Soliudeen A Arojuraye | National Orthopaedic Hospital Dala Kano (original) (raw)

Papers by Soliudeen A Arojuraye

Research paper thumbnail of Comparative study of the outcomes of one-stage versus two-stage reconstruction of chronic multiligament knee injury

The Surgeon, 2024

A B S T R A C T Background: Multi-ligament knee injury (MLKI) is a complex orthopaedic knee probl... more A B S T R A C T
Background: Multi-ligament knee injury (MLKI) is a complex orthopaedic knee problem, usually following
traumatic knee dislocation. Surgical management is preferred and has resulted in better clinical outcomes.
However, the optimal surgical treatment protocol is continuously evolving. This study aimed to compare the
outcomes of one-stage versus two-stage reconstruction of MLKI.
Materials and methods: This retrospective comparative study was conducted between July 2020 and December
2023 at a government orthopaedic hospital in Nigeria. The inclusion criteria include males and females between
18 and 45 years of age who had one- or two staged knee reconstructions for MLKI and were followed up for a
minimum of 12 months. The exclusion criteria were patients below 18 and above 45 years of age, those with
previous knee surgery, those associated with femoral or tibia fractures, those with radiological evidence of
osteoarthritis, and those with follow-ups less than 12 months. Clinical outcomes using the Lysholm scoring
system and complication rate were recorded. The statistical analysis was performed using SPSS version 23.
Results: Fifty-one patients (26 in the OS group and 25 in the TS group) were studied. There was a significant
difference between the preoperative and postoperative Lysholm scores in the two groups (p = 0.86 and 0.57 for
OS and TS, respectively). However, there was no significant difference between the postoperative Lysholm scores
in the two groups (p = 0.918).
Conclusion: One-stage and two-stage reconstruction of chronic MLKI give similar excellent clinical outcomes

Research paper thumbnail of Outcome of percutaneous reconstruction of chronic lateral collateral ligament rupture

Chinese Journal of Traumatology, 2023

Many techniques have been described for the reconstruction of chronic lateral collateral ligament... more Many techniques have been described for the reconstruction of chronic lateral collateral ligament (LCL) rupture with different autograft options. The advantages of percutaneous LCL reconstruction include small incisions, minimal soft tissue disruption, less postoperative pain, and speedy rehabilitation and recovery. The aim of this study was to report the functional outcome of percutaneous LCL reconstruction and overall patient satisfaction in Africans. Methods: This prospective and interventional study involving 51 patients with chronic LCL rupture who had percutaneous LCL reconstruction using peroneus longus autograft was conducted between January 2021 and December 2022 in National Orthopaedic Hospital, Dala-Kano, Nigeria. The inclusion criteria were patients between the ages of 18 and 45 years with chronic isolated LCL and not more than 1 injury of knee ligament. Exclusion criteria were active infection, and multi-ligament knee injury requiring 2staged surgery. The knee functions were assessed preoperatively, 3 months, 6 months, and 12 months postoperatively using the Lysholm scoring system. Patient satisfaction with the outcome of the treatment was assessed using a 5-point Likert scale. Relevant information was recorded into Microsoft Excel sheet and data was analyzed using SPSS version 23.0 for windows. The paired samples t-test was used to compare the clinical outcomes as continuous variables. Statistical significance was considered at p < 0.05. Results: The mean age of the patients was (30.10 ± 5.90) years. The median time from injury to surgery was 7 months (ranging from 3 to 28 months). The mean follow-up period was (14.07 ± 3.13) months. The mean preoperative and 1-year postoperative Lysholm scores were 44.33 ± 12.97 and 97.96 ± 1.23, respectively. Conclusion: Percutaneous LCL reconstruction using peroneus longus autograft significantly improves patient knee function and results in excellent patient satisfaction.

Research paper thumbnail of Arthroscopic Anterior Cruciate Ligament Reconstruction Learning Curve: Analysis of Operating Time and Clinical Outcomes

J West Afr Coll Surg, 2024

Background: Technical proficiency for arthroscopic anterior cruciate ligament reconstruction (ACL... more Background: Technical proficiency for arthroscopic anterior cruciate ligament reconstruction (ACLR) is complex and requires learning and practice. Achieving an appropriate level of competency with this surgery is important for patient safety and satisfactory surgical outcomes. There is limited literature about the learning curve in ACLR in Africa. Objectives: This study aimed to demonstrate the learning curve associated with ACLR. Materials and Methods: This retrospective study on arthroscopic ACLR was conducted between January 2020 and June 2023 with a minimum of 12 months follow-up. The primary outcome measure was operation time, whereas the secondary outcome measures were functional outcome and postoperative complications. Results: One hundred fifty-nine ACLR met the inclusion criteria and were analysed. The mean age of the patients was 31.47 ± 9.50 years. There were 148 (93.1%) males and 11 (6.9%) females. The median operation time was 50 min (45-190 min). There was progressively decreasing operation time with increasing number of cases done until after the first 19 cases. The mean operating time for the first 19 cases was 143.89 ± 32.84 min, whereas the mean operating time for the later 140 cases was 53.81 ± 9.72 min (P = 0.000). Conclusions: The operation time for arthroscopic ACLR progressively decreased until after the first 19 cases. There was, however, no significant difference in the clinical outcome between the cases done during the learning curve and those done at proficiency.

Research paper thumbnail of Timing of surgery following SARS‐CoV‐2 infection: an international prospective cohort study

Anaesthesia, 2021

SummaryPeri‐operative SARS‐CoV‐2 infection increases postoperative mortality. The aim of this stu... more SummaryPeri‐operative SARS‐CoV‐2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS‐CoV‐2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre‐operative SARS‐CoV‐2 infection were compared with those without previous SARS‐CoV‐2 infection. The primary outcome measure was 30‐day postoperative mortality. Logistic regression models were used to calculate adjusted 30‐day mortality rates stratified by time from diagnosis of SARS‐CoV‐2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre‐operative SARS‐CoV‐2 diagnosis. Adjusted 30‐day mortality in patients without SARS‐CoV‐2 infection was 1.5% (95%CI 1.4–1.5). In patients with a pre‐operative SARS‐CoV‐2 diagnosis, mortality was increased in patients having surgery wi...

Research paper thumbnail of SARS‐CoV‐2 infection and venous thromboembolism after surgery: an international prospective cohort study

Anaesthesia, 2021

SummarySARS‐CoV‐2 has been associated with an increased rate of venous thromboembolism in critica... more SummarySARS‐CoV‐2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri‐operative or prior SARS‐CoV‐2 were at further increased risk of venous thromboembolism. We conducted a planned sub‐study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS‐CoV‐2 diagnosis was defined as peri‐operative (7 days before to 30 days after surgery); recent (1–6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre‐operative anti‐coagulation for baseline comorbidities was no...

