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Aim: This retrospective analysis documents the features and factorsthat potentially affect outcomes in septic arthritis in the Cross River Basinarea of south-south Nigeria. Patientsand Methods: A retrospectiveanalysis of 43 patients who presented with septic arthritis in 45 joints betweenSeptember 2007 and August 2010.All patients with pain, fever, joint swelling and non-weight bearing-refusal tomove the limb and had a joint aspiration productive of a turbid and-or purulent aspirate were included in theanalysis. Patients whose joint aspiration produced frank blood or a clearexudate were excluded. Results: There were 24 males and 19 femalesM:F = 1.3:1. Forty patientswere children while three wereadults. Thirty-three patients were urban dwellers, 8 were semi-urban dwellersand 2 were rural dwellers. Twenty-fivechildren were first seen by a Paediatrician. Only 5 patients were firstseen by an Orthopaedic surgeon. Definitive treatment was conservative in 28 children and arthrotomy-washout in12 children and 3 adults. Staphylococcusaureus was the commonest isolated pathogen in both age groups. Conclusion: Injudicious interventions in musculoskeletal conditions consist not only of traditional bone setting and other unorthodoxpractices, but also sub-optimal orthodox medical practices. Healthcare outcomes in Africa are a function of the skewed distribution of the healthcare workforce and a weak referralchain. The near absence of follow-up culture underscores the need for educationon injudicious antibiotic therapy to be directed at patients and physicians.Judicious interventions in musculoskeletal sepsis at first contact and astrengthening of the referral chain are important.

KEYWORDS

Septic Arthritis; Health Seeking Contact; Definitive Treatment; South-South Nigeria

Cite this paper

I. Ikpeme, N. Ngim, A. Ikpeme and A. Oku -Septic Arthritis: A Need to Strengthen the Referral Chain in a Developing Economy,- Open Journal of Orthopedics, Vol. 3 No. 2, 2013, pp. 110-118. doi: 10.4236-ojo.2013.32022.





Autor: Ikpeme A. Ikpeme, Ngim E. Ngim, Anthonia A. Ikpeme, Afiong O. Oku

Fuente: http://www.scirp.org/



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