Prevalence, Pattern and Treatment of Traumatic Bone Loss Following Long Bone Open Fractures at Kilimanjaro Christian Medical Centre.

The East African health research journal Pub Date : 2024-01-01 Epub Date: 2025-01-30 DOI:10.24248/eahrj.v8i3.813
Tangai E Mwanga, Lele M Fabrice, Peter M Magembe, Rogers Temu, Honest Massawe, Octavian Shirima, Faiton N Mandari, Reginald R Shoo
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Abstract

Background: Bone loss