Mandibular fractures in Kano, Northwest Nigeria: etiology and pattern of presentation

BACKGROUND

Mandibular fractures are universal in distribution, but its etiologies and presentation patterns differ from one country to another because of varying socioeconomic, cultural and geographical factors. We analyzed the etiological factors and presentation patterns of mandibular fractures in a tertiary hospital at Nigeria's second largest city.

METHODS

Patients with isolated mandibular fractures at Aminu Kano Teaching Hospital, Kano were prospectively reviewed over a 12-months period. Patients' demographic information and fracture characteristics (etiology, site, pattern and number of fracture) were recorded and analyzed.

RESULTS

One hundred and forty-eight patients presented with 180 mandibular fractures. There were eight-fold higher men with mandibular fractures than women (M: F =8.3:1) with highest incidence in third decade of life. Road traffic accidents (84.46%) was the major etiology while iatrogenic fracture (0.68%) was found in one patient. Mandibular body was the most fractured site (41.11%) with parasymphyseal and angle regions accounting for 27.78% and 23.89% of total recorded fractures respectively.

CONCLUSIONS

Mandibular fractures in Kano, Northwest Nigeria occurred predominantly in men in the third decade and are mostly caused by road traffic accidents. The majority of these fractures involved the mandibular body.

A review of noma cases in a tertiary hospital located in a conflict endemic region in Nigeria

Noma, a neglected tropical disease (NTD), is a preventable oro-facial gangrenous infection causing destruction of oro-facial tissues if untreated. This descriptive study was conducted in North-Eastern Nigeria which has witnessed armed insurgency increasing risk of noma. Data was obtained from patients' records at a tertiary hospital after a dental educational outreach using radio and visits to the hospital's ante/postnatal clinics. Data analysis was conducted at 95% confidence interval with p≤ 0.05 considered significant. Records of 49 patients were retrieved but 31 (63.3%) were utilised due to poor documentation. Age ranged from 2-63 years. Children (0-16 years) and Adults (17-59 years) were 67.7% and 25.8% respectively. Males were 13 (41.9%) and females, 18 (58.1%). Poor oral hygiene and malnutrition were common findings. Stage (WHO Staging System) 2 (51.6%) and 4 (22.6%) were the most common presentation. Successfully managed and referred cases were 51.6% and 48.4% respectively. Successful management was associated with early stages of noma (p = <0.001). Children were most vulnerable. Outreaches using radio and education to pregnant women and nursing mothers can boost early presentation and better outcomes. Attention to case documentation and inclusion of noma into the WHO list of NTDs are recommended.

Social impact of cleft lip repair on married adults: an uncommon finding from a semi-urban African settlement

An orofacial cleft may have an appreciable psychosocial impact on patients that could affect their social lives, including the choice of who they marry. We retrospectively reviewed the impact of repair of cleft lip on marriage in adult patients in our institution by questioning a group of patients treated from July 2009-June 2017. There were 120 adult patients who had cleft lips repaired, of whom 17 (14%) patients changed their marital status. The mean (SD) ages of the 17 were 32 (1), range 20-41, years. Five of the 17 were men, and 12 women, with a male:female ratio of 0.4: 1. All 17 patients confirmed that the unrepaired cleft affected the choice of who they initially married. After repair, the five male patients married additional wives (one wife each (n=4), and two wives (n=1)). Of the 12 female patients all divorced their spouses, but only nine had remarried at the time of the study. We conclude that unrepaired cleft lip in an adult in our environment may affect the choice of partner. This choice may be altered if facial aesthetics improve after repair of the cleft.