Correlation of anthropometric parameters with semitendinosus tendon length in anterior cruciate ligament injured patients.

Anterior cruciate ligament reconstruction (ACLR) surgery is now a common procedure performed following a tear of the anterior cruciate ligament. The length of the harvested hamstring tendon is critical to the outcome of the surgery as it may influence the final length and thickness of the graft. The goal of this study was to attempt to establish a relation- ship between the height, weight and body mass index and the harvested length of the semitendinosus tendon of patients having ACLR surgery. This was a retrospective study. The weight, height, and body mass index (BMI) of patients for primary anterior cruciate ligament reconstruction were noted. The average length of the tendon was noted. The correla- tion between each of these anthropometric parameters and the tendon length was estimated. The range of values for the semitendinosus length, height and weight in males and females respectively were 24-39cm (31.26 +/- 2.93) and 26-35cm (29.26 +/- 2.08); 1.6-1.96 m and 1.65-1.8m; and 52-110kg and 60-106kg. Only the height revealed a moderate correlation with the length of the harvested tendon among the male patients. Linear regression analyses yielded the equation Sem- itendinosus tendon length = 23.25xheight-10.28 at a p-value of 0.002. Patient height could be predictive of the length of the harvested semitendinosus tendon.

Predictive Value of Clinical and Magnetic Resonance Image Findings in the Diagnosis of Meniscal and Anterior Cruciate Ligament Injuries.

BACKGROUND: Anterior Cruciate Ligament (ACL) injuries may be accompanied by associated injuries such as meniscal injuries. Clinical evaluation alone may at times miss the diagnosis of ACL injury and one or more associated injuries. However, an adjuvant diagnostic tool such as an MRI of the knee may be unaffordable to some patients. The goal of this study was to compare the sensitivity, specificity and predictive value of clinical and magnetic resonance image (MRI) findings in the diagnosis of anterior cruciate ligament and meniscal injuries. METHODS: This was a prospective study. The cases of ACL injury recruited had a magnetic resonance imaging of the injured knee, and knee arthroscopy done. The clinical, magnetic resonance imaging and arthroscopic diagnostic findings were all noted. The sensitivity, specificity, positive predictive value and negative predictive values of clinical and MRI findings were compared, with arthroscopic findings as gold standard. RESULTS: A total of seventy-seven patients were recruited for the study. There were fifty-four males and twenty three females. The results of the tests of the sensitivity, specificity, positive predictive value and negative predictive value of clinical diagnosis and MRI when compared with arthroscopy findings, in detecting meniscal and anterior cruciate ligament injuries were as follows: For Clinical evaluation; Anterior Cruciate ligament: 81%, 80%, 86% and 76%; Medial Meniscus: 84%, 77%, 84% and 93%; and Lateral Meniscus: 85%, 77%, 85% and 82% respectively. For MRI: Anterior Cruciate Ligament (ACL): 87%, 89%, 93% and 78% ; Medial Meniscus: 87% 79%, 70% and 82%; and the Lateral Meniscus: 70%, 76% 73% and 72%. CONCLUSION: The specificity, sensitivity and predictive value of clinical and MRI findings were comparable in relation to the diagnosis of ACL and Medial Meniscus tears. However, the values of these parameters were better with clinical examination than with MRI in relation to the diagnosis of lateral meniscus tears.

ARTHROSCOPIC PARTIAL MENISCECTOMY - SHORT-TERM CLINICAL OUTCOME IN AN ORTHOPAEDIC CENTER IN SOUTHWESTERN NIGERIA.

BACKGROUND: Meniscal tears are one of the common causes of knee pain. AIM: To evaluate the early clinical results of arthroscopic partial meniscectomy in the treatment of meniscal tears. STUDY DESIGN: This was a prospective study in which consecutive patients presenting with meniscal injury, who met the inclusion criteria were recruited for the study. SETTING: National Orthopaedic Hospital, Lagos. METHODOLOGY: Biodemographic data and clinical findings were obtained. The visual analogue pain score and WOMET score were computed pre-operatively and at least 6-months post-operatively and these values compared using the Wilcoxon's signed rank. The level of significance was set at 0.05. RESULTS: A total of 19 patients with 19 knees were included. Degenerative longitudinal tears were the commonest findings in 15 (79%), complex tears in 3 (16%) and radial tear in 1 (5%). The medial meniscus was more affected (52%) than lateral meniscus (48%). The red-white zone was involved in 12 (63%) cases and the white-white zone in 5 (37%). The median duration of follow up was 7 months while the median (IQR) WOMET score decreased from 59 (IQR =22) to 26.5(IQR=23), (Z= -3.409, P=001 ) and the visual analogue pain rating scale improved from 5 (IQR=1.5) to 3 (IQR=2.5) (Z= -3.346, P=001 ). CONCLUSION: Arthroscopic partial meniscectomy offers a good short term clinical outcome for patients with knee pain secondary to meniscal injury.

Drink driving and risky behavior among university students in southwestern Nigeria-Implications for policy development.

BACKGROUND: Drink driving contributes significantly to road traffic injuries. Little is known about the relationship between drink driving and other high-risk behaviors in non-Western countries. The study aimed to assess the relationship between drink driving and other risky behaviors including making phone calls, sending text messages, nonuse of protective gear, and driving against traffic. METHODS: A cross-sectional survey of risky behavior among undergraduates was conducted. A stratified random sampling method was used to identify young undergraduates who had driven a motorized vehicle in the past year. The Alcohol Use Disorder Identification Test (AUDIT) and other tools developed by researchers were used to identify the risky behaviors. RESULTS: Of 431 respondents, 10.7% had engaged in drink driving in the past 12 months. The most common risky behavior was making phone calls (63.7%), followed by nonuse of helmets (54.7%), driving against traffic (49.2%), nonuse of seat belts (46.8%), and sending text messages (26.1%). Alcohol use was significantly associated with making phone calls (U = 1.148; P < .0001), sending text messages (U = 1.598; P = .021), nonuse of helmets (U = 1.147; P < .0001), driving against traffic (U = 1.234; P < .0001), and nonuse of seat belts (U = 3.233; P = .001). Drink driving was associated with all risky behaviors except nonuse of seat belts (U = 1.842; P = .065). CONCLUSION: Alcohol use and drink driving were associated with multiple risky driving behaviors. This provides useful insight for policy development and presents additional challenges for traffic injury prevention.

Pentalogy of cantrell: a report of three cases.

Pentalogy of Cantrell is a rare upper midline syndrome that may present in association with anomalies outside the torso. The pentad - the supraumbilical body wall defect, sternal defect, deficiency of the anterior diaphragm, defect of the diaphragmatic pericardium, and the intracardiac anomalies - was first described by Cantrell et al., in 1958. The defect is said to be more common in males, and survival is dependent on the cardiac malformations and on the degree of completeness of the syndrome. We report three cases of Cantrell's pentalogy managed in our unit. Two of the patients were females and one a male. All were seen at peripheral health centers before being referred to us. Age at presentation for the girls was 18 hours and 36 hours, respectively, the boy presented at the age of six weeks. All of their parents were unschooled manual workers. All patients presented with a defect in the supraumbilical body wall, bifid sternum, and a visible cardiac impulse. We were unable to do echocardiography to rule out intracardiac anomalies in the three patients. The thin membranous covering of the epigastrium in the female patients was managed conservatively. Both female patients were discharged against medical advice as requested by their parents, due to financial constraints. The male patient was lost to follow up after two clinic visits. A multidisciplinary approach to the management of this syndrome is recommended.