Research paper thumbnail of Old unreduced elbow dislocation: Patients’ perspectives on outcome of open reduction

The Surgeon, 2020

INTRODUCTION Old unreduced elbow dislocation is not uncommon in developing countries. Many author... more INTRODUCTION Old unreduced elbow dislocation is not uncommon in developing countries. Many authors have reported outcome of open reduction in the management of this problem. However, we did not find any study that document patient reported outcome. OBJECTIVE the objective of this study was to determine the patients' perspectives of outcome of open reduction in the management of old unreduced elbow dislocation. METHODS This was a prospective interventional study of 49 consecutive patients with old unreduced simple elbow dislocation who were treated with open reduction at the National Orthopaedic Hospital, Dala - Kano, Nigeria and Albarka Clinic Kano, Nigeria between January 2015 and December 2019. RESULTS Fourty nine patients were studied with median age of 31.0 years (range: 19-60 years). The majority of the patients were within 31-40 years age group. The male to female ratio was 6:1. Using the Mayor Elbow Performance Scale (MEPS) and Patients specific Functional scale (PSFS); there are significant improvements in postoperative functional capability of the patients (P = 0.000). With the short assessment for patient satisfaction (SAPS), 93.3% of patients were either satisfied or very satisfied with the outcome of open reduction. CONCLUSION The outcome of open reduction for old unreduced elbow dislocation is good and is well accepted by the patients.

Research paper thumbnail of Elective surgery system strengthening: development, measurement, and validation of the surgical preparedness index across 1632 hospitals in 119 countries

The Lancet

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as ind... more Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index to support local elective surgical system strengthening and address growing backlogs. Methods First, we performed an international consultation through a four-stage consensus process to develop a multidomain index for hospital-level assessment (surgical preparedness index; SPI). Second, we measured surgical preparedness across a global network of hospitals in high-income countries (HICs), middle-income countries (MICs), and low-income countries (LICs) to explore the distribution of the SPI at national, subnational, and hospital levels. Finally, using COVID-19 as an example of an external system shock, we compared hospitals&amp;amp;amp;#39; SPI to their planned surgical volume ratio (SVR; ie, operations for which the decision for surgery was made before hospital admission), calculated as the ratio of the observed surgical volume over a 1-month assessment period between June 6 and Aug 5, 2021, against the expected surgical volume based on hospital administrative data from the same period in 2019 (ie, a pre-pandemic baseline). A linear mixed-effects regression model was used to determine the effect of increasing SPI score. Findings In the first phase, from a longlist of 103 candidate indicators, 23 were prioritised as core indicators of elective surgical system preparedness by 69 clinicians (23 [33%] women; 46 [67%] men; 41 from HICs, 22 from MICs, and six from LICs) from 32 countries. The multidomain SPI included 11 indicators on facilities and consumables, two on staffing, two on prioritisation, and eight on systems. Hospitals were scored from 23 (least prepared) to 115 points (most prepared). In the second phase, surgical preparedness was measured in 1632 hospitals by 4714 clinicians from 119 countries. 745 (45•6%) of 1632 hospitals were in MICs or LICs. The mean SPI score was 84•5 (95% CI 84•1-84•9), which varied between HIC (88•5 [89•0-88•0]), MIC (81•8 [82•5-81•1]), and LIC (66•8 [64•9-68•7]) settings. In the third phase, 1217 (74•6%) hospitals did not maintain their expected SVR during the COVID-19 pandemic, of which 625 (51•4%) were from HIC, 538 (44•2%) from MIC, and 54 (4•4%) from LIC settings. In the mixed-effects model, a 10-point increase in SPI corresponded to a 3•6% (95% CI 3•0-4•1; p&amp;amp;amp;lt;0•0001) increase in SVR. This was consistent in HIC (4•8% [4•1-5•5]; p&amp;amp;amp;lt;0•0001), MIC (2•8 [2•0-3•7]; p&amp;amp;amp;lt;0•0001), and LIC (3•8 [1•3-6•7%]; p&amp;amp;amp;lt;0•0001) settings. Interpretation The SPI contains 23 indicators that are globally applicable, relevant across different system stressors, vary at a subnational level, and are collectable by front-line teams. In the case study of COVID-19, a higher SPI was associated with an increased planned surgical volume ratio independent of country income status, COVID-19 burden, and hospital type. Hospitals should perform annual self-assessment of their surgical preparedness to identify areas that can be improved, create resilience in local surgical systems, and upscale capacity to address elective surgery backlogs.

Research paper thumbnail of Pattern of presentation of patella instability at the national orthopaedic hospital, Dala Kano, Nigeria

Pyramid Journal of Medicine, 2020

Patella instability is a clinical condition in which patella dislocation had occurred at least tw... more Patella instability is a clinical condition in which patella dislocation had occurred at least twice, or where patella instability following initial dislocation had persisted for more than three months. It can be unilateral or bilateral. Females are more affected, and it can affect the quality of life of the individual affected. This study is a retrospective survey of all patients who had recurrent patella dislocation at National Orthopedic hospital, Dala, Kano between January 2009 and November 2019. A total of 49 patients were treated with recurrent patella dislocation were found with a predominant young age (11-20 years-old) and a female preponderance (56.4%). Pain, instability or both are the main forms of presentation. Trauma, ligamentous laxity as well as hypoplasia of femoral condyle were risk factors identified. Arthroscopic medial plication and lateral release and was done in 28 (71.8%) patients as a means of treatment. Three patients (7.7%) had medial patellofemoral ligamen...

Research paper thumbnail of Pattern of presentation of patella instability at the national orthopaedic hospital, Dala Kano, Nigeria

Pyramid Journal of Medicine, 2020

Patella instability is a clinical condition in which patella dislocation had occurred at least tw... more Patella instability is a clinical condition in which patella dislocation had occurred at least twice, or where patella instability following initial dislocation had persisted for more than three months. It can be unilateral or bilateral. Females are more affected, and it can affect the quality of life of the individual affected. This study is a retrospective survey of all patients who had recurrent patella dislocation at National Orthopedic hospital, Dala, Kano between January 2009 and November 2019. A total of 49 patients were treated with recurrent patella dislocation were found with a predominant young age (11-20 years-old) and a female preponderance (56.4%). Pain, instability or both are the main forms of presentation. Trauma, ligamentous laxity as well as hypoplasia of femoral condyle were risk factors identified. Arthroscopic medial plication and lateral release and was done in 28 (71.8%) patients as a means of treatment. Three patients (7.7%) had medial patellofemoral ligamen...

