B T Ugwu1. 1. Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria. ugwub@yahoo.com
Abstract
BACKGROUND: Metal arrows are still used in communal conflicts on the Jos Plateau in the north central region of Nigeria, even at the turn of the 21st Century with yet undetermined pattern and outcome. OBJECTIVE: To determine the pattern of the injuries and the factors that influence the outcome of this uncommon condition. METHODS: A prospective study of nine patients managed over a 6-year period. Information obtained on each patient included sex, age, site of and event leading to the injury, treatment offered and its outcome. The data were analyzed using Microsoft Excel Software. RESULTS: Nine cases of metal tipped arrow chest injuries are reported. They were all males. Six (67%) cases arrived at the Accident & Emergency Department alive with the arrows partly or completely in the chest. Three cases died in the field of combat giving a mortality rate of 33. The other six (66.6%) were received alive. All the six (67%) had emergency thoracotomy and all of them survived with two (22%) morbidities. In five (56%) cases, including the three dead cases, the arrows were partly inside the chest and partly protruding outside while in four (44%) cases the metal arrows were completely inside the chest. The left hemithorax was more commonly involved with 6 (67%) cases, 2 (22%) on the right and the manubrium sterni in one (11%) case. The associated injuries were arrow injury of the thigh in one (11%) patient and Colles fracture in two (22%) patients. Hospitalization period ranged between 10 to 18 day while mortality was 33% and morbidity was 22% as a result of wound infection. CONCLUSION: Arrow chest injuries on the Jos Plateau result from communal conflicts among young male adults. Emergency thoracotomy resuscitation produce good outcome in majority of the patients. Bow, arrows and crossbows should be banned as weapons, and instruments for hunting and sports.
BACKGROUND: Metal arrows are still used in communal conflicts on the Jos Plateau in the north central region of Nigeria, even at the turn of the 21st Century with yet undetermined pattern and outcome. OBJECTIVE: To determine the pattern of the injuries and the factors that influence the outcome of this uncommon condition. METHODS: A prospective study of nine patients managed over a 6-year period. Information obtained on each patient included sex, age, site of and event leading to the injury, treatment offered and its outcome. The data were analyzed using Microsoft Excel Software. RESULTS: Nine cases of metal tipped arrow chest injuries are reported. They were all males. Six (67%) cases arrived at the Accident & Emergency Department alive with the arrows partly or completely in the chest. Three cases died in the field of combat giving a mortality rate of 33. The other six (66.6%) were received alive. All the six (67%) had emergency thoracotomy and all of them survived with two (22%) morbidities. In five (56%) cases, including the three dead cases, the arrows were partly inside the chest and partly protruding outside while in four (44%) cases the metal arrows were completely inside the chest. The left hemithorax was more commonly involved with 6 (67%) cases, 2 (22%) on the right and the manubrium sterni in one (11%) case. The associated injuries were arrow injury of the thigh in one (11%) patient and Colles fracture in two (22%) patients. Hospitalization period ranged between 10 to 18 day while mortality was 33% and morbidity was 22% as a result of wound infection. CONCLUSION: Arrow chest injuries on the Jos Plateau result from communal conflicts among young male adults. Emergency thoracotomy resuscitation produce good outcome in majority of the patients. Bow, arrows and crossbows should be banned as weapons, and instruments for hunting and sports.
Authors: B I Akhiwu; A S Adoga; O P Binitie; C C Ani; M Iweagwu; O Adetutu; T Ureme; D D George; P D Didamson; E Oseni-Momodu; B T Ugwu Journal: J West Afr Coll Surg Date: 2016 Apr-Jun