Christian Chukwuemeka Madubueze

National Hospital Abuja

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Njoku Isaac Omoke

Ebonyi State University

Oladimeji Ranti Babalola

National Hospital Abuja

Agama Nnachi Egwu

Federal Teaching Hospital Abakaliki

Habila Umaru

National Hospital Abuja

Christian O. Onyebuchi Chukwu

Ebonyi State University

Kenechi Madu

National Hospital Abuja

Chinedu Gregory Nwigwe

Ebonyi State University

Peace Ifeoma Amaraegbulam

Federal Medical Centre

Kehinde Sunday Oluwadiya

Ekiti State University

NjokuI Omoke

Ebonyi State University

Cooperative Institutions

National Hospital Abuja

Ebonyi State University

Federal Teaching Hospital Abakaliki

University Teaching Hospital

University of Nigeria Teaching Hospital

Federal Neuro Psychiatric Hospital

Federal Medical Centre

Obafemi Awolowo University

Lagos State Health Service Commission

Babcock University

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Trauma during pregnancy in a Nigerian setting: Patterns of presentation and pregnancy outcome

International Journal of Critical Illness and Injury Science (2013)

NjokuI Omoke OnyebuchiK Azubike UmeoraO U Joannes Christian Chukwuemeka Madubueze

Context: Trauma is an important health concern during pregnancy in developing nations though it is under-reported.
Aims: The aim of this study was to determine the patterns of presentation and feto- maternal outcomes of trauma during pregnancy in a Nigerian setting.
Settings and Design: A hospital-based retrospective analysis of database of entire patient population who presented in Ebonyi State University Teaching Hospital, Abakaliki, with trauma during pregnancy.
Materials and Methods: The data on demographics, obstetrics, and injury characteristic in addition to the outcome of all injured pregnant women hospitalized from January 2002 to December 2010 were analyzed.
Statistical Analysis: SPSS version 16 and quantitative skills software SISA were used in data analysis.
Results: Trauma-necessitated hospitalization in 12 per 1000 pregnant women admitted in antenatal ward and was a complication of pregnancy in 4.7 per 1000 live birth in the hospital. Physical assault was the predominant causative factor and accounted for 46% of injuries whereas road traffic accident (motorcycle injury related in over 80%) was involved in 30.2% of the patients. The parity of the patients was significantly related to the trimester of pregnancy at the time of injury - 73% of grand-multiparae and about 60% of primigravida involved presented with injury in the 3 ^rd and 2 ^nd trimester, respectively (P < 0.017). Preterm delivery (7.9%), abruptio placentae (4.8%), and stillbirth (4.8%) were common obstetric complications observed. Maternal mortality of 1.6% and fetal loss of 7.9% were associated with trauma.
Conclusions: Injury prevention measures during pregnancy deserve a place in any policy response aimed at reducing feto-maternal morbidity and mortality in developing countries.

10.4103/2229-5151.124155

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Citations (16)

Traumatic extremity amputation in a Nigerian setting: patterns and challenges of care

International Orthopaedics (2011)

Njoku Isaac Omoke Christian Onyebuchi Otu Chukwu Christian Chukwuemeka Madubueze Agama Nnachi Egwu

10.1007/s00264-011-1322-7

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Day Case Anterior Cruciate Ligament Reconstruction Surgery – a Study of Early Treatment Outcomes in a Regional Orthopaedic Centre

Journal of West African College of Surgeons (2022)

Oladimeji Ranti Babalola S E Itakpe Tale Olajire Oladunjoye James Imeh Akpan Christian Chukwuemeka Madubueze