Research paper thumbnail of Internal splintage of acute acromioclavicular joint dislocation using polyester suture: Experience from a Nigerian orthopaedic hospital

Nigerian Postgraduate Medical Journal, 2022

Background: Various surgical options have been described for acute acromioclavicular joint (ACJ) ... more Background: Various surgical options have been described for acute acromioclavicular joint (ACJ) disruption. Dynamic fixation of these fractures is the most favoured option. However, no single modality of treatment has been adjudged to be the best option so far. Purpose: The goal of this study was to present the outcome of internal splintage of acute ACJ disruption using polyester suture without clavicle drilling in our setting. Patients and Methods: This prospective study was done at the National Orthopedic Hospital, Dala, Kano, on those with acute ACJ injuries between January 2016 and June 2021. Forty five patients (36 males and 9 females) had internal splintage of acute ACJ disruption using polyester-5 suture loops around the coracoid process and clavicle without bone drilling. Results: The average age of the patients in this study was 31.51 ± 11.43 years, while the age group with highest frequency was 21–30 years, accounting for 17 (37.8%) of all the patients. The mean pre-opera...

Research paper thumbnail of Outcome of Surgical Fixation of Intertrochanteric Femoral Fractures with Dynamic Hip Screw

Background: Intertrochanteric fracture of the femur is one of the common fractures in the elderly... more Background: Intertrochanteric fracture of the femur is one of the common fractures in the elderly with osteoporosis due to trivial fall. When occurs in the young, intertrochanteric fracture is usually due to high-energy injuries such as motor vehicular accident or fall from height. Dynamic Hip Screw (DHS) fixation has remained the gold standard for the treatment of stable intertrochanteric femoral fractures to which other options are compared.The aim of this study was to assess radiological and functional results in stable intertrochanteric femoral fractures treated with Dynamic Hip Screw fixation.This study was a prospective, interventional study involving 48 consecutive patients with stable intertrochanteric femoral fractures that were treated using internal fixation with DHS between December 2015 and November 2018 at the National Orthopaedic Hospital, Dala Kano. All patients were followed up for a minimum of 6 months. The mean age of the patients was 56.8 ± 15.0 years. There was ...

Research paper thumbnail of Anteroinferior versus superior plating techniques for displaced midshaft clavicle fractures: A retrospective single centre cohort study from Northern Nigeria

BACKGROUND Clavicle fractures are common injuries accounting for up to 5% of all fractures in adu... more BACKGROUND Clavicle fractures are common injuries accounting for up to 5% of all fractures in adults. Most clavicle fractures heal well with nonoperative treatment, some however, require surgical intervention especially when they are displaced. While plating remains the most popular and most successful method of clavicle fixation; the optimal position of the plate is yet to be agreed upon. PURPOSES The purpose of this study was to compare the functional outcomes of displaced clavicle fractures fixed with superior and anteroinferior plating techniques. PATIENTS AND METHODS This retrospective cohort study of 69 patients (45 males and 24 females) was carried out between January 2014 and December 2018 at a government orthopaedic hospital in north-western part of Nigeria. The study involved all consecutive patients who sustained a displaced mid-shaft clavicle fracture and had open reduction and internal fixation (ORIF) with either superior plating (SP) or anterior-inferior plating (AIP) ...

Research paper thumbnail of Functional outcome of arthroscopic reconstruction of chronic anterior cruciate ligament ruptures using single-bundle triple-weaved hamstring tendons in northern Nigeria

International Journal of Orthopaedics Sciences, 2020

Though anterior cruciate ligament (ACL) is the most commonly reconstructed ligament all over the ... more Though anterior cruciate ligament (ACL) is the most commonly reconstructed ligament all over the world, its arthroscopic reconstruction was relatively less frequent in the West African sub region until recently. The patronage of the traditional bone setters in the acute phase of closed knee injuries has made Chronic ACL injury the main form of presentation with significant secondary injuries and degenerative changes from sub-optimal initial care. The aim of this study was to determine functional outcome and patient's satisfaction from Arthroscopic chronic ACL injury repair. Diagnoses were made using clinical parameters and MRI. Lysholm scores were determined preoperatively, and repeated with patient's satisfaction assessment (using the Likert scale) at 3, 6, 12, 24 and 48 months postoperatively. Arthroscopic single-bundle ACL repair using a triple-weaved hamstring tendon (s) was done for all the patients. Debridement and meniscectomy were done for various degrees of degenerative changes and irreparable meniscal injuries respectively. No one was dissatisfied and 91.4% of the patients had well to excellent Lysholm scores at 2 years of follow up. It was concluded that arthroscopic chronic ACL rupture reconstruction using single-bundle triple-weaved hamstring autografts with good rehabilitation offers good to excellent knee function and patients' satisfaction with minimal complications.

Research paper thumbnail of Comparison of Efficacy Safety Between Intravenous and Intraarticular Tranexamic Acid in Reducing Blood Loss after Total Knee Arthroplasty

International Journal of Orthopaedics, 2019

Research paper thumbnail of Internal Splintage of Acute Acromioclavicular Joint Dislocation Using Polyester Suture: Experience from a Nigerian Orthopaedic Hospital

Nigerian Postgraduate Medical Journal | Published by Wolters Kluwer - Medknow, 2022

Background: Various surgical options have been described for acute acromioclavicular joint (ACJ) ... more Background: Various surgical options have been described for acute acromioclavicular joint (ACJ) disruption. Dynamic fixation of these
fractures is the most favoured option. However, no single modality of treatment has been adjudged to be the best option so far. Purpose: The
goal of this study was to present the outcome of internal splintage of acute ACJ disruption using polyester sutures without clavicle drilling in
our setting. Patients and Methods: This prospective study was done at the National Orthopedic Hospital, Dala, Kano, on those with acute
ACJ injuries between January 2016 and June 2021. Forty-five patients (36 males and 9 females) had internal splintage of acute ACJ disruption
using polyester‑5 suture loops around the coracoid process and clavicle without bone drilling. Results: The average age of the patients in this
study was 31.51 ± 11.43 years, while the age group with the highest frequency was 21–30 years, accounting for 17 (37.8%) of all the patients.
The mean pre‑operative and post‑operative disability (QuickDASH) scores were 80.08 ± 10.75 and 3.23 ± 3.58, respectively. There was a
significant difference between pre‑operative and post‑operative QuickDASH scores with P < 0.001. Conclusion: Internal splintage of acute
ACJ dislocation using polyester‑5 suture loop without bone drilling is effective and safe.

