TY - JOUR PY - 2017// TI - High morbidity and mortality after lower extremity injuries in Malawi JO - International journal of surgery (London, England) A1 - Chagomerana, Maganizo B. A1 - Tomlinson, Jared A1 - Young, Sven A1 - Hosseinipour, Mina C. A1 - Banza, Leonard A1 - Lee, Clara N. SP - 23 EP - 29 VL - 39 IS - N2 - 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.

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Language: en

LA - en SN - 1743-9191 UR - http://dx.doi.org/10.1016/j.ijsu.2017.01.047 ID - ref1 ER -