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Evaluation of Some Treatment Options Inlate and Neglected Hip Fractures Using the Modified Harris Hip Score

Open Journal of Orthopedics 2024年第6期14卷 259-269页

作者： shaphat shuaibu ibrahim Abubakar Musa Olaoluwa Moses Shodipo Emuan Timothy Zailani Buhari Stephen Yusuf Mienda Isa Department of Orthopaedics Abubakar Tafawa-Balewa University Teaching Hospital (ATBUTH) Bauchi Nigeria Orthopaedic Unit Department of Surgery FMC Bida Nigeria

Background: The choice of the appropriate operative intervention in patients with late and neglected hip fracture continuous to be a huge dilemma for orthopedic surgeons. Purpose: To evaluate the satisfaction or otherwise of some treatment options using the modified Harris-hip score (HHS) in resource poor setting. Materials and Methods: A retrospective cross-sectional study conducted at ATBUTH, Bauchi. Data of 60 patients over the age of 18 years with hip fractures (femoral neck, intertrochanteric and sub trochanteric fractures) who had operative intervention between 1st September 2019 and 31st August 2020 with cannulated screws, Proximal femur lock compression plate (PFLCP), cementlessor cemented bipolar hemiarthroplasty (BHA). Results: The mean age of studied patients was 65.7 ± 16.1 years, with age ranging from 19 - 101 years. M:F ratio was 1.2:1 across all age groups and 1:1.4 amongst those >60 years. 51 patients (85%) presented > 1 week after injury with 24 patients (40%) sustaining hip fractures from low energy trivial indoor fall and 28 patients (46.7%) mostly younger sustaining fractures from high energy motor vehicular accident (MVA). The prevalence rate for femoral neck, intertrochanteric and subtrochanteric fractures were 32 (53.3%), 17 (28.3%) and 11 (18.3%) respectively. From the data retrieved, 21patients (35.0%), 17 patients (28.3%), 20 patients (33.3%) and 2 patients (3.3%) had PFLCP, cemented BHA, cementless BHA and cannulated screw fixation respectively. Most (66.7%) of those who had PFLCP achieved satisfactory radiologic union and there was also 94.1% and 85% satisfactory outcome rate amongst the patients with cemented BHA and cementless BHA respectively. Irrespective of the operative intervention method at 1 year follow-up, there was a statistically significant improvement in post-operative HHS (P value 0.02), with 83.4% having good to excellent results. Conclusion: There is highrate of late and neglected hip fracture in our environment. Satisfac

关键词： Hip Fracture Late and Neglected BHA PFLCP Cannulatedscrew Outcome Measures HHS

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Risk Factors for Lower Extremity Amputation among Diabetic Patients with Diabetic Foot Gangrene in ATBUTH, Bauchi

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Open Journal of Orthopedics 2024年第9期14卷 391-403页

作者： Stephen Yusuf shaphat shuaibu ibrahim Abubakar Musa Yusuf Aliyu Salihu Friday Titus Nyako Ngwan David Wujika Department of Orthoepaedics and Trauma Abubakar Tafawa Balewa University Teaching Hospital Bauchi Nigeria Radiology Department Abubakar Tafawa Balewa University Teaching Hospital Bauchi Nigeria Department of Orthopedic and Trauma Surgery University of Maiduguri Maiduguri Nigeria Department of Surgery Modibbo-Adama University Teaching Hospital Yola Nigeria

