Minister, UCH ex-CMD decry escalating orthopaedic crisis, resistant bacteria

The Minister of State for Health, Dr Isiaq Salako, a former Chief Medical Director (CMD) at the University College Hospital (UCH), Ibadan, Prof. Temitope Alonge, and other orthopaedic experts have decried the escalating orthopaedic crisis, saying increasing resistant bacteria are complicating diagnosis and treatment.

They lamented that musculoskeletal infections are now becoming harder to detect and complicated to treat, saying efforts to diagnose and treat orthopaedic patients are gradually becoming insufficient.

Speaking in Ibadan at the 48th Annual General Meeting (AGM) and Scientific Conference of the Nigerian Orthopaedic Association, with the theme: “Musculoskeletal Infections: Prevention, Diagnostic, and Treatment”, Salako, who was represented by Prof. Jesse Otegbayo, said that considering rising trauma cases, limited diagnostic facilities, and the escalating wave of antimicrobial resistance, Nigeria is at a difficult intersection.

According to him, these infections determine how long people stay in hospital, how much families spend, and in many cases whether a patient returns fully to work or lives with disability.

He noted that the Federal Ministry is strengthening the National Emergency Medical Service and Ambulance System to improve early response, expanding infection-control capacity in surgical centres, and upgrading trauma units with essential consumables and modern imaging tools.

In his keynote address, Alonge said today’s injuries are rarely straightforward because some of them now come from high-impact crashes, gunshot wounds, assaults, and other unpredictable sources. He lamented that these wounds introduce bacteria that behave differently from what surgeons dealt with a decade ago.

“For years, we behaved as if Staphylococcus aureus was behind everything, but that world is gone. The organisms we see now are more diverse, more resistant, and sometimes completely undetectable using the older methods.”

He recalled a time when Gram stains and simple cultures could reliably identify an infection, adding that comfort is fading because many organisms have adapted.

“Some avoid detection, others resist multiple antibiotics, and a number of them hide within biofilms. These changes can push us toward molecular imaging, a technology that looks directly at bacterial cells rather than relying on their behaviour in a laboratory dish.”

Alonge also clarified a long-standing concern in trauma practice, which is open fractures, saying they remain the most common emergency cases because managing them properly requires strict adherence to an 11-step protocol.

He explained that where that process breaks down, infections like chronic osteomyelitis become almost inevitable.

He, however, blamed delays, unregulated treatments, and the growing involvement of quacks for many of the preventable complications surgeons now treat.

Earlier, in her remarks, the Secretary to the Government of Oyo State, Prof. Olanike Adeyemo, hailed the medical experts for choosing Ibadan to host its 48th AGM.

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