Background Psychological distress is a significant and growing public health concern in patients with musculoskeletal injuries. Open tibia fractures are among the most common injuries with both physical and psychological impacts. However, most care focuses on physical management, such as medications and surgery, with limited attention given to the mental aspect, leading to suboptimal outcomes. Methods A descriptive cross-sectional study was conducted among patients with open tibia fractures treated at Muhimbili Orthopaedic Institute. A consecutive sampling method was used, where a structured questionnaire was administered during face-to-face interviews to gather data from participants. The mental health domain scores of the short form 36 were utilized to evaluate the likelihood of psychological distress and emotional well-being among study participants. Results A total of 328 patients with a mean age of 35.04 ± 12.61 years were enrolled in the study after meeting the inclusion criteria. They were primarily male (80.8%) and roughly half had completed secondary education (54.3%). Most participants were single (70.1%), had no formal employment (81.1%), and lived below the poverty line, with 68% of them earning less than $200 USD monthly. Notably, 91.5% of them lacked health insurance. The proportion of psychological distress was found to be 66.5%, which was significantly associated with lower education levels, unemployment, low income, acute post-injury phase (three weeks), clinical complications, and poor social support. Conclusion There is a higher level of psychological distress among patients with open tibia fractures in our setting, which warrants the need to consider the psychological component of treatment when caring for them based on their risk profile.
Background Persistent anterior knee pain (AKP) is a complication post-total knee arthroplasty (TKA), primary or revision, due to patellofemoral joint, malalignment, and prosthetic designs. TKA is an intervention for end-stage knee osteoarthritis for pain relief and restoration of function. Several studies advocate non-resurfacing because a native patella enhances kinematics and improves patients’ satisfaction. We aimed to identify the incidence of persistent AKP and quality of life after TKA, 6-month pre- and postoperative. Methods A retrospective cohort study by consecutive sampling for 103 patients, with a mean age of 66.65 years, who met the inclusion criteria, gave informed consent, and had undergone TKA with non-resurfacing of the patella between 2019 and 2023 (94 Primary and 9 Revisions) at St. Luke’s Orthopaedic and Trauma Hospital, Kenya. Ethical approval was given by the Institutional Research and Ethics Committee and licensed by the National Commission for Science, Technology and Innovation. Data were collected from surgical registers, medical files, and telephone interviews using the Kujala Score and the 36-item short form survey instrument (SF-36). Study variables were demographic characteristics, functional outcome, and overall patient satisfaction, and were analyzed using descriptive statistics and paired sample t tests for pre- and postoperative scores. McNemar’s test for paired categorical variables. Statistical significance was set to have a P < .05, and effect sizes were calculated with Cohen’s d and phi coefficient (φ). Results The Kujala score improved from 36.07 ± 7.19 preoperative to 67.84 ± 3.73 postoperative (t = 39.51, P < .0001). McNemar’s test revealed a highly significant reduction of 84.5% in pain following surgery (χ² = 87, P < .0001) and an incidence of 15.5% (16) of persistent AKP with non-patella resurfacing with the SF-36. Conclusion We had improved functional outcomes and quality of life at 6 months after the operation. These findings suggest that routine resurfacing may not be necessary, so a selection approach should be guided by patient characteristics, intraoperative findings, and implant design, especially in resource-limited settings.
Background Sigmoid volvulus (SV), a condition in which the sigmoid colon twists around its mesentery, is the most common cause of intestinal obstruction in our institution and can lead to gangrene if not treated promptly. The study aimed to address the limited data on clinical outcomes for gangrenous SV in the country. Methods A prospective cohort study was conducted on 40 patients at the University Teaching Hospitals in Lusaka, Zambia between May 2024 and April 2025. Data was collected using a researcher-administered structured questionnaire. Patients were followed up for a minimum period of 30 days postoperatively. Univariate and multivariate analysis were carried out using R. A P value of < .05 at 95% confidence interval was considered significant. Results The results showed no significant differences in baseline characteristics such as age, body mass index, and blood pressure between the two groups. The median hospital stay was 9 days for the RPA group and 8 days for the Hartmann’s group, which was not a significant difference (p = .457). Postoperative complications occurred in 22.5% of all patients, with no significant difference between the resection and primary anastomosis (RPA) group (20%) and the Hartmann’s group (26.7%). Common complications included surgical site infections and stoma-related issues. An anastomotic leak occurred in 16% of patients who underwent primary anastomosis. Mortality was low and comparable between both groups (RPA: 8%; Hartmann’s: 6.7%). Conclusions RPA was the more frequently performed procedure and demonstrated similar outcomes to Hartmann’s in terms of complications, hospital stay, and mortality. These findings suggest that RPA can be safely performed in selected patients with gangrenous SV, especially where adequate surgical expertise and perioperative care are available.
Fragility fractures of the femoral neck in young adults are uncommon. Neurolathyrism has been linked to pathologicalfractures, but femoral neck involvement has not been specifically described. We report a low-energy femoral neck fracturein a patient with longstanding neurolathyrism who was managed with a valgus intertrochanteric osteotomy. The pathwaysthrough which neurolathyrism increases fracture susceptibility remain poorly understood. Possible contributors includereduced mobility and abnormal loading from spastic paraparesis and direct toxin-related effects of Lathyrus sativus on bonestructure and osteoblastic function. This report presents the case and reviews the literature to summarize biological andmechanical factors that may increase fracture risk in this population.
Background Since 2015, surgery has gained recognition in broader global health agendas, yet the delivery of care across Africa remains below international targets. The Pan-African Surgical Conference (PASC) 2025 was formed to engage multidisciplinary experts in dialogue to troubleshoot challenges with critical surgical workforce expansion. This report summarizes key themes and recommendations from the meeting. Methods The 5-day program was developed by an international steering group and included 5 domains: surgical education, innovation, balanced surgical ecosystems, research, and policy and advocacy. Audio recordings underwent thematic analysis to identify recurring concepts and develop a list of recommendations, enhancing the session transcripts. Results More than 550 delegates from 36 countries (23 in Africa) attended the meeting. Hands-on training was provided to 204 participants through preconference workshops, including microsurgery stimulation, life support certification, pain management, nontechnical skills, and global surgery advocacy. Fifty-nine oral abstracts and 54 posters were presented in the scientific program. Most submissions (78.9%) were led by African investigators. The following 6 recommendations emerged from the meeting dialogue: (1) strengthen a pan-African network of surgical providers, policy experts, and researchers; (2) expand intracontinental leadership and training pathways; (3) promote policy reforms that increase workforce capacity and equitable access to surgical care; (4) expand research capacity to enhance contextually relevant research led by African investigators; (5) embrace innovation and technological advancements to enhance efficiency; and (6) prioritize investment into locally driven and sustainable solutions. Conclusions PASC 2025 effectively engaged regional leaders in clinical care, education, research, and policy from across sub-Saharan Africa to produce recommendations for scaling up the surgical workforce that are grounded in contextual experience and evidence.
