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Background: While the congenital clubfoot deformity is a common deformity recorded in Uganda, the incidence of the condition had never been accurately determined. The objective of this study was to measure the overall incidence of congenital clubfoot deformity in a representative sample of births. Methods: A study of all babies born with foot anomalies took place from March 2006 to October 2007. The study was based at 8 Regional Hospitals with active maternity units and a functioning clubfoot clinic. All babies with foot deformities at birth at any of eight centres as detected by the delivery room staff were referred to the respective centre's clubfoot clinic. The children were examined by clubfoot clinic orthopedic officers who diagnosed the specific deformity. Children referred to the clinic from any source and born at the maternity unit were included in the study. The denominator was all live births at the centre during the study period. Results: The total number of live births during the study period was 110,336. The maternity units of the centres identified 290 infants with a foot deformity. One hundred and thirty infants born during the study period were diagnosed in the clubfoot clinic as having a congenital clubfoot deformity. The proportion of infants with a clubfoot deformity was 1.2 per 1000 births over the 20-month period. The male to female ratio was 2.4:1. Recommendation: The rate of clubfoot deformities in the newborn can be used to estimate the numbers of children who should be treated and to estimate resource needs for the identification and management of this treatable congenital malformation. By comparing the number of those treated with the expected number of cases, the numbers of children with neglected clubfoot can be calculated.

BackgroundMusculoskeletal injuries are a common cause of morbidity after road traffic injury (RTI) in motorizing countries. District hospitals provide front-line orthopedic care in Uganda and other sub-Saharan African nations. Improving care at the district hospital level is an important component of the World Health Organization’s strategy for surgical and trauma systems strengthening, but the data necessary to inform RTI safety and care initiatives has previously been insufficient at the district hospital level. The objective of this study was to provide data on the patient population and patterns of musculoskeletal injury caused by RTI at Ugandan district hospitals.MethodsIn this cross-sectional study, all patients with musculoskeletal injuries identified on x-ray presenting to three Ugandan district hospitals from October 2013 to January 2014 were interviewed and examined to obtain data on patient demographics and injury context by road user category. This manuscript is a sub-group analysis of RTI victims from a broader dataset of all musculoskeletal injuries.ResultsVulnerable road users comprised 92 % of musculoskeletal RTI patients, with 49 % (95 % CI 41–57 %) pedestrians, 41 % (95 % CI 33–49 %) motorcyclists, and 2 % (95 % CI 0–4 %) cyclists. Commonly injured subgroups included student pedestrians (33 % (95 % CI 22–44 %) of pedestrians) and motorcyclists with less than a post-secondary education (74 % (95 % CI 63–85 %) of motorcyclists). The morning hours were the most common time of injury for all RTI patients (37 %%; 95 % CI 30–44 %) and motorcyclists (46 %; 95 % CI 34–58 %), while pedestrians were most commonly injured in the evening (32 %; 95 % CI 21–43 %).ConclusionsBy demonstrating commonly injured demographic groups and high frequency times of day for injury, this surveillance study of musculoskeletal RTI suggests targeted avenues for future road safety research in the districts of Uganda. Compared with previous studies from the capital of Uganda, these results suggest that Ugandan district hospitals care for a disproportionate share of vulnerable road users, a discrepancy which may pertain to other sub-Saharan African nations, as well. Strengthening district hospital orthopedic care should be considered a priority of strategies aimed at improving outcomes for these vulnerable groups.

Purpose Supracondylar fractures (SCF) of the humerus is one of the commonest global health concerns among children and need a rigorous management process to obtain satisfactory outcomes. It is of paramount importance to use systematic guidelines to aid abate bad fracture outcomes. The study primarily sought to determine the functional and radiological management outcomes of SCF of the humerus in children at Mulago National Referral Hospital (MNRH) and associated factors to the outcomes. Methods We conducted a hospital-based, cross-sectional study among children managed for SCF of the humerus at MNRH. Using Flynn’s criteria, current flexion and extension at the elbow joints, humeroulnar angle and the neurology were assessed and compared to the contralateral limb to get the functional outcomes. The pre-management digital radiographs of the elbow joint were compared with the current radiographs to assess radiological outcomes. Bivariate and multivariate analyses were used to determine the associated factors. Results Of the 77 children, 46 (60%) were male with a mean age of 7.86±2.30 years. Gartland type I fracture constituted 55.8% (43), type II was 29.9% (23) and type III was 14.3% (11). About 88.3% of the patients were managed non-operatively and 11.7% were managed operatively. The overall satisfactory functional outcome was 46.7%, while 81.8% of the patients had a satisfactory radiological outcome at 6 months after the intervention. Delay in seeking treatment, type 1 fracture, and prolonged duration of immobilization were significantly associated with unsatisfactory functional management outcome. Type II fracture and prolonged duration of immobilization were significantly associated with unsatisfactory radiological management of SCF of the humerus. Conclusion The short-term functional outcome was unsatisfactory, while a satisfactory radiological outcome was found in most of the patients. Duration of immobilization, type of fracture, and seeking late medical care had a negative impact on the outcome of these fractures.

Background: Malignant musculoskeletal tumours are comparatively rare tumours and delays in diagnosis and treatment are common. Understanding the factors that influence delay is important so as to improve the outcomes for cancer patients. Aim: To describe factors associated with delay in presentation of patients with primary musculoskeletal tumours. Study Design: Descriptive cross-sectional study. Setting: The study was conducted in a tertiary referral hospital from July to December 2014. Methodology: 56 patients with a confirmed histopathological diagnosis of a primary malignant musculoskeletal tumour and who had consented to the study were included. Data was collected using a pre-tested questionnaire. The clinical findings, laboratory results and radiographs of the lesions and the chest, as well as histopathological results were used to stage the musculoskeletal tumour. Data was analyzed using SPSS software version 20.0. Univariate and bivariate analysis was done for associations and results presented in the form of tables, pie charts and bar graphs. Results: A total of 56 patients were studied, 34 (60.7%) males and 22 (39.3%) females with a male to female ratio of 1.5:1. 73.2% (41) of the patients were adults while children comprised 26.8% (15). The age range was 4yrs-78yrs, with a mean of 32.25yrs. The mean patient delay was four months with 50% (28) of the patients seeking care for the first time after three months. Males were twice as likely to present late compared to females (OR 2.5, P=0.10) while patients younger than 40 years were more likely to present late (OR 1.4, P=0.59). Low educational level (OR 3.7, P=0.15) and low family income (OR 2.3, P=0.38) were associated with delayed presentation. Conclusion: Delayed presentation of patients with MS tumours is influenced by a multitude of factors ranging from the socio-demographics (age, sex, education level), socio-economic status and tumour knowledge, beliefs and perception.