A comparative analysis of the outcome of flexor tendon repair in the index and little fingers: does the little finger fare worse?

The clinical and hand therapy notes of 180 patients who had single digit flexor tendon repairs in zones I and II from January 2000 to December 2004 were reviewed. Data from 60 index and 108 little fingers at 5 weeks, 8 weeks and 12 weeks follow-up visits were included. In zone I injuries, there was a statistically significant difference in flexion contracture (worse in the little fingers ) at all follow-up points. Although the range of motion and percentage of patients in the excellent category of the Strickland and Glogovac criteria were greater in the index finger group than the little finger for zone I and II injuries, these differences were not statistically significant. The rupture rate was also higher in the little finger group.

Arteriovenous fistula for patients on long term haemodialysis in jos, Nigeria.

BACKGROUND: The introduction of haemodialysis has prolonged the lives of patients with end-stage-renal disease (ESRD). To maintain them on long-term dialysis, vascular access procedures are required. OBJECTIVES: To describe the experience with arteriovenous fistula (AVF) from a developing country. METHODS: Eighty-two AVF were created in 74 patients on maintenance haemodialysis. They all had side-to-end AVF using prolene 7/0 monofilament suture for anastomoses. RESULTS: There were 55 males and 19 females with a male: female ratio of 2.9:1. The ages ranged from 18 to 70 years with a mean of 43.4 "12.1 years. Most of the AVF created were on the left upper limbs with the radio-cephalic and brachio-cephalic accounting for more than 70% . Eight patients developed thrombosis of the veins used for the AVF and one developed a pseudo aneurysm. CONCLUSIONS: Arteriovenous fistula makes long-term haemodialysis feasible. It can be created easily and has a low rate of complications.

Testicular torsion on the Jos Plateau.

In order to determine the pattern and the factors that influenced outcome, we retrospectively studied fifty-seven patients with torsion of the testis admitted to the Jos University Teaching hospital between August 1993 and July 2001. The age ranged from 2 to 55 years with a mean of 22.7 years. Majority (79%) of the patients were in the second and third decades of life. The main suspected precipitating factors in this study were cold weather and scrotal trauma: in 28% of the cases no cause could be ascertained. Eight (14%) patients presented within 4 hours and 35 (61%) presented after 24 hours of the onset of symptoms. Both sides were equally affected. Testicular pain, retraction and scrotal swelling were the most common presenting complaints. The highest incidence 65%) occurred between November and February when the weather on the Jos plateau is coldest. At surgery, 34 (60%) patients were found to have associated congenital anomalies; in 22 (39%) patients, the testis was non-viable. There was no mortality in this series and the complications were superficial wound infection (14%), testicular atrophy (7%) and sub-fertility (16%). High index of suspicion in a patient with acute scrotum, prompt and effective surgery will improve testicular salvage.

Cleft lip and palate: the Jos experience.

OBJECTIVE: To determine the pattern of occurrence of cleft lip/palate and the factors that may have influenced treatment outcome. DESIGN: Descriptive Study. SETTING: Jos University Teaching Hospital, Jos, Nigeria. SUBJECT: This study included 107 consecutive patients with cleft lip/palate managed between January 1991 and June 1997. MAIN OUTCOME MEASURES: The pattern of occurrence of cleft lip/palate, the peculiarities of the malformation in this environment as well as factors that influenced treatment outcome. RESULTS: The 107 patients were aged between one day and twenty-six years at presentation. There were three adults aged between 18 and 26 years with a mean of 22.3 years and 104 children with a mean age of 9.5 months. The male/female ratio was 1. 1:1, the anomaly was 2.4 times commoner on the left and the cleft lip alone was the most frequent mode of presentation (52%). The incidence was higher in the 3rd and 4th siblings. In 13% of these patients, there were other associated congenital anomalies such as Van der Woude's Syndrome, Down's Syndrome and congenital heart disease. Complications were noted in 16(14.9%) patients and these included dehiscence after repair in 8(7.5%) patients, oronasal fistulae in 2(1.9%), nasal speech in 4(3.7%) and hypertrophic scar in 2(1.9%). Eighty nine percent of these repairs were satisfactory to the parents of the affected children. All the adult patients were satisfied with their repair. CONCLUSION: The low incidence of this anomaly in our environment may be due to underreporting in the rural areas. Public enlightenment programs should help improve early presentation.

Pyogenic thyroiditis and HIV infection.

Infective thyroiditis remain rare disease entity. Six patients were seen in Jos, Nigeria in the last five years. All of them were HIV positive. The presentation and management of these patients are high-lighted. The clinical features and bacteriology were similar to those previously documented for infective thyroiditis.