Permanent Civilian Musculoskeletal disability following injury-17 Year trends.

Abstract

Background: This study was aimed at determining the magnitude of civilian permanent musculoskeletal disability from injuries and identifies trends observed in the proportions of major causes of the disability in the last two 'decades'.

Settings: Addis Ababa University, Medical Faculty, Department of Orthopedic Surgery, Tikur Anbessa Hospital

Methods: This was a retrospective analysis of Orthopedic Medical Board proceedings, Jan.1988-Jan.2005. Medical records and medical board proceeding decisions of 3,687 applications for assessment of permanent musculo-skeletal disability following injury were audited. Non- civilian applications, disabilities not from injury and other forms of disability were excluded from the study.

Results: Males accounted for 81% of cases. The majority (87.4%) were middle aged in the working age (20-60 years). The mean age was 28 year. Road traffic crushes were the commonest (47%) cause of injury followed by machine injury (18%) and fall injury (17.8%). The commonest sites injured were the hand (26%) and the leg (12%). Sixty percent of the applications were made within less than six months of the injury and 93% (450/484) of the reapplications were from this group. The board awarded whole- person disability percentage of less than 10% for 2,105 (57%) and of these 258 (7%) was awarded 'zero'. It also recommended resumption of the previous 'Normal' work in 2,655 (72%) of the applications. Over the decades, increasing trend in proportion of permanent musculo-skeletal disability applicants from road traffic accidents, machine injury and fall was observed. On the contrary, proportion of civilian applicants of permanent musculo-skeletal disability from explosives and assaults have shown a decreasing trend.

Conclusion: Number of applicants for disability assessment is increasing and most of the causes are preventable. Road traffic accident, machine injury and fall (in a respected order) are commonest causes of permanent civilian musculo-skeletal disability applications. Trends in proportions of causes of permanent musculo-skeletal disability change over a period. Pre-screening may save the medical board's time and applicant's money.