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   2018| March-April  | Volume 59 | Issue 2  
    Online since June 10, 2019

 
 
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ORIGINAL ARTICLES
Traumatic hip dislocations in an orthopedic center in Lagos
Ranti Oladimeji Babalola, Emmanuel Adeyinka Laiyemo, Siyaka Simpa Audu, Kehinde Adesola Alatishe, Chukwudalu Nnamdi Ijezie
March-April 2018, 59(2):20-23
DOI:10.4103/nmj.NMJ_139_18  PMID:31263318
Background: Hip dislocations are one of the orthopedic emergencies. They may result from a high-energy transfer as in a road traffic crash. Prompt recognition and treatment can reduce the long-term morbidity associated with delayed reduction. The goal of this study was to evaluate the epidemiology and outcome of treatment. Patients and Methods: This was a retrospective study that involved cases of traumatic hip dislocations seen at the National Orthopedic Hospital, Lagos, Nigeria, between January 1, 2010 and June 30, 2014. Biodemographic characteristics, mechanism of injury, and type of dislocations were retrieved from case files. Thompson and Epstein type of the dislocated hips as well as the presence of pre- and post-reduction complications was noted. Results: Forty-five patients had hip dislocations in the study period. Only 27 had the relevant information to be included in the study. All cases were posterior hip dislocations. The median follow-up was 9 months (range 6–30 months). More dislocations occurred on the left [18 (67.0%)] than on the right [9 (33.0%)]. The median age of patients was 37 years (range 21–73 years). Twenty-six dislocations (96.3%) were due to road traffic crash and a case (3.7%) was due to an industrial accident. Grade IV Epstein was the most common injury recorded. Twenty-four (89.0%) cases were managed with closed reduction, whereas the remaining 3 (11.0%) cases had open reduction. The associated complications observed were sciatic nerve injury, avascular necrosis of the head of the femur, and protrusio acetabuli. Conclusion: Road traffic crash remains a leading cause of traumatic hip dislocation. Severity of injury and delay in reduction contributes to the complications of treatment.
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Hematological indices of patients with retained lead pellets in the craniomaxillofacial region following gunshot wounds
Ekaniyere Benlance Edetanlen, Dauda B Saheeb
March-April 2018, 59(2):15-19
DOI:10.4103/nmj.NMJ_30_18  PMID:31263317
Background: Acute and chronic environmental lead exposures are associated with alteration of hematological parameters. It is not known whether retained lead pellets have similar effects on hematological variables to environmental exposures. Objective: The objective of this study is to assess the effects of retained lead pellets on hematological indices in patients that sustained gunshot injuries to the craniomaxillofacial region. Patients and Methods: We examined individuals with retained pellets following gunshot injuries to the craniomaxillofacial region using a prospective cohort study design in a tertiary health center, Nigeria. Results: A total of 54 male individuals (27 in each group) enlisted in the study. The age of the patients and control subjects ranges from 20 to 58 years, with a mean age of 40.3 years. The mean blood lead levels (BLLs) of the exposed group were lower than the unexposed (P = 0.03). There were statistically significant (P < 0.05) variations in the hematological indices between the exposed and the unexposed groups. There was a significant association (P < 0.001) between the hematological indices assessed and the BLLs, number of retained pellets, and duration of retention. No basophilic stippling was observed in the red cell morphology of the individuals. Conclusion: Retained lead pellets cause significant elevated BLL and associated higher hematocrit, hemoglobin concentration, and mean cell volume.
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