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Singh R, Seth I, Seth A, Singh S, Aiyappan RK, Yadav CM, Jain H, Tawde A, Agrawal GK, Jain A. How Not To Fix a Tibial Fracture: A Case Report on Treatment By a Quack. Cureus 2023; 15:e40203. [PMID: 37435249 PMCID: PMC10331172 DOI: 10.7759/cureus.40203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2023] [Indexed: 07/13/2023] Open
Abstract
Quackery in the orthopaedic profession has existed for quite a long time. Due to the shortage of orthopaedic healthcare staff in public hospitals and the high costs in private facilities, members of disadvantaged communities turn to unlicensed and unskilled practitioners (quacks). The main factors responsible for the increased number of quacks performing orthopaedic treatment are illiteracy, high treatment cost, mismatch in the orthopaedic surgeon-to-population ratio, especially in rural areas, and the absence of any form of health insurance. Moreover, their easy availability and offer of low-cost treatment draw innocent and illiterate patients to them, even though these quacks perform orthopaedic treatment in the most unhygienic, unsterilized, and unconventional manner. The government should intervene and take measures to make orthopaedic treatment more affordable and accessible, especially to the rural population.
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Affiliation(s)
- Roop Singh
- Orthopaedics, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, IND
| | - Isha Seth
- Obstetrics and Gynaecology, Amrita Hospital, Faridabad, IND
| | - Aditya Seth
- Orthopaedics, Krishna Institute of Medical Sciences (KIMS) Sunshine Hospital, Hyderabad, IND
| | - Sunayana Singh
- Obstetrics and Gynecology, Government Medical College and Hospital, Chandigarh, IND
| | | | - Chander Mohan Yadav
- Orthopaedics and Rehabilitation, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, IND
| | - Harsh Jain
- Orthopaedics and Rehabilitation, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, IND
| | - Anish Tawde
- Arthroplasty, Krishna Institute of Medical Sciences (KIMS) Sunshine Hospital, Hyderabad, IND
| | - Gaurav K Agrawal
- Orthopaedics, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, IND
| | - Aditi Jain
- Internal Medicine, Sawai Man Singh Medical College, Jaipur, IND
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Garikapati V, Konadu-Yeboah D, Mengesha MG, Marenah K, Harrison WJ. Systematic review of complications associated with treatment by traditional bone setters for musculoskeletal injury. Trop Doct 2023; 53:13-19. [PMID: 36062723 DOI: 10.1177/00494755221122543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In order to synthesise the existing evidence of Traditional Bone Setters' (TBS) treatment and its associated complications in Low and Middle Income Countries (LMICs), we conducted a literature search following PRISMA guidelines. The keywords "traditional bone setter", "traditional bone healer", "traditional bone setting", "fracture", "complication", "low income country"," low to middle income country", "poor outcome" and "death" were searched in PubMed. Articles included in the review demonstrated complications associated with treatment by TBS for Musculoskeletal injury in LMICs. Out of 878 papers screened, twelve studies were finally included for review. Seven were prospective, and five retrospective studies. All were observational studies with all but one hospital based, the remaining being community based, and investigated the outcomes of treatment of fractures by traditional bonesetters published between 1999 and 2020 in LMICs. In total, this review covers 833 participants with 691 complications of TBS treatment. We identify a significant number of limb and life-threatening complications including mortality associated with the treatment by TBS. However, recent studies have shown that TBS are willing and keen to engage with local orthodox services and training courses. As shown in many countries, this can lead to a reduction in complications including mortality and can form a favourable environment where TBS and orthodox services can work side by side.
