire was designed that was used to retrieve information on the patients biodata, their injuries and the reasons why they DAMA. Results: A total of 49 patients were interviewed over this period. The mean age of the patients was 36.7 years. Students (22.4%), traders (20.4%) and artisans (24.5%) were commonly involved in this practice. Eighteen (36.7%) of the respondents claimed to have taken DAMA due to hospital cost, 18 (36.7%) also DAMA because of their believe in Traditional Bone Setters. Eleven patients (22.4%) simply said they want treatment near home while one patient each gave the fear of amputation and hospital protocol as their reasons for DAMA. Conclusion: Cost of treatment and believe in traditional bone setters were the 2 main reasons why most patients with fracture DAMA. Measures to reduce the cost of treatment and patient's education about the dangers with unorthodox treatment of fractures and dislocations should help to reduce this behaviour.

International Journal of Injury Control and Safety Promotion, Nov 6, 2014

In developing countries, most motorcycles are ridden with more than one occupant. The objective o... more In developing countries, most motorcycles are ridden with more than one occupant. The objective of this study was to establish the relative vulnerability of riders and co-riders to injury and determine the injury risk factors in multi-occupant motorcycle crashes. Between January and December 2010, we collected crash and injury data from victims of multi-occupant motorcycle. It is a hospital-based study. The probability of sustaining injuries was similar for co-riders and riders, but co-riders were more likely to sustain severe injuries. Occupants of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;2-occupant motorcycles were also more likely to be involved in risky behaviours like not wearing helmet and speeding than those on 2-occupant motorcycles. Occupants of motorcycles on which there were more than two occupants were at an increased risk of sustaining injuries compared with occupants of motorcycles with only two occupants (OR: 2.1, 95% CI: 1.1-4.3). Motorcycle co-riders were more vulnerable to severe injuries than riders. The significance of the study finding to prevention was discussed.

General Hospital Psychiatry, 2009

Objective: The study compares psychological symptoms between amputees and other orthopedic patien... more Objective: The study compares psychological symptoms between amputees and other orthopedic patients. Method: Forty-two consecutive amputees were interviewed between 7 and 28 days after amputation, and an equal number of other orthopedic patients matched for age, sex, marital status, and occupation were used as controls. Each respondent completed a sociodemographic questionnaire, while clinical variables were obtained from the case notes. Respondents also completed the General Health Questionnaire, State Trait Anxiety Inventory, and the Zung Self-Rating Depression Inventory. Results: The mean age of amputees in this study was 42.33 years (S.D.=15.89 years), and the average weekly income is #3500.00 ($29.00). Anxiety and depressive symptoms were high among amputees (64.3% and 59.5%, respectively) compared to other orthopedic patients (14.3% and 12.0%, respectively). Correlation analysis showed that there was significant correlation between anxiety and age (negative), marital status, and level of education, while depressive symptoms significantly correlated significantly with age (negative) and marital status. Conclusion: Psychological symptoms are high in this sample of amputees, indicating the importance of social and emotional support for these patients.

Journal of Foot & Ankle Surgery, Jul 1, 2011

It is customary to administer prophylactic antibiotics before exsanguination of the limb and infl... more It is customary to administer prophylactic antibiotics before exsanguination of the limb and inflation of a tourniquet in extremity surgery. To compare the clinical outcome in lower limb operations when prophylactic antibiotics were administered before versus after limb exsanguination and tourniquet inflation, we randomized patients to the administration of prophylactic antibiotics 5 minutes before exsanguination and inflation of the tourniquet (ABT) and administration of prophylactic antibiotics 1 minute after inflation of the tourniquet (AAT). A total of 106 patients completed the study, including 76 males (71.7%) and 30 females (28.3%). Of the 106 patients, 54 (50.9%) received antibiotics before tourniquet inflation (ABT) and 52 (49.1%) after tourniquet inflation (AAT). Most of the operations (71.7%) involved open reduction and internal fixation of fractures. In the ABT group, 8 wounds (14.8%) developed postoperative infection. In the AAT group, 2 (3.9%) developed wound infection (P = .031). The mean period to wound healing in the ABT group was 4.0 ± 2.3 weeks and was 3.0 ± 0.5 weeks in the AAT group (P = .002). Overall, 100% of the patients in the AAT group were satisfied compared with 85.2% in the ABT group. The difference was statistically significant (P = .005). The results of our study suggest that administration of prophylactic antibiotics before exsanguination and inflation of a lower extremity tourniquet does not give better results than administration of the antibiotic shortly after inflation of the tourniquet.

