HEALTH AND FITNESS JOURNAL INTERNATIONAL (HFJI)
PUBLISHED BY
HEALTH AND FITNESS ASSOCIATION OF NIGERIA
Vol. 4 No 1 & 2
Dec 2003
ISSN – 1595 – 4013
2
TABLE OF CONTENTS
CONTENTS
PAGE
HARMFUL TRADITIONAL PRACTICES AFFECTING
WOMEN’S HEALTH IN ENUGU STATE:
A GENDER-BASED RESPONSE
URSULA C. EGEJUR U NNAB UEZE
5
PSYCHODYNAMICS OF GROUP STRESS AND
TEAM PERFORMANCE
O. G. OSHODIN & G. O. EGOR:
17
FRACTURES: PATTERN OF INCIDENCE! CAUSATIVE
FACTORS AND TREATMENT AT OLIVES HOSPITAL,
IBADAN, NIGERIA
OLAITAN, O. ‘LANRE
28
ANAEROBIC PERFORMANCE OF LOWER AND UPPER
LIMBS IN MALE AND FEMALE ADOLESCENTS
F. R. HARUNA
37
THE RELATIONSHIP BETWEEN DRUG EDUCATION
TEACHING AND KNOWLEDGE OF EFFECT OF DRUG ON
INDIVIDUAL AMONG PRIMARY SCHOOL PUPILS
ONIVANGI, SHUAIB. O. & OWOJAIYE, SUNDA ONI
3
45
NUTRITION AND BODY WEIGHT CONTROL AMONG
PUBLIC SERVANTS IN EKITI STATE, NIGERIA
DR. J.A.ADEGUN
51
THE PREVALENCE OF LOW BACK PAIN IN
SCHOOL CHILDREN IN ILORIN METROPOLIS
ADESINA M. O. & TALABI. A.E.
58
PRIMARY HEALTH CARE AND HEALTH EDUCATION
ONIFADE, O.A.
64
IMPLICATION OF RECREATION CENTRE
MANAGEMENT ON HEALTH AND FITNESS
HANNAH .I. MUSA & ECHERUO M. C.
76
KINESIOLOGICAL PRINCIPLES AND SPORTS
PERFORMANCES: A REVIEW
BAKINDE S.T.
84
ATTITUDES OF ADULTS TOWARDS ENVIRONMENTAL
HEALTH PROBLEMS: A CASE STUDY OF UMUEKWE
COMMUNITY IN NIGERIA
O. G. OSHODIN & GODWIN NNEJI OKERE
91
MOTIVATIONAL INTENT FOR RECREATIONAL PHYSICAL
FITNESS PROGRAMME BY OFFICERS AND MEN OF
NIGERIA IMMIGRATION SERVICE IN NIGERIA
ECHERUOM C.
104
4
PERCEPTION OF HEALTH PERSONNEL ON THE FACTORS
OF INFESTATION OF CHILDHOOD DISEASE AMONG
SCHOOL CHILDREN IN ILORIN LOCAL GOVERNMENT
AREA OF KWARA STATE.
ONIVANGI, S. O.
111
COMPARATIVE STUDY OF FITNESS LEVEL OF NORMAL
AND DEAF PUPILS IN SCHOOLS: A CASE STUDY OF
SPECIAL SCHOOL IN AKWA IBOM STATE, NIGERIA.
JONA I. N.
120
MANIFESTATION OF SEXUAL DYSFUNCTION BY
LITERATE MARRIED WOMEN: IMPLICATION FOR
MARITAL COUNSELLING
ABDULRAZA Q OLA YINKA ONIYE
129
5
Advisory committee:
Professor L.Emiola
-
University of Ilorin
Professor O.Oshodin
-
University of Benin
Professor S. Jimoh
-
University of Ilorin
Dr. S. Umoh
-
Professor A Adewoye
-
Dr. Danladi Musa
-
Professor A. L. Toriola
-
6
University of Ilorin
University of Ilorin
Bayero University, Kano
University of the North, South Africa.
EDITORIAL
This edition (6th) is dedicated to great men and women whose thoughts
have contributed to the realization of the importance of Health and Fitness in our
lives.
These great thoughts:
•
To keep the body in good health is a duty... otherwise we shall not be
able to keep our minds strong and clear — Buddha
•
The ideal and goals of life which have always made mankind feel fulfilled
rest on good health - Anonymous
•
Love is the beauty of the soul... Health is its strength — Anonymous
•
Good health is a foundation for the quality day and life- George Wilber.
•
Healthy people provide a strong foundation for economic development.World Economic Forum 2002.
- have brought home to us the truth that poor health and fitness will certainly
detract from our ability to maximize our potentials in this new era.
