CHOICES FOR OPERATIVE MANAGEMENT OF FRACTURES IN A DEVELOPING COUNTRY

Abstract

Introduction: Fracture fixation in poor countries is hampered by lack of financial resources. It is important to define what fracture types present for surgery to channel scarce resources appropriately. Objectives: This study describes the commonest fractures treated surgically, and operative fixation methods used in patients who presented for operative fracture fixation. Methods: A retrospective review of all patients who have had operative fixation of fractures at the Cape Coast Teaching Hospital and St. Joseph Orthopaedic hospital located in the Central and Eastern Regions of Ghana, respectively, between January 2016 to December 2018. We reviewed the operation records of 1,168 for their age, gender, fractured bone, type of fracture, operative fixation method and devices used for fixation. Results: A total of 1,168 patients were treated operatively irrespective of age in the three-year period reviewed. Male (817) to females (351) ratio of 2.3:1. Only hip fractures (60%) were more common in females. The 21 – 40 years age group had the highest number of fractures (50% of femur fractures, 52% of tibial and 56% of forearm fractures) and operative procedures. 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: Scarce resources should be channelled towards acquiring the requisite instrumentation and skill set for the fixation of tibial and femur fractures in the short term as these fractures represent the most commonly fixed fractures in a resource poor setting.