Day-case anterior cruciate ligament reconstruction has the potential benefit of reduced hospital stay and reduced cost of care. The goal of this preliminary report was to compare the outcome of day-case arthroscopic anterior cruciate ligament reconstruction with those of in-patient care in terms of pain control and short-term functional outcome.This was a prospective comparative study involving patients who had anterior cruciate ligament reconstruction performed in our unit between January 2019 to July 2021 for isolated anterior cruciate ligament rupture. The patients were offered the option of in-patient and day-case anterior cruciate ligament reconstruction. All cases were isolated anterior cruciate ligament ruptures with no other ligament injury.A total of twenty-one-day case and twenty-five in-patient anterior cruciate ligament reconstruction were managed during the period of the study. The median numeric pain scores at day 2 and 7 in the day case group was 8.0 (IQR=2.0) and 5.0 (IQR= 3.0) respectively and in-patient group was 7.0 (IQR =1.5) and 4.0 (IQR= 2.0) respectively. The international knee documentation score (IKDC) at 6 months in the day case and in-patient groups were 68.6 (IQR= 9.3) and 67.2 (IQR= 25.0) respectively. The Mann-Whitney U test indicated that patients who had ACL reconstruction on in-patient care basis had statistically significant lower visual analogue scale pain scores on the second (z=-2.58, P = 0.01) and seventh (z=-3.41 P = 0.001) post-operative days compared to patients who had ACL reconstruction on day case basis. There was no statistically significant difference in the median IKDC scores of both groups at 6 months. The cost of care in the day case group was 40% lower than those of the in-patient group.Although the cost of care in the day case group appeared lower as compared to the in-patient group, the day case group had higher post-operative pain scores compared to the in-patient group. Although the post-operative functional scores were similar in both groups, this was not statistically significant.

10.4103/jwas.jwas_125_22

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Pattern of musculoskeletal injuries in the elderly.

Deleted Journal (2008)

Christian Chukwuemeka Madubueze

The elderly are the fastest growing part of the population of most developed countries and consume a disproportionately high amount of health resources with attendant pressures on health care providers, relatives and the tax payers. 1, 2, 3,4 However there is limited information on the utililisation of health care facilities and trauma patterns among the elderly in Nigeria. The study was to determine the hospital incidence, causes and pattern of musculoskeletal injuries in elderly patients seen at National Orthopaedic Hospital Lagos (N.O.H.L). A prospective study of adults 65 years of age and older presenting at the N.O.H.L with musculoskeletal injuries from 1st August 2003 to 31st July 2004 was undertaken. Data were analysed using Chi square and Fisher's exact test. Ninety one patients were seen in this study comprising of 45 females (49.5%) and 46 males (50.5%). A total of 6,947 new patients with musculoskeletal trauma presented to N.O.H.L in this period. Incidence rate of injuries in the elderly was therefore calculated to be 276 per 10,000 patients or 2.8%.Thirty seven patients (40.7%) were between the age 65 to 69 years. 76 patients (83.5%) had bony injuries. Fifteen patients had only soft tissue injuries ranging from abrasions to avulsion injuries. Femoral fractures were commonest overall with 34 cases (46.6% of total). Most of these fractures were in the femoral neck accounting for 20 patients or 58.8% of all femoral fractures and 27.4% of all fractures. Fifty four patients (59.4%) had injuries caused by falls. 64.8% of these falls occurred at home with 48.6% of these falls occurring in the bathroom. Femoral neck fractures are the commonest fractures seen in these patients and they were mainly caused by falls in the bathroom Keywords: musculoskeletal injuries, elderly, health care, Lagos. Ebonyi Medical Journal Vol. 6 (1) 2007 pp. 44-52

10.4314/ebomed.v6i1.41500

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Attitudes of Nigerian orthopaedic surgeons to the use of prophylactic antibiotics

International Orthopaedics (2015)

Christian Chukwuemeka Madubueze Habila Umaru Abdurazaq A Alada

10.1007/s00264-015-2822-7

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Citations (11)

Road traffic injuries as seen in a Nigerian teaching hospital

International Orthopaedics (2010)

