Background: A well-organized and efficient prehospital transport is associated with improved outcome in trauma patients. In Nigeria, there is paucity of information on prehospital transport of patients with spinal cord injury (SCI) and its relation to mortality. Objective: To determine if prehospital transportation is a predictor of mortality in patients with SCI in Nigeria. Design: Prospective cohort study Methods: Prehospital transport related conditions, injury arrival intervals and persons that brought patients with SCI to the casualty were noted. Data analyzed using descriptive statistics, the chi-square test and multiple logistic regressions. Main Outcome Measures: Mortality within 6 weeks on admission Results: 168 patients with SCI presented in the casualty during this review period. Majority (67.9%) presented after 24 hrs of the injury. Majority (58.3%) were conveyed into the casualty by their relatives. Salon car (54.2%) was the most common mode of transportation where majority (55.4%) laid on their back during the transfer. Majority (75%) of the patients had multiple hospital presentation before reporting in our casualty.The mortality observed was 16.7%. Multivariate analysis after adjusting for age, gender, and means of transportation revealed that age (OR= 63.41, 95% CI= 9.24-43.53), crouched position during transfer (OR= 23.52, presentation after 24 hrs (OR=5.48,) and multiple hospital presentation (OR= 7.94, 95% CI= 1.89-33.43) were associated with mortality within 6 weeks of admission. Conclusion: A well-organized and efficient prehospital transport would reduce mortality in spinal cord injured patients. Public enlightenment campaign on factors that could reduce road traffic injury would help reduce mortality.
Study design: A prospective study. Objectives: To determine the cost of acute phase of injury (ASCI) among spinal cord-injured patients managed conservatively in Nigeria. Settings: Gwagwalada, Abuja. Methods: Over a 1-year period (1 January 2009 to 31 December 2009), the cost of ASCI of consecutive spinal cord-injured patients, gainfully employed preinjury, who paid the hospital bill directly from their purses and could estimate their daily income, and who were managed conservatively for 6 weeks before discharge to rehabilitation, was prospectively examined. Results: A total of 34 cases of spinal cord-injured patients with a mean age of 35.4±12.8 years were included in this study. The mean cost of ASCI over 6 weeks was $1598.29, an average of 6.4-232.8% of patients' annual income where 450% of the people live on less than a dollar a day. The mean cost of hospitalization was 14.9% of the total cost of ASCI in this study. It was significantly more expensive to treat tetraplegics compared with paraplegics. Conclusion: This study identified the cost of acute phase of spinal cord injury in Nigeria to assist clinicians in planning treatment that could reduce financial burden on the patients but optimize patients' care.
FJI offered added benefit over physiotherapy in LBPs diagnosed with FJA. Patients with FJI have a significant reduction in pain symptom than the patients in the physiotherapy group. Though majority of the patients reported satisfactory outcome, the FJI patients group had a better outcome.
Background: The commonest congenital musculoskeletal deformity worldwide is talipes equino varus (CTEV). Of the various treatment methods available, the most acceptable treatment currently for CTEV worldwide is serial manipulation and casting using the Ponseti technique. The Ponseti technique consists of weekly manipulation and casting for an average of six to eight weeks followed by bracing of the feet till school age. Some studies have shown evidence that more frequent casts may have similar outcomes with weekly casts using the Ponseti method. This study compared the efficacy of management of idiopathic CTEV using an accelerated protocol of twice weekly casts, with the standard weekly Ponseti protocol. Methods: The study was a randomized case control study with a group of patients undergoing an accelerated casting protocol involving twice weekly casts compared with another group who went through the normal weekly Ponseti protocol. Results: A total of 45 feet in 28 patients were studied. The study showed a significantly shorter treatment period in the accelerated protocol (39 days) compared with the standard protocol (52 days); with no significant increase in the number of casts needed for treatment. Conclusions: A twice weekly Ponseti casting protocol enables completion of the casting period earlier than the standard Ponseti method.
The mean postoperative MDA of 84.9% of the knees operated at 2 years was 9.4° ± 3.1° with recurrence rate of 15.1%. Postoperative MDA is a good outcome measure for surgical treatment of Blount disease and surgical correction should aim at producing post MDA ≤10°.
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