Polydactyly is a duplication of the digits of the hands or feet. It is a congenital anomaly and can manifest as a single disorder or as a component of a syndrome. It is typically an autosomal dominant inherited condition with variable expression and incomplete penetrance. It is genetically heterogenic being caused by mutations in different genes. It manifests in different forms, based on the position of occurrence of the extra digit. It can occur as a single disorder as a component of a syndrome. Its presentation ranges from just a skin tag to a complete digit with the accompanying metatarsal or metacarpal bone. It can result in functional impairment or it may just be a cosmetically unacceptable digit with no functional impairment. Treatment depends on the nature of the extra digit as well as any functional impairment it may be causing. Surgical excision is employed and various reconstruction procedures are also employed in treatment, and must be well planned out to avoid a worsening of function. We present two cases; a 3-month-old baby girl presenting with a hereditary preaxial polydactyly (PPD) (Wassel type V) of both feet and a 29-year-old man with isolated postaxial polydactyly of the right foot with which was symptomatic.

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Background: Open fractures of the tibia and fibula present with multiple management challenges of wound care, bone stabilization, potential risk of infection and its control. Attempt to resolve this problem, stabilization of the fracture with external fixators was introduced. However, this procedure predisposes infection too. This was an overview of the disposition of infection in the course of managing type III fractures in our center.Methods: This was a retrospective study of disposition of infection in Gustilo and Anderson type III open fractures of the tibia and fibula treated with external fixation device over ten years in Jos university teaching hospital. Data extracted from patients records and operation notes included age, sex, nature of open fracture with respect to Gustilo and Anderson classification in theater. Wound culture reports extracted early and weeks after commencement of treatment. The findings were analyzed using Epi info statistical software version 3.5.3.Results: A total of 74 patients, 63 (85.1%) males and 11 (14.9%) females (M:F=5.7:1) with mean age of 37.97±13.57 years. The mean duration of injury-presentation time was 13.48±38.73 days, 41 (55.4%). Patients that present with clinical infection were 40 (54.1%) among which staphylococcus aureus was isolated in 21 (28.3%). While treatment was on, the flora became altered. Motor cycles were responsible for 25 (33.7%), gunshots 20 (27%), motor vehicle injuries 19 (25.6%) while pedestrians accounted for 9 (12.2%).Conclusions: Type III fractures sustained from high energy risk of infections due to late presentation in our setting. Bacterial isolates tend to alter in course of hospitalization.

Ankylosing spondylitis (AS) is a rare inflammatory disorder that affects the axial skeleton. It is characterized by inflammation of the joints of the spine with subsequent bridging of the spinal segments resulting in a reduced mobility of the spine and subsequent stiffness of the spine. It can be a severely limiting condition adversely affecting the quality of life of affected individuals. It has been found to be commoner in Caucasians and Asians but rare in blacks in the Americas with few cases reported amongst the African Black population. It is associated with the occurrence of the major histocompatibility complex (MHC) class 1 allele HLA-B27. We present the case of a 44-yearold Nigerian man presenting with a 21-year history of progressively worsening back pain and stiffness associated with hip pain and difficulty in extending his neck. He had no extraspinal manifestations. He was diagnosed with Ankylosing Spondylitis using the modified New York criteria. He was commenced on selective COX2 inhibitors and a physical therapy program aimed at improving the flexibility of the spine and reducing pain. He had a significant improvement in his pain and improved flexibility of his spine in all planes. Ankylosing spondylitis affects the axial skeleton primarily but there may be some extra spinal manifestations such as anterior uveitis, psoriasis and inflammatory bowel disease. Various modalities are employed in its treatment ranging from physical therapy, drugs e.g. Nonsteroidal anti-inflammatory drugs, tumour necrosis factor inbibitors and surgery where complications arise. These have proven effective in improving the symptoms of the disease and quality of life.

Aims:To determine the prevalence, pattern and presentation of the diabetic foot ulcer. Background: A diabetic foot ulcer is a major complication in diabetes mellitus and probably the major component of diabetic foot. It occurs in 15% of all patients with diabetes and precedes 84% of all lower leg amputations. Poverty, low economic status and ignorance have resulted in this devastating disease. It may worsen in the next decade. There are multiple risk factors that predispose an individual to DM foot ulcer; they include age, gender(male), type of DM, glycaemic (HbA1c) or FBG level, duration of DM (>10yrs) occupational status particular habits of self-foot care and infection. Patients and Methods: This consists of 69 diabetic patients; male and female included done between the months of January 2019 to March 2019. A demographic data questionnaire and social history were obtained. Overnight fasting serum glucose was obtained. Serum glucose was determined by enzymatic glucose oxidase method. Affi et al.; IJTDH, 41(1): 10-15, 2020; Article no.IJTDH.50484 11 Data obtained were subjected to Stata Version 11 Software to determine the graphical representation, mean, standard deviation of the analysis. Results: Thirty-Five 35 were male and 34 were female had type 2 diabetes. Forty-Three 43 patients had foot ulcer, 21 patients had gangrene and 5 had infection. The number of patients with peak glucose values 10 mmol/L and least glucose at 20-25 mmol/L. Those of duration 4-6 years were the most affected the age group most affected is between 40-59 yrs. Discussion and Conclusion: Risk factors for foot ulceration discovered among a host other factors identified in this study, were the infection, low socioeconomic status, improper footwear, poor glycaemic control, structural foot deformity and untreated gangrene. The role of poor glycaemic control in the genesis of diabetic complications cannot be overemphasized as the mean FPG was noted to be considerably higher in patients with foot ulceration As part of a comprehensive foot care programme, education on foot care should be directed at patients, family members and healthcare providers. Not less than 85% of all diabetic foot-related problems are preventable. This can be achieved through a combination of good care of foot, provided by an inter-professional diabetes care team, and appropriate education for people with diabetes. Original Research Article