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Affiliation(s)
- Vivek Garikapati
- Department of Trauma & Orthopaedics, Countess of Chester, Chester, UK
| | - Dominic Konadu-Yeboah
- 259295Department of Surgery (Orthopaedics and Trauma), Komfo Anokye Teaching Hospital, Kumasi, Ashanti, Ghana
| | - Mengistu G Mengesha
- Orthopedic Surgery, Hawassa University Comprehensive Specialised Hospital, Hawassa, Ethiopia
| | - Kebba Marenah
- Department of Surgery, Edward Francis Small Teaching Hospital, Banjul, The Gambia
| | - W J Harrison
- Department of Trauma & Orthopaedics, Countess of Chester, Chester, UK
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Seyoum N, G/Giorgis D, Nega B. Pattern of Vascular Diseases at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Ethiop J Health Sci 2019; 29:377-382. [PMID: 31447506 PMCID: PMC6689717 DOI: 10.4314/ejhs.v29i3.10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Background Vascular diseases are evolving fast in sub-Saharan Africa, but its management is challenged by lack of expertise and infrastructure. In the light of the prevailing challenge, this study was done to see the pattern of vascular disease and its treatment in a tertiary referral hospital. Methods A prospective cross-sectional study was done over a period of one year (February 9, 2016 to February 8, 2017) at Tikur Anbessa specialized hospital (TASH) at Addis Ababa, Ethiopia. Results A total of 386 patients were seen at the surgical OPD. Of these, 78(20.2%) were admitted and operate on. The male to female ratio was 1.3:1. The mean age affected was 39 +/- 10 (Range 12–91 years). On the other hand, 132 (34.2%) patients came with PAD. Of them, 46(34.8%) presented with either frank Gangrene or pre-gangrene stage. The rest 86(65.1%) had claudication pain. The other diseases seen are Varicose Vein, 100(25.9%), Carotid body tumors, 60(15.4%), Aneurysmal diseases, 36(9.1%), Vascular malformations, 34(8.7%), and Vascular injuries, 22(5.6%). During the study period, 28(35.9%) PAD, 22(28.2%) trauma patients, 8(10.2%) Chemodectomas, 8(10.2%) aneurysms, 6(7.7%) hemangiomas, 4(5.1%) varicose vein and 2(2.6%) AV fistula patients were operated. Conclusion The pattern of vascular disease in Ethiopia is becoming a challenge. The gap created due to limited vascular surgeons, poor infrastructure and absent supply chain system has significantly compromised the number and type of operated-on patients. These challenges result in preventable morbidity and mortality.
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Affiliation(s)
- Nebyou Seyoum
- Cardiothoracic and Vascular Unit, Department of Surgery, School of Medicine, College of Health Sciences, Addis Ababa University, Ethiopia
| | - Dawit G/Giorgis
- Cardiothoracic and Vascular Unit, Department of Surgery, School of Medicine, College of Health Sciences, Addis Ababa University, Ethiopia
| | - Berhanu Nega
- Cardiothoracic and Vascular Unit, Department of Surgery, School of Medicine, College of Health Sciences, Addis Ababa University, Ethiopia
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Oboirien M, Agbo SP, Ajiboye LO. Evaluation of locked plate in the osteosynthesis of fractures in osteoporotic bones. Ann Afr Med 2017; 16:127-130. [PMID: 28671153 PMCID: PMC5579896 DOI: 10.4103/aam.aam_3_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The use of conventional dynamic compression plates (DCPs) in osteoporotic bones is associated with higher chances of implant failure. The advent and use of locking combi-plates have ensured a stable construct during osteosynthesis of fractures in osteoporotic bones. OBJECTIVES The study aims to assess the outcome of use of locking combi-plates in the management of fractures in osteoporotic bones in our environment. MATERIALS AND METHODS Cases of patients with nonunion and localized osteoporosis from January 2014 to December 2014 that were managed with locked combi-plates were reviewed. Outcome was assessed by time to healing, stability of implant construct after 6 and 12 months. RESULTS There were 10 patients with mean age of 47.4 ± 12.63 years. There were 9 males and 1 female, and road traffic crashes were the mechanism of injury in 90% (n = 9) and gunshot injuries in 10% (n = 1). Atrophic nonunion was the most common indication for osteosynthesis with 80%, followed by fibrous nonunion with 10.0%. The humerus was the most common long bone involved with 50%. Locked broad DCP was used in 62.5%, and the duration between initial injury and surgery was 6 and 48 months, with an average of 17.5 months. The outcome was such that 90% healed after 12 months on follow-up while one case had the implant backing out and delay union at 6 months. CONCLUSION The use of locked plate in the management of nonunion in the presence of osteoporosis ensures stable fixation construct and healing. Contexte: L'utilisation de plaques