Pathologic fractures of long bones in Nigerian children

Journal of Children's Orthopaedics - Tập 2 - Trang 475-479 - 2008
Akinyele Lawrence Akinyoola1, Elkanah Ayodele Orimolade1, Moruf Babatunde Yusuf1
1Department of Orthopaedic Surgery and Traumatology, Obafemi Awolowo University, Ile-Ife, Nigeria

Tóm tắt

Pathologic or spontaneous fractures are recognised causes of morbidity in children. There is a paucity of data on their aetiology and patterns in African children. A combined retrospective and prospective study of 47 children aged 15 and below with pathologic fractures of long bones seen from January 2000 to December 2006. The setting was the Orthopaedic and Traumatology department of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. A total of 47 patients with a mean age of 5.3 years ± SD with pathologic fractures of 50 long bones were seen and treated. The most commonly affected bones were the femur (28%), tibia (28%) and humerus (26%). Chronic osteomyelitis following inadequately treated acute haematogenous osteomyelitis was the commonest cause of pathologic fractures (74.5%). The mean duration of fracture union was 6.8 ± 2.3 months and the outcome was satisfactory in 91.4% of cases. The aetiology of pathologic fractures in the African population is different from their causes in Caucasian children. Chronic osteomyelitis following inadequately treated acute haematogenous osteomyelitis continues to plague many children in our environment.

Tài liệu tham khảo

Knorr P, Schmittenbecher PP, Dietz HG (1996) Treatment of pathological fractures of long tubular bones in childhood using elastic stable intramedullary nailing. Unfallchirurg 99(6):410–414 Vigler M, Weigl D, Schwarz M, Ben-Itzhak I, Salai M Bar—On E (2006) Subtrochanteric femoral fractures due to simple bone cysts in children. J Pediatr Orthop B 15(6):439–442 Ortiz EJ, Isler MH, Navia JE, Canosa R (2005) Pathologic Fractures in children. Clin Orthop Relat Res 432:116–126, doi:10.1097/01.blo.0000155375.88317.6c Rang M, Wenger D, Mubarak S (2005) Fractures in Special circumstances. In: Rang M, Pring ME, Wenger DR (eds) Rang’s children’s fractures, 3rd edn. Lippincott, Williams and Wilkins, USA, pp 285–288 Presedo A, Dabney KW, Miller F (2007) Fractures in patients with cerebral palsy. J Pediatr Orthop 27(2):147–153 Ebong WW (1986) Pathological fracture complicating long bone osteonyelitis in patients with sickle cell disease. J Pediatr Orthop 6(2):177–181 Oyemade GAA, Dawodu AH, Olusanya AOA (1977) Osteomyelitis in Nigerian children (A review of 40 cases). J Trop Med Hyg 80(9):183–186 Gelfand MS, Cleveland KO, Heck RK, Goswami R (2006) Pathological fracture in acute osteomyelitis of long bones secondary to community-acquired methicillin-resistant Staphylococcus aureus: two cases and review of the literature. Am J Med Sci 332(6):357–360, doi:10.1097/00000441-200612000-00010 Ogunjumo DO (1982) The clinical pattern of chronic pyogenic osteomyelitis in a Nigerian community. J Trop Med Hyg 85(5):187–194 Ebong WW (1986) Acute osteomyelitis in Nigerians with sickle cell disease. Ann Rheum Dis 45:911–915, doi:10.1136/ard.45.11.911 Nwadiaro HC, Ugwu BT, Legbo JN (2000) Chronic osteomyelitis in patients with sickle cell disease. East Afr Med J 77(1):23–26 Essien IAJ, Ndukwe AU (1994) Chronic ossteomyelitis: a 12-month experience at the National Orthopaedic Hospital, Enugu. Niger Postgrad Med J 3(1):22–25 Epps CH Jr, Bryant DD, Coles MJ, Castro O (1991) Osteomyelitis in patients who have sickle cell disease. J Bone Joint Surg Am 73:1281–1294 Alonge TO, Ogunlade SO, Omololu AB, Fashina AN, Oluwatosin A (2002) Management of chronic osteomyelitis in a developing country using ceftriaxone–PMMA beads: an initial study. Int J Clin Pract 56(3):181–183 Alonge TO, Ogunlade SO, Omololu AB (2003) The Belfast technique for the treatment of chronic osteomyelitis in a tropical teaching hospital. Int Orthop 27:125–128 SICOT