Research paper thumbnail of Anteroinferior versus superior plating techniques for displaced midshaft clavicle fractures: A retrospective single centre cohort study from Northern Nigeria

The Surgeon, 2021

Background Clavicle fractures are common injuries accounting for up to 5% of all fractures in ad... more Background

Clavicle fractures are common injuries accounting for up to 5% of all fractures in adults. Most clavicle fractures heal well with nonoperative treatment; however, they require surgical intervention, especially when displaced. While plating remains the most popular and most successful method of clavicle fixation; the optimal position of the plate is yet to be agreed upon.
Purposes

The purpose of this study was to compare the functional outcomes of displaced clavicle fractures fixed with superior and anteroinferior plating techniques.
Patients and methods

This retrospective cohort study of 69 patients (45 males and 24 females) was carried out between January 2014 and December 2018 at a government orthopaedic hospital in the north-western part of Nigeria. The study involved all consecutive patients who sustained a displaced mid-shaft clavicle fracture and had open reduction and internal fixation (ORIF) with either superior plating (SP) or anterior-inferior plating (AIP) and were followed up for at least one year. Data analyzed include age, sex, laterality, mode of injury, the time from initial injury to surgery, type of plate used, position of the plate, union rate, functional outcome and perioperative complications.
Results

Forty-two patients had SP and twenty-seven patients had AIP. Forty-one (97.6%) patients had fracture union in the SP group while all the twenty-seven patients (100%) in the AIP group had fracture union. The mean QuickDASH scores were 3.2 ± 4.6 and 3.6 ± 4.7 in AIP and SP groups respectively. There was no significant difference in the union rates and functional outcome between the two groups.
Conclusion

Both superior and anteroinferior plating techniques are safe and effective in the surgical management of displaced mid-clavicle fractures.
Level of evidence

Level 3, retrospective cohort study.
Keywords

Research paper thumbnail of Original Research Article Traditional bone setting: an avoidable cause of major limb amputations

Int J Res Orthop., 2021

ABSTRACT Background: Despite the availability of modern health care services, patients in Nigeria... more ABSTRACT
Background: Despite the availability of modern health care services, patients in Nigeria still seek treatment by
traditional bone setters. One of the major complications of this type of native fracture treatment is limb gangrene
necessitating amputations. The objective of this study was to determine the role of traditional bone setting in major limb
amputations.
Methods: This retrospective study was carried out at a government orthopedic referral hospital. The study involved all
patients who underwent major limb amputation between January 2015 and December 2019 in our center. Data were
retrieved from medical records and operation registers. Information regarding age, sex, indications and levels of
amputation and complications were studied.
Results: During the study period; of the 297 major limb amputations performedd, 194 (65.3%) were due to traditional
bone setting. The median age of the patients was 11.0 years (1 to 45 years) and the interquartile range was 10 years.
Majority of the patients 86 (44.3%) affected were children less than 10 years of age. Male were more affected than
female (M:F=1:2). Lower limb is more affected than the upper limb. The commonest amputation done was below knee
amputation in 79 (40.7%) of cases. The commonest complication was surgical site infection which occurred in 32
(16.5%) patients.
Conclusions: Traditional bone setting is a leading cause of major limb loss especially in children.
Keywords: Traditional bone setting, Amputation, Gangrene

Research paper thumbnail of Functional outcome of arthroscopic reconstruction of chronic anterior cruciate ligament ruptures using single-bundle triple-weaved hamstring tendons in northern Nigeria Alabi IA, Nkanta C, Okoh N, Arojuraye SA and Abbas AD

International Journal of Orthopaedic Sciences, 2020

Though anterior cruciate ligament (ACL) is the most commonly reconstructed ligament all over the ... more Though anterior cruciate ligament (ACL) is the most commonly reconstructed ligament all over the world, its arthroscopic reconstruction was relatively less frequent in the West African sub region until recently. The patronage of the traditional bone setters in the acute phase of closed knee injuries has made Chronic ACL injury the main form of presentation with significant secondary injuries and degenerative changes from sub-optimal initial care. The aim of this study was to determine functional outcome and patient's satisfaction from Arthroscopic chronic ACL injury repair. Diagnoses were made using clinical parameters and MRI. Lysholm scores were determined preoperatively, and repeated with patient's satisfaction assessment (using the Likert scale) at 3, 6, 12, 24 and 48 months postoperatively. Arthroscopic single-bundle ACL repair using a triple-weaved hamstring tendon (s) was done for all the patients. Debridement and meniscectomy were done for various degrees of degenerative changes and irreparable meniscal injuries respectively. No one was dissatisfied and 91.4% of the patients had well to excellent Lysholm scores at 2 years of follow up. It was concluded that arthroscopic chronic ACL rupture reconstruction using single-bundle triple-weaved hamstring autografts with good rehabilitation offers good to excellent knee function and patients' satisfaction with minimal complications.

Research paper thumbnail of Pattern of presentation of patella instability at the national orthopaedic hospital, Dala Kano, Nigeria

Pyramid Journal of Medicine, 2020

Patella instability is a clinical condition in which patella dislocation had occurred at least tw... more Patella instability is a clinical condition in which patella dislocation had occurred at least twice, or where patella instability following initial dislocation had persisted for more than three months. It can be unilateral or bilateral. Females are more affected, and it can affect the quality of life of the individual affected. This study is a retrospective survey of all patients who had recurrent patella dislocation at National Orthopedic hospital, Dala, Kano between January 2009 and November 2019. A total of 49 patients were treated with recurrent patella dislocation were found with a predominant young age (11-20 years-old) and a female preponderance (56.4%). Pain, instability or both are the main forms of presentation. Trauma, ligamentous laxity as well as hypoplasia of femoral condyle were risk factors identified. Arthroscopic medial plication and lateral release and was done in 28 (71.8%) patients as a means of treatment. Three patients (7.7%) had medial patellofemoral ligament reconstruction (MPFLR) while the remaining 8 patients (20.5%) were managed non-operatively.

Research paper thumbnail of Old Unreduced Elbow Dislocation: Patients' Perspectives of Open Reduction

Copyright © 2020 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved, 2020

Abstract INTRODUCTION: Old unreduced elbow dislocation is not uncommon in developing countries. M... more Abstract
INTRODUCTION:
Old unreduced elbow dislocation is not uncommon in developing countries. Many authors have reported the outcome of an open reduction in the management of this problem. However, we did not find any study that documents the patient-reported outcome.

OBJECTIVE:
the objective of this study was to determine the patients' perspectives of the outcome of an open reduction in the management of old unreduced elbow dislocation.

METHODS:
This was a prospective interventional study of 49 consecutive patients with old unreduced simple elbow dislocation who were treated with open reduction at the National Orthopaedic Hospital, Dala - Kano, Nigeria and Albarka Clinic Kano, Nigeria between January 2015 and December 2019.

RESULTS:
Forty-nine patients were studied with a median age of 31.0 years (range: 19-60 years). The majority of the patients were within 31-40 years age group. The male to female ratio was 6:1. Using the Mayo Elbow Performance Scale (MEPS) and Patients specific Functional scale (PSFS); there are significant improvements in postoperative functional capability of the patients (P = 0.000). With the short assessment for patient satisfaction (SAPS), 93.3% of patients were either satisfied or very satisfied with the outcome of open reduction.

CONCLUSION:
The outcome of open reduction for old unreduced elbow dislocation is good and is well accepted by the patients.

