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Biomedical subjects

C U Nwadinigwe

Publications and source records attributed to C U Nwadinigwe.

4 recordsLinked to original sources
PubMedDate not supplied

Unwholesome trauma care: a cautionary note.

BACKGROUND: Trauma care requires proper training on how to diagnose life and limb threatening conditions. The aim of this paper is to report an extreme case of unwholesome practice that drained the patient physically, emotionally and financially. METHODS: The medical record of the patient and relevant literature were reviewed. RESULT: A 25-year-old commercial motorcyclist (okada) presented with a huge discharging leg ulcer with exposed plate and necrotic distal half of the right tibia on the account of uninformed treatment he received from his primary physician and a traditional bonesetter spanning a period of five months. The foot was found to be grossly deformed and insensate. Below knee amputation was done as salvage. CONCLUSION: Our undergraduate curriculum should change to expose medical students more to basic trauma care. A designated body should regulate activities of traditional bonesetters. The practitioners should be made to undergo some form of training to recognize high-risk trauma patients and the need for early referral.

Accidents, Traffic↗
PubMedDate not supplied

Fractures in children.

BACKGROUND: The burden of diseases in children in our environment is dominated by infections and malnutrition; paediatric trauma has low advocacy and as such is given scant attention. The aim of this study is to review and describe the pattern of paediatric fractures in our local setting. METHOD: A retrospective review of all the medical records of children below the age of fourteen years who were admitted to our center on account of major trauma between January 1999 and December 2003 was done. Those with incomplete records were excluded. RESULTS: The patients ranged in age from 1 +/-13 years with mean of 6.7 +/- 2.9 years. They were mostly males 60 (61.2%) and females 38 (38.8%). The causes of the accidents were diverse. Road traffic accidents were most common 47(51%). A great number of these resulted from unguarded children hit by motor vehicles while crossing the road 33 (36.7%). Forty-one (41.8%) patients fell from various heights. Of these number thirty (30.6%) fell while playing. Most fractures were close 70 (71.4%) while 25 (25.5%) were open fractures and 3 (3.1%) pathological fractures. The most common site of injury was the femoral shaft 33.7%; this was followed by fractures of the supracondylar region of the humerus 17.3%, distal radius 15.3% and tibialfibula 15.3%. More than half of the patients 58 (59.2%) presented fresh to our hospital, while 27 (27.6%) presented initially to traditional bonesetter (TBS) and 13 (13.3%) were referred from private practitioners. Of those twenty-seven patients from the TBS, seven came with compartment syndrome and three had frank gangrene. Most of the patients were managed conservatively. Preliminary traction followed by plaster of Paris (POP) application in 36 (36.7%), and manipulation under anaesthesia (M.U.A) and POP (30.6%), were common definitive treatments given. Sixteen patients (16.3%) had open reduction and internal fixation. Acute compartment syndrome 7 (7.1%) and frank gangrene 3 (3.1%) were the commonest complications and were due to late referral by traditional bonesetters. CONCLUSION: In our environment, fractures in children are common and are frequently associated with morbidities due to interference by traditional bonesetters. These injuries are highly preventable and paediatric trauma prevention strategies directed at parents, children as well as other road users would help to reduce the burden of such fractures especially in the developing countries where the burden of other childhood diseases obscures trauma care.

Accidents↗
PubMedDate not supplied

Traumatic spinal cord injuries (SCI): a study of 104 cases.

BACKGROUND: Management of spinal cord injured patients is an integral part of trauma care. There is need to congregate these patients in spinal units where dedicated experts and facilities exist for better outcome of treatment and rehabilitation. The objective of this study therefore, is to promote improved quality of care in the group of patients by highlighting the deficiencies in our setting. METHODS: This is a retrospective study of all traumatic spinal cord injured (SCI) seen at the National Orthopaedic Hospital, Enugu over a six-year period. Information about the demographics, aetiology, level of injury, associated injuries, time of presentation, referral hospital, state of injury, duration of hospitalization, outcome of treatment were obtained from patients' records. Data were analyzed using commercially available SPSS for windows 9. Descriptive statistics are given. RESULTS: There were 104 patients, 88 males and 16 females, giving a ratio of 5.5:1. Road traffic accident, 60 (57.7%), was the commonest aetiological factor and the cervical spine, 70 (67.3%), was most often involved. Head and neck injuries were common associated injuries, 19 (18.3%) in patients with cervical spine injury. Six (5.8%) of our patients were obtunded. Most patients, 69 (66.4%), were received from private hospitals after a mean duration of 7 days. Hospitalization ranged from 1 week-120 weeks with a mean of 11 weeks. Pressure sore was the commonest complication, 30 (28.8%). Thirty six (34.4%) of patients died mainly from respiratory failure. Most of the discharged wheel bound patients (97%) were lost to follow up. CONCLUSION: For better outcome we re-emphasize the need to establish and congregate these patients into regional spinal units. We also suggest a social legislation, which will be fundamental to social re-integration of these SCI and other severely disabled patients.

Adolescent↗