Lower limb amputation in diabetic foot disease: experience in a tertiary hospital in southern Nigeria

The diabetic foot is characterised by the triad of neuropathy, infection, and ischaemia, which may ultimately lead to limb amputation. It is important to understand the factors that place diabetic patients at increased risk of amputation in our society, hence the need for this study. The medical records of all patients admitted and treated for diabetic foot complications over a 3-year period (January 2007 to December 2009) were retrieved. Relevant information was obtained from the case notes. Thirty-six (36) patients entered the study, 25 males and 11 females (M:F ratio 2.3:1.0). Mean age was 54 years (range 24­74). Patients presented with foot gangrene (58%), ulceration (31%) and infection (11%) with trauma being the most common precipitating factor (53%). Nineteen patients (53%) had lower limb amputation, the commonest of which was below knee. Of the patients that had amputation, 18 (95%) had type 2 diabetics. Adequate diabetic foot disease preventive strategies need to be designed and implemented to reduce the incidence of lower limb amputations

Footcare practices among Nigerian diabetic patients presenting with foot gangrene

Diabetic foot ulceration and gangrene is a major cause of morbidity andmortality. This study has examined potential preventive footcare practices in a cohort of diabetic patients presenting with foot gangrene. One hundred and two (102) diabetic emergencies presented during the study period. Diabetic foot gangrene accounted for 27 (26%) of these cases. There were 18 males and 9 females (M:F = 2:1), with a mean age of 52+13 years. The mean duration of ulceration was 4±3 weeks and mean ulcer­gangrene interval was 1.2±0.5 weeks. Only 9 patients (33%) had been exposed to any form of footcare education, 15 patients (55%) treated their ulcers by unorthodox means, and 63% of the patients practiced no significant footcare. More widespread education and awareness is needed to prevent the continuing and serious problem of diabetic foot gangrene and consequent lower limb amputation

Motorcycle Road Traffic Injuries in Southern Nigeria: The Small Motorcycle as a Prevention Strategy

Background: The commonest mode of public transportation in Uyo is by motorcycle. There are two sizes of motorcycle in common use - the big one (Qlink or Skygo model; made in China) and the small one (C90; made in China). The study was carried out to determine if there is a lower risk of RTI severe enough to be brought to the hospital; attributable to using a small motorcycle. Methods: Motorcycle RTI victims admitted at the Accident and Emergency department of the University of Uyo Teaching Hospital (UUTH); were reviewed prospectively over a 15 month period. Three community visual surveys of the proportion of small to large motorcycles were also conducted. Results: A total of 131 RTI victims were reviewed over 15 months. The visual surveys of motorcycles in Uyo revealed that the mean proportion of small to large is 38 to 62; a ratio of 1:1.6. Eighty-three (63.3) of the 131 RTI's involved motorcycles. 74 of these occurred in large motorcycles. There was a statistically significant relationship between motorcycle size and occurrence of an RTI severe enough to be brought to hospital. Conclusion: There is a lower risk of RTI severe enough to be brought to hospital; from using a small motorcycle

Acute bilaterial anterior shoulder dislocation following domestic assault

A rare case of acute bilateral anterior shoulder dislocation in an elderly woman is presented. This injury resulted from domestic physical assault by her daughter in-law. Patient defaulted after initial treatment - a common practice by patients in our society. This case is being reported to highlight the occurrence of this rare orthopaedic emergency

Review of Seventy consecutive cases of limb injuries in calabar the role of motorcyclists

Background: Limb injuries are common. The aims of this study were to evaluate the pattern of limb injuries seen at the University of Calabar Teaching Hospital (UCTH); Calabar and the role ofmotorcyclists in their causation. Methodology: Prospective study from 1st January; 2005. Seventy consecutive patients with limb injuries presenting at the accident and emergencyunit of UCTH were evaluated. Results: The seventy patients who entered the study presented between 1st January 2005 and 31st May 2005. They sustained eighty five (85) limb injuries.Ages ranged from 4.5years to 68years with mean of 30years. Male to female ratio was 2.7:1. Road Traffic Accident (RTA) was the commonest cause of injury accounting for 76.8of cases withmotorcycle accidents constituting 52.8of these. Fracture was the most common injury accounting for 54 cases (63.5). Fracture of the tibia and fibula (combined) was the most common fracture (37.0). Head injury was the most common associated injury (66.7). Conclusion: Motorcycle accidents are important causes of limb injuries. Appropriate measures to reduce incidence of road traffic accidents would significantly curtail the rate of occurrence of limb injuries