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 Table of Contents  
ORIGINAL ARTICLE
Year : 2018  |  Volume : 10  |  Issue : 2  |  Page : 87-89

Epidemiology of traumatic fractures in a tertiary health center in Nigeria


1 Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Nigeria
2 Department of Surgery, Federal Medical Centre, Birnin Kebbi, Nigeria

Date of Web Publication22-Nov-2018

Correspondence Address:
Dr. Oni Nasiru Salawu
Department of Surgery, Federal Medical Centre, Birnin Kebbi
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jotr.jotr_35_16

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  Abstract 


Background: The incidence of fractures from trauma is increasing due to increase in means of transportation, poor roads and disobedience of road safety laws. Adequate knowledge about the involvement of different parts of the body in trauma will aid planning towards management of these fractures. Aim: This is to show the etiology and frequency of the affected bone of the body by trauma, which can serve as a template for future health care planning and delivery. Patients and Methods: This was a prospective study in which data from all patients that presented at the accident and emergency unit of University of Ilorin Teaching Hospital with fractures, from January 2012 to December 2012 were analyzed. Results: During the study period, a total of 401 fractures in 334 patients were seen. Isolated fractures were seen in 227 patients, while 107 patients had multiple fractures. Male to female ratio was 2.8 : 1, the mean age was 34.2 ± 5.4 years. The commonest bone fractured was the Tibia which accounted for 25% (100 cases). The commonest form of trauma causing these fractures was motor vehicle crash which accounted for 75.6% (303 cases). Conclusion: Prevention of road traffic accident by provision of good roads and enforcement of road safety laws will reduce fractures significantly.

Keywords: Economic, fractures, injury


How to cite this article:
Babalola O M, Salawu ON, Ahmed B A, Ibraheem G H, Olawepo A, Agaja S B. Epidemiology of traumatic fractures in a tertiary health center in Nigeria. J Orthop Traumatol Rehabil 2018;10:87-9

How to cite this URL:
Babalola O M, Salawu ON, Ahmed B A, Ibraheem G H, Olawepo A, Agaja S B. Epidemiology of traumatic fractures in a tertiary health center in Nigeria. J Orthop Traumatol Rehabil [serial online] 2018 [cited 2018 Dec 19];10:87-9. Available from: http://www.jotr.in/text.asp?2018/10/2/87/245994




  Introduction Top


Musculoskeletal injuries are a major public health problem globally, contributing a large burden of disability, suffering, and mortality.[1] The World Health Organization (WHO) global burden of disease estimated that the combined rate of extremity injury from fall and road traffic crashes (RTCs) ranged from 1000 to 2600 people per 100,000 per year in low- and middle-income countries.[1]

The leading cause of death in low- and middle-income countries among people between the age of 5 and 45 years is trauma, and this accounts for about 9% of disease burden in Africa.[2] The fraction of global death due to injuries was estimated by WHO to be 9.6%.[3],[4] The most common cause of trauma in Nigeria is RTC.[5],[6],[7],[8],[9],[10],[11],[12],[13] The trauma from RTC has increased tremendously in Nigeria since the introduction of motorcycle as a means of commercial transportation in the country.[14],[15],[16],[17]

In Nigeria, the most commonly affected age groups are the young, which contribute a large percentage to the economic force of the country, and as a result, this has led to a high economic loss.[5],[17],[18],[19] The lower-limb bones are the most commonly reported fractures following RTC.[5],[10],[12],[13],[14],[20],[21],[22]

The aim of this study is to show the frequency of the affected bone of extremity and spine by trauma, for adequate future planning of management. This will guide toward the peculiar areas of emphasis in training and also plan toward the implant need of our environment.


  Patients and Methods Top


This was a prospective study carried out in the University of Ilorin Teaching Hospital between January 2015 and December 2015. All patients who presented with trauma during the study period were included in the study.

Following presentation at accident and emergency unit of the hospital, the biodata of the patients were obtained, history of the injury was obtained, and examination and investigation of the injured part of the body were done. The details of the findings were recorded in pro forma.

Data analysis was done by the Statistical Package for the Social Science version 17, and the result was presented in frequency tables.


