Overview of Indications and Outcome of Musculoskeletal External Fixation in a National Orthopaedic Hospital in Northern Nigeria.

Abstract

Objective: To study the indications and outcome of external fixation at the National Orthopaedic Hospital Dala-Kano (NOHD).
Patients and Methods: This is a 5year retrospective study of the uses, challenges and problems of external fixator usage at National Orthopaedic Hospital Dala Kano.
Results: There were 90 males (81.8%) and 20 Females (18.2%) with a male to female ratio of M:F, 4.5:1. The mean age was 33.1 years (range 6-75year). The uniplanar fixator (AO type) was the commonest type accounting for 80 (72.7%), followed by the Charnleys clamp for arthrodesis 19(17.3%), the Ilizarov circular frame 7 (6.4%), the linear rail fixation system 3 (2.7%) and the Wagner device 1(0.9%). Open injuries were the commonest indications accounting for 71/110(64.6%). This was followed by
indication for arthrodesis 23(20.9%), limb reconstruction procedures 11/110(10%) and infected non-unions 5(4.5%) . The mean duration of application was 10.8 weeks (range 0.3-44weeks). The mean duration of hospital stay was 14.3 weeks while the mean waiting time was 21.4 days. There were 11 complications occurring 45 times in 32 patients. Osteomyelitis was the commonest occurring in 10 (9%), this was followed by pin tract infection 8(7.2%), equinus deformity 9(8.2%) and joint stiffness 6(5.4%). Satisfactory results were achieved in 74(67.3%),
unsatisfactory 30 (27.3%) and the procedure was abandoned in 6
patients.
Conclusion: We conclude that open injuries are the commonest indication for external musculoskeletal fixation. Satisfactory result was achieved in most cases. The Ilizarov circular frame and the linear rail system are increasingly used in our centre to treat challenging trauma and orthopaedic problems.. Males were much more affected than females in our study.

Key words: external fixation, indications, outcome, Northern
Nigeria.