Does the Proximal Femur Geometry Predict Early Functional Outcome after Plate Fixation of Geriatric Pertrochanteric Fractures?

BACKGROUND: The proximal femur geometry determines the hip force distribution. The femoral neck axis length (FNAL), the hip axis length (HAL), the femoral head diameter, and the femoral neck-shaft angle (FNSA) could influence the risk and outcome of pertrochanteric fractures. Restoring these parameters to their prefracture values could predict early hip function. AIM: To determine if the postoperative proximal femur geometry of geriatric patients with plating for pertrochanteric fractures predicts the early functional outcome. MATERIALS AND METHODS: The study was a prospective study carried out at the National Orthopaedic Hospital Enugu for 18 months. Geriatric patients who had Proximal Femoral Locking fixation for pertrochanteric fractures were recruited. Radiological parameters of the proximal femur in the unaffected and fixed hips were measured and compared. The functional outcomes of the patients were measured at 3 months postoperative period using the Harris hip score (HHS). Multiple linear regression was conducted on the parameters to determine the HHS. RESULTS: Thirty patients participated in the study, with a significant difference (P < 0.001) in the mean FNSA between unaffected (M = 128.69, standard deviation (SD) =2.93) and operated hips (M = 121.81, SD = 8.86). The FNSA was the only significant predictor of hip function, with a 1-degree increase improving the HHS by 1.30. CONCLUSION: There is a significant difference in the FNSA between the unaffected and the operated hips. The FNSA significantly predicts the early hip function and should be reconstructed to within normal range during surgery.

The relationship of white blood cell and platelet counts to cigarette smoking in adult Nigerians.

This study was undertaken to examine the relationship between cigarette-smoking and total white blood cell count (wbcc) and platelet count (pc) in adult Nigerians. We also studied the relationship of the white blood cell and platelet counts to the duration of the smoking habit and number of cigarette smoked per day. Three hundred and fifty-two healthy male adults, aged 18-52 years, were studied. They were randomly allocated to two groups--176 smokers and 176 non-smokers. The smoking habit was assessed from a minimum period of 1 year and a minimum number of 5 cigarettes per day. Results revealed that platelet count was higher for the regular Nigerian smoker than for non-smoker. The difference between mean platelet counts for smokers and non-smokers was statistically significant (t = 2.64 p = 0.0046). Man WBC count in smokers was slightly higher than for non-smokers. However, unlike in the case of platelet counts, the mean difference in WBC count between smokers and non-smokers is not statistically significant (t = 0.07, p value = 0.9442). Similar studies based on white population has showed statistically significant increases in wbcc and pc in smokers.

Invasive thymoma and myasthenia gravis in a three-and-a-half-year-old boy: case report and literature review.

Thymomas are very rare tumours in the paediatric age group, characteristically slow growing and only few cases have been reported in the literature. The commonest disease associated with thymomas in the adult is myasthenia (MG). There are reports to suggest that this association does not occur in the paediatric age group. We report the unique case of a 3-years-7-month-old boy who presented with a very rapidly increasing mediastinal tumour. He developed Florid M.G. after excision through a median sternotomy. The histology of the excised tumour was that of a thymoma.