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Publications


2014

Admani, AA, Gakuya EM.  2014.  ANTERIOR SUPERIOR DISLOCATION OF THE HIP JOINT: A REPORT OF 3 CASES AND REVIEW OF THE LITERATURE. East African Orthopaedic Journal. Abstract

Traumatic anterior dislocation of the hip forms approximately 11% of hip dislocations and is divided into
superior and inferior types. Anterior superior hip dislocation accounts for 10% of anterior hip dislocations.
The clinical appearance of anterior superior hip dislocation resembles that of a fracture of the femoral neck,
whereas the radiological appearance resembles that of posterior hip dislocation.The objective of this article is to use three cases to describe the management of this condition and highlight pitfalls in the same. The article also points out unusual mechanisms causing this injury. Key words: Anterior dislocation, Hip joint, Open reduction, Iliofemoral ligament

Gakuya, EM, Kamau DM, Gakuu LN, Sang EK.  2014.  COMPARISON OF CLOSED FEMUR FRACTURE: SKELETAL TRACTION AND INTRAMEDULLARY NAILING COST-EFFECTIVENESS. East African Orthopaedic Journal. 8:4-9. Abstract

Background: Fractures of the femur are common injuries affecting the productive age group. Skeletal
traction is the mainstay of treatment in Kenya, hence comparison with operative management, to determine which is more cost-effective. To our knowledge no similar study has been done in Africa.Objective: To determine the cost-effectiveness of skeletal traction compared to intramedullary nailing. Design: Prospective conventional sampling analytical study. Setting: Hospital based study in a referral and teaching institution - Kenyatta National Hospital, orthopaedic wards. Study population: Patients admitted at Kenyatta National Hospital with diaphyseal femur fracture aged between 18 – 50 years. The study was done from October 2012 to May 2013. Materials and methods: A structured data collection sheet was used. It included the patient particulars, hospital stay and per diem cost, the type of injury, type of management and comparing the cost of
each, X-ray findings during treatment and at 3 months to assess for union. Data was represented in
form of tables, and figures. Results: Males were more affected than females, with a mean age of 31.5 years. The mean length of hospital stay was 11.48 days for the operative group and 66.7 days for the skeletal traction group. The average total hospital cost for the operative group was Kshs 54, 380.44 (US$640) compared to Kshs 67,792 (US$798) for the traction group. In the operative group 24 patients had union with one delayed union while in the traction group 12 patients had union, 9 with mal union and 4 delayed union.
Conclusion: Intramedullary nailing is more cost-effective than skeletal traction. It met the dominant
strategy, because it was significantly less costly than skeletal traction, with a better outcome

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