Pattern of adult appendicular skeleton fractures at a teaching and referral hospital.

Abstract

BACKGROUND: Trauma is a public health burden resulting in increased morbidity, mortality and disability for the survivors. Musculoskeletal trauma results in dramatic, distracting and life threatening injuries. No study on distribution of appendicular skeleton fractures and severity exists in Kenya. This will permit policy on appendicular skeleton fracture treatment. OBJECTIVE: The study aims to determine the fracture prevalence of the appendicular skeleton, describing the fracture pattern, severity and common mechanism of injury. STUDY DESIGN: Cross-sectional study SETTING : Kenyatta National Hospital: Accident and Emergency department, Intensive Care Unit (ICU) and the orthopaedic wards. METHODOLOGY: The sample size population was of 385 patients. All patients seen over the period of three months were registered, listed and assigned consecutive numbers. Those who met the inclusion criteria underwent modified systematic random sampling, and were then recruited and consented. Data obtained was stratified and analysed on mechanism of injury, anatomic site involvement and fracture classified based on the AO/OTA classification system. Categorical data is presented in tables, graphs and charts. Chi-square test for proportion was used. RESULTS: 385 patients seen had sustained 480 fractures. Male 80% and female 20%, with median age of 32 years (24-43years). Majority are isolated 79% and closed (79%) following road traffic accidents (63%) as mechanism of injury. Lower limb fractures (66.7%) were predominant and upper limb (33.3%). CONCLUSION: Road traffic accident is the common cause of lower limbs and pedestrians sustained more fractures. The tibia/fibula is commonly affected in regional distribution.