The burden of femoral shaft fractures in Tanzania

Conway, Devin; Albright, Patrick; Eliezer, Edmund; Haonga, Billy; Morshed, Saam; Shearer, David

doi:10.1016/j.injury.2019.06.005

Cited by 13 publications

(14 citation statements)

References 15 publications

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“…To allow the patient to ascend stairs comfortably, the sum of hip and knee range of motion and flexion should be at least 160°. [14,15] In our study majority of the cases were males 80 (62.5%) and 48 (37.5%) were females. There was no any significantly difference among both groups related to age 29 ears and body mass index 2kg/m 2 .…”

Section: Discussionsupporting

confidence: 47%

“…Even more concerning is the fact that existing trials of non-SIGN implants generally followed patients for less than a year and didn't employ equipment that had been well tested. Additional studies are needed to fill this knowledge gap, especially in low-and middle-income countries (LMICs), where femur fractures are common [14] and SIGN nails are commonly used.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Compare the Results of Closed Interlocking Nail Shaft of Femur Versus open Interlocking Nail

Khan¹,

Khan²,

Khan³

et al. 2022

PJMHS

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Objective: Aim of current study is to compare the outcomes between closed vs open interlocking nail among patients had femur shaft fracture. Study Design:Retrospective cohort study Place and Duration:Orthopedics department of Mardan Medical Complex and Muhammad Medical College and Hospital, Mirpurkhas during the period from 16th June 2020 to 15th July 2021. Methods:One hundred and twenty eight patients with ages 25-70 years were included in this study. All the patients had femoral shaft fracture. Patients’ age, sex, body mass index and cause of fracture was calculated after taking informed written consent. Included patients were equally divided in two groups. Group O received open interlocking nail and closed interlocking nail technique was used in group P group. Post-operatively radiological and surgical outcomes among both groups were assessed and compared in terms of union, non-union and delayed union. Prevalence of infection among both groups was also calculated. Flynn’s criteria were used to assessfunctional outcomes. We used SPSS 23.0 edition to analyze all of the data. Results:Majority of the cases were males 80 (62.5%) and 48 (37.5%) were females. There was no any significantly difference among both groups related to age and body mass index. High impact of collision was the most common cause found in 75 (58.6%) followed by RTA 35 (27.3%) and fall found in 18 (14.1%) cases. Mean duration of surgery in group O was 92.34±5.23 minutes and in group P was 62.12±3.33 minutes. Mean union time in closed group was lower 19.14±5.45 weeks as compared to open group 28.7±6.19 weeks. Frequency of union in group P was higher among 64 (96.9%) as compared to group O 52 (81.3%) cases. Delayed union in group O found among 14 (21.9%) cases and in group P was among 7 (10.9%) cases. According to Flynn’s criteria, closed interlocking nail showed significantly excellent and good results with pp value <0.05 as compared to open technique. Rate of complications were also lower in closed group with p value <0.05. Conclusion: In this research we concluded that closed interlocking nail for femur shaft was effective and useful as compared to open interlocking nail in terms of good radiological and functional outcomes. Except this, post-operative complications were also noticed lower in patients who received closed interlocking nail. Keywords:Closed/Open interlocking nail, Surgery, Femur Shaft, Outcomes, Complications

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Section: Discussionsupporting

confidence: 47%

Section: Introductionmentioning

confidence: 99%

Compare the Results of Closed Interlocking Nail Shaft of Femur Versus open Interlocking Nail

Khan¹,

Khan²,

Khan³

et al. 2022

PJMHS

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“…However, these observations are based on extrapolation from studies done at a small number of facilities in a limited number of locations, and from surveillance systems, household surveys and facility-/hospital-level data inquiries. Attempts have been made to calculate incidences of femoral shaft fractures using hospital data and staff interviews in Malawi [ 13 ]. Without understanding the burden of injury through registries, it is difficult to inform policy and allocate resources which will achieve the greatest impact in injury prevention, treatment, and rehabilitation of injured persons.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of fractures and their treatment in Malawi: Results of a multicentre prospective registry study to guide orthopaedic care planning