7
FRACTURES: PATTERN OF INCIDENCE! CAUSATIVE
FACTORS AND TREATMENT AT OLIVES HOSPITAL, IBADAN,
NIGERIA
OLAITAN, O. ‘LANRE
DEPARTMENT OF PHYSICAL AND HEALTH EDUCATION,
UNWERSJTYOFJLORIN, KWARA STATE,
NIGERIA.
ABSTRACT
In this study, the pattern of incidence of fracture was studied, so also the
possible ways of preventing the complications of fracture were highlighted.
Fracture, which is known as any breaking in the continuity of a bone, was the
main focus and the causative factors and treatment measures at the Olives
Hospital and Maternity, Ibadan, Nigeria were highlighted. The study comprised of
28 cases of fracture reported at the Olives Hospital and Maternity, Ibadan,
between July 2001-July 2002. The most threatening causes of fracture were
found to be road traffic accident (RTA.), the next commonest place of occurrence
was in the school. Immobilization was found to be very effective in preventing
the complications of fracture, good positioning on the fracture bed and mild
exercise after the cast removal was found to have enhanced very speedy
recovery to return the victim to former limb function. 89.3% of all the cases
were fully recovered without any complication while only 10.7% where treatment
still continued have a mild contracture. Various preventive measures such as,
public lectures as well as establishment of fracture management centers in
Nigeria were recommended.
INTRODUCTION
The bones of the body are important, for they provide strength and stability for
all other organs. They also carry other important functions. According to
Anderson (1996), our bones provide a vast storehouse for minerals, fats, and
proteins, all of which are constantly being utilized to meet the needs of the body.
8
There are about 206 bones in the human body. The number varies
according to person’s age with children having a few more. As a person grows
older, some of the lower bones in the spine fuse together (Waimsiery & Murphy,
1982). The stability of the body depends on the bones. When the bone is
cracked or broken, the condition is referred to as a “fracture”. Appley & Solomon
(1993), opined that, fractures are the most common types of injury to bone.
Gatterall (1992) believed that many people suffered serious deformities
because of poor management and mal-handing of fracture. Infact, some are
unfortunate not to receive treatment at all for years and after some time,
deformities that might have easily, been prevented by proper treatment did
occur. There is no reason for neglecting a broken bone as much can be done by
first aiders and doctors especially now that orthopedists are now available almost
everywhere. Every fracture should be given appropriate treatment right from the
very first. The first aid given to the fractured bone predetermined the end result
(Fishbein, 1963).
Two major classes of fractures, ‘simple’ and ‘compound’ have been
recognized (Anderson, 1996). In simple fracture, there is usually no break in the
skin while in a compound fracture, the skin may be torn, and the broken ends of
the bones may be seen piercing out through the skin. Of these two, the
compound fracture is far more serious because of the danger of infection, which
may penetrate into the body through the opening. Careless handling of fracture
may sometimes turn a simple fracture into a compound fracture. Therefore,
9
proper handing is more important so that deformity is reduced and possibility of
infection is rendered impossible. However, simple fractures must not be
considered lightly, although, some broken ends of the bone may not be sticking
though the skin, but they may cut through some of the nearby nerves and blood
vessels. Furthermore, if in fracture, the broken bone ends lacerate some of the
internal organs, like the lungs or bladder; it is therefore referred to as
“complicated” fracture (Catterall 1992). Therefore, all fractures must be handled
with care.
The causes of fractures as highlighted by Monk (1982), are by direct
violence or indirect violence. The most common causes of fractures are by direct
violence. This includes severe contusion or impact, such as a blow or fall. An
indirect violence type of fracture is by falling on the outstretched arm or elbow
this may transmit the force to the clavicle to break in which the arm or elbow
may not necessarily fracture. So also powerful muscular contraction may cause
fracture. This can occur when there is no muscle synchronization (Monk, 1982).
There are many signs and symptoms of fracture. In most case of fracture,
the victim will tell that he heard or felt the bone snap. This snap maybe inform of
a crepitus or key sound. So also, there will be pain and tenderness in the area,
followed by swelling. The skin may become discoloured due to the presence of
bleeding beneath the tissues. The broken ends of the bone may sometimes be
felt over lapping. The injured part may appear to be a little shorter than the
uninjured one (Cyriax, 1983). In case of severe fracture, the victim may
10
complain of weakness or sometimes, faintness may occur. This is known as
“shock”. This must be immediately treated before any further thought is given to
the broken bone (Monk, 1988).
Diagnosis of fracture according to Apley & Solomon (1983), is mainly
though x-ray. Other methods of diagnoses are by looking for the signs and
symptoms such as, deformity of the area, direct or indirect tenderness, loss of
limb function, crepitus bony deviation, swelling of the area, echymosis,
discolouration, pains, false joint, etc.