Copyright © 2020 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

KEYWORDS:
Open reduction; Patients perspectives; Unreduced Elbow Dislocation

PMID: 32204984 DOI: 10.1016/j.surge.2020.03.001

Research paper thumbnail of Comparative study of the outcomes of one-stage versus two-stage reconstruction of chronic multiligament knee injury

The Surgeon, 2024

A B S T R A C T Background: Multi-ligament knee injury (MLKI) is a complex orthopaedic knee probl... more A B S T R A C T
Background: Multi-ligament knee injury (MLKI) is a complex orthopaedic knee problem, usually following
traumatic knee dislocation. Surgical management is preferred and has resulted in better clinical outcomes.
However, the optimal surgical treatment protocol is continuously evolving. This study aimed to compare the
outcomes of one-stage versus two-stage reconstruction of MLKI.
Materials and methods: This retrospective comparative study was conducted between July 2020 and December
2023 at a government orthopaedic hospital in Nigeria. The inclusion criteria include males and females between
18 and 45 years of age who had one- or two staged knee reconstructions for MLKI and were followed up for a
minimum of 12 months. The exclusion criteria were patients below 18 and above 45 years of age, those with
previous knee surgery, those associated with femoral or tibia fractures, those with radiological evidence of
osteoarthritis, and those with follow-ups less than 12 months. Clinical outcomes using the Lysholm scoring
system and complication rate were recorded. The statistical analysis was performed using SPSS version 23.
Results: Fifty-one patients (26 in the OS group and 25 in the TS group) were studied. There was a significant
difference between the preoperative and postoperative Lysholm scores in the two groups (p = 0.86 and 0.57 for
OS and TS, respectively). However, there was no significant difference between the postoperative Lysholm scores
in the two groups (p = 0.918).
Conclusion: One-stage and two-stage reconstruction of chronic MLKI give similar excellent clinical outcomes

Research paper thumbnail of Outcome of percutaneous reconstruction of chronic lateral collateral ligament rupture

Chinese Journal of Traumatology, 2023

Many techniques have been described for the reconstruction of chronic lateral collateral ligament... more Many techniques have been described for the reconstruction of chronic lateral collateral ligament (LCL) rupture with different autograft options. The advantages of percutaneous LCL reconstruction include small incisions, minimal soft tissue disruption, less postoperative pain, and speedy rehabilitation and recovery. The aim of this study was to report the functional outcome of percutaneous LCL reconstruction and overall patient satisfaction in Africans. Methods: This prospective and interventional study involving 51 patients with chronic LCL rupture who had percutaneous LCL reconstruction using peroneus longus autograft was conducted between January 2021 and December 2022 in National Orthopaedic Hospital, Dala-Kano, Nigeria. The inclusion criteria were patients between the ages of 18 and 45 years with chronic isolated LCL and not more than 1 injury of knee ligament. Exclusion criteria were active infection, and multi-ligament knee injury requiring 2staged surgery. The knee functions were assessed preoperatively, 3 months, 6 months, and 12 months postoperatively using the Lysholm scoring system. Patient satisfaction with the outcome of the treatment was assessed using a 5-point Likert scale. Relevant information was recorded into Microsoft Excel sheet and data was analyzed using SPSS version 23.0 for windows. The paired samples t-test was used to compare the clinical outcomes as continuous variables. Statistical significance was considered at p < 0.05. Results: The mean age of the patients was (30.10 ± 5.90) years. The median time from injury to surgery was 7 months (ranging from 3 to 28 months). The mean follow-up period was (14.07 ± 3.13) months. The mean preoperative and 1-year postoperative Lysholm scores were 44.33 ± 12.97 and 97.96 ± 1.23, respectively. Conclusion: Percutaneous LCL reconstruction using peroneus longus autograft significantly improves patient knee function and results in excellent patient satisfaction.

Research paper thumbnail of Arthroscopic Anterior Cruciate Ligament Reconstruction Learning Curve: Analysis of Operating Time and Clinical Outcomes

J West Afr Coll Surg, 2024

Background: Technical proficiency for arthroscopic anterior cruciate ligament reconstruction (ACL... more Background: Technical proficiency for arthroscopic anterior cruciate ligament reconstruction (ACLR) is complex and requires learning and practice. Achieving an appropriate level of competency with this surgery is important for patient safety and satisfactory surgical outcomes. There is limited literature about the learning curve in ACLR in Africa. Objectives: This study aimed to demonstrate the learning curve associated with ACLR. Materials and Methods: This retrospective study on arthroscopic ACLR was conducted between January 2020 and June 2023 with a minimum of 12 months follow-up. The primary outcome measure was operation time, whereas the secondary outcome measures were functional outcome and postoperative complications. Results: One hundred fifty-nine ACLR met the inclusion criteria and were analysed. The mean age of the patients was 31.47 ± 9.50 years. There were 148 (93.1%) males and 11 (6.9%) females. The median operation time was 50 min (45-190 min). There was progressively decreasing operation time with increasing number of cases done until after the first 19 cases. The mean operating time for the first 19 cases was 143.89 ± 32.84 min, whereas the mean operating time for the later 140 cases was 53.81 ± 9.72 min (P = 0.000). Conclusions: The operation time for arthroscopic ACLR progressively decreased until after the first 19 cases. There was, however, no significant difference in the clinical outcome between the cases done during the learning curve and those done at proficiency.

Research paper thumbnail of Timing of surgery following SARS‐CoV‐2 infection: an international prospective cohort study

Anaesthesia, 2021

SummaryPeri‐operative SARS‐CoV‐2 infection increases postoperative mortality. The aim of this stu... more SummaryPeri‐operative SARS‐CoV‐2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS‐CoV‐2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre‐operative SARS‐CoV‐2 infection were compared with those without previous SARS‐CoV‐2 infection. The primary outcome measure was 30‐day postoperative mortality. Logistic regression models were used to calculate adjusted 30‐day mortality rates stratified by time from diagnosis of SARS‐CoV‐2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre‐operative SARS‐CoV‐2 diagnosis. Adjusted 30‐day mortality in patients without SARS‐CoV‐2 infection was 1.5% (95%CI 1.4–1.5). In patients with a pre‐operative SARS‐CoV‐2 diagnosis, mortality was increased in patients having surgery wi...

Research paper thumbnail of SARS‐CoV‐2 infection and venous thromboembolism after surgery: an international prospective cohort study

Anaesthesia, 2021

SummarySARS‐CoV‐2 has been associated with an increased rate of venous thromboembolism in critica... more SummarySARS‐CoV‐2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri‐operative or prior SARS‐CoV‐2 were at further increased risk of venous thromboembolism. We conducted a planned sub‐study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS‐CoV‐2 diagnosis was defined as peri‐operative (7 days before to 30 days after surgery); recent (1–6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre‐operative anti‐coagulation for baseline comorbidities was no...

