RESUMEN

BACKGROUND: Trauma is now one of the fastest growing epidemics globally but low and middle-income countries (LMICs) are more severely affected in terms of cost, disability and death. The high-energy trauma of road traffic accidents and violence often produces open fractures which can be difficult to manage in resource-poor settings. Adequate stabilization, such as provided by locked nails, has been found to ensure better outcome for open fractures. There is dearth of published studies on the use of locked intramedullary nail in the treatment of open fractures in Nigeria. METHODS: This is a prospective observational study of all the 101 open fractures of the humerus, femur and tibia treated over a period of 92 months with Surgical Implant Generation Network (SIGN) nail. Fracture severity was classified according to the modified Gustilo-Anderson system. The intervals between fracture and antibiotics administration, débridement and definitive fixation, as well as surgery duration and method of fracture reduction were noted. Outcomes measured at follow-up included infection, ongoing radiographic healing, knee flexion/shoulder abduction beyond ninety degrees (KF/SA > 900), full weight bearing (FWB), painless squatting (PS&S)/shoulder abduction-external rotation (SAER). RESULTS: Most of the patients fall between ages 20 and 49 years; 75.5% of them were males. There were more Gustilo-Anderson type IIIA fractures than other types but nine type IIIB tibia fractures were also nailed. The overall infection rate was 15%, contributed mostly by the type IIIB fractures. By the 12th post-operative week, at least 79% had ongoing radiographic healing and had achieved all of KF/SA > 900, FWB, and PS&S/SAER. CONCLUSION: The SIGN nail's solid construct reduces the risk of infection and allows earlier use of the limb, making it particularly suitable in LIMCs where socioeconomic functioning often requires an unhindered use of the limbs.

Asunto(s)

Fijación Intramedular de Fracturas , Fracturas Abiertas , Masculino , Humanos , Adulto Joven , Adulto , Persona de Mediana Edad , Femenino , Fracturas Abiertas/epidemiología , Fracturas Abiertas/cirugía , Fijación Intramedular de Fracturas/efectos adversos , Nigeria/epidemiología , Extremidades , Fijadores Internos

RESUMEN

Angiofibrolipoma is a neoplasm composed of fibrocytes, capillaries and matured adipose tissues. It is a rare histopathologic variant of lipoma, characterized by matured adipocytes, blood vessels and dense collagenous tissues. It is an extremely rare tumor with very few cases reported in the literature. We are reporting a 9-year-old boy who presented with a right calf swelling noticed since birth, slowly increasing in size which became painful about a year prior to presentation (at about the age of 8 years). The mass extended from the popliteal fossa to the junction of the gastro-soleus. Mid calf circumference on the right was 44 cm and 24 cm on the left. Clinically there was no foot drop. He had neither preceding trauma nor fall. He had no systemic symptom. Pre-operative plain radiographs, incisional biopsy and other ancillary investigations were done. Histopathology result after excisional biopsy revealed angiofibrolipoma and postoperative clinical improvement was significant. To our knowledge, such a case has not been previously reported in the literature.