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   2014| January-June  | Volume 3 | Issue 1  
    Online since August 26, 2014

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Results of percutaneous rush pin fixation in distal third fibular fracture: A retrospective study
Ramji Lal Sahu
January-June 2014, 3(1):17-23
Aims: Aim of this retrospective study is to evaluate the results of percutaneous rush pin fixation in distal third fibular fractures. Settings and Design: Retrospective study. Materials and Methods: This study was conducted in the Department of Orthopedic Surgery in M. M. Medical College from July 2006 to November 2010. Seventy-eight patients were recruited from emergency and outpatient department, having closed fracture of distal third fibula. Postoperatively all the patients were functionally evaluated as per Kristenson's criteria and the Weber's criteria which included objective criteria, subjective criteria, and radiological evaluation at 3, 6, and 12 months after the surgery. Results: Out of seventy-eight patients, 69 patients underwent union in 90-150 days with a mean of 110.68 days. Touch down weight bearing was started on 2 nd postoperative day. Complications found in four patients who had nonunion, and five patients had delayed union which was treated with bone graft. The results were excellent in 88.46% and good in 6.41% patients. Conclusions: I conclude that the fixation using rush pin in distal third fibular fracture is a safe and effective method of surgery that could be performed easily as well as minimal soft tissue disruption and did not require secondary surgery to remove the wire, and showed sufficient stability after fixation. Therefore, closed reduction and internal fixation with rush rods is one of the good treatment modalities of distal fibular fracture.
  13,748 775 -
Trauma care in Africa: The way forward
Charles Mock, Robert Quansah, Olive Kobusingye, Jacques Goosen
January-June 2014, 3(1):3-10
  10,429 1,062 11
Burn prevention and first aid knowledge: A focus on adolescents in Zaria
Abdulrasheed Ibrahim, Malachy Eneye Asuku, Tukur Dahiru
January-June 2014, 3(1):11-16
Background: Burns in developing countries accounts for significant morbidity and mortality. Despite the impressive advances in the science of injury-control and prevention, burns have remained the neglected disease of modern society and are still regarded by many as an act of fate and bad luck. The aim of this study was to determine the knowledge of burn prevention and first aid treatment in adolescents as baseline information to develop an effective burn prevention program. Materials and Methods: A survey to ascertain the knowledge of burns prevention and first aid was conducted in 10 junior secondary schools in Zaria. It was divided into three sections; demographic, knowledge of burn prevention practices and first aid treatment at home and a self-report of radio and television viewing habits. Descriptive frequencies were used to describe the student's knowledge of burn prevention and first aid treatment. Chi-square analyses were conducted to identify any significant differences between students who had previous knowledge of burn prevention and those who did not. Results: A total of 335 students from 10 schools took part in the survey. Their age ranged from 10 to 17 years with a mean age of 14.8 years. There were 192 males (57%) and 143 females (43%). Seventy three students (21.5%) had previous knowledge of burn prevention and first aid, compared with 262 (77.3%) who had no previous knowledge of burn prevention. Those who had previous knowledge of burn prevention and first aid for burns were more likely to select the appropriate answers to burn prevention practices and first aid treatment at home (P < 0.0001). Majority of the students indicated that information on television (94.3%) or radio (90.7%) will be helpful in preventing burn injuries. Conclusion: Knowledge deficits exist in burn prevention and first aid knowledge among adolescents in Zaria. The use of the electronic media (television and radio) is suggested as an effective strategy to increase awareness.
  10,076 1,260 4
Comprehensive management of pediatric mandibular fracture caused by an unusual etiology
Divesh Sardana, Krishan Gauba, Ashima Goyal, Vidya Rattan
January-June 2014, 3(1):39-42
Mandibular fractures in children are rare due to thick adipose tissue, resiliency of bone and protective and care taking nature of the parents. These fractures carry different etiology and treatment considerations with them when compared with similar types of injuries in adults. Furthermore, the associated complications may have long lasting effect on the growth and development of the child's face and developing teeth. The purpose of this case report is to highlight the occurrence of mandibular fracture in 7-year-old caused by horse-kick and its subsequent management by open cap-splint with circum-mandibular wiring.
