Single-stage intramedullary nailing for patients with multiple concurrent long-bone fractures in a low-resource setting: what factors contribute to prolonged operative duration?

Purpose: To investigate the factors that prolonged the operative duration (OD) in patients who underwent single-stage locked intramedullary nailing of their multiple concurrent long-bone fractures (LBFs) using Surgical Implant Generation Network (SIGN) nails.

Methods: Forty-nine patients who fulfilled the inclusion criteria were enrolled prospectively over 8½ years. Data collected included age, sex, injury mechanism and severity, fracture characteristics, nail types and diameter, OD, fracture-to-fixation time, length of hospital stay (LOS), functional outcomes and complications.

The impact of a communal multidisciplinary tumour board on medical education.

Introduction: Numerous challenges hinder the development of multidisciplinary medical education in a resource-constrained environment. Communal tumour boards built through networking could be a suitable model for the effective management of diseases and enhancement of medical education. This study evaluated the impact of an integrated care pathway for patients with musculoskeletal tumours via multi-institutional networking in a metropolis.

Difficulty in financing fracture care in south-western Nigeria: a prospective cohort study of predictors and recommendations for improvement.

Background: Bone fractures remain a significant global public health issue despite preventive measures, leading to substantial health and economic consequences. Effective treatment options are difficult to access in most sub-Saharan African countries, leading to reliance on unqualified practitioners and resulting in serious complications that worsen poverty. In Nigeria, the main challenge is the need for out-of-pocket payment for healthcare, which is the primary method of health financing.

Intramuscular lipomas posing diagnostic and pre-operative counselling challenges in a low-resource setting: A case series.

Introduction: Intramuscular lipomas (IMLs) are uncommon primary adipose tissue tumours deep within the muscle. A high likelihood of misdiagnosing them as other benign and malignant masses necessitates imaging studies to confirm the diagnosis and plan treatment. Ultrasonography is useful but CT and MRI provide a more accurate diagnosis.

Reamed intramedullary nailing of diaphyseal multifragmentary femur fractures (AO/OTA 32-C) without fluoroscopy guidance: prospective analysis of methods and short-term outcomes in a low-resource setting.

Purpose: To describe the methods and outcomes of reamed intramedullary nailing (IMN) of diaphyseal multifragmentary femur (AO/OTA C2 and C3) fractures (DMFFs) in a low-resource setting without fluoroscopy and fracture table.

Methods: The prospective study involved 35 DMFFs among 318 femur fractures treated ≤ 3 weeks post-injury with SIGN nails. The fractures were fixed without fluoroscopy, fracture table and power reaming.

Retrograde intramedullary nailing with supplemental plate and lag screws allows early weight bearing following distal end-segment femur fractures (AO/OTA 33) in a low-resource setting.

Purpose: To underline the feasibility of achieving early weight bearing in patients with distal end-segment femur fractures (AO/OTA 33) treated with retrograde intramedullary nailing and supplemental plate or lag screws in the absence of C-arm.

Methods: 41 distal end-segment femur fractures (DFFs) included in the study were treated with SIGN nails with or without a side plate in a center that lacked intraoperative fluoroscopy and fracture table. A medial or lateral para-patellar incision was used for fracture reduction, nail insertion and side plate placement.

Follow-up non-attendance after long-bone fractures in a low-resource setting: a prospective study of predictors and interventions to increase attendance rates.

Background: While the majority of traumatic injuries occur in low- and middle-income countries, the published literature comes chiefly from high-income countries due to poor follow-up. Clinical and radiographic post-surgical trauma follow-up is essential to high-quality research and objective monitoring for healing and/or complications. This study aimed to identify the predictors of follow-up non-attendance in a low-resource setting and investigate the extent to which interventional efforts based on mobile phone technology (MPT) and home visits improved the follow-up rates for fractures treated with SIGN nails.

Locked intramedullary nailing of diaphyseal femur fractures without intraoperative fluoroscopy, fracture table and power reaming: retrograde affords greater procedural efficiency than antegrade approach.

Purpose: To compare the intraoperative procedural efficiency of antegrade and retrograde locked intramedullary nailing of diaphyseal femur fractures without intraoperative fluoroscopy, power reaming devices and fracture tables.

Methods: A secondary analysis of prospectively collected data was conducted on 238 isolated diaphyseal femur fractures fixed with SIGN Standard and Fin nails within three weeks of injury. The data included baseline patient and fracture characteristics, nail type and diameter, fracture reduction methods, operative times and outcome measures.

Infection complicating locked intramedullary nailing of open lower-extremity fractures: incidence, associated risk factors, and lessons for improving outcome in a low-resource setting.

: Infection is the chief complication that makes open fractures difficult to treat. Most low- and middle-income countries (LMICs) are missing out on modern management techniques developed to achieve better outcomes in high-income countries (HICs). One of these is the use of locked intramedullary (IM) nails.