Background: Diabetic mellitus was described as an evolving global epidemic of the twenty-first century, due to the exponential rise in the number of people with the condition. Lower extremity amputation is one of the common complications of diabetes. With increase in the number of people with diabetes there will also be increase in the number of diabetics going for lower extremity amputation, increasing both the financial as well as psychologic burden of treatment. Methodology: A prospective cross-sectional study of all diabetic patients going for lower extremity amputation will be done. All the patients with advanced diabetic foot syndrome needing lower extremity amputation are enrolled (Wagener stage IV and V), both through the clinic and emergency center. Informed consent is obtained from the patient after which data are collected using a structured questionnaire. All the investigation results of the patients were also documented. Data collected are analyzed using the SPSS version 29. Chi-square and student t-test were used to measure significant relationship between the variables at 95% confident interval. Results: Within the period of study, which extends from 1st January 2022 to 1st of January 2024, a total of 171 patients were recruited. All diabetic patients with diabetic foot Wagener grade IV and V who presented to the clinic or emergency department were enrolled in the study. We found a significant relationship between gender, previous procedure on the affected limb or amputation of the contralateral limb, knowledge of foot care among diabetics and risk of amputation. There was, however, no statistically significant relationship between. There is no statistically significance relationship between the level of education, occupation, presence of co-morbidity with the risk of amputation among diabetic patients with foot syndrome. Conclusion: Previous lower limb procedure/amputation, male gender, paucity of knowledge on foot care, prolonged duration of the dis

关键词： Diabetes Mellitus Lower Limb Amputation Risk Factors Rehabilitation

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Clinical Versus Doppler Based Assessment in Determining Amputation Level in Diabetic Foot Gangrene;A Prospective Cross-Sectional Study at Atbuth, Bauchi

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Open Journal of Orthopedics 2024年第8期14卷 366-373页

作者： shaphat shuaibu ibrahim Stephen Yusuf Abubakar Musa Shirama Yakubu Bababa Yusuf Aliyu Salihu Makama Baje Salihu Bukar Shehu Department of Orthoepaedics and Trauma Abubakar Tafawa-Balewa University Teaching Hospital Bauchi Nigeria Department of Radiology Abubakar Tafawa-Balewa University Teaching Hospital Bauchi Nigeria Department of Surgery Abubakar Tafawa-Balewa University Teaching Hospital Bauchi Nigeria

Background: Amputation is defined as the surgical removal of a limb or part of a limb through the bone. If the amputation is done above or below the knee, they are termed major while minor amputations involve the partial removal of foot including forefoot resections, ray amputation of the digits or parts of the digits. Significant number of patients with diabetic foot ulcers end with amputations. In the past the amputation level was decided by clinical assessment alone, such as physical examination using color, temperature, peripheral pulses and wound bleeding during surgical procedure. The use of Doppler ultrasound to measure arterial blood pressure at the proposed amputation site has been advocated as a predictor of amputation success. An optimal choice of the level of amputation can reduce amputation complications. Methodology: A Prospective comparative randomized cross-sectional study carried out between 1st January 2022 and 1st January 2024 in ATBUTH, Bauchi amongst patients with diabetic foot Wagener stage IV and V scheduled for amputation. Outcome measures of wound break down, flap necrosis and re-amputation were assessed amongst the clinical based level assessment group and the doppler based level assessment group. Results: A total of 171 patients were recruited into the study. Males 103 and 68 are females, giving a male to female ratio of 1.5:1. mean age 47 years. There were 84 patients in the clinical based level assessment group and 87 patients in the doppler based level assessment. Conclusion: Diabetes mellitus foot disease is a significant risk factor for non-traumatic lower limb amputation and doppler level assessment is superior to clinical level in determining amputation level among diabetic patients scheduled for amputation. P-value 0.003.

关键词： Diabetics Amputation Foot Gangrene Doppler Clinical

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Small Cell Prostate Cancer;Center Review of Two Cases and Testimony of a Rare and Aggressive Disease

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Case Reports in Clinical Medicine 2024年第9期13卷 410-417页

作者： Makama Baje Salihu Haruna Liman Stephen Yusuf Dauda Suleiman shaphat shuaibu ibrahim Yusuf Aliyu Salihu Isa Sajo Mienda Department of Urology ATBUTH Bauchi Bauchi State Nigeria Department of Orthopaedics ATBUTH Bauchi Bauchi State Nigeria Department of Histopathology ATBUTH Bauchi Bauchi State Nigeria Department of Radiology ATBUTH Bauchi Bauchi State Nigeria