According to Monk (1988), all fractures should be handled with care most
especially by immobilization through application of splints which may be
improvised from many different things such as, coat, pillow, folded blanket,
magazine, several newspapers folded together, and similar articles may be very
useful as splint. Sticks, branches from trees, umbrellas, walking sticks, car tools
(if on the highway), cupboard doors, wide boards, broom handles, all these may
serve in any emergency. If in school, rulers are the best types of splits especially
for any of the limb fractures. The main thing is hold to the broken fragments
steady and interrupts the movement of the site abruptly. The splint is well
padded where it touches the skin to provide cushion to the injured part. It may
be necessary to sling the injured part if it involves the upper limb i.e. the
shoulders upper arms, lower arms, wrists or hands.
11
Complications of Fractures
Apely & Solomon (1993), stressed that complications of fracture are very
difficult to correct. They include, shock, thromboembolism and infections such as
tetanus and gas gangrene. Local complications may involve the bones or the soft
tissues in the vicinity of the fracture. The complication involving the fractured
bone includes infection, delayed union and non-union, mal-union, growth
disturbance and a vascular necrosis. Complication involving the injured soft
tissue is vascular injury, compartment syndrome (Volkmann’s Ischhaemia) nerve
injury, visceral injury and myositis ossiflcans. While the complications involving
join are joint stiffness osteoarthritis and sudeck’s atrophy.
METHED0LOGV
28 patients, 20 males and 8 females reported for treatments from various
places Ibadan, majority of which were brought by members of Federal Road
Safety Crops (FRSC) to Olives Hospital and Maternity Ibadan, Nigeria.
Schoolteachers’ and relatives brought the remaining cases to the hospital all
between July 2001 and July. 2002 (Fig 1).
As each patient reported for treatment, the relevant history of occurrence
was taken, and the affected parts of the body were examined by physical
examination and followed by X-ray for more precise diagnosis.
In order that they may understand the purpose of treatment, the various
complications including the possible residual deformities and disabilities were
fully explained to them and their relatives. To avoid or prevent the complications
12
of fracture, the cooperation of the patients and their relatives were sought right
from the first day of reporting for treatment, so that they can carry out all
instructions given to them.
All the 28 patients with fractures of legs, arms and collarbone were
treated at Olives Hospital and Maternity Ibadan in a 12 months period from July
2001 to July 2002. In all cases, the clinical notes and radiographs (Xray films)
were examined. Completed follow-up was available in all the cases. There were
20 males and 8 females with ages ranging from 5 to 35 years (mean 22.1 years)
(fig 2). Over half of the patients were between 20 and 34years of age. The
causes of injury are as shown. With road traffic accident (RTA) as most
prevalence. (Table 1).
TYPES OF FRACTURE
In the 28 patients, diagnosis was made within the first 24 hours. All the
patients had pain, swelling and tenderness in the sites of the fracture.
Eleven patients had fracture of one upper leg bone (femur) each, 3 with
fractures of both upper leg bones (both femur), 5 with fractures of one lower leg
bones (tibia and fibula) each 3 with fracture on one upper arm bone (humerus),
3 with fracture of one lower arm bone (radius and Ulna) and only 3 with the
fracture of one collar bone (clavicle) (Table 2.)
RESULTS
Although the sample size of this sample was rather small, the findings
have thrown more light on possible prevention of fracture complications as well
13
as identified some beneficial procedure of hospital workers in the management
of fractures. In this study, the most threatening causes of fracture as been found
to be Road Traffic Accident (RTA). The second major cause was identified to be
fall. (Fig I). The commonest place of occurrence of fracture was identified as, on
the highway especially along Thadan —Oyo-Ilorin road, while the second
commonest place of occurrence was at school. The age group most commonly
involved in fractures was found to be 25-29 years old (Fig 2/Table3). The males
(70.4%) were found to be more involved in the incidence of fracture than
females (where only 28.6% were involved) (table 3).
This study has identified that good positioning while on fracture bed and
immobilization of the affected area were found to have enhanced the much
speedy recovery that followed.
In about 5 cases where mal-alignment were seemingly setting in, the
repeat cast after re-alignment that were employed were found to be useful
particularly at the acute phase. The other procedures, particularly the intensified
programmme of exercise after the union in the bone and cast removal were
found very helpful in returning the affected limb to their previous normal
functions.
In all cases treated 25 (i.e. 89.3%) fully recovered and were fmally
discharged without any complications. In only 3 cases (i.e. 10.7%) treatment still
continued but in these cases there were no traces of any 4.