Christian Chukwuemeka Madubueze Christian O. Onyebuchi Chukwu Njoku Isaac Omoke Odion P. Oyakhilome Chidi Ozo

10.1007/s00264-010-1080-y

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Citations (52)

Arthroscopy and orthopedic residency: a cross-sectional study of training structure in a resource-constrained environment

Pan African Medical Journal (2023)

Oladimeji Ranti Babalola Kehinde Sunday Oluwadiya Christian Chukwuemeka Madubueze Ibrahim Abolaji Alabi Kenechi Madu

orthopedic residency training was established in the West African sub-region a few decades ago, but sub-specialty in arthroscopy has only become established in the last decade. This study was aimed at evaluating available arthroscopy training resources and their impact on skill acquisition by orthopedic residents.this was a cross-sectional study involving the use of a structured online survey of consultant orthopedic surgeons and orthopedic resident doctors. Details relating to the structure of training and challenges with training and recommendations for improved training were enquired.one hundred and two responses were received. There were 95% males (73) and 5% (4) females among the residents and 92% (23) males and 8% (2) females among the responding consultants. Of the residents, 47% (36) were registrars while 53% (41) were senior registrars. Seventy-six percent (77) were residents and twenty-five (24%) were consultants. Didactic lectures were the most impactful available training adjunct. Only 3% (2) of the residents had access to dry laboratory sessions with no specified number of practice hours attached. There was no computer simulation laboratory or cadaveric laboratory training facility for arthroscopy training in any of the training centres. Ninety-two percent (23) of the responding consultants would prefer a 6-12-month rotation in arthroscopy for residents. Fifty-three percent (41) of the residents had regular opportunities to participate in arthroscopic surgeries.orthopedic residency in arthroscopy in Nigeria is emerging and can be improved upon by increasing the available training resources and trained personnel.

Specialty

Cross-sectional study

10.11604/pamj.2023.45.42.36208

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Arthroscopic outside-in meniscal repair: A short-term clinical experience

African Journal of Medical and Health Sciences (2017)

RantiO Babalola EmmanuelA Laiyemo ShopekhaiE Itakpe Christian Chukwuemeka Madubueze OlaoluwaM Shodipo

Objective: Meniscal injuries are very common knee injuries that are presented to an orthopaedic surgeon. The goal of our study was to assess the early outcome of outside-in meniscal repair in the management of meniscal tears. Patients and Methods: This study was a prospective case series conducted at the National Orthopaedic Hospital, Lagos. Consecutive cases of patients with meniscal tears who met the inclusion criteria were recruited. Anterior cruciate ligament reconstruction was performed with semitendinosus autograft. Meniscal repair was performed arthroscopically by only two surgeons using the outside-in technique with size 2 polydioxanone suture. The Western Ontario and McMaster University Evaluation Tool (WOMET) score was computed during the pre-operative stage and at least 6-months post-operatively as outcome measure. The visual analogue scale (VAS) and WOMET scores in the pre- and post-operative periods were noted. Results: Five patients with injured menisci underwent meniscal repair. The median duration of follow-up was 14 months (range 8–30 months). Using Barret’s criteria, we determined that a clinically healed meniscus was obtained in only 2 (40%) patients. The WOMET score improved from a mean of 46 (±18) to 20 (±10.7) between the pre- and post-operative stages, and the mean VAS score decreased from 4.6 (±0.5) to 2.5 (±1.3). Discussion: The poor health-seeking behaviour in our environment would explain the delayed presentations of our patients. However, it has been established that chronic tears do heal. Outside-in technique remains at the moment our method of choice for meniscal repair because of the challenges we face for equipment and funding of health care in our environment. Trephination of the meniscus was performed to improve the chances of healing. Using Barret’s criteria, we had a healing rate of 40% (2). Conclusions: The outside-in technique remains an option for the treatment of chronic tears with good clinical improvement in the short term.