Schade

Mbowuwa²,

Chidothi³

et al. 2021

PLoS ONE

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Importance Injuries cause 30% more deaths than HIV, TB and malaria combined, and a prospective fracture care registry was established to investigate the fracture burden and treatment in Malawi to inform evidence-based improvements. Objective To use the analysis of prospectively-collected fracture data to develop evidence-based strategies to improve fracture care in Malawi and other similar settings. Design Multicentre prospective registry study. Setting Two large referral centres and two district hospitals in Malawi. Participants All patients with a fracture (confirmed by radiographs)—including patients with multiple fractures—were eligible to be included in the registry. Exposure All fractures that presented to two urban central and two rural district hospitals in Malawi over a 3.5-year period (September 2016 to March 2020). Main outcome(s) and measure(s) Demographics, characteristics of injuries, and treatment outcomes were collected on all eligible participants. Results Between September 2016 and March 2020, 23,734 patients were enrolled with a median age of 15 years (interquartile range: 10–35 years); 68.7% were male. The most common injuries were radius/ulna fractures (n = 8,682, 36.8%), tibia/fibula fractures (n = 4,036, 17.0%), humerus fractures (n = 3,527, 14.9%) and femoral fractures (n = 2,355, 9.9%). The majority of fractures (n = 21,729, 91.6%) were treated by orthopaedic clinical officers; 88% (20,885/2,849) of fractures were treated non-operatively, and 62.7% were treated and sent home on the same day. Open fractures (OR:53.19, CI:39.68–72.09), distal femoral fractures (OR:2.59, CI:1.78–3.78), patella (OR:10.31, CI:7.04–15.07), supracondylar humeral fractures (OR:3.10, CI:2.38–4.05), ankle fractures (OR:2.97, CI:2.26–3.92) and tibial plateau fractures (OR:2.08, CI:1.47–2.95) were more likely to be treated operatively compared to distal radius fractures. Conclusions and relevance The current model of fracture care in Malawi is such that trained orthopaedic surgeons manage fractures operatively in urban referral centres whereas orthopaedic clinical officers mainly manage fractures non-operatively in both district and referral centres. We recommend that orthopaedic surgeons should supervise orthopaedic clinical officers to manage non operative injuries in central and district hospitals. There is need for further studies to assess the clinical and patient reported outcomes of these fracture cases, managed both operatively and non-operatively.

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“…Of the 15,745 femoral fractures in Australia during 2013-2014, only 1456 (9.24%) were coded as femoral shaft fractures occurring in the diaphysis of the bone (5). International incidence estimates of femoral shaft fractures range from 2 to 18 per 100,000 people, while an Australian study, which included all patients (age, treatment, died pre-hospital) reported a higher incidence of 21 per 100,000 (3,(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Are you Pulling My Leg? Does the Use of Traction Splints in the Pre-Hospital Management of Patients with Femur Fractures Reduce the Complications Compared to Traditional Splinting?

Syme¹

2020

Australasian Journal of Paramedicine

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IntroductionFemoral shaft fractures are a serious but infrequently seen injury in the pre-hospital environment. Management of these fractures includes immobilisation, analgesia, fluid administration and appropriate conveyance. Despite traction splints being widely used since World War I, there has been no systematic review published to date. In order to support evidence-based practice this systematic review will attempt to determine if the use of traction splints in the pre-hospital management of patients with femoral shaft fractures reduces the complications compared to traditional splinting. MethodsA systematic review using the MEDLINE database (1946 to 27 August 2019) using a combination of keywords and medical subject headings. The reference lists of all relevant papers were reviewed to identify further papers. The title and abstracts of all records retrieved by the search strategy were reviewed by one independent author to identify potentially relevant papers. All potentially relevant papers were read in full text. ResultsA total of 42 papers were identified from the search strategy; 10 met the inclusion criteria and informed the results of this paper. Five key themes were identified: inappropriate application; on-scene times; effect on pain; vascular complications; and nerve complications.ConclusionTraction splints are frequently applied incorrectly but no statistical increase in on-scene times was found. A statistically significant decrease in the need for blood transfusions was demonstrated with the application of a traction splint.

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The burden of femoral shaft fractures in Tanzania

Cited by 13 publications

References 15 publications

Compare the Results of Closed Interlocking Nail Shaft of Femur Versus open Interlocking Nail

Compare the Results of Closed Interlocking Nail Shaft of Femur Versus open Interlocking Nail

Epidemiology of fractures and their treatment in Malawi: Results of a multicentre prospective registry study to guide orthopaedic care planning

Are you Pulling My Leg? Does the Use of Traction Splints in the Pre-Hospital Management of Patients with Femur Fractures Reduce the Complications Compared to Traditional Splinting?

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