Incidence and Pattern of Extremity Fractures seen in Accident and Emergency Department of a Nigerian Teaching Hospital

Abstract

Background: Extremity fracture is an important component of musculoskeletal injury worldwide. The distributions of etiological factors and types of extremity fractures vary from and within subregions and have implications in preventive and treatment strategies. This study aimed at determining the incidence and pattern of extremity fractures seen in accident and emergency department (A and ED) of a teaching hospital in a developing country. Patients and Methods: This was a prospective study of all patients with extremity fractures seen in A and ED of Federal Teaching Hospital Abakaliki over 12 months between February 1, 2016 and January 31, 2017. Results: Extremity fractures necessitated visit in 251 patients with 306 fractures giving an incidence of 22.6/1000/year of A and ED attendances (39.2/1000 males and 9.2/1000 females), with age range of 2–90 years and a mean of 35.6 ± 16.7 years. Road traffic accident (RTA) (184, 73.3%), fall from height (23, 9.2%), and gunshot (13, 5.2%) were the three top causes of fractures, whereas tibia, femur, and humerus were three top bones involved. Of the 306 fractures, 270 (88%) involved the long bones, 193 (63.1%) were close, and 113 (36.9%) were open fractures. Forty-four (17.5%) of them were multiply injured patient and head injury in 32 (12.8%) the topmost associated injury. One hundred and ninety-four (77.3%) were admitted into surgical ward and 28 (11.2%) self-discharged against medical advice. Conclusion: Appropriate preventive mechanisms based on the observed pattern is needed; a policy response to curb the menace of RTAs may invariably reduce the incidence of extremity fractures. Treatment strategies entail appropriate facilities and skilled workforce to deal with fractures of varying degrees of severity and complexity observed.