Trauma is a major problem in both developing and developed countries. World wide road-traffic injuries (RTIs) represent 25% of all trauma deaths. Injuries cause 12% of the global disease burden and are the third commonest cause of death globally. In our own environment, trauma is also important, with RTIs being a leading cause of morbidity and mortality. There is limited data on RTIs in West African countries, and this necessitated our study. We aimed to find common causative factors and proffer solutions. This was a one year prospective study examining all cases of trauma from RTIs seen at the Accident and Emergency Department of the Ebonyi State University Teaching Hospital (EBSUTH), Abakaliki, Nigeria. Three hundred and sixty-three patients were studied. There was a male/female ratio of 3.4:1, with the modal age being 25 years. Most injuries involved motorcycles (54%). Passengers from cars and buses were also commonly affected (34.2%). Most of accidents occurred from head-on collisions (38.8%). Soft-tissue injuries and fractures accounted for 83.5% of injuries. The head and neck region was the commonest injury site (41.1%), and the most commonly fractured bones were the tibia and fibula (5.8%). Death occurred in 17 patients (4.7%), and 46 (12.7%) patients discharged themselves against medical advice. Improvements in road safety awareness, proper driver education-especially motorcycle drivers-and proper hospital care are needed in our subregion.

Purpose We aimed to determine the epidemiological pattern and highlight challenges of managing traumatic amputation in our environment. Method This was a ten-year retrospective study of all the patients with traumatic extremity amputation seen in Ebonyi State University Teaching Hospital and Federal Medical Centre Abakaliki from January 2001 to December 2010. Result There were 53 patients with 58 amputations studied. There was a male to female ratio of 3:1 and the mean age was 32.67±1.54 years. Amputations were more prevalent in the rainy season. Road traffic accident was the predominant causative factor and accounted for about 57% of amputations. A majority of the patients (81.4%) had no prehospital care and none of the amputated parts received optimum care. Three patients underwent re-attachment of amputated fingers and one was successful. Wound infection (in 56.6% of patients) was the most common complication observed. Overall mortality was 7.5% and all were due to complications of amputations. Conclusion Appropriate injury prevention mechanisms based on the observed patterns are needed. Educational campaigns for prevention should be intensified during the rainy season and directed toward young men. Measures aimed at improving pre-hospital care of patients and optimum care of amputated parts is an important aspect to be considered in any developmental programme of replantation services in the sub-region.

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Road traffic injuries (RTI) are a rapidly growing public health problem in developing countries. This study was aimed at assessing the early outcome of RTIs received in our hospital emergency room. Understanding this will help to achieve optimum injury outcome. A prospective study was conducted on all patients presenting with RTIs to the emergency room of the Ebonyi University Teaching Hospital, Abakaliki, from 1 March 2007 to 29 February 2008. Out of 363 patients: 72.45% were treated in the emergency unit and discharged; 12.7% left against medical advice; 10.9% were admitted to the ward; and 4.7% died. Self-discharge against medical advice was significantly related to the type of injury (78.3% had fracture/dislocation) and gender (P = 0.001). The patronage of traditional bone setters, because of cultural belief that they have supernatural ability to treat fractures, was the major reason given by those who left against medical advice. The morbidity and mortality rate was significantly related to the road type (P = 0.005 - a higher rate was observed for RTIs received on intercity roads than intracity ones) and the type of crash (P = 0.03 - more than half from head on collisions). Although the mortality rate was within the expected range, the preventable death rate was high, and the majority of deaths occurred within the 'golden hour' . Improvement in pre-hospital and emergency room care of patients with RTIs, as well as public awareness of the availability and efficacy of orthodox orthopaedic trauma care, are needed in the developing countries.