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Background: Published data on congenital musculoskeletal anomaly in subsaharan Africa are few.Aim: To review the pattern of congenital musculoskeletal abnormalities seen at the Obafemi Awolowo University Teaching Hospitals' Complex (O.A.U.T.H.C) Ile-Ife.Materials and Methods: The clinical records of patients who presented to the O.A.U.T.H.C, Ile-Ife, with congenital musculoskeletal abnormalities over 7 years (July 2000 to June 2007) were reviewed. Comprising patients delivered in the hospital, referred patients seen in the Orthopaedic clinics and those admitted to the hospital Orthopaedic, Paediatric and Postnatal wards. The following data were extracted; age, gender, diagnoses, description of the abnormality and the presence of associated congenital deformities. The side of the body involved and bilaterality were noted.Result: Over this period, 123 patients met the criteria. Eighty one were males while 42 were females with a M:F= 2:1 Congenital talipes equinovarus(CTEV) deformity was the most common congenital musculoskeletal anomaly in 64(52.0%) patients. Others were Polydactyly 16 (13.0%) and syndactyly 11(8.9%). Other common congenital orthopaedic anomalies encountered include: Arthrogryposis multiplex congenital 7(5.7%), congenital knee dislocation 6(4.9%), Calcaneovalgus deformity 5(4.1%) and absent radius 5(4.1%). Among the patients with clubfoot, there was a predominance of bilateral involvement of both foot with 63.4% of the idiopathic variety showing bilaterality and 60.9% of the non-idiopathic variety having bilateral involvement. The idiopathic Variety constituted 64.1% of the club foot deformities. Spina bifida cystica was the most common associated deformity among the patients with nonidiopathic clubfoot.Conclusion: Congenital talipes equinovarus was the most common congenital Musculoskeletal anomaly seen at the Obafemi Awolowo University Teaching Hospital Ile-Ife, with a high incidence of bilaterality. Spina bifida cystica was the most associated anomaly in the non-idiopathic club foot in this centre.Keywords: Congenital, Musculoskeletal, anomaly, Tertiary, Referral, Centre.

Background:The aim of this study was to find out the reasons why trauma victims with Orthopaedic injuries take their discharge against medical advice.Methods: This was a prospective study conducted on Trauma victims presenting to the Wesley Guild Hospital Ilesha who took their discharge against medical advice (DAMA) over a 2 year period. A questionnaire was designed that was used to retrieve information on the patients biodata, their injuries and the reasons why they DAMA.Results: A total of 49 patients were interviewed over this period. The mean age of the patients was 36.7 years. Students (22.4%), traders (20.4%) and artisans (24.5%) were commonly involved in this practice. Eighteen (36.7%) of the respondents claimed to have taken DAMA due to hospital cost, 18 (36.7%) also DAMA because of their believe in Traditional Bone Setters. Eleven patients (22.4%) simply said they want treatment near home while one patient each gave the fear of amputation and hospital protocol as their reasons for DAMA.Conclusion: Cost of treatment and believe in traditional bone setters were the 2 main reasons why most patients with fracture DAMA. Measures to reduce the cost of treatment and patient’s education about the dangers with unorthodox treatment of fractures and dislocations should help to reduce this behaviour.

No Abstract.African Journal of Paediatric Surgery Vol. 1(2) 2005: 56-61