de compression dynamiques conventionnelles dans les os ostéoporotiques est associée à des chances plus élevées de défaillance de l'implant. L'avènement et l'utilisation de combi-plaques de verrouillage ont assuré une construction stable lors de l'ostéosyntheis de fractures dans les os ostéoporotiques. Objectifs: L'étude vise à évaluer le résultat de l'utilisation de combi-plaques de verrouillage dans la gestion des fractures dans les os ostéoporotiques dans notre environnement. Méthodologie: Les cas de patients atteints d'ostéoporose non syndiquée et localisée de janvier 2014 à décembre 2014 qui ont été gérés avec des combi-plaques verrouillées ont été examinés. Le résultat a été évalué par le temps de guérison, la stabilité de la construction d'implant après 6 et 12 mois. Résultats: il y avait 10 patients avec un âge moyen de 47,4 12,63. Il y avait 9 hommes et 1 accident de la route et de la route était le mécanisme de la blessure dans 90% (n = 9) et les blessures par balle dans 10% (n = 1). La non-union atrophique était l'indication la plus courante pour l'ostéosynthèse avec 80%, suivie d'une non-union fibreuse avec 10,0%. L'humérus était l'os le plus fréquent impliqué avec 50%. La plaque de compression dynamique bloquée (DCP) a été utilisée à 62,5% et la durée entre la blessure initiale et la chirurgie était de 6 et 48 mois avec une moyenne de 17,5 mois. Le résultat était tel que 90% ont été guéris après 12 mois de suivi, tandis que 1 cas avait l'implantation de l'implant et retardé l'union à 6 mois. CONCLUSION L'utilisation de la plaque verrouillée dans la gestion de la non-union en présence d'ostéoporose assure une construction stable de fixation et une guérison.
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Affiliation(s)
- Muhammad Oboirien
- Department of Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | - Stephen Patrick Agbo
- Department of Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
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Abstract
Children represent the most vulnerable members of our global society, a truth that is magnified when they are physically wounded. In much of the developed world, society has responded by offering protection in the form of law, injury prevention guidelines, and effective trauma systems to provide care for the injured child. Much of our world, though, remains afflicted by poverty and a lack of protective measures. As the globe becomes smaller by way of ease of travel and technology, surgeons are increasingly able to meet these children where they live and in doing so offer their hands and voices to care and protect these young ones. This article is intended as an overview of current issues in pediatric trauma care in the developing world as well as to offer some tips for the volunteer surgeon who may be involved in the care of the injured child in a setting of limited resource availability.
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Affiliation(s)
- Jacob Stephenson
- UC Davis Health System, 2221 Stockton Boulevard, Cypress Building #3107, Sacramento, CA 95817.
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Agu TC, Ojiaku ME. The indications for major limb amputations: 8 years retrospective study in a private orthopaedic and trauma centre in the south-east Nigeria. J Clin Orthop Trauma 2016; 7:242-247. [PMID: 27857497 PMCID: PMC5106472 DOI: 10.1016/j.jcot.2016.03.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 03/31/2016] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Major limb amputation is a common orthopaedic trauma procedure and it is indicated mainly for traumatic gangrene and for trauma related limb conditions. The loss of a limb is devastating to the patient even when it is done to save life. The aims of the study are to highlight the indications for major limb amputations and to find out if there are any concurrent pattern changes. PATIENTS AND METHODS This is a retrospective study analysing medical records of all the patients, who had major limb amputations over a period of 8 years, between October 2007 and September 2015 in a private orthopaedic and trauma centre in the south-east sub-region of Nigeria. RESULTS Traumatic gangrene was the commonest indication for amputation n = 30 (44.7%), followed by diabetic gangrene n = 15 (22.3%), and then traditional bone setters' gangrene n = 10 (14.9%). These were trailed by mangled extremity, malignant conditions of the limb and polydactyl in that order of decreasing frequency. CONCLUSION Traumatic gangrene and other trauma related limb conditions are the leading indications for amputation in this study despite some recent reports stating otherwise. Trauma is largely preventable and so there is a need for continued intensification of the public campaign on road use as a means of preventing severe limb injuries and thus reducing consequent need for amputations.