Solid locked intramedullary nailing for expeditious return of bone-setting-induced abnormal fracture union victims to work in South-western Nigeria.

Wage earning in low- and middle-income countries (LMICs) is predominantly through physical labour. Consequently, limb-related disabilities caused by abnormal fracture unions (AFUs) preclude gainful employment and perpetuate the cycle of poverty. Many AFUs result from traditional bone-setting (TBS), a pervasive treatment for long bone fractures in LMICs.

The functional outcome after tumor resection and endoprosthesis around the knee: a systematic review.

The evidence for the functional outcome of endo- prosthetic replacement (EPR) after tumour resection has been from few cohort studies. A scoping search revealed no systematic review on patient reported outcome measures after EPR around the knee. The purpose of this study was to evaluate the functional outcome of distal femoral and proximal tibial EPR after tumour resection.

Radiation-free interlocking intramedullary nailing of three-hundred and seventy long bone fractures in Ogbomoso, Nigeria.

Long bone fracture care in developing countries remains largely different from that of the developed world where closed reduction and internal fixation with locked intramedullary nail is the standard treatment. This study in a developing country presents the pattern and outcome of treatment of 370 long bone fractures using the SIGN nail over a five-year period in order to underline the wide array of patients and fractures treatable with the nail. Using a prospective descriptive approach, all the 342 patients with 370 fractures of the humerus, femur and tibia treated from July 2014 to June 2019 were studied.

of the femoral bone.

Histoplasmosis due to is an emerging AIDS-defining opportunistic infection in HIV positive seen predominantly on the African continent between the Tropics of Cancer and Capricorn. is an invasive fungal organism with tropism for lymph nodes, skin and bones. The infection occurs more in patients with a CD4 count <50/mm and is usually dissemnnated Histoplasmosis due to is an emerging AIDS-defining opportunistic infection in HIV positive seen predominantly on the African continent between the Tropics of Cancer and Capricorn.

Non-ossifying fibroma of the right clavicle.

Non-ossifying fibromas (NOFs) or fibroxanthomas are benign intracortical, multilocular and well-circumscribed lesions, which most commonly affect children and adolescents with an estimated prevalence of 30%-40% of all normal children. They are most commonly located in the distal femoral and distal tibial metaphysis although they can also be found in the fibula and upper extremity. Clinically, NOFs are asymptomatic and are detected only incidentally on radiographs where they appear as solitary, eccentric and lytic lesion in the metaphysis of a long bone and often polycyclic in shape.

Cavernous Hemangioma of the Left Forearm.

Cavernous hemangiomas are benign hamartomatous proliferation of endothelial tissues. They can arise virtually anywhere in the body and do not contain tissues native to the organ or structure in which they are located. Contrary to what is seen in capillary hemangiomas and the cavernous cutaneous variety, intramuscular hemangiomas almost always never regress.

Desmoplastic fibroma of the ulna bone.

A fibroma is a benign tumour composed of fibrous connective tissue and they can grow in all organs. They can be classified based on consistency into hard or soft fibroma, based on histological characteristics into desmoplastic, chondromyxoid, ossifying, non-ossifying fibroma. They can also be classified based on tissue of origin or location in the body, it can also be classified into superficial or deep fibroma.

Bone malignancies in orthopaedic hospital Igbobi Lagos, Nigeria.

Aims And Objectives: To document the pattern of bone malignancies in a highly populated orthopaedic hospital in Lagos Nigeria;

Patients And Methods: A total of 21 cases of primary malignant bone tumours were studied. This comprised 12 cases of Osteosarcoma, 7 cases of Malignant Fibrous Histiocytoma (MFH) and 2 cases of Chondrosarcoma. Males (13) were affected more than females (8) giving a male to female ratio of 1.

Benign fibrous histiocytoma of a metacarpal bone.

Benign fibrous histiocytoma (BFH) is a rare skeletal tumour. Its occurrence in the metacarpal bones is even rarer. The management in this location can be challenging, involving tumour resection and metacarpal reconstruction.

Fine needle aspiration cytology of bone tumours--the experience from the National Orthopaedic and Lagos University Teaching Hospitals, Lagos, Nigeria.

Background: Due to difficulty in confirming clinical suspicions of malignancy in patients presenting with bone tumours, the cost of surgical biopsies where hospital charges are borne almost entirely by patients, competition with bone setters and healing homes with high rate of loss to follow up; we set out to find if sufficient material could be obtained to arrive at reliable tissue diagnosis in patients with clinical and radiological evidence of bone tumours in our hospitals.

Methods: After initial clinical and plain radiographic examinations, patients were sent for fine needle aspirations. Aspirations were carried out with size 23G needles of varying lengths with 10 ml syringes in a syringe holder (CAMECO, Sebre Medical, Vellinge, Sweden).