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Traditional bone setter's gangrene (TBSG) is the term we use to describe the sequelae sometimes seen after treatment with native fracture splints. Twenty five consecutive complications were recorded in 25 patients aged between 5-50 years with a median age of 10 years. The major complication of the native fracture splint treatment was distal limb gangrene necessitating proximal amputations in 15 cases.

A study was made of 100 major amputations performed on 96 patients in two regional hospitals in a 10-year period in Nigeria. The objective of the study was to evaluate the outcome of major amputations in Nigeria. The median age of patients was 30 years with male to female ratio 3:1. Ninety of the 100 major amputations involved the lower limbs with the above-the-knee/elbow-the-knee ratio of 0.5. Trauma was the leading indication for 70 amputations, of these 60 were iatrogenic resulting from mismanaged fractures by the traditional bone setters. The non-traumatic indications were: diabetic limb gangrene (20); bone malignancies (9); and vascular insufficiency (1). Provisional amputation was offered in 60 cases, of these 10 had reamputation. There were eight (8.5%) mortalities. The functional outcome for this group was discouraging. Only 25 amputees affording successful prosthetic fitting and social rehabilitation. Major amputation in Nigeria foreshadows a dismal existence and emphasizes the need for health policies which are effective in controlling the risk factors.

In 60 controls and 108 patients admitted with acute abdominal pain, Rapignost urinary amylase correctly identified (++) 18 of the 23 patients with acute pancreatitis (AP), with 8 results being equivocal (+), and 1 false negative. This is a suitable screening test for AP, but an equivocal result requires further investigation. In 14 patients with AP the serum amylase was over 1000 U/l with no false-positive results, whereas when 316 U/l was used as the diagnostic threshold, 22 cases were identified (but with 2 false positives). Serum lipase was 100% sensitive in the diagnosis of AP, but there were three false-positive results.

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