  7,824 713 -
Analysis of complication of mandibular fracture
Akhiwu Benjamin, Kolo Emmanuel Sara, Amole Ibiyinka Olushola
January-June 2014, 3(1):24-29
Background: In recent times, the use of wire osteosynthesis with maxillomandibular fixation (MMF) has been replaced by miniplate osteosynthesis. This has been attributed to the complications following the use of the earlier mentioned treatment modality. This however, cannot be said to be the same in developing countries mainly due to inadequate resources. The present study is aimed at identifying the complications associated with the use of wire osteosynthesis and MMF with the aim of determining if despite the said complications, these treatment modalities are still relevant in a resource poor setting. Materials and Methods: A descriptive cross-sectional study of all patients presenting with mandibular fractures to the accident and emergency department and the maxillofacial surgery unit of Aminu Kano Teaching hospital over a 2-year period who consented to participate in the study were recruited. Results: Closed reduction and immobilization was the commonest modality of treatment accounting for 53.10%, while open reduction and internal fixation using wire osteosynthesis accounted for only 34.51%. Majority of the subjects (53.98%) were treated under general anesthesia, while local anesthesia was used in 38.94% of cases. In addition, there was an insignificant association between modalities of treatment and etiology of fracture (χ2 = 18.235; degrees of freedom (df) = 24; P = 0.791, and critical χ2 = 37.65). In terms of complications, about 12.82% of patients who had open reduction as a form of treatment suffered nonunion as against 10% in closed reduction. Malunion, however, was higher in closed reduction (8.33%) than in open reduction which accounted for 5.13%. Not surprisingly, open reduction presented with a high rate of infection of about 28% as against 18.33% in closed reduction. Similarly, closed reduction presented with a higher rate of malocclusion of about 6.67% compared with 5.13% recorded with open reduction. Conclusion: Despite the advent of miniplate osteosynthesis, the relevance of wire osteosynthesis and MMF in a resource poor setting cannot be underestimated.
  7,670 717 2
Hand injuries from cassava milling machine in sub-urban Nigeria
Emmanuel E Esezobor, Oluwafemi O Awe, John E Onuminya, Andrew E Dongo, Osita C Nwokike, Folake O Abikoye, Edwin O Edonmwonyi, Quincy O Aigbonoga
January-June 2014, 3(1):30-34
Background: Nigeria is the highest cassava producer in the world. The processing of cassava tubers into a valuable product involves grinding in locally fabricated machines. This process exposes the hand to injuries. Aim: The aim of this study is to investigate the pattern of presentation and outcome of hand injury from locally fabricated cassava milling machines in our rural plastic surgery practice. Materials and Methods: This is a prospective clinical audit of patients with hand injuries from cassava milling machines managed in Irrua Specialist Teaching Hospital from January 2010 to December 2011. Demographic data, type of injury and outcome were documented and analyzed. Result: There were 33 patients who had injuries from locally fabricated cassava milling machines. Females in the second decade of life were mostly affected. Mutilating injury involving digits 2, 3, 4 and 5 of the dominant hand was the main finding. Although, no amputation was recorded, stiffness was a major complication. Conclusion: We observed that the dominant hand of female teenagers is mostly at risk in locally fabricated cassava milling machine hand injuries. This injury is preventable.
  5,627 485 -
A 30-year-old man with complicated open globe injury
Avinash Mishra, Neeraj Bhargava, Vinod Kumar Baranwal, Gaurav Luthra
January-June 2014, 3(1):45-48
Penetrating ocular trauma is an important cause of visual loss in young adults. The fate of the traumatized eye depends upon the treatment adopted, with early reporting and appropriate surgical management reducing the visual loss. However, sometimes even after the best of surgical interventions these patients may develop various vision-threatening complications. Here, we report a patient who presented with a large corneosclera laceration which was successfully repaired as an emergency procedure. However, subsequently he developed an inflammatory hypopyon which was successfully managed, only to go ahead and hurt his affected eye yet again and develop an anterior chamber (AC) leak. This too was managed successfully and finally this patient could be discharged with an absolutely normal vision.
