Department of Anatomy, Histology and Embryology

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Browsing Department of Anatomy, Histology and Embryology by Author "Coleen S., Sabatini"

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    Burden of gluteal fibrosis and postinjection paralysis in the children of Kumi District in Uganda
    (BMC Musculoskeletal Disorders, 2018) Kristin, Alves; Norgrove, Penny; John, Ekure; Robert, Olupot; Olive, Kobusingye; Jeffrey N., Katz; Coleen S., Sabatini
    Abstract Background: The purpose of this study was to estimate the prevalence of postinjection paralysis (PIP) and gluteal fibrosis (GF) among children treated in a rural Ugandan Hospital. Methods: We conducted a retrospective cohort study by reviewing the musculoskeletal clinic and community outreach logs for children (age < 18 yrs) diagnosed with either PIP or GF from Kumi Hospital in Kumi, Uganda between 2013 and 2015. We estimated the prevalence as a ratio of the number of children seen with each disorder over the total population of children seen for any musculoskeletal complaint in musculoskeletal clinic and total population of children seen for any medical complaint in the outreach clinic. Results: Of 1513 children seen in the musculoskeletal clinic, 331 (21.9% (95% CI 19.8–24.1%)) had PIP and another 258 (17.1% (95% CI 15.2–19.0%)) had GF as their diagnosis. Of 3339 children seen during outreach for any medical complaint, 283 (8.5% (95% CI 7.6–9.5%)) had PIP and another 1114 (33.4% (95% CI 31.8–35.0%)) had GF. Of patients with GF, 53.9% were male with a median age of 10 years (50% between 7 and 12 years old). Of patients with PIP, 56.7% were male with a median age of 5 years (50% between 2 and 8 years old). Conclusion: PIP and GF comprise over 30% of clinical visits for musculoskeletal conditions and 40% of outreach visits for any medical complaint in this area of Uganda. The high estimated prevalence in these populations suggest a critical need for research, treatment, and prevention. Keywords: Gluteal fibrosis, Post-injection paralysis
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    Paediatric musculoskeletal disease in Kumi District, Uganda: a cross-sectional survey
    (SICOT aisbl, 2018) Kristin, Alves; Norgrove, Penny; Olive, Kobusingye; Robert, Olupot; Jeffrey N., Katz; Coleen S., Sabatini
    Abstract Purpose The purpose of this study is to estimate the burden of musculoskeletal disease among children treated in Kumi District, Uganda, to inform training, capacity-building efforts, and resource allocation. Methods We conducted a retrospective cohort study by reviewing the musculoskeletal (MSK) clinic and community outreach logs for children (age < 18 years) seen at Kumi Hospital in Kumi, Uganda, between January 2013 and December 2015. For each patient, we recorded the age, sex, diagnosis, and treatment recommendation. Results Of the 4852 children, the most common diagnoses were gluteal and quadriceps contractures (29.4% (95% CI 28.1– 30.7%), 96% of which were gluteal fibrosis), post-injection paralysis (12.7% (95% CI 11.8–13.6%)), infection (10.5% (95% CI 9.7–11.4%)), trauma (6.9% (95% CI 6.2–7.6%)), cerebral palsy (6.9% (95% CI 6.2–7.7%)), and clubfoot (4.3% (95% CI 3.8– 4.9%)). Gluteal fibrosis, musculoskeletal infections, and angular knee deformities create a large surgical burden with 88.1%, 59.1%, and 54.1% of patients seen with these diagnoses referred for surgery, respectively. Post-injection paralysis, clubfoot, and cerebral palsy were treated non-operatively in over 75% of cases. Conclusion While population-based estimates of disease burden and resource utilization are needed, this data offers insight into burden of musculoskeletal disease for this region of Sub-Saharan Africa.We estimate that 50%of the surgical conditions could be prevented with policy changes and education regarding injection practices and early care for traumatic injuries, clubfeet, and infection. This study highlights a need to increase capacity to care for specific musculoskeletal conditions, including gluteal fibrosis, post-injection paralysis, infection, and trauma in the paediatric population of Uganda.
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    Surgical Release of Gluteal Fibrosis in Children Results in Sustained Benefit at 5-Year Follow-up
    (Wolters Kluwer Health, Inc, 2021) Amanda L., Reilly; Francis R., Owori; Ruth, Obaikol; Elizabeth, Asige; Harriet, Aluka; Norgrove, Penny; Robert, Olupot; Coleen S., Sabatini
    Background: Gluteal fibrosis (GF) is a fibrotic infiltration of the gluteal muscles resulting in functionally limiting contracture of the hips and is associated with injections of medications into the gluteal muscles. It has been reported in numerous countries throughout the world. This study assesses the 5-year postoperative range of motion (ROM) and functional outcomes for Ugandan children who underwent surgical release of GF. Methods: A retrospective cohort study of children who underwent release of GF in 2013 at Kumi Hospital in Eastern Uganda. Functional outcomes, hip ROM, and scar satisfaction data were collected for all patients residing within 40 km of the hospital. Results: One hundred eighteen children ages 4 to 16 at the time of surgery were treated with surgical release of GF in 2013 at Kumi Hospital. Of those 118, 89 were included in this study (79.5%). The remaining 29 were lost to follow-up or lived outside the study’s radius. Detailed preoperative ROM and functional data were available for 53 of the 89 patients. In comparison with preoperative assessment, all patients postoperatively reported ability to run normally (P<0.001), sit upright in a chair (P< 0.001), sit while eating (P<0.001), and attend the entire day of school (P< 0.001). Passive hip flexion (P<0.001) improved when compared with preoperative measurements. In all, 85.2% (n= 75) of patients reported satisfaction with scar appearance as “ok,” “good,” or “excellent” 29.2% (n= 26) of patients reported back or hip complaints. Conclusions: Overall, the 5-year postoperative outcomes suggest that surgical release of GF improves ROM and functional quality of life with sustained effect. Level of Evidence: Level IV—case series. Key Words: gluteal fibrosis, injection injury, pediatric hip contracture, fibrosis surgery, treatment outcome, Uganda