Research paper thumbnail of Old unreduced elbow dislocation: Patients’ perspectives on outcome of open reduction

The Surgeon, 2020

INTRODUCTION Old unreduced elbow dislocation is not uncommon in developing countries. Many author... more INTRODUCTION Old unreduced elbow dislocation is not uncommon in developing countries. Many authors have reported outcome of open reduction in the management of this problem. However, we did not find any study that document patient reported outcome. OBJECTIVE the objective of this study was to determine the patients' perspectives of outcome of open reduction in the management of old unreduced elbow dislocation. METHODS This was a prospective interventional study of 49 consecutive patients with old unreduced simple elbow dislocation who were treated with open reduction at the National Orthopaedic Hospital, Dala - Kano, Nigeria and Albarka Clinic Kano, Nigeria between January 2015 and December 2019. RESULTS Fourty nine patients were studied with median age of 31.0 years (range: 19-60 years). The majority of the patients were within 31-40 years age group. The male to female ratio was 6:1. Using the Mayor Elbow Performance Scale (MEPS) and Patients specific Functional scale (PSFS); there are significant improvements in postoperative functional capability of the patients (P = 0.000). With the short assessment for patient satisfaction (SAPS), 93.3% of patients were either satisfied or very satisfied with the outcome of open reduction. CONCLUSION The outcome of open reduction for old unreduced elbow dislocation is good and is well accepted by the patients.

Research paper thumbnail of Elective surgery system strengthening: development, measurement, and validation of the surgical preparedness index across 1632 hospitals in 119 countries

The Lancet

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as ind... more Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index to support local elective surgical system strengthening and address growing backlogs. Methods First, we performed an international consultation through a four-stage consensus process to develop a multidomain index for hospital-level assessment (surgical preparedness index; SPI). Second, we measured surgical preparedness across a global network of hospitals in high-income countries (HICs), middle-income countries (MICs), and low-income countries (LICs) to explore the distribution of the SPI at national, subnational, and hospital levels. Finally, using COVID-19 as an example of an external system shock, we compared hospitals&amp;amp;amp;#39; SPI to their planned surgical volume ratio (SVR; ie, operations for which the decision for surgery was made before hospital admission), calculated as the ratio of the observed surgical volume over a 1-month assessment period between June 6 and Aug 5, 2021, against the expected surgical volume based on hospital administrative data from the same period in 2019 (ie, a pre-pandemic baseline). A linear mixed-effects regression model was used to determine the effect of increasing SPI score. Findings In the first phase, from a longlist of 103 candidate indicators, 23 were prioritised as core indicators of elective surgical system preparedness by 69 clinicians (23 [33%] women; 46 [67%] men; 41 from HICs, 22 from MICs, and six from LICs) from 32 countries. The multidomain SPI included 11 indicators on facilities and consumables, two on staffing, two on prioritisation, and eight on systems. Hospitals were scored from 23 (least prepared) to 115 points (most prepared). In the second phase, surgical preparedness was measured in 1632 hospitals by 4714 clinicians from 119 countries. 745 (45•6%) of 1632 hospitals were in MICs or LICs. The mean SPI score was 84•5 (95% CI 84•1-84•9), which varied between HIC (88•5 [89•0-88•0]), MIC (81•8 [82•5-81•1]), and LIC (66•8 [64•9-68•7]) settings. In the third phase, 1217 (74•6%) hospitals did not maintain their expected SVR during the COVID-19 pandemic, of which 625 (51•4%) were from HIC, 538 (44•2%) from MIC, and 54 (4•4%) from LIC settings. In the mixed-effects model, a 10-point increase in SPI corresponded to a 3•6% (95% CI 3•0-4•1; p&amp;amp;amp;lt;0•0001) increase in SVR. This was consistent in HIC (4•8% [4•1-5•5]; p&amp;amp;amp;lt;0•0001), MIC (2•8 [2•0-3•7]; p&amp;amp;amp;lt;0•0001), and LIC (3•8 [1•3-6•7%]; p&amp;amp;amp;lt;0•0001) settings. Interpretation The SPI contains 23 indicators that are globally applicable, relevant across different system stressors, vary at a subnational level, and are collectable by front-line teams. In the case study of COVID-19, a higher SPI was associated with an increased planned surgical volume ratio independent of country income status, COVID-19 burden, and hospital type. Hospitals should perform annual self-assessment of their surgical preparedness to identify areas that can be improved, create resilience in local surgical systems, and upscale capacity to address elective surgery backlogs.

Research paper thumbnail of Pattern of presentation of patella instability at the national orthopaedic hospital, Dala Kano, Nigeria

Pyramid Journal of Medicine, 2020

Patella instability is a clinical condition in which patella dislocation had occurred at least tw... more Patella instability is a clinical condition in which patella dislocation had occurred at least twice, or where patella instability following initial dislocation had persisted for more than three months. It can be unilateral or bilateral. Females are more affected, and it can affect the quality of life of the individual affected. This study is a retrospective survey of all patients who had recurrent patella dislocation at National Orthopedic hospital, Dala, Kano between January 2009 and November 2019. A total of 49 patients were treated with recurrent patella dislocation were found with a predominant young age (11-20 years-old) and a female preponderance (56.4%). Pain, instability or both are the main forms of presentation. Trauma, ligamentous laxity as well as hypoplasia of femoral condyle were risk factors identified. Arthroscopic medial plication and lateral release and was done in 28 (71.8%) patients as a means of treatment. Three patients (7.7%) had medial patellofemoral ligamen...

Research paper thumbnail of Pattern of presentation of patella instability at the national orthopaedic hospital, Dala Kano, Nigeria

Pyramid Journal of Medicine, 2020

Patella instability is a clinical condition in which patella dislocation had occurred at least tw... more Patella instability is a clinical condition in which patella dislocation had occurred at least twice, or where patella instability following initial dislocation had persisted for more than three months. It can be unilateral or bilateral. Females are more affected, and it can affect the quality of life of the individual affected. This study is a retrospective survey of all patients who had recurrent patella dislocation at National Orthopedic hospital, Dala, Kano between January 2009 and November 2019. A total of 49 patients were treated with recurrent patella dislocation were found with a predominant young age (11-20 years-old) and a female preponderance (56.4%). Pain, instability or both are the main forms of presentation. Trauma, ligamentous laxity as well as hypoplasia of femoral condyle were risk factors identified. Arthroscopic medial plication and lateral release and was done in 28 (71.8%) patients as a means of treatment. Three patients (7.7%) had medial patellofemoral ligamen...