  5,600 429 -
Mother to child impact: An unusual cause of blunt chest trauma
Kelechi E Okonta, Emmanuel O Ocheli, Peter D Okoh, Uriah S Etawo
January-June 2014, 3(1):49-51
The presence of airbags in the internal front row of cars is the main reason for not allowing children occupy the front seat while in a car. Its deployment in low-speed collision may cause injury to the front occupant especially children because of the difference in sizes. An 18-month-old girl presented in the emergency with progressive dyspnea 6 h following a road traffic accident. She was carried on the laps of her unbelted mother in the front row of a car which had low-speed collision with a stationary car parked off the road. The mother was propelled forward; hitting her head on the dash board with laceration on the forehead with the child sustaining a crush injury which was deployed by the mother instead of the airbag. This resulted in bilateral hemothoraces and lung contusion. Even when the airbag was not deployed in low-speed collusion state, the compressive effect of the passenger holding a child protectively might cause severe crushing injury like blunt chest trauma.
  5,108 367 1
Reversible blindness following squash ball injury
Avinash Mishra, Vinod Kumar Baranwal, Vinod Kumar Patra, Neeraj Bhargava
January-June 2014, 3(1):52-54
Hyphema is the presence of red blood cells in the anterior chamber and is the most common mode of clinical presentation, after significant ocular trauma. Traumatic hyphema is an opthalmic emergency and its treatment is generally medical; however, occurrence of secondary hemorrhage may necessitate surgical intervention. Though hyphema is of such a common occurrence there is still a lack of agreement about its management protocols basically involving medical management versus an early surgical intervention. Controversy also exists regarding the various strategies to be adopted to prevent rebleeding.Here, we report an interesting case of a young patient who developed total hyphema, following a squash ball injury. He was initially managed conservatively but suffered rebleeding into the anterior chamber along with its associated complications and finally required an active surgical intervention. He showed a remarkable postsurgical improvement and was finally discharged with a normal visual acuity of 6/6 in both eyes.
  4,819 481 -
Bilateral blindness from ocular injury: A 15 year review
Adepoju Feyi Grace, KF Monsudi, BJ Adekoya
January-June 2014, 3(1):35-38
Background: Ocular injury remains a significant cause of monocular visual impairment and blindness worldwide; impact on bilateral blindness needs further elucidation. Aims: The aim of this study is to review cases of bilateral blindness from ocular injury: The etiology, risk factors, psychosocial effect as well as suggest preventive measures. Materials and Methods: A 15 year retrospective review of bilateral blindness from ocular injury at the eye clinic of the University of Ilorin Teaching Hospital (UITH) From January 1997 through December 2012 was carried out. Results: Sixteen cases of traumatic bilateral blindness were recorded, compared to 2155 total number of bilateral blindness recorded during the study period, giving a proportion of 0.8%. This consisting of 12 males and 6 females. The modal age group was 17-33 years. Blindness resulting from chemical assault was (37.5%), gunshot injury (12.5%), and assault for presumed ritual purposes made up 25%. The major risk factors identified are male sex, younger age group, students, and artisan. Psychosocial burden in the immediate period of loss of vision include anxiety, fear of loss of occupation or basic skills, denial and hope for visual restoration, aggression, poor appetite, and excessive crying. Three patients developed depression and required medical management. Conclusion: Bilateral blindness in our environment is mainly assault-related from chemicals, gunshot, and rituals. Public enlightenment on far reaching consequences of sudden traumatic blindness, health education on preventive measures, legislation and adequate punitive measures are important tools required to reduce this menace. Adequate psychotherapy by behavioral scientist, rehabilitation, and societal reintegration is mandatory to effectively treat cases.
  4,595 398 2
Synchronous gastric rupture in blunt trauma to chest
Bhupinder Singla, Inderjit Chawla, Vikas Singh, Mandeep Singh
January-June 2014, 3(1):43-44
We report a case of synchronous gastric rupture caused by blunt trauma to chest in an 8-year-old child that was successfully repaired by primary closure. In this paper, we emphasize the need for early diagnosis and the aggressive surgical treatment as a key to decreasing the mortality and morbidity from this relatively rare injury, especially in children of this age group.
  4,462 361 -
Sustaining a vehicle: A voice and a platform for trauma research in Africa - The second coming of the African Journal of Trauma
Babatunde A Solagberu
January-June 2014, 3(1):1-2
  3,589 366 -