14
CONCLUSIONS & RECOMMENDATIONS
The most threatening causes of fracture discovered in this study at Olives
Hospital and Maternity Ibadan was Road Traffic Accident (RTA). In this study,
more incidents of fracture were recorded for the ages are 25-29 years old than
other age groups. (Fig 2). This could be based on the fact that young adult
between 25-29 years of age are very active and for curiosity, they involved more
in energy tasking work especially, driving than the other lower age groups. This
age group is also noted for undertaking very risky driving skill from this study,
the acquired knowledge of the pattern of the most common causes of fractures
provides the basis of campaigns for successful preventive measures. As a first
step the drivers need to be educated on road safety education and only be
awarded the drivers’ license having passed the prescribed test accordingly.
The second step of this preventive measures should involve education of
the people generally on how to place things and be careful wherever they are, to
avoid falls. In this instance, things should be well placed in the schools and the
childrenlpupils should be properly monitored while playing on the swings and
other recreational equipment in the school. Moreover, first aid training should be
made available for all, irrespective of their professions and first aid boxes should
be made available in vehicles especially commercial vehicles, in schools, at
home, and in industries.
So also, there should be public lectures and demonstrations in all
communities and institutions on how to be more safety conscious generally. Such
15
topic like Road Safety Education, School Safety Education, Home Safety
Education and Industrial Safety Education Should be included.
Finally,
fractures
management
centre/orthopedic
units
should
be
established in most of the government hospitals and other medical centres all
over the country where comprehensive management of all fracture cases could
be undertaken. In addition, all the existing hospitals all over the country should
developed and equip their orthopedic units with relevant facilities to help in the
prompt management of accidents and fracture cases in our society.
TABLE 1: MECHANISM OF INJURY OF FRACTURE OF THE BONE
Cause
No of cases
%
Road Traffic Accident (RTA)
17
60.7
Fall
8
28.6
Blow
3
10.7
Total
28
100
TABLE 2: TYPE OF FRACTURE SITES
Fracture
No of patients
Percentage of total patients %
14 (3 bilateral)
50
Tibia/fibula
5
17.9
Humerus
3
10.7
Radius/Ulna
3
10.7
Clavicle
3
10.7
28
100
Femur
Total
16
TABLE 3: SEX AND AGE DISTRIBUTION
Age in year
Male
Female
Total
5
0.4
-
-
-
-
5-9
3
4
6
21.4
10-14
3
-
3
10.7
15-19
-
-
-
-
20-24
4
-
4
14.3
25-29
5
5
10
35.7
30-34
5
-
5
35.7
Total
20
8
28
100
79.4%
28.6%
100%
*
% Total
TABLE 4: THERAPEUTIC REPONSES
Therapeutic responses
Male
Female
Total
%
Complete recovery without complication
17
8
25
89.9
Still treating with mild bony deviation
3
-
3
10.7
20
8
28
100
71%
28%
100%
*
(contracture)
Total
% Total
17
25
20
15
10
5
0
Highw ay (Road)
Fig. 1:
School
Home
Place of occurrence
12
10
8
6
4
2
0
5-9yrs
10-14yrs
15-19yrs
25-29yrs
30-34yrs
39-34yrs
Fig 2: Age of the patients
70
60
50
40
30
20
10
0
RTA
FALL
18
OTHERS
Acknowledgement
The author of this paper is profoundly grateful to the members of Federal
Road Safety Corps (FRSC) and Nigerian Police Force. At the same time, I am
greatly indebted to the Medical Dk€4r and the entire staff of Olive Hospital
Maternity, Ibadan, Nigeria.
19
REFERENCES
Anderson, C.R (1996), Modern ways to health. Vol. 1 & 2. (Revised.Edition),
Teenessee: Southern Publishing Association
Apley, A.G & Solomon, (1993), Concise System of orthopaedics and fractures.
Cambridge: Butterworth Heinemann Ltd.
Catterall, A. (1992), Recent advances in orthopeadics. Edinburgy:
Longman Group UK, Ltd
Cyriax,
J.
(1983),
Textbook
of
orthopeadic
medicine:
treatments
by
manipulation, message and injection. Vol II (11th Ed.), London:
Bailliere Tindall Publishers.
Fishbein, M (1963), Illustrated medical and health encyclopedic. Vol. III New
York: H.S. Stuttman Co., Publishers.
Monk, C.J.E (1988), Orthopaddics for undergraduates (2nd Ed.), Oxford: Oxford
University Press.
Stone, D.R & Lambert, G.E (1975), Orthopaedic, physicians assistant techniques
allied health series. Indianapolis. Howard W. Sams & Co., Inc.
Walmsley, R & Murphy, T.R (1975), Jemieson’s illustrations of regional anatomy.
Church Linvigston. Hong Kong: Longman Group Ltd.
20