  Results Top


During the study period, a total of 401 fractures were seen in 334 patients; the ages ranged from birth to 78 years with a mean age of 34.2 ± 5.4 years. There were 246 males and 88 females with a male-to-female ratio of 2.8:1. The most common form of trauma was motor vehicle-related injuries; this was followed by motorcycle-related injury as shown in [Table 1].
Table 1: Etiology of fractures

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The most common type of fracture was the tibia (n = 100, 25%); this was followed by the femur (n = 77, 19.2%) as shown in [Table 2].
Table 2: Types of fractures

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Isolated limb fractures were seen in 227 patients (56.6%), while multiple injuries were seen in 107 patients (26.7%), 1 patient had floating shoulder and floating elbow (0.2%), floating elbow was recorded in 11 patients (2.7%), 9 patients had bilateral tibia fractures (2.2%), and floating knee was seen in 7 patients (1.7%).

This study has shown that the most common cause of tibia fractures was motorcycle; fall was the most common cause of ankle fractures while motor vehicle was the most common cause of clavicular, humeral, radioulnar, spine, pelvic, femoral, and tibial fractures as shown in [Table 3].
Table 3: Etiology and frequency of fractures

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  Discussion Top


This study has shown the proportion of involvement of limbs and spine in trauma. Males are more involved than females; this may be adduced to the fact that males are more involved in rigorous and risky activities than females. This finding is similar to those reported by Thanni andKehinde and Ngim et al. in Nigeria.[10],[14]

The mean age group of patients involved with trauma was 34.2 ± 5.4 years. This means that fractures are more common among the young age group, which constitutes high percentage of the labor force of the country; this will eventually cause a great loss to both the patient's family and the nation, in terms of workforce and economic loss. Nwagbara and Opara and Labinjo et al. in their studies also noticed the young age group to be the most common group affected by trauma.[5],[17]

Fractures of long bones of the limb accounted for 73.1% of all the fractures, and limbs are the organ of locomotion which is essential for daily activities; this level of limb involvement shows the degree of incapacitation caused by trauma. The most common fracture was tibia and this may be due to the use of motorcycles as a means of transportation in the country; the tibia is usually at risk of fracture in motorcycle rider or passenger, when the motorcycle get involved in RTC, since there is no part of the motorcycle to protect this body part during accident. Next to tibia fracture in frequency in this study was femoral fracture. This findings agreed with the results of Ngim et al and Enweluso et al in Calabar and Lagos respectively.[14],[22] The study shows that fracture in the lower-limb bone is more common than those of upper-limb bones, and this was against the findings of Ebong in Ibadan where upper-limb fractures were more common than the lower-limb fractures.[23]

Fractures of the spine accounted for 12.7% (n = 51), and this is noteworthy as this high percentage demands for facilities and adequate training in the management of spine fractures. Okoro and Ohadugha in Owerri reported 1.9% (n = 19) of spine fractures which is lower compared to the finding in this study.[12] This increase in spine fracture may be adduced to increasing bad roads in the country, disobedience of road signs by the drivers, increasing violence, and industrialization in the country.

The most common cause of fractures was RTC and this accounted for 75.6% (n = 303). This finding was higher than that reported by Solagberu et al. about 16 years ago from this center.[6] This may be due to increase in means of transportation, bad road, and disobedience of road signs, hence the need for trauma prevention so as to reduce the increasing in trend. The most common form of RTC was motor vehicle followed by motorcycle; this may be due to high-energy impact involved in motor vehicle and motorcycle crashes. This finding is similar to the reports of Nwagbara and Opara and Solagberu et al.[5],[6]


  Conclusion Top


From this study, it can be proven that prevention of RTC by provision of good roads and enforcement of road safety laws will reduce fractures to a large extent. Improvement in facilities in terms of equipment and training on management of spinal cord-injured patients will improve the outcome of management of these patients since there is an increase in reported cases as shown by this study.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Mock C, Cherian MN. The global burden of musculoskeletal injuries: Challenges and solutions. Clin Orthop Relat Res 2008;466:2306-16.  Back to cited text no. 1
    
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Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012;380:2197-223.  Back to cited text no. 3
    
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Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012;380:2095-128.  Back to cited text no. 4
    