Research paper thumbnail of Internal splintage of acute acromioclavicular joint dislocation using polyester suture: Experience from a Nigerian orthopaedic hospital

Nigerian Postgraduate Medical Journal, 2022

Background: Various surgical options have been described for acute acromioclavicular joint (ACJ) ... more Background: Various surgical options have been described for acute acromioclavicular joint (ACJ) disruption. Dynamic fixation of these fractures is the most favoured option. However, no single modality of treatment has been adjudged to be the best option so far. Purpose: The goal of this study was to present the outcome of internal splintage of acute ACJ disruption using polyester suture without clavicle drilling in our setting. Patients and Methods: This prospective study was done at the National Orthopedic Hospital, Dala, Kano, on those with acute ACJ injuries between January 2016 and June 2021. Forty five patients (36 males and 9 females) had internal splintage of acute ACJ disruption using polyester-5 suture loops around the coracoid process and clavicle without bone drilling. Results: The average age of the patients in this study was 31.51 ± 11.43 years, while the age group with highest frequency was 21–30 years, accounting for 17 (37.8%) of all the patients. The mean pre-opera...

Research paper thumbnail of Outcome of Surgical Fixation of Intertrochanteric Femoral Fractures with Dynamic Hip Screw

Background: Intertrochanteric fracture of the femur is one of the common fractures in the elderly... more Background: Intertrochanteric fracture of the femur is one of the common fractures in the elderly with osteoporosis due to trivial fall. When occurs in the young, intertrochanteric fracture is usually due to high-energy injuries such as motor vehicular accident or fall from height. Dynamic Hip Screw (DHS) fixation has remained the gold standard for the treatment of stable intertrochanteric femoral fractures to which other options are compared.The aim of this study was to assess radiological and functional results in stable intertrochanteric femoral fractures treated with Dynamic Hip Screw fixation.This study was a prospective, interventional study involving 48 consecutive patients with stable intertrochanteric femoral fractures that were treated using internal fixation with DHS between December 2015 and November 2018 at the National Orthopaedic Hospital, Dala Kano. All patients were followed up for a minimum of 6 months. The mean age of the patients was 56.8 ± 15.0 years. There was ...

Research paper thumbnail of Anteroinferior versus superior plating techniques for displaced midshaft clavicle fractures: A retrospective single centre cohort study from Northern Nigeria

BACKGROUND Clavicle fractures are common injuries accounting for up to 5% of all fractures in adu... more BACKGROUND Clavicle fractures are common injuries accounting for up to 5% of all fractures in adults. Most clavicle fractures heal well with nonoperative treatment, some however, require surgical intervention especially when they are displaced. While plating remains the most popular and most successful method of clavicle fixation; the optimal position of the plate is yet to be agreed upon. PURPOSES The purpose of this study was to compare the functional outcomes of displaced clavicle fractures fixed with superior and anteroinferior plating techniques. PATIENTS AND METHODS This retrospective cohort study of 69 patients (45 males and 24 females) was carried out between January 2014 and December 2018 at a government orthopaedic hospital in north-western part of Nigeria. The study involved all consecutive patients who sustained a displaced mid-shaft clavicle fracture and had open reduction and internal fixation (ORIF) with either superior plating (SP) or anterior-inferior plating (AIP) ...

Research paper thumbnail of Functional outcome of arthroscopic reconstruction of chronic anterior cruciate ligament ruptures using single-bundle triple-weaved hamstring tendons in northern Nigeria

International Journal of Orthopaedics Sciences, 2020

Though anterior cruciate ligament (ACL) is the most commonly reconstructed ligament all over the ... more Though anterior cruciate ligament (ACL) is the most commonly reconstructed ligament all over the world, its arthroscopic reconstruction was relatively less frequent in the West African sub region until recently. The patronage of the traditional bone setters in the acute phase of closed knee injuries has made Chronic ACL injury the main form of presentation with significant secondary injuries and degenerative changes from sub-optimal initial care. The aim of this study was to determine functional outcome and patient's satisfaction from Arthroscopic chronic ACL injury repair. Diagnoses were made using clinical parameters and MRI. Lysholm scores were determined preoperatively, and repeated with patient's satisfaction assessment (using the Likert scale) at 3, 6, 12, 24 and 48 months postoperatively. Arthroscopic single-bundle ACL repair using a triple-weaved hamstring tendon (s) was done for all the patients. Debridement and meniscectomy were done for various degrees of degenerative changes and irreparable meniscal injuries respectively. No one was dissatisfied and 91.4% of the patients had well to excellent Lysholm scores at 2 years of follow up. It was concluded that arthroscopic chronic ACL rupture reconstruction using single-bundle triple-weaved hamstring autografts with good rehabilitation offers good to excellent knee function and patients' satisfaction with minimal complications.

Research paper thumbnail of Comparison of Efficacy Safety Between Intravenous and Intraarticular Tranexamic Acid in Reducing Blood Loss after Total Knee Arthroplasty

International Journal of Orthopaedics, 2019

Research paper thumbnail of Internal Splintage of Acute Acromioclavicular Joint Dislocation Using Polyester Suture: Experience from a Nigerian Orthopaedic Hospital

Nigerian Postgraduate Medical Journal | Published by Wolters Kluwer - Medknow, 2022

Background: Various surgical options have been described for acute acromioclavicular joint (ACJ) ... more Background: Various surgical options have been described for acute acromioclavicular joint (ACJ) disruption. Dynamic fixation of these
fractures is the most favoured option. However, no single modality of treatment has been adjudged to be the best option so far. Purpose: The
goal of this study was to present the outcome of internal splintage of acute ACJ disruption using polyester sutures without clavicle drilling in
our setting. Patients and Methods: This prospective study was done at the National Orthopedic Hospital, Dala, Kano, on those with acute
ACJ injuries between January 2016 and June 2021. Forty-five patients (36 males and 9 females) had internal splintage of acute ACJ disruption
using polyester‑5 suture loops around the coracoid process and clavicle without bone drilling. Results: The average age of the patients in this
study was 31.51 ± 11.43 years, while the age group with the highest frequency was 21–30 years, accounting for 17 (37.8%) of all the patients.
The mean pre‑operative and post‑operative disability (QuickDASH) scores were 80.08 ± 10.75 and 3.23 ± 3.58, respectively. There was a
significant difference between pre‑operative and post‑operative QuickDASH scores with P < 0.001. Conclusion: Internal splintage of acute
ACJ dislocation using polyester‑5 suture loop without bone drilling is effective and safe.