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Affiliation(s)
- Thaddeus Chika Agu
- Consultant Orthopaedic Surgeon, Lecturer, Imo State University, Owerri, Nigeria,Visiting Consultant Orthopaedic & Trauma Surgeon, First Choice Specialist Hospital, Nkpor, Nigeria,Corresponding author. Tel.: +234 8034053944
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Edaigbini SA, Delia IZ, Aminu MB, Bosan IB, Ibrahim A, Anumenechi N. Vascular surgeries in West Africa: challenges and prospects. Asian Cardiovasc Thorac Ann 2014; 23:552-7. [PMID: 25429087 DOI: 10.1177/0218492314561646] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The field of vascular surgery is evolving in sub-Saharan Africa but the practice is bedeviled by lack of expertise and infrastructure challenges. The consequences are a low volume of operations and a dearth of data. Available data are not representative of the wider picture, therefore, this study was undertaken to evaluate the practice of vascular surgery in a tertiary institution, in the light of the prevailing challenges. METHODS Data from all patients with vascular-related pathologies managed in our surgical outpatient clinic and accident and emergency wards were obtained from the clinic and in-patient records from January 2008 to December 2012. Age, sex, diagnosis, treatment, and complications were noted. There were 73 patients comprising 45 (61.6%) males and 28 (38.4%) females. The age range was 1-90 years (mean 43.5 years). RESULTS The pathologies managed included end-stage renal disease (n = 36, 49.3%), nontraumatic and posttraumatic aneurysms (n = 13, 17.8%), vascular trauma (n = 12, 16.4%), peripheral vascular disease (n = 5, 6.9%), congenital vascular malformations (n = 4, 5.5%), and thrombotic diseases (n = 3, 4.1%). Fifty-four (74.0%) surgeries were performed, with a complication rate of 5.5% and 2.7% mortality. CONCLUSIONS The practice of vascular surgery in Zaria, Nigeria, is fraught with challenges. The gap created by the dearth of skilled vascular surgeons is filled by competent cardiothoracic surgeons. Infrastructure decay and lack of prostheses limit the number and variety of operable cases. These challenges result in preventable morbidity and mortality.
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Affiliation(s)
- Sunday A Edaigbini
- Division of Cardiothoracic Surgery, Ahmadu Bello University, Zaria, Nigeria
| | - Ibrahim Z Delia
- Division of Cardiothoracic Surgery, Ahmadu Bello University, Zaria, Nigeria
| | - Muhammad B Aminu
- Division of Cardiothoracic Surgery, Ahmadu Bello University, Zaria, Nigeria
| | - Istifanus B Bosan
- Division of Nephrology, Department of Medicine, Ahmadu Bello University, Zaria, Nigeria
| | - Abdulrasheed Ibrahim
- Division of Plastic and Reconstructive Surgery, Ahmadu Bello University, Zaria, Nigeria
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Sabzi Sarvestani A, Taheri Azam A. Amputation: a ten-year survey. Trauma Mon 2013; 18:126-9. [PMID: 24350170 PMCID: PMC3864397 DOI: 10.5812/traumamon.11693] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2013] [Revised: 06/11/2013] [Accepted: 07/28/2013] [Indexed: 11/16/2022] Open
Abstract
Background Limb loss occurs due to different causes and has been increased in many countries. It has without exception, great economic, psychological and social impacts. Objectives This study assesses the demographics of amputees in one city of Iran. Patients and Methods This retrospective study was undertaken on all of the amputees between April 2002 and December 2011. Patients’ demographics including age, sex, the amputated limb, etiology of limb loss and level of amputation were recorded. Results We had 216 patients in the study. The average number of amputations was 21.6 per year and varied from 14 to 32. The mean age of amputation was 39.26± 12.6 years. Of the patients, 172 were male (79.62%) and 44 female (20.37%); 119 of the amputations (55.09 %) were major and 97 minor (44.9 %). The most common cause of amputation was trauma and the most common was the toe. In trauma patients the mean age was 38.12± 10.25 years and 98 (83.7%) were male. Conclusions In contrast to similar studies in developed countries, trauma was found to be the major cause of all types of amputations. Results of this study may be used in prevention planning.
