Sickle cell disease is an autosomal recessive disorder that is common in people of African, Middle-Eastern and Mediterranean ancestry and its incidence varies from 10 to 40% of the population across equatorial Africa. The homozygous sickle cell disease affects about 2% of neonates in Nigeria and accounts for 25% of deaths in children under 5 years in Africa annually. The most common clinical manifestations are pain and anaemia. Pain associated with sickle cell pain crisis is usually severe, requiring treatment with strong opioids in addition to other interventions such as oxygen therapy and hydration with isotonic solutions. In order to accommodate the complex biopsychosocial components of this condition, pharmacotherapy, psychotherapy, functional restoration and other nonopioid pharmacotherapies need to be integrated in a multidisciplinary protocol for optimal outcome. There is a dearth of studies on the ideal analgesic regimen in the management of sickle cell crisis. Adoption of morphine PCA as the Gold standard in this condition is derived from studies on acute pain management protocols that are nonspecific for sickle cell pain crisis. More research is needed to identify the most appropriate opioid analgesic protocol in the management of sickle cell pain crisis. Such study requires exploration of alternative methods of opioid administration as PCA equipment may not be universally accessible in places (especially, resource-limited settings) where sickle cell disease is most endemic.

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Champy plates are becoming more and more accepted for the fixation of simple mandibular fractures. Champy plates have the following advantages over other metbods: the plates are small, flexible, easily adaptable and the monocortical screws allow a rapid surgical application. This case report and literature review examined the use of a locking bone plate/screw system for use in mandibular surgery. The use of a locking plate/screw system was found to be simple, and it offers advantages over conventional bone plates by not requiring the plate to be compressed to the bone to provide stability.

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