Assessing the methods and outcomes of management of orthopaedic trauma patients in Kenyatta National Hospital (a Comparative Study)

Abstract

The study, "Assessing the methods and outcomes of management of orthopaedic trauma patients in Kenyatta National Hospital (A comparative study)" is aimed at comparing the different methods of management of orthopaedic trauma injuries and their outcomes not only in clinical terms but also in terms of socio-economic stresses where the time spent in hospital and for recovery is a major factor. The methods being considered in this study (though not all have been taken to account) are majorly,traction and ORIF (Open Reduction and Internal Fixation) The traction method has been taken to represent the more conservative methods of management while itscounterpart ORIF, the more modern and radical methods of management. The main objective of the study is to compare the incidences of malunions, non unions, misalignments and other downfalls associated with conservative management of orthopaedic patients. However, I am also looking at the socioeconomic implications of each method. The study, whose main hypothesis is "The conservative treatment of orthopaedic fractures provides acceptable functional results and is more cost effective" aims at answering a few fundamental questions such as how effective traction is as a method of management of orthopaedic injuries, its demerits and the possibility of tailoring a cost effective ORIF package at the KNH. It is a comparative retrospective survey of patient files to evaluate the relative proportion of traction procedures that do not take and therefore force the patients to undergo ORIF as a corrective measure. The study population will comprise of consenting patients, numbering 384, and chosen using a stratified sampling system. Data collection methods will involve observation of clinical methods, interviews with the relevant medical personnel and checklists. The study is expected to take at least 24weeks (This being the minimum amount of time required for a fracture of the lower limb to heal). The budget put in place was carefully calculated and amounting to Ksh.128,935 that will cater for both personnel and material. The expected benefits of this study include, putting in place a more cost effective method of orthopaedic trauma management that would reduce both the overall hospital cost, the time spent in the orthopaedic ward for both treatment and recovery (and subsequently reduce bed occupancy rates in the orthopaedic wards and further allowing the a quicker return to normalcy for patients by allowing sooner return to school or economic viability.