|Year : 2018 | Volume
| Issue : 2 | Page : 87-89
Epidemiology of traumatic fractures in a tertiary health center in Nigeria
OM Babalola1, Oni Nasiru Salawu2, BA Ahmed1, GH Ibraheem1, A Olawepo1, SB Agaja1
1 Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Nigeria
2 Department of Surgery, Federal Medical Centre, Birnin Kebbi, Nigeria
|Date of Web Publication||22-Nov-2018|
Dr. Oni Nasiru Salawu
Department of Surgery, Federal Medical Centre, Birnin Kebbi
Source of Support: None, Conflict of Interest: None
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|| |
Musculoskeletal injuries are a major public health problem globally, contributing a large burden of disability, suffering, and mortality. 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.
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. The fraction of global death due to injuries was estimated by WHO to be 9.6%., The most common cause of trauma in Nigeria is RTC.,,,,,,,, The trauma from RTC has increased tremendously in Nigeria since the introduction of motorcycle as a means of commercial transportation in the country.,,,
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.,,, The lower-limb bones are the most commonly reported fractures following RTC.,,,,,,,
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|| |
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|| |
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].
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].
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].
| Discussion|| |
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.,
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.,
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., 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.
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. 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. 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.,
| Conclusion|| |
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
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3]