Management of Patients with Post- Traumatic Exposed Bones at Moi Teaching and Referral Hospital, Eldoret, Kenya

Abstract

Background: The global frequency for open long bone fracture is at least 11.5 cases per 100,000 persons
per year. Precise published research information regarding the characteristics and the management of
patients with post- traumatic exposed bones for Africa, Kenya and Moi Teaching and Referral Hospital-
Eldoret is non- existent. This study will provide the much needed research information.
Objective: To assess the characteristics of patients with post- traumatic exposed bones with their
management at Moi Teaching and Referral Hospital, Eldoret.
Setting: Moi Teaching and Referral Hospital, Eldoret, Kenya.
Design: Hospital based descriptive retrospective study.
Subjects: One hundred and ninety six patients managed for post- traumatic exposed bones between 1st
January, 2006 and 31st December, 2010.
Methods: The medical records (files) were retrieved from the Records Department; data was gathered,
recorded in observation checklist, organized, cleaned and analyzed in the statistical package for social
science software version 19.
Results: Males-167, females-29; ratio: 5.76:1. Mean age: 32.51 years (SD=13.26). Referrals were 51%, at least 60% were of low literacy and income earning status. All patients had exposed bones due to open fractures (97%) and degloving injuries (3%). Road traffic accidents were responsible in 49.5% of the patients. Duration of ailment was 0-300 days (median= 1.00). All patients benefited from surgical  interventions. Waiting time for surgery was 0-67 days (median= 1.00); while number of procedures were 1-9 (mean= 2, (SD=1.6)). Survival was 99.5%; length of hospitalization was 2- 177 days (median= 24.00; mean= 36.3 days (SD= 32.8)). The main complication was infection (62 patients). Follow up was adhered to by 59% of the patients.
Conclusions and Recommendations: Majority of patients were: referred, males, of low literacy and low income earning status. All patients had exposed bones and benefited from one form or another of the
numerous surgical interventions with satisfactory outcome. Scarcity of resources remained major  challenge. There is need to create awareness and empower people socio-economically; as well as providing resources required in prevention, control and treatment of this disorder.

Key words: Exposed bones, Debridement, Fracture stabilization, Coverage procedure