Tibial Diaphyseal Fractures: Aetiology, morphology and treatment in adult patients at Moi Teaching And Referral Hospital, Eldoret, Kenya

Abstract

Background: Tibial Diaphyseal Fractures (TDFs) arise from various forms of trauma and assume different patterns. They are responsible for high morbidity and mortality.
Objective: To describe the mechanism of injury, morphology and treatment methods of tibial diaphyseal fractures in adult patients at Moi Teaching and Referral Hospital, Eldoret, Kenya.
Methods: A descriptive prospective study on 89 adult patients with tibia shaft fractures. An interviewer administered questionnaire was used to collect data. Association between categorical variables was assessed using Pearson’s Chi Square test.
Results: The median age was 28.0 years (IQR: 24.0-40.0) with a male to female ratio of 3.2:1. Most of the TDF (67.4%) were due to Road Traffic  Accidents (RTAs); fall 16 (18.0%) and the least, gunshot 3 (3.4%). Up to 40.9% of the fractures were open type while (59.1%) were closed. Middle 1/3 tibia shaft was the commonest site of fracture at 52.7%. Fibula fracture was the most associated injury at 62.9%. Operative management was done
in 61.6%.
Conclusion: Road Traffic Accidents were the major cause of TDF with motorcycles injuries leading. Most TDF were closed type; mainly at mid third level. Fibular fractures were the most associated injuries. Treatment of TDF was mainly surgical using locked intramedullary nail.

Key words: Tibia Diaphyseal Fractures (TDFs), Road Traffic Accidents (RTAs), Motor Vehicular Accident (MVA)