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Affiliation(s)
- Amene Sabzi Sarvestani
- Department of Surgery, Imam Ali Educational Hospital, Zahedan University of Medical Sciences, Zahedan, IR Iran
- Corresponding author: Amene Sabzi Sarvestani, Department of Surgery, Imam Ali Educational Hospital, Zahedan University of Medical Sciences, Zahedan, IR Iran. Tel: +98-5413425717 Fax: +98-7125223566, E-mail:
| | - Afshin Taheri Azam
- Department of Orthopedics, Tehran University of Medical Sciences,Tehran, IR Iran
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Eze KC. Complications and co-morbidities in radiographs of patients in traditional bone setters’ homes in Ogwa, Edo State, Nigeria: a community-based study. Eur J Radiol 2012; 81:2323-8. [DOI: 10.1016/j.ejrad.2011.06.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2011] [Accepted: 06/07/2011] [Indexed: 11/16/2022]
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Ademuyiwa AO, Usang UE, Oluwadiya KS, Ogunlana DI, Glover-Addy H, Bode CO, Arjan BVAS. Pediatric trauma in sub-Saharan Africa: Challenges in overcoming the scourge. J Emerg Trauma Shock 2012; 5:55-61. [PMID: 22416156 PMCID: PMC3299155 DOI: 10.4103/0974-2700.93114] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2011] [Accepted: 03/21/2011] [Indexed: 11/03/2022] Open
Abstract
All over the world, pediatric trauma has emerged as an important public health problem. It accounts for the highest mortality in children and young adults in developed countries. Reports from Africa on trauma in the pediatric age group are few and most have been single center experience. In many low-and middle-income countries, the death rates from trauma in the pediatric age group exceed those found in developed countries. Much of this mortality is preventable by developing suitable preventive measures, implementing an effective trauma system and adapting interventions that have been implemented in developed countries that have led to significant reduction in both morbidity and mortality. This review of literature on the subject by pediatric and orthopedic surgeons from different centers in Africa aims to highlight the challenges faced in the care of these patients and proffer solutions to the scourge.
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Affiliation(s)
- Adesoji O Ademuyiwa
- Department of Surgery, Pediatric Surgery Unit, College of Medicine, University of Lagos, Lagos, Nigeria
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Chalya PL, Mabula JB, Dass RM, Ngayomela IH, Chandika AB, Mbelenge N, Gilyoma JM. Major limb amputations: a tertiary hospital experience in northwestern Tanzania. J Orthop Surg Res 2012; 7:18. [PMID: 22578187 PMCID: PMC3413574 DOI: 10.1186/1749-799x-7-18] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2011] [Accepted: 05/11/2012] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Major limb amputation is reported to be a major but preventable public health problem that is associated with profound economic, social and psychological effects on the patient and family especially in developing countries where the prosthetic services are poor. The purpose of this study was to outline the patterns, indications and short term complications of major limb amputations and to compare our experience with that of other published data. METHODS This was a descriptive cross-sectional study that was conducted at Bugando Medical Centre between March 2008 and February 2010. All patients who underwent major limb amputation were, after informed consent for the study, enrolled into the study. Data were collected using a pre-tested, coded questionnaire and analyzed using SPSS version 11.5 computer software. RESULTS A total of 162 patients were entered into the study. Their ages ranged between 2-78 years (mean 28.30 ± 13.72 days). Males outnumbered females by a ratio of 2:1. The majority of patients (76.5%) had primary or no formal education. One hundred and twelve (69.1%) patients were unemployed. The most common indication for major limb amputation was diabetic foot complications in 41.9%, followed by trauma in 38.4% and vascular disease in 8.6% respectively. Lower limbs were involved in 86.4% of cases and upper limbs in 13.6% of cases giving a lower limb to upper limb ratio of 6.4:1 Below knee amputation was the most common procedure performed in 46.3%. There was no bilateral limb amputation. The most common additional procedures performed were wound debridement, secondary suture and skin grafting in 42.3%, 34.5% and 23.2% respectively. Two-stage operation was required in 45.4% of patients. Revision amputation rate was 29.6%. Post-operative complication rate was 33.3% and surgical site infection was the most common complication accounting for 21.0%. The mean length of hospital stay was 22.4 days and mortality rate was 16.7%. CONCLUSION Complications of diabetic foot ulcers and trauma resulting from road traffic crashes were the most common indications for major limb amputation in our environment. The majority of these amputations are preventable by provision of health education, early presentation and appropriate management of the common indications.
