Orthopaedic aspects of sickle-cell disease at Kenyatta National hospital
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Date
1991-04Author
Odwongo, Simon P
Type
ThesisLanguage
enMetadata
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A retrospective study of 100 patients with orthopaedic aspects of
sickle-cell disease was carried out. Males and females were almost
equally affected in a ratio of 1.3: 1.2. A half of the patients (50%) were
below 5 years of age and the least number was after 20 years of age. Most
patients originated from Nyanza province (76%) followed by Western
province (19%) with a few from Rift Valley and Coast provinces (1% and
2% respectively). Most patients presented generally with pain (87%) and
swelling (82%) while nearly a half had fever (49%) and limping or loss of
function of the affected limb (41%). Swelling, tenderness and warmth
were the predominant local signs in percentages of 83, 68 and 31
respectively. The mean haemoglobin level was 7.8 gldl in the 86 patients
who had results in the file. The majority of patients were HbSF (55%)
and followed by sickle-cell anaemia (HbSS - 35%). Blood culture and pus
swab specimens taken from patients with osteomyelitis and septic
arthritis had no growth demonstrated in 31 patients (57.4%) while
isolation was done in the remainder of patients. Bacterial isolates
revealed Salmonella typhimurium to be the predominant organism
(8patients (14.8%) and 4 patients (30.8%)) in osteomyelitis and septic
arthritis respectively. Radiologically the limbs (appendicular skeleton)
was dorminantly affected (99.5%). 119 lesions were diagnosed in the
study group. Osteomyelitis ranked first (45.4%) followed by hand and
foot syndrome (dactylitis) (24.4%) in the clinical diagnosis. Entities of
respective orthopaedic aspects of sickle-cell disease such as haemoglobin
electrophoresis, anatomical sites, treatment, results and complications
are discussed.
Citation
A Dissertation Submitted In Part. Fulfilment For The Degree Of Master Of Medicine (surgery) Of The University Of Nairobi.Publisher
University of Nairobi