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  Citation statistics : Table of Contents
   2015| January-June  | Volume 11 | Issue 1  
    Online since October 8, 2015

 
 
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ORIGINAL ARTICLES
Pattern of hand injuries seen in the accident and emergency unit of an urban orthopedic hospital
Ochuko Rex Dafiewhare, Adesina Ajibade
January-June 2015, 11(1):8-11
DOI:10.4103/0794-9316.166853  
Background: The development of hand surgery in our subregion is still very much in its infancy. At the national level, very little documentation exists on the patterns of hand injuries. This study was aimed at determining the patterns of hand injuries seen in an urban orthopedic hospital in Kano, Kano State, Nigeria. Patients and Methods: A retrospective study of 101 cases of hand injuries presenting between April 2009 and April 2010 in the accident and emergency unit was carried out. Results: There were 86 (85.1%) and 15 (14.9%) males and females, respectively. The mean age of the patients was 25.69 ± 14.04 years. Out of all the patients, 55.4% were presented within 6 h of injury. Traumatic amputations and fractures were the commonest types of injury. There was no significant difference between left and right hand involvement in injuries. The triad of occupational injuries, injuries from road accidents, and domestic accidents was the most common. Traditional bone setters played very little role in the prehospital management of injuries. Conclusion: Occupational hand injuries are most common among young working males. Early presentation of the patients and low involvement of traditional bone setters reflect the severity of hand injuries to victims.
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CASE REPORT
Final functional outcome in a case of wrist drop
Prasanta Kumar Bhattacharyya, Subhasish Ghosh, Arijit Roy, Manab Nandy
January-June 2015, 11(1):29-31
DOI:10.4103/0794-9316.166849  
Tendon transfers are used to restore balance and function to paralyzed, injured, or absent neuromuscular motor units. The goal is to improve the balance of a neurologically impaired hand. In the upper extremity, tendon transfers are most commonly used to restore function following injury to the radial, median, and ulnar nerves. We report the case of an Indian Border Security Force (BSF) jawan who had wrist drop following a bullet injury to the left upper arm.
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ORIGINAL ARTICLES
Satisfaction of plastic surgeons with job, working environment, and practice in Nigeria: A pilot study
Emmanuel E Esezobor, Ojochide S Ebune, Festus A Okhimamhe
January-June 2015, 11(1):12-18
DOI:10.4103/0794-9316.166850  
Introduction: Dissatisfaction has serious consequences for both the physicians and patients. Studies had shown that job dissatisfaction among physicians is associated with increase rate of medical errors thus jeopardizing patients' safety. Plastic surgeons are not exempted from this problem. This study is aimed at knowing the level of satisfaction of plastic surgeons with their job, working environment and practice in Nigeria Materials and Methods: This is a cross-sectional study of plastic surgeons that attended the 19th annual scientific conference and annual general meeting of Nigerian Association of Plastic, Reconstructive and Aesthetic Surgeons (NAPRAS) in Lokoja Kogi State, Nigeria. Data on the determinant of Job satisfaction as described in “Medicine in Australia: Balancing Employment and Life (MABEL) questionnaire” was used. The level of significance was set at P ≤ 0.05. Result: There were 31 respondents with all the geographical zones except North-West represented. The mean age was 41.06 ± 5.84 years and the Female: Male ratio was 1: 5.2. There were more respondents who were indecisive on the level of satisfaction with the patients they see. Of those who were decisive (41.9%), more were dissatisfied (25.8%). Most respondents are dissatisfied with the level of support provided and work location. On objectively assessing the level of job satisfaction among this same group of plastic surgeons, only one (3.2%) respondent was satisfied. Conclusion: Plastic surgeons in Nigeria are not satisfied with their job. Remuneration seem to be far down the list of the causes of their job dissatisfaction.