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Affiliation(s)
- Phillipo L Chalya
- Department of Surgery, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania
| | - Joseph B Mabula
- Department of Surgery, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania
| | - Ramesh M Dass
- Department of Orthopaedic, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania
| | - Isdori H Ngayomela
- Department of Orthopaedic, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania
| | - Alphonce B Chandika
- Department of Surgery, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania
| | - Nkinda Mbelenge
- Department of Orthopaedic, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania
| | - Japhet M Gilyoma
- Department of Surgery, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania
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Psychological reactions to amputation in a sample of Nigerian amputees. Gen Hosp Psychiatry 2009; 31:20-4. [PMID: 19134505 DOI: 10.1016/j.genhosppsych.2008.08.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2008] [Revised: 08/06/2008] [Accepted: 08/18/2008] [Indexed: 10/21/2022]
Abstract
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.
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Akinyoola A, Ojo O, Oginni L. Microbiology of amputation wound infection in a Nigerian setting. J Wound Care 2008; 17:202, 204-6. [DOI: 10.12968/jowc.2008.17.5.29150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- A.L. Akinyoola
- Department of Orthopaedic Surgery and Traumatology, Obafemi Awolowo University, Ile-Ife, Nirgeria
| | - O.D. Ojo
- Department of Orthopaedic Surgery and Traumatology, Obafemi Awolowo University, Ile-Ife, Nirgeria
| | - L.M. Oginni
- Department of Orthopaedic Surgery and Traumatology, Obafemi Awolowo University, Ile-Ife, Nirgeria
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Abstract
Amputation is a common surgical procedure in Nigeria but there are no national data on the subject. The objective was to determine the common indications for amputation in Nigeria, mortality rate, and regional differences in indications. Results of studies on amputation in Nigeria over a 15-year period were collated and analysed. The most frequent indications for amputation were trauma (34%); complication of traditional bonesetting (TBS) (23%); malignant tumours (14.5%); diabetic gangrene (12.3%); infections (5.1%); peripheral artery disease (2.1%); and burns (2.1%). In the southern regions, trauma is the most common indication while complications of traditional bonesetting are the most common in the northern and eastern regions. The average age of the Nigerian amputee is 33 years. Hospital mortality after amputation is 10.9%. The estimated prevalence of extremity amputation in Nigeria is 1.6 per 100,000. Peripheral artery disease is an uncommon indication for amputation in Nigeria while trauma, complication of traditional bonesetting, malignant tumours and diabetic gangrene are relatively much more common. The young male is frequently affected.
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Affiliation(s)
- L O A Thanni
- Department of Orthopaedics and Traumatology, College of Health Sciences, Olabisi Onabanjo University, P.M.B.2022, Sagamu, Ogun State, Nigeria.