Research paper thumbnail of Anteroinferior versus superior plating techniques for displaced midshaft clavicle fractures: A retrospective single centre cohort study from Northern Nigeria

The Surgeon, 2021

Background Clavicle fractures are common injuries accounting for up to 5% of all fractures in ad... more Background

Clavicle fractures are common injuries accounting for up to 5% of all fractures in adults. Most clavicle fractures heal well with nonoperative treatment; however, they require surgical intervention, especially when displaced. While plating remains the most popular and most successful method of clavicle fixation; the optimal position of the plate is yet to be agreed upon.
Purposes

The purpose of this study was to compare the functional outcomes of displaced clavicle fractures fixed with superior and anteroinferior plating techniques.
Patients and methods

This retrospective cohort study of 69 patients (45 males and 24 females) was carried out between January 2014 and December 2018 at a government orthopaedic hospital in the north-western part of Nigeria. The study involved all consecutive patients who sustained a displaced mid-shaft clavicle fracture and had open reduction and internal fixation (ORIF) with either superior plating (SP) or anterior-inferior plating (AIP) and were followed up for at least one year. Data analyzed include age, sex, laterality, mode of injury, the time from initial injury to surgery, type of plate used, position of the plate, union rate, functional outcome and perioperative complications.
Results

Forty-two patients had SP and twenty-seven patients had AIP. Forty-one (97.6%) patients had fracture union in the SP group while all the twenty-seven patients (100%) in the AIP group had fracture union. The mean QuickDASH scores were 3.2 ± 4.6 and 3.6 ± 4.7 in AIP and SP groups respectively. There was no significant difference in the union rates and functional outcome between the two groups.
Conclusion

Both superior and anteroinferior plating techniques are safe and effective in the surgical management of displaced mid-clavicle fractures.
Level of evidence

Level 3, retrospective cohort study.
Keywords

Research paper thumbnail of Original Research Article Traditional bone setting: an avoidable cause of major limb amputations

Int J Res Orthop., 2021

ABSTRACT Background: Despite the availability of modern health care services, patients in Nigeria... more ABSTRACT
Background: Despite the availability of modern health care services, patients in Nigeria still seek treatment by
traditional bone setters. One of the major complications of this type of native fracture treatment is limb gangrene
necessitating amputations. The objective of this study was to determine the role of traditional bone setting in major limb
amputations.
Methods: This retrospective study was carried out at a government orthopedic referral hospital. The study involved all
patients who underwent major limb amputation between January 2015 and December 2019 in our center. Data were
retrieved from medical records and operation registers. Information regarding age, sex, indications and levels of
amputation and complications were studied.
Results: During the study period; of the 297 major limb amputations performedd, 194 (65.3%) were due to traditional
bone setting. The median age of the patients was 11.0 years (1 to 45 years) and the interquartile range was 10 years.
Majority of the patients 86 (44.3%) affected were children less than 10 years of age. Male were more affected than
female (M:F=1:2). Lower limb is more affected than the upper limb. The commonest amputation done was below knee
amputation in 79 (40.7%) of cases. The commonest complication was surgical site infection which occurred in 32
(16.5%) patients.
Conclusions: Traditional bone setting is a leading cause of major limb loss especially in children.
Keywords: Traditional bone setting, Amputation, Gangrene

Research paper thumbnail of Functional outcome of arthroscopic reconstruction of chronic anterior cruciate ligament ruptures using single-bundle triple-weaved hamstring tendons in northern Nigeria Alabi IA, Nkanta C, Okoh N, Arojuraye SA and Abbas AD

International Journal of Orthopaedic Sciences, 2020

Though anterior cruciate ligament (ACL) is the most commonly reconstructed ligament all over the ... more Though anterior cruciate ligament (ACL) is the most commonly reconstructed ligament all over the world, its arthroscopic reconstruction was relatively less frequent in the West African sub region until recently. The patronage of the traditional bone setters in the acute phase of closed knee injuries has made Chronic ACL injury the main form of presentation with significant secondary injuries and degenerative changes from sub-optimal initial care. The aim of this study was to determine functional outcome and patient's satisfaction from Arthroscopic chronic ACL injury repair. Diagnoses were made using clinical parameters and MRI. Lysholm scores were determined preoperatively, and repeated with patient's satisfaction assessment (using the Likert scale) at 3, 6, 12, 24 and 48 months postoperatively. Arthroscopic single-bundle ACL repair using a triple-weaved hamstring tendon (s) was done for all the patients. Debridement and meniscectomy were done for various degrees of degenerative changes and irreparable meniscal injuries respectively. No one was dissatisfied and 91.4% of the patients had well to excellent Lysholm scores at 2 years of follow up. It was concluded that arthroscopic chronic ACL rupture reconstruction using single-bundle triple-weaved hamstring autografts with good rehabilitation offers good to excellent knee function and patients' satisfaction with minimal complications.

Research paper thumbnail of Pattern of presentation of patella instability at the national orthopaedic hospital, Dala Kano, Nigeria

Pyramid Journal of Medicine, 2020

Patella instability is a clinical condition in which patella dislocation had occurred at least tw... more Patella instability is a clinical condition in which patella dislocation had occurred at least twice, or where patella instability following initial dislocation had persisted for more than three months. It can be unilateral or bilateral. Females are more affected, and it can affect the quality of life of the individual affected. This study is a retrospective survey of all patients who had recurrent patella dislocation at National Orthopedic hospital, Dala, Kano between January 2009 and November 2019. A total of 49 patients were treated with recurrent patella dislocation were found with a predominant young age (11-20 years-old) and a female preponderance (56.4%). Pain, instability or both are the main forms of presentation. Trauma, ligamentous laxity as well as hypoplasia of femoral condyle were risk factors identified. Arthroscopic medial plication and lateral release and was done in 28 (71.8%) patients as a means of treatment. Three patients (7.7%) had medial patellofemoral ligament reconstruction (MPFLR) while the remaining 8 patients (20.5%) were managed non-operatively.

Research paper thumbnail of Old Unreduced Elbow Dislocation: Patients' Perspectives of Open Reduction

Copyright © 2020 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved, 2020

Abstract INTRODUCTION: Old unreduced elbow dislocation is not uncommon in developing countries. M... more Abstract
INTRODUCTION:
Old unreduced elbow dislocation is not uncommon in developing countries. Many authors have reported the outcome of an open reduction in the management of this problem. However, we did not find any study that documents the patient-reported outcome.

OBJECTIVE:
the objective of this study was to determine the patients' perspectives of the outcome of an open reduction in the management of old unreduced elbow dislocation.

METHODS:
This was a prospective interventional study of 49 consecutive patients with old unreduced simple elbow dislocation who were treated with open reduction at the National Orthopaedic Hospital, Dala - Kano, Nigeria and Albarka Clinic Kano, Nigeria between January 2015 and December 2019.

RESULTS:
Forty-nine patients were studied with a median age of 31.0 years (range: 19-60 years). The majority of the patients were within 31-40 years age group. The male to female ratio was 6:1. Using the Mayo Elbow Performance Scale (MEPS) and Patients specific Functional scale (PSFS); there are significant improvements in postoperative functional capability of the patients (P = 0.000). With the short assessment for patient satisfaction (SAPS), 93.3% of patients were either satisfied or very satisfied with the outcome of open reduction.

CONCLUSION:
The outcome of open reduction for old unreduced elbow dislocation is good and is well accepted by the patients.

Copyright © 2020 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

KEYWORDS:
Open reduction; Patients perspectives; Unreduced Elbow Dislocation

PMID: 32204984 DOI: 10.1016/j.surge.2020.03.001