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Nwagbara IC, Opara KO. Limb trauma in a University Teaching Hospital setting. Niger J Surg 2011;17:64-7.  Back to cited text no. 5
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6.
Solagberu BA, Adekanye AO, Ofoegbu CP, Kuranga SA, Udofia US, Abdur-Rahman LO, et al. Clinical spectrum of trauma at a University Teaching Hospital in Nigeria. Eur J Trauma 2002;28:365-9.  Back to cited text no. 6
    
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Nwagbara IC, Opara KO, Enweani UN. Surgical accident and emergencies: The experience of Imo state University Teaching Hospital. Niger J Surg Sci 2010;20:11-6.  Back to cited text no. 7
    
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Solagberu BA, Duze AT, Ofoegbu CP, Adekanye AO, Odelowo EO. Surgical morbidity and mortality pattern in the accident and emergency room – A preliminary report. Afr J Med Med Sci 2000;29:315-8.  Back to cited text no. 8
    
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Odelowo EO. The problem of trauma in Nigeria. Pattern as seen in a multicentre study. Trop Geogr Med 1991;43:80-4.  Back to cited text no. 9
    
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Thanni LO, Kehinde OA. Trauma at a Nigerian teaching hospital: Pattern and docu-mentation of presentation. Afr Health Sci 2006;6:104-7.  Back to cited text no. 10
    
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Solagberu BA, Adekanye AO, Ofoegbu CP, Udoffa US, Abdur-Rahman LO, Taiwo JO, et al. Epidemiology of trauma deaths. West Afr J Med 2003;22:177-81.  Back to cited text no. 11
    
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Okoro IO, Ohadugha CO. The anatomic pattern of fractures and dislocations among accident victims in Owerri Nigeria. Niger J Surg Res 2006;18:54-6.  Back to cited text no. 12
    
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Owoola AM, Thanni LO. Epidemiology and outcome of limb fractures in Nigeria; a hospital based study. Niger J Orthop Trauma 2012;11:97-101.  Back to cited text no. 13
    
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Ngim NE, Udosen AM, Ikpeme IA. Review of seventy consecutive cases of limb injuries in Calabar the role of motorcyclists. Niger J Orthop Trauma 2006;5:38-40.  Back to cited text no. 14
    
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Oluwadiya KS, Oginni LM, Olasinde AA, Fadiora SO. Motorcycle limb injuries in a developing country. West Afr J Med 2004;23:42-7.  Back to cited text no. 15
    
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Solagberu BA, Ofoegbu CK, Nasir AA, Ogundipe OK, Adekanye AO, Abdur-Rahman LO, et al. Motorcycle injuries in a developing country and the vulnerability of riders, passengers, and pedestrians. Inj Prev 2006;12:266-8.  Back to cited text no. 16
    
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Labinjo M, Juillard C, Kobusingye OC, Hyder AA. The burden of road traffic injuries in Nigeria: Results of a population-based survey. Inj Prev 2009;15:157-62.  Back to cited text no. 17
    
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Nwagbara IC. Treatment of femoral shaft nonunion. Orient J Med 2010;1:1-5.  Back to cited text no. 18
    
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Ikpeme I, Ngim N, Udosen A, Onuba O, Enembe O, Bello S, et al. External jig-aided intramedullary interlocking nailing of diaphyseal fractures: Experience from a tropical developing centre. Int Orthop 2011;35:107-11.  Back to cited text no. 19
    
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Agaja SB, Ehalaiye BF. Pattern of fracture and dislocation injuries at ECWA hospital, Egbe Kogi state, Nigeria. Niger J Orthop Trauma 2005;4:46-54.  Back to cited text no. 20
    
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Ikem IC, Ogunlusi JD, Ine HR. Achieving interlocking nails without using an image intensifier. Int Orthop 2007;31:487-90.  Back to cited text no. 21
    
22.
Enweluzo GO, Giwa SO, Obalum DC. Pattern of extremity injuries in polytrauma in Lagos, Nigeria. Niger Postgrad Med J 2008;15:6-9.  Back to cited text no. 22
    
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    Tables

  [Table 1], [Table 2], [Table 3]



 

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Abstract
Introduction
Patients and Methods
Results
Discussion
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References
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