choices for operative management of fractures in a developing country.
Keywords:Keywords: Fractures, operative fixation method, orthopaedic services, hospitals
Aims: Operative management of fractures has changed significantly in the 21st century with the introduction of simple but effective devices and procedures to improve fracture care and healing outcomes. This study describes the commonest fractures treated surgically, type of fractures and operative fixation methods used for patients seeking orthopaedic services in two hospitals in Ghana.
Methods: Review of all patients who have had operative fracture fixation at the Cape Coast Teaching Hospital and St. Joseph Orthopaedic Hospital between January 2016 to December 2018. Operation records of 1,168 were reviewed for their age, gender, fractured bone, type of fracture, operative fixation method and devices used for fixation.
Results: A total of 1,168 fractured patients were treated operatively irrespective of age in the 3 year period reviewed. Males (817)compared to females (351) in a ratio of 2.3:1. The 21 – 40 year age group had the highest number of fractures (50% of femur fractures, 52% of tibial and 56% of forearm fractures) managed operatively. Plate osteosynthesis was found to be the most preferred method of fixation for the major long bones; femur 360(66 %), Humerus 69(78% ), radius and ulna 81(78%).
Conclusion: Fractures of the femur and tibial shafts represent an overwhelming majority of operatively managed long bone fractures. Plating as opposed to the gold standard of intramedullary nailing was the most commonly employed fixation method for femur and tibial fractures, so scarce resources should be channelled towards acquiring the requisite instrumentation and skill set for the fixation of these fractures.
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