Small cell cancers were initially described in the lungs and later found to occur in a wide range of organs of the body, constituted a disease entity that is characterized by an aggrieve path/course and a huge disease related mortality. They are also called neuroendocrine tumors with peculiar histologic and biologic disease entity. Here we present two cases of small cell cancer of the prostate seen and managed in our facility with focus on their presentation, disease progression and outcome. The first patient was a 72-year-old retired military officer who presented with a progressively painful scrotal swelling of 3-month duration, and scrotal ulceration with contact bleeding of a month duration associated with a foul-smelling discharge. There was also history of progressive weight lost, loss of appetite and constipation. Patient was pale and lethargic on examination with a foul smelling exophytic scrotal mass. Serum PSA was 4 ng/l (within normal limit). Wedge biopsy and trucut prostate biopsy revealed small cell cancer of the prostate. Patient was resuscitated and prepared for chemoradiation, had a single dose of chemotherapy and died before the second dose. Second patient was a 63-year-old farmer who presented with lower urinary tract symptoms, progressive weight loss and constipation of two months duration, a known hypertensive and diabetic who has been regular on his medication. He was lethargic on examination, pale and unable to stand without support. Trucut prostate biopsy shows small cell cancer of the prostate. He was also resuscitated and being prepared for chemoradiation but died before commencement of treatment.

关键词： Small Cell Prostate Cancer Mortality Chemoradiation

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Drug Use and Abuse among Orthopedic Ward Patients—A Revolving Cycle of Menace in Atbuth, Bauchi

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Journal of Biosciences and Medicines 2024年第9期12卷 13-20页

作者： Yusuf Stephen shaphat shuaibu ibrahim Timothy Emuan Buhari Abdullahi Zailani Bukar Shehu Aminu Umar Shirama Yakubu Bababa ibrahim Babangida Hussaini Blessing Eneh Vincent Department of Orthoepaedics and Trauma Abubakar Tafawa Balewa University Teaching Hospital Bauchi Nigeria Department of Radiology Abubakar Tafawa Balewa University Teaching Hospital Bauchi Nigeria Department of Nursing Abubakar Tafawa Balewa University Teaching Hospital Bauchi Nigeria

Background: The use of drugs for purposes other than those for which they are meant to be used or in excess amounts. Psychoactive drugs are some of the drugs more commonly abused, also, antibiotics and other medications too can be misused. Drug abuse and misuse can lead to serious social, medical and emotional harm to the patients, and antibiotic resistance that makes treatment harder are also likely complications. Method: Patients in both male and female wards of the Orthoepaedics Department of ATBUTH, Bauchi were interviewed using a structured questionnaire and their responses were recorded and data were analyzed using the SPSS version 29. Results: A total of 112 patients were interviewed, 76 males and 36 females. Thirty-two (28.6%) patients had taken various kinds of unprescribed medications while on admission: 9 patients had taken unprescribed tramadol, 4 patients had taken codeine, 6 Ampiclox, 5 flagyl and about 8 patients had taken different kinds of traditional medications while on admission. Among the 32 patients, 23 (72%) are aged less than 30 years, 5 (16%) are aged between 30 and 50 years and 4 (12%) are aged above 50 years. Sixteen (50%) had such medications brought to them by relatives or friends, 10 (30%) were given by other patients on admission, 5 (15%) brought or bought the drugs by themselves while 1 (5%) were given by a non-clinical staff of the hospital. Conclusion: Drug misuse and abuse is a very serious, deleterious practice with destructive consequences in its wake, such consequences as drug dependency with all its antecedent effects, antibiotic resistance and difficulties in controlling/managing infections are but a few. So, it’s very important to both educate patients about these terrible practices and cope with the spread of them in our wards and hospitals.

关键词： Drug Abuse Misuse Dependency Resistance

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