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Post burn digital contracture our way: The pains, The gains
Zainab Yunusa Kaltungo, Adamu D Bojude, Olabisi Shakiru Olajide
January-June 2015, 11(1):19-22
DOI:10.4103/0794-9316.166848  
Background: Post burn digital contractures account for 30% of new outpatient clinic visits but 25% of elective surgery load in our practice. There is a lot of backlog and pressure to operate particularly in the pediatric age group. We were able to demonstrate in this series that irrespective of the duration, uncomplicated post burn contractures are usually not complicated by ankylosis and a single stage complete release is possible. Aims and Objectives: 1. To determine if multiplicity of joint involvement and duration between burn and corrective surgery affect outcome. 2. To determine the range of complications after post burn digital contracture release. 3. To determine if preoperative plain radiographs are necessary in uncomplicated post burn digital contractures. Materials and Methods: Retrospective analysis of the records of 33 patients. Data collected included socio demographic and disease characteristics, etiology of burns, duration of burns before corrective surgery, complications after corrective surgery. Data was analyzed using SPSS version 16.0. All patients with contractures in other joint other than digits and from other causes other than burns, or burns associated with mechanical trauma were excluded. Results: Mean age 8 yrs, nearly equal sex distribution. Scald 48.5%, flame 21.2%, contact burn 9.1%, others 21.2%. Mean duration between burn and contracture release 40months. Overall, 172 joints were involved in 33 patients, 69.7% had incision ,+ FTSG, 3% had incision+ STSG, 6.1% had Z plasty only and 21.2% had Z plasty + FTSG. In 32 patients (97%) complete intra op contracture release was achieved. Twenty patients (60.6%) healed without complications, recorded complications post op were wound infection (30%), graft shift and digital tip gangrence. Conclusion: Prolonged duration between burn and eventual contracture release does not affect achieving complete contracture release, neither does multiplicity of joint involvement.
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An analysis of skin cancer in albinos in Ibadan
Samuel Adesina Ademola
January-June 2015, 11(1):23-28
DOI:10.4103/0794-9316.166852  
Context: Skin cancers are common among albinos living in Africa. Deleterious effect of ultraviolet rays from sunlight and nearness to the equator places the African Albinos at risk for skin cancer. Aims: This study aims to present skin cancers in albinos as seen by a plastic surgeon, sensitize the public to the magnitude of dangers that albinos are exposed to, highlight the challenges faced in their management and suggest strategies for improved outcomes. Settings and Design: A retrospective review of skin cancers among albinos was conducted at the University College Hospital, Ibadan, Nigeria. Methods and Material: The charts, operation and cancer registry records of all albinos referred to a plastic surgery division over a ten year period was reviewed. Demographic data and relevant information relating to skin lesions were extracted. Statistical Analysis: Descriptive analysis was done with the aid of statistical package for social sciences (SPSS) version 20. Results: Nineteen patients with fifty nine skin lesions comprising 13 males and 6 females were reviewed. Mean age of the patients was 33.6 (SD 12.8) years, 50% were unmarried, over 90% were Christians and 44% were not employed. The lesions were on the face in 84.6% while scalp and neck lesions were present in 36.8 and 31.6% of patients respectively. In 73.7% of the patients, the lesions were advanced. Basal cell carcinoma and squamous cell carcinoma were of equal proportion. Conclusions: Albinos in Nigeria should be exposed to public health intervention to reduce the incidence of skin cancers through targeted public health educational programmes; structured multicenter and population based research, surveillance, and improved access to healthcare.
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REVIEW ARTICLE
Reconstruction of soft tissue defects in the distal third of the leg, ankle, and foot: A meta-analysis
Samuel Adesina Ademola, Wasiu Olushola Adebayo, Olukemi Lawani
January-June 2015, 11(1):1-7
DOI:10.4103/0794-9316.166851  
Management of soft tissue defects in the distal third of the leg, ankle and foot has evolved over time despite its challenges. No option of coverage is universally recommended for defects in this region of the body. Our objectives were to review and analyze outcomes of reported options of reconstruction of soft tissue defects in this region. We conducted a search of PUBMED and HINARI databases from 2000-2014 to identify reported options of reconstruction of soft tissue defects of the leg, ankle, and foot. Pooled data from suitable articles were analyzed and the success and complication rates as well as the relative risks for failure and complications were computed. One thousand and thirty two articles were retrieved out of which thirty three met the inclusion criteria for analysis. All the 33 articles were uncontrolled cohort and descriptive studies. There were 14 reports on sural artery flap, 6 on perforator-based flaps, and 5 on free flaps. Cross leg flaps, adipofascial, peroneus brevis, and hemisoleus muscle flaps were reported in two studies each while medial plantar, supramalleolar, and skin grafts were reported in one study each. Flap failure was the commonest complication with free flaps while reconstruction with skin grafts had the lowest failure rate. Free flaps were, however, versatile for reconstruction of complex defect. Conclusively, meticulous planning is required in the reconstruction of defects of the lower third of the distal third of the leg, ankle, and foot in order to use the most appropriate method for best outcomes.
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