PATTERN, MAGNITUDE AND OUTCOME OF OPEN FRACTURES INAABET HOSPITAL ORTHOPEDICS WARD, ADDIS ABEBA, ETHIOPIA: A ONE YEAR REVIEW

Abstract

bstract Background: A bone fracture is defined as a break in the structural continuity of a bone. Fractures are classified based on the etiological, clinical and radiological classification. An open fracture refers to an osseous disruption in which a break in the skin and underlying soft tissue communicates directly with the fracture and its hematoma. A retrospective study conducted in Gondar University Hospital in 2013 among patients who sustained injuries presenting to the emergency room,22.9% had fractures with 21.3% of them being open fractures.(9) Knowing the magnitude, nature, pattern and site of open fractures commonly presenting to an institution helps in planning on effective treatment and also helps in developing effective systems of directing resources Objective: The main objective of this study was to determine the pattern, magnitude of different types, identify common causes of and outcomes of open fractures in AaBET hospital among patients operated on for open fractures over a period of one year. Method: A descriptive, cross sectional, retrospective study was conducted among patients operated on for open fractures in a one year period from 01/02/2017 to 01/02/2018.The study was conducted according to the time table provided by the department of public health that spans from January, 2018 to July, 2018. The necessary information was obtained from patients’ charts which were first identified from the Operation room log book. The data obtained from this study is mainly presented in textual and tabular form. Results: From a total of 241 patients included in the study, 177 (73.4%) were males and 64(26.6%) were female giving a male to female ratio of 2.76 to 1.0 showing a significant predominance by males. Majority of patients were found in a younger age group with a mean age of 31.96 ± 14 years. Road traffic accidents were the major cause of open fractures identified by the study accounting for 56.4% of patients, with the most affected age group being 25-44 years. The most common type of fracture was Tibio-Fibular fractures found in 68.9% of the study population and based on the Gustilo & Anderson classification of severity of fractures,100 (48.5%) had Gustilo &Anderson type 2 fractures followed by Gustilo & Anderson type 3A fractures, Gustilo & Anderson Type 1 fractures, Gustilo & Anderson Type 3B fractures, and Gustilo & Anderson Type 3C fractures accounting for 54 (26.2%), 33 (16%), 14 (6.8%) and 5(2.4%) respectively. The most common surgeries done for open fractures was Sign Nail 105 (43.6%) followed by External Fixator 96 (39.8%), and Irrigation and debridement with cast or gutter. Plating, open reduction and internal fixation, and amputation account for 24 (9.9%) patients. Conclusion and Recommendation: There were significantly more male patients who had surgeries done for open fractures than were females and majority of patients were younger individuals, ages found in middle adulthood. Road traffic accidents were the major reason for patients to sustain open fractures. The most commonly involved part of the body was the lower limb. SignNails and External fixators were the two most commonly performed surgeries for open fractures. Average hospital stay was two weeks. So, there is further need of a study conducted to determine the factors that influence these outcomes and identify any possible measures to be taken to reduce the most common causes of open fractures. Keywords: Ethiopia, Africa, Open fracture, Trauma, Road Traffic Accident, AaBET Hospital, SignNail, External Fixator