Ibadan played host this week to some of the country’s most respected orthopedic surgeons as the Nigerian Orthopedic Association held its 48th Annual General Meeting and Scientific Conference.
The gathering, which stretched through the week, evaluated and examined problems reshaping trauma care across Nigeria: musculoskeletal infections that are becoming harder to detect and far more complicated to treat.
With trauma cases rising from road crashes, industrial activity and the security challenges that now form part of daily life, experts at the conference agreed that the old approach to diagnosis and treatment have become insufficient for medical care.
The theme of the meeting, Musculoskeletal Infections: Prevention, Diagnostic, and Treatment, captured both the urgency and the shifting realities facing clinicians in the country.
Shortly after his keynote address, former Chief Medical Director of the University College Hospital, Professor Temitope Alonge, spoke with journalists, providing clarity and pathway forward.
He drew a straight line between the country’s fast-changing environment and the infection patterns showing up in operating rooms.
He explained that injuries today are rarely straightforward. They come from high-impact crashes, gunshot wounds, assaults and other unpredictable sources. These wounds he said introduce bacteria that behave very 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,” Professor Alonge said.
He recalled a time when gram stains and simple cultures could reliably identify an infection. He revealed that comfort is fading noting that many organisms have adapted.
Some avoid detection, others resist multiple antibiotics and a number of them hide within biofilms. These changes, he noted, explain the growing push toward molecular imaging, a technology that looks directly at bacterial cells rather than relying on their behavior in a laboratory dish.
He pointed to ubiquicidin, a positively charged peptide that binds to bacteria and, when used with tracers like Technetium-99 MDP, helps clinicians detect infections that would otherwise remain invisible.
The technique is proving especially useful for patients who come back with unexplained pain after knee or hip replacements.
“Cultures come back negative and we call them sterile inflammations but negative doesn’t always mean clean. Molecular imaging gives you a more honest picture,” he said.
Prof Alonge also clarified on a long-standing concern in trauma practice which is open fractures. They remain the most common emergency cases, and he stressed that 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 blamed delays, unregulated treatments and the growing involvement of quacks for many of the preventable complications surgeons now see.
The Federal Ministry of Health shared similar concerns. Representing the Minister of State for Health, Dr Isiaq Adekunle, the current University College Hospital (UCH) Chief Medical Director, Professor Jesse Otegbayo, spoke about the national implications of these infections.
He said Nigeria sits at a difficult intersection: rising trauma cases, limited diagnostic facilities and an escalating wave of antimicrobial resistance.
“These infections determine how long people stay in the hospital, how much families spend and in many cases whether a patient returns fully to work or lives with disability,” he said.
He noted that the 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.
Prof Otegbayo also highlighted the challenge of performing total hip replacements for sickle cell disease patients. Nigeria carries the world’s highest burden of avascular necrosis of the femoral head, a condition that he said often leads to surgery.
He explained further that managing such cases requires extensive planning, coordinated anesthesia and meticulous follow-up.
He described the National Orientation Agency (NOA) as a key partner in improving surgical outcomes nationwide and encouraged participants to use the conference to sharpen standards, share new approaches and drive evidence-based policy.
Earlier, Professor Olanike Adeyemo, the Secretary to the Government of Oyo state, who represented governor Seyi Makinde commended the medical experts for choosing to host its 48th AGM in Ibadan, the capital of Oyo state.
While reaffirming the commitment of the present Makinde led government to providing and sustaining quality healthcare system in the state, she expressed confidence and optimism that the outcome of the conference would further reshape the medical landscape in the state.
Declaring the conference officially opened, the SSG urged participants to leverage on their expertise to network and create an environment that would be both beneficial to the medical community and the state as a whole.