Non-union treatment outcomes in South-East Nigeria

Madu, Kenechi; Nnyagu, Henry; Ede, Osita

doi:10.4103/njot.njot_23_18

Cited by 3 publications

(11 citation statements)

References 1 publication

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“…We encountered a lower incidence of complications than reported by previous authors who used implants other than locked IM nail: Three humerus fracture cases (15%) had radial nerve palsy which had recovered by the 12th week follow-up, but Madu et al 11 and Olasinde et al 12 reported 23.5% and 27.3% respectively in patients treated with plate and screws. One tibia fracture had superficial surgical site infection which healed with debridement and antibiotic treatment while three (3.1%) fractures had deep infection for which the implants were removed after the fractures had healed.…”

Section: Discussionmentioning

confidence: 49%

“…Conversely, Ogunlade et alwho treated similar fractures with plate and screws in an analogous population initially mobilised their patients on non-WB crutches for 6–8 weeks, partial WB when callus was radiographically visible and full WB only when the fracture was “judged to have healed enough”, the whole process taking 3–4 months 9 . Another comparable study by Madu et al 11 reported a better outcome with locked IM nailing than plating of femoral non-unions. Locked IM nailing is known to tolerate early WB and joint motion 1 , 11 .…”

Section: Discussionmentioning

confidence: 87%

“…Another comparable study by Madu et al 11 reported a better outcome with locked IM nailing than plating of femoral non-unions. Locked IM nailing is known to tolerate early WB and joint motion 1 , 11 . Hence, immediate WB as tolerated has been recommended for tibial and femoral shaft fractures treated with locked IM nail whereas initial 6–8 weeks of touch-down WB followed by progressive WB is recommended for plate and screws osteosynthesis of similar fractures 5 .…”

Section: Discussionmentioning

confidence: 87%

“…Thus, most surgeons in LMICs have continued to treat AFUs with methods which are less compatible with early WB. These include external fixation, and internal fixation using plates or unlocked intramedullary (IM) nails [9][10][11][12] .Long bone fractures have been turned into an epidemic by rapid urbanizations, increased use of motorized vehicles and incessant violent incidents in many LMICs. Regrettably, traditional bone-setting (TBS) has continued to flourish in LMICs as the first line (or the only) care for these injuries.…”

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confidence: 99%

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confidence: 99%

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Solid locked intramedullary nailing for expeditious return of bone-setting-induced abnormal fracture union victims to work in South-western Nigeria

Adesina

Eyesan

Amole

et al. 2022

Sci Rep

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Wage earning in low- and middle-income countries (LMICs) is predominantly through physical labour. Consequently, limb-related disabilities caused by abnormal fracture unions (AFUs) preclude gainful employment and perpetuate the cycle of poverty. Many AFUs result from traditional bone-setting (TBS), a pervasive treatment for long bone fractures in LMICs. The objective of this study was to accentuate the expediency of solid locked intramedullary nail in the early restoration of victims of TBS-induced abnormal fracture unions (AFUs) to their pre-injury functioning, including work. One hundred AFUs in 98 patients treated with a solid locked intramedullary nail in our center over a period of 7 years were prospectively studied. We found the mean age to be 47.97 years. Males constituted 63.9% of the patients’ population. Atrophic non-union accounted for 54.1% of the AFUs. The mean fracture-surgery interval was 21.30 months. By the 12th post-operative week, more than 75% of the fractures had achieved knee flexion/shoulder abduction beyond 90°, were able to squat and smile (or do shoulder abduction-external rotation), and were able to bear weight fully. The study demonstrated the expediency of solid locked nail in salvaging TBS-induced abnormal fracture unions in a way that permitted early return to pre-injury daily activities and work, thereby reducing fracture-associated poverty.