Meniscus

Polydioxanone

10.4103/ajmhs.ajmhs_2_17

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Citations (3)

Limb amputations in Nigeria: The National hospital abuja experience

Nigerian Journal of Surgical Research (2015)

Habila Umaru Christian Chukwuemeka Madubueze Abdulrazak Alada ChibuikeMathias Onu

Background: Limb amputation is a common live saving surgical procedure in orthopedics and trauma practice that is associated with profound psychological, social and economic consequences on patients and his family. Current reports from some parts of Nigeria suggest that diabetic complications are taking the lead as cause for limb amputations in place of trauma the traditionally known etiological factor in the country. Objectives: To review the indications for amputations in our center and to compare our findings with published information, in view of its effect on the individual and the society and to suggest preventive measures. Materials and Methods: An 8 years retrospective study of extremity amputations performed in our hospital. Data on age, gender, indication for amputation, level of amputation, and outcome of surgery were extracted from the patients' case files and the operation register. Data were analyzed using SPSS version 16 and result presented in diagrammatic and tabular form. Results: The records of 106 patients were analyzed, there were 73 males and 33 females (ratio of 2.2:1), the age ranged from 8 to 92 years with a mean age and (standard deviation) 43.76 (±18.69) years. Diabetic foot gangrene was the most common indication for limb amputation in 46 (43.3%) patients compared to trauma 22 (20.8%). Below knee amputation was the most frequent level of amputation 50 (47.2%). The most frequent complication encountered was surgical site infection in 30 (28.3%). Conclusion: Diabetic foot gangrene was the leading indication for amputation in this study. Intense public enlightenment on prevention, early detection and effective treatment of diabetes and its complications will reduce the incidence of amputations in our environment.

10.4103/1595-1103.166884

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Analysis of risk factors for wound infection after extremity fracture caused by machete cut in a resource-limited setting

African Journal of Emergency Medicine (2022)

Njoku Isaac Omoke Christian Chukwuemeka Madubueze Francis Ndubuisi Ahaotu Chinedu Gregory Nwigwe Anthony Anakweze Anagor

Machete cut fracture is a unique subset of open fracture. The sharp force of a wielded machete that cleanly divides soft tissue envelope with minimal or no contusion results in an open fracture wound that is relatively less prone to infection. However, in resource-limited settings, the wound infection rate after machete cut fracture is relatively high. This study aimed to determine the risk factors for wound infection after extremity machete cut fractures in a Nigerian setting. We undertook a retrospective analysis of the patients who were seen in the Emergency room of two tertiary hospitals in Nigeria with a machete cut extremity fracture from 2009 to 2018. The association of wound infection with population and wound characteristics as well as intervention related factors were evaluated. Statistical significant factors for wound infection in the Univariable analysis were entered into a Multivariable regression analysis to evaluate the risk of each factor when adjusted to other factors. There were 113 machete-cut fractured bones in 67 eligible patients and wound infection was a complication in 45 (39.8%) of the cases (95%CI 30.3 – 49.7%).The factors significantly associated with high wound infection rate were smoking, haematocrit < 30%, fractures sustained outdoors, lower extremity fractures, a wound size of >5cm in length, injury-to-hospital arrival interval > 6hrs. Multivariable regression analysis identified wound size >5 cm (aOR 14.142, 95%CI (2.716 - 73.636); p = 0.002), injury-to- hospital arrival interval later than 6hrs (aOR 4.410, 95% CI (1.003-19.394); p = 0.050) and administration of antibiotics later than 3hrs of injury (aOR 5.736, 95%CI (aOR1.362 - 24.151; p = 0.017) as independent risk factors for wound infection. Wound infection after open fractures caused by machetecut is more likely to occur in patients that present later than six hours after injury, wounds more than 5cm in length and delayed antibiotic administration. Appropriate treatment protocols can be instituted with this knowledge.

Open fracture

Wound infection

10.1016/j.afjem.2022.05.002

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Citations (2)