ABSTRACT
Chest trauma is an important cause of mortality in children worldwide. In this study we present our experience with childhood chest trauma within a five years period. This was a 5-year prospective study of consecutive patients with chest trauma. Data entered into a pre-planned proforma included demographic information, type of injury, mechanism of injury, associated injuries, type of treatment given, outcome of management and duration of hospital stay. There were 36 children aged between 2 and 16 years (mean age: of= 10.5 ± 6.2 years). There were 24 males and 12 females (m:f 2:1). Twenty seven (75%) of the 36 patients had blunt trauma while nine (25%) had penetrating chest injury. Road traffic accident was responsible for chest trauma in 26 (72.2%) children, but 6 (16.7%) other children were victims of civil unrest while 4 (11.1%) fell from heights. Haemo-pneumothorax was common in 10 (27.8%) patients. Twenty five out of the 36(69.4%) patients had associated injuries, 10 (40%) were head injuries, followed closely by abdominal injury in 8 (32%). Chest trauma in children is common in our environment. Majority of the children suffered blunt trauma following road traffic accidents. Prompt recognition and treatment of affected children is needful for a successful outcome
Subject(s)
Accidents, Traffic , Child , Prospective Studies , Thorax , Wounds and InjuriesABSTRACT
Gangrene usually supervenes following prolonged pressure of tight splintage by traditional bone setters (TBS) in the process of treating fractures. However; various complications such as blisters; pressure sores; Volkmann's ischaemia/ contracture; Crush syndrome and pregangrene occur by the same mechanism depending on degree of pressure and duration of splintage of the limb. Method: This is a guest lecture delivered to resident doctors. Literature search was done through the internet and some unlisted journals and texts. Experiences of various institutions in Nigeria and abroad concerning bone setters' gangrene were elucidated. Attempt was made to broaden the concept of bone setters' gangrene to include all complications that arise through the same mechanism. The aetiology; pathophysiology and treatment of the various conditions were highlighted and the solution and way-forward suggested. Result: The various health institutions recorded unacceptably high percentage of amputations secondary to bone setters' gangrene e.g. Zaria - 57to 63; Jos - 60-77.8. Enugu recorded mortality of 26.7while Banjul had 11.1mortality in their series. Nearly all the series suggested education of bone setters as a solution. Conclusion: A different approach to limiting bone setters' gangrene is suggested such as condemning bone setters' practice and expanding orthopaedic care
Subject(s)
Bone and Bones , GangreneABSTRACT
Gangrene usually supervenes following prolonged pressure of tight splintage by traditional bone setters (TBS) in the process of treating fractures. However; various complications such as blisters; pressure sores; Volkmann's ischaemia/ contracture; Crush syndrome and pregangrene occur by the same mechanism depending on degree of pressure and duration of splintage of the limb. Method: This is a guest lecture delivered to resident doctors. Literature search was done through the internet and some unlisted journals and texts. Experiences of various institutions in Nigeria and abroad concerning bone setters' gangrene were elucidated. Attempt was made to broaden the concept of bone setters' gangrene to include all complications that arise through the same mechanism. The aetiology; pathophysiology and treatment of the various conditions were highlighted and the solution and way-forward suggested. Result: The various health institutions recorded unacceptably high percentage of amputations secondary to bone setters' gangrene e.g. Zaria - 57to 63; Jos - 60-77.8. Enugu recorded mortality of 26.7while Banjul had 11.1mortality in their series. Nearly all the series suggested education of bone setters as a solution. Conclusion: A different approach to limiting bone setters' gangrene is suggested such as condemning bone setters' practice and expanding orthopaedic care