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Settakorn J, Rangdaeng S, Arpornchayanon O, Lekawanvijit S, Bhoopat L, Attia J. Why were limbs amputated? An evaluation of 216 surgical specimens from Chiang Mai University Hospital, Thailand. Arch Orthop Trauma Surg 2005; 125:701-5. [PMID: 16215719 DOI: 10.1007/s00402-005-0060-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2005] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Limb loss has a devastating effect on patients. To know the underlying causes of limb amputation would be helpful in planning public health strategies in the country. The objectives of this study are (1) to identify the primary causes and the feature of limb amputations in the setting of a university hospital, and (2) to study the time trends of the causes of limb amputation over a period of 5 years. MATERIALS AND METHODS The clinical and pathological data from 216 amputated limbs submitted to the Pathology Department of Chiang Mai University Hospital from 2000 to 2004 were reviewed. RESULTS Of these, 188 cases were first time amputations, and 28 cases were repeat amputations. The 188 first amputated specimens included 23 upper limbs (12%) and 165 lower limbs (88%), from 115 male (61%) and 73 female (39%) patients. Dysvascular (46%), tumor-related (36%), and infection-related (10%) amputations were the three most common scenarios. The rate of amputation was high in 2004 (32%) owing to an unexpected increase in the numbers of dysvascular amputation. Atherosclerosis accounted for at least 52% of dysvascular amputations. The leading cause of tumor-related amputations was sarcoma (72%), almost half of which were osteosarcomas. The major cause of lower limb amputation was dysvascular (51%) whereas that of upper limb amputation was tumor related (61%). Subgroup analysis of the major limb amputations revealed that 44% were tumor related, 39% were dysvascular, and 8% were infection-related causes. The proportion of major limb losses in the tumor-related group (87%, 59/68) was significantly higher than those in the dysvascular group (62%, 53/86) (P = 0.001). In addition, the proportion of upper limb losses in the tumor-related group (21%, 14/68) was significantly greater than those in the dysvascular group (2%, 2/86), (P < 0.001). The causes of 28 repeat amputations were similar, i.e., dysvascular (61%), tumor related (29%), and infectious related (7%). CONCLUSION (1) Atherosclerosis, a potentially preventable disease is responsible for the great proportion of limb losses in Northern Thailand; (2) the numbers of dysvascular amputation seem to be increasing; (3) tumor, especially sarcoma, is the most common cause of major limb amputations as well as upper limb loss.
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Affiliation(s)
- Jongkolnee Settakorn
- Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
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Agarwal A, Agarwal R. The prevention of traditional bone setter's gangrene. THE JOURNAL OF BONE AND JOINT SURGERY. BRITISH VOLUME 2005; 87:1306; author reply 1306-7. [PMID: 16129765 DOI: 10.1302/0301-620x.16755] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
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Abstract
A two-year retrospective survey in southern Ethiopia revealed that 49 amputations had been performed, 25 of which were for gangrene following tight splintage applied by traditional bone setters. The aim of this study was to determine if it was possible to reduce this incidence of gangrene by offering one-day instructional courses to bone setters. In ten separate one-day courses 112 tradition healers attended. In addition, two-day courses were given to local health assistants, who also received written instructions for the safe care of fractures. A two-year prospective study revealed a marked reduction in amputations, from 49 to 25, with only seven rather than 25 being required for gangrene. We found that it is possible to educate traditional healers so that fewer gangrenous limbs require to be amputated.
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Affiliation(s)
- M. Eshete
- Arba Minch Hospital, P. O. Box 26493, Addis Ababa, Ethiopia
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Abstract
Maya bonesetters and their clients have been affected by the entry of radiographic technology into highland Guatemala. Bonesetters rely on a form of embodied knowledge to perform their manual work, the kind of knowledge X-rays threaten to supersede. This article examines how Maya bonesetters are meeting this challenge to their legitimacy and how they are positioning themselves pragmatically within a world of changing biomedical resources and contested health knowledge.
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Affiliation(s)
- Servando Hinojosa
- Department of Psychology and Anthropology, University of Texas-Pan America, Edinburg, Texas 78541, USA.
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Hinojosa SZ. "The Hands Know": Bodily Engagement and Medical Impasse in Highland Maya Bonesetting. Med Anthropol Q 2002. [DOI: 10.1525/maq.2002.16.1.22] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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