Global Journal of Health Science, Jul 12, 2020

Background: According to the literature, long bone fractures are not common in the elderly, with ... more Background: According to the literature, long bone fractures are not common in the elderly, with fractures occurring as a result of low energy and trivial falls. While epidemiological studies of long bone fractures in elderly patients in developed countries are scarce, it is almost non-existent in resource-poor location. Hence, this study of the patterns and presentation of long bone fractures amongst the elderly population in an African poor resource setting and their short-term outcomes following operative intervention Methodology: This was a retrospective study involving 48 patients who were 60 years and above and had intramedullary nailing for their long bone fractures. Biodata and other variables of interest such as fracture aetiology, level, type, infection, union and further surgeries were extracted. Collected data were analyzed using the SPSS version 20. Statistical significance was inferred at p<0.05. Result: Forty-eight interlocking nailings done in the elderly patients who were 60 years old and above over a 15-year period (February 2004-January 2019) were retrieved. The average age was 70.0 ± 7.51 years, with 56.3% as females. Closed fractures accounted for 75%, while the mechanism of injury was mostly Road Traffic Accident {RTA} (70.8%). Non-union was significantly related to the level of fracture, p = 0.04. While the infection rate was related to the type of fracture (open fractures), p = 0.02. Conclusion: Elderly long bone fractures followed majorly Road traffic accident (motorcycle-pedestrian) in resource-poor setting. for which most of the fractures united. The adverse outcome was associated with open fractures and proximal fractures.

The Internet Journal of Orthopedic Surgery, 2008

Introduction: There is paucity of literature on exposed bone (EB) classification. We aimed at cla... more Introduction: There is paucity of literature on exposed bone (EB) classification. We aimed at classification and scoring of exposed long bones of limb. Patients and Methods: A clinical based observational prospective non-randomized three years study of EB was evaluated at tertiary teaching hospitals. Patient's informed consent and institutions ethical clearance were obtained. Research question was EB's are not the same. The type I (AEB) and type II (CEB) were EB occurring for less than six weeks or more respectively. The type I and II EB patients constituted what we coined "Exposed Bone Syndrome" (EBS). One major symptom and one major sign with two or more symptoms and two or more minor signs constituted diagnostic EBS criteria. The measuring instrument was Ile-Ife EBS protocol. Outcome measures were duration of hospital stay and mortality. Data was analyzed with SPSS version 11.0 software using Pearson correlation, Yates's coefficient, Spearman correlation, Mantel-Haenszel odd ratio package. The alpha error level was p<0.05. Results: A total of 155 EB patients (111 males=71.6%; 44 females= 28.4%) with 74.2% in lower limb and 25.8% in upper limb met the inclusion criteria's. Trauma was the main predisposing factor to EB (p<0.000). The age, sex, religion, location of EB, body side involvement, blood use, genotype, fever and blood chemistry were not significant. The presence and number of EB, bone viability ,length of bone exposed, haemogram, microorganism, pain, bleeding, recurrent discharge ,deformity ,sinuses, joint exposure, putrefying odor , hyper pigmentation, hypo pigmentation ,exuberant hair growth ,puckered scar, rocking detachment and limb length discrepancy were significant symptoms and signs (p<0.05) in EB classification. A preliminary scoring of the significant clinical features of EB that ranged from 9-44 was documented. Conclusion: Exposure of bones is often seen in clinical orthopedics practice. Management of exposed bone portends a great challenge to the surgeons. Exposed bone syndrome is a distinct clinical entity that could be classified into two types using Ile Ife diagnostic protocol. Mclanre Exposed Bone Scoring System (MEBSS) is simple to apply and reproducible for epidemiology and management of exposed bone.