BackgroundTuberculous tenosynovitis poses a significant public health challenge, especially in developing countries. It usually affects the flexor tendons of the wrist.Case presentationWe present a case of a 65-year-old Ghanaian female. She presented a progressively enlarging mass over the volar aspect of the right wrist and palm. She did not have a previous history of tuberculosis. However, her erythrocyte sedimentation rate was high and Mantoux (purified protein derivative) test was strongly positive (more than 15 mm). Radiograph of ulna, radius, and wrist showed osteopenic changes around the distal radius. Excision biopsy of the mass was done and samples sent for histopathology comment. The findings were an inflamed, thickened synovia with rice bodies: suggestive of tuberculous tenosynovitis. Anti-tuberculous chemotherapy was commenced on the second postoperative day.ConclusionTuberculous tenosynovitis of the wrist is uncommon. However, in developing countries like Ghana where tuberculosis is prevalent, it should be part of the differential diagnosis of compound palmar ganglion in order to prevent delayed diagnosis and treatment.
Background: The study aimed at assessing the impact of the availability of battery-powered drills on the management of orthopedic cases presenting to the orthopedic unit of the department of surgery at a major teaching hospital serving the southern part of Ghana.Methods: This study was a single center retrospective study. Authors examined the total number of cases, average time spent on cases in the operating room, and the average patient waiting time for surgery between January 2012 and December 2014. A paired sample t-test was used to evaluate the effectiveness of the orthopedic drills for the pre-and post-intervention periods.Results: There were statistical significant differences in the total number of cases (p<0.01), the average time spent on cases in the operating room (p<0.01), and the average waiting time for surgery (p<0.05) between January 2012 to June 2013 when manual hand drills were in use and July 2013 to December 2014 when the battery-powered drills were introduced.Conclusions: The introduction of the battery-powered drills led to a significant improvement in the total number of cases done. There was a reduction in time spent per case in the operating room as well as the average waiting time to having surgery.
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