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Section: Discussionmentioning

confidence: 49%

Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 87%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Solid locked intramedullary nailing for expeditious return of bone-setting-induced abnormal fracture union victims to work in South-western Nigeria

Adesina

Eyesan

Amole

et al. 2022

Sci Rep

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Follow-up non-attendance after long-bone fractures in a low-resource setting: a prospective study of predictors and interventions to increase attendance rates

Adesina,

Amole,

Akinwumi

et al. 2023

BMC Health Serv Res

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Background While the majority of traumatic injuries occur in low- and middle-income countries, the published literature comes chiefly from high-income countries due to poor follow-up. Clinical and radiographic post-surgical trauma follow-up is essential to high-quality research and objective monitoring for healing and/or complications. This study aimed to identify the predictors of follow-up non-attendance in a low-resource setting and investigate the extent to which interventional efforts based on mobile phone technology (MPT) and home visits improved the follow-up rates for fractures treated with SIGN nails. Methods This was a prospective study of 594 patients with long-bone fractures. Socio-demographic (e.g. age, gender, marital status, education level, etc.) and clinical (e.g. fracture type, concomitant injuries, comorbidity, etc.) data were collected on each patient. Before discharge, the importance of follow-up was explained to patients and their relations. They were encouraged to attend even if they felt well. Their residential addresses and telephone numbers were validated and securely stored. Patients who missed their appointments were contacted by phone. Those who failed to honour 2 or 3 rescheduled appointments were visited in their home. The patients were divided into those who returned for the primarily scheduled follow-up without prompting (volition group) and those who did not come (non-attenders). Univariate analyses and binary logistic regression were conducted to determine the significant predictors of non-attendance. Results The proportion of patients in the volition group reduced from 96.1% at 6 weeks to 53.0% at 12 weeks and 39.2% at 6 months. However, interventional efforts increased these values to 98.5%, 92.5%, and 72.4% respectively. Walking unaided before the primarily scheduled 12-week appointment was the major reason for not attending the follow-up. Education, occupation, post-operative length of hospital stay (PLOS) and infection were significantly associated with non-attendance but younger age, long distances from the hospital, being separated or divorced, difficulty paying the in-patient care bill, closed fracture, having no (or a non-limb) concomitant injury, achieving painless weight bearing ≤ 6 weeks post-operatively and needing no additional surgery were independent predictors of non-attendance. Conclusions Our study sheds light on the predictors of follow-up non-attendance and demonstrates how interventional efforts improved attendance rates in a low-resource setting. In addition, efforts that better the socio-economic status of people such as more-encompassing health insurance coverage and greater work flexibility can improve the follow-up attendance rates.

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Early Treatment Outcome of Humeral Shaft Fracture Non-Union in Adults: Comparative Study of Plating versus Interlocking Nailing

Galadima,

Ajiboye,

Salihu

et al. 2024

Health

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Background: Fractures of humeral shaft in adults are common injuries. Humeral shafts non-union either from late presentation after initial treatment by traditional bone setters or failed non-operative orthodox care is a major problem in this part of the world. This non-union is a major treatment challenge with increased cost of care and morbidity in this part of the world. Humeral shaft non-union can be treated with locked intra-medullary nailing (LIMN) or dynamic compression plating (DCP). Study on comparison of these methods of fixation in this part of the world is scarce in literature search, hence the reason for this study. Objective: The objectives of this study are:(1) to compare early clinical outcome following fixation of humeral shaft fracture nonunion with DCP versus LIMN; (2) to compare the time of radiologic fracture union of DCP with LIMN; (3) to compare complications following fixation of humeral shaft fracture nonunion with DCP versus LIMN. Patients and Methods: This was a randomized control study done for 2 years in which fifty adult patients with humeral shaft non-union were recruited. The patients were grouped into 2 (P = DCP & N = LIMN). Forty five of the patients completed the follow up periods of the study and then analyzed. The P group had ORIF with DCP while the N group had ORIF with LIMN. Both groups had grafting with cancellous bones. Each patient was followed up for a period of 6 months at the time which radiographic union is expected. Any patient without clinical and/or radiographic evidence of union after six months of surgery was diagnosed as having recurrent non-union. The data generated was analyzed using SPSS Version 23. The results were presented in charts and tables. The paired t-test was used while considering p value < 0.05 as statisti-

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Non-union treatment outcomes in South-East Nigeria

Cited by 3 publications

References 1 publication

Solid locked intramedullary nailing for expeditious return of bone-setting-induced abnormal fracture union victims to work in South-western Nigeria

Solid locked intramedullary nailing for expeditious return of bone-setting-induced abnormal fracture union victims to work in South-western Nigeria

Follow-up non-attendance after long-bone fractures in a low-resource setting: a prospective study of predictors and interventions to increase attendance rates

Early Treatment Outcome of Humeral Shaft Fracture Non-Union in Adults: Comparative Study of Plating versus Interlocking Nailing

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