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Citation
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Chagomerana MB, Tomlinson J, Young S, Hosseinipour MC, Banza L, Lee CN. Int. J. Surg. (London, England) 2017; 39: 23-29. |
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Affiliation
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Department of Plastic Surgery, The Ohio State University, 915 Olentangy River Road Suite 2100, Columbus, OH 43212, USA. |
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Abstract
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INTRODUCTION: A lower extremity injury can be a devastating event in low-income countries due to limited access to surgical care. Its incidence, treatment patterns, and outcomes, however, have not been well-described.
METHODS: We prospectively enrolled all patients admitted with lower extremity trauma to a tertiary hospital in Lilongwe, Malawi between October 2010 and September 2011. Patients with a lower extremity injury but primarily admitted for unrelated reasons were excluded. The outcomes were deaths, complications, and length of hospital stay.
RESULTS: Of the 905 patients eligible for analysis, 696 (77%) were males. Most patients had femur fractures (46%), and most were treated non-operatively (70%). Overall mortality rate was 3.9%. For adult patients with femur fractures, mortality was higher in patients treated with traction (9.0%) than for those treated with surgery (1.3%). The total complication rate was 15%, with adjusted odds of developing a complication higher in patients with concurrent head injury (OR = 2.8; 95% CI: 1.3 - 6.0), and patients who had an operative treatment (OR = 2; 95% CI: 1.2 - 1.9). The median length of stay was 16 days (IQR: 6 - 27) and was greatest among patients with femur fractures.
CONCLUSION: Lower extremity injuries resulted in substantial mortality and morbidity in this low-income country. Mortality was particularly high among patients with femur fractures who did not have surgery. Modern orthopedic trauma surgery is greatly needed in low-income countries.
Copyright © 2017 IJS Publishing Group Ltd. All rights reserved.
Language: en |