Limb deformities: the Lagos, Nigeria experience

Background: Individuals with various forms and degrees of limb deformities are common on the streets of Lagos; Nigeria. State-sponsored screening and surgical correction of the deformities were carried out in Lagos between June 2004 and May 2006. A report on the pattern of limb deformities is presented. Methods: This was a prospective study of all the patients that were seen and treated during the various screening programmes and operating sessions. Data was stored electronically and analysed using Microsoft Excel software. Results: A total number of 1;321 patients were screened; and 344 satisfied the inclusion criteria for enrolment. They were aged between 9 months and 64 years but only 20were aged 5-years and below. Females constituted 58.2and males 41.8. A total of 513 limbs were surgically corrected. The most frequent deformity and disease entity were bilateral genu varum (45.1) and Blounts disease (48.7); respectively. Proximal tibial wedge corrective osteotomy was the most frequent surgical procedure performed. Most beneficiaries presented late and were discharged within 48-hours of hospital admission. Conclusions: Improved public awareness about the availability of hospital based resources to solve the problem of limb deformity is advocated

Congenital constriction ring syndrome of the limbs: a prospective study of 16 cases

Background: The congenital constriction ring syndrome is characterised by fibrous bands that encircle; strangle and even amputate parts of the foetus. It is a common condition amongst Ghanaian patients; but data on it is quite scanty. Materials and Methods: A prospective study of patients presenting at a plastic surgical clinic in Ghana with the characteristics of the congenital constriction ring syndrome was undertaken. The patients were examined clinically and the findings recorded. An x-ray and clinical photograph of the affected limbs was taken. Treatment required several staged operations. Surgical correction of the constriction ring was done by excision and Z-plasty to prevent or alleviate lymphoedema; separation of distally fused digits and skin grafting of defect. Results: Sixteen patients made up of 10 males and six females were seen. The age at presentation ranged from nine days to 12 years with a mean age of 14.6 months. Twenty-two limbs were affected; made up of four right upper limbs; six left upper limbs; seven right lower limbs and five left lower limbs. In the upper limb malformations involved 42 digits; in the lower limb malformations involved 33 toes; one foot and five legs. Four main types of lesions were found: constriction rings; intrauterine amputations; acrosyndactyly; and simple syndactyly. Conclusion: Congenital constriction ring syndrome is of uncertain aetiology and could cause morbidity in the newborn. The syndrome and its complications are amenable to corrective surgery with good results. Early intervention is desirable for a successful outcome