Simple fracture of the tibia and fibula following a road traffic accident in a child street hawker

Abstract

Background: Street hawking remains one of the major health challenges in Nigeria. The involvement of children in street hawking, as was seen in this case study, constitutes child labour and is a form of child abuse. The major reason given by all hawkers engaging in the  trade was the 3 need to contribute to the family income. Motor vehicular accident, topped the list of problems faced by street  hawkers in Nigeria. Astudy done in South-eastern Nigeria showed that 70% of road traffic accidents victims were pedestrians who were  either crossing the major roads unguarded or  were hawking along the road.

Methods: This is a case report of an 11-year-old boy who was knocked down by a motorbike while hawking on the street. He presented to  the accident and emergency unit of the hospital within 30 minutes of the accident with pains and swelling of the right leg. The patient  had difficulty walking with the injured leg and had to be carried to the hospital.

Results: On examination the patient was found to be  anxious and in painful distress. He was not pale, anicteric and not dehydrated. He was  afebrile to touch with a temperature of 36.8^o C.  He did not have peripheral lymphadenopathy or pedal oedema. There was a swelling at the middle third of the right leg with some  deformity. There was no differential warmth on palpation, but he had marked tenderness and crepitus around the  swelling. There were  also bruises on both knees and elbows.

Conclusion: Prevention of fracture complication will include reporting early to hospital which is  important because infection of an open fracture could lead to osteomyelitis, which is a dreaded complication that could be extremely  difficult to treat requiring long-term antibiotics and debridement of the bone to achieve control. Prevention of street hawking especially  in children involves proper education of parents against undue exposure of their children to risks is one of the ways to reduce this  fracture.