The pattern of radiological findings in upper limb injury as seen at Kenyatta National Hospital

Abstract

Upper limb injuries are a major cause of morbidity, with consequent loss in terms of man-working hours (9,12). A large population is affected and there are broad social, economic and health implications (5,6,8,9,10,16,18). Such morbidity could be reduced through improved management of upper limb injuries (15), and this can be achieved by knowing the causes and distribution of such injuries. My desire to provide statistical data relating to the incidence and causes of upper limb injuries was the real motivation behind this study. Ultimately it is my hope that the findings ofthis study will go along way in guiding improved patient management strategies at Kenyatta National Hospital and the Kenyan nation at large. Between June 2006 and December 2006 a total of 218 patients with injuries to the upper limbs were studied. Out of these, 162 were males while the remaining 56 were females. Though there was a wide age distribution from 2yr to 73yr, the bulk of these patients were in the 0-15yr age bracket. This age group is no doubt the most versatile and physically active and therefore more likely to be involved in traumatic incidences than any other group. In contrast to previous trends (25,26) in which road traffic accidents constituted the single most common cause of upper limb injuries, it emerged from this study that today the commonest aetiology is a fall (55.96%),followed by automobile accidents (18.35%). The other notable causes included assault, occupational and gunshot. Fractures, dislocations/ subluxations and soft tissue injuries of the upper limbs were recorded. In a small minority of patients (3.6%) there were associated injuries in other parts of the body such as the head and pelvis. Although plain radiography formed the basis for imaging patients with upper limb injuries, additional imaging modalities such as sonography, computed tomography and magnetic resonance imaging had a positive diagnostic value over and above plain x-rays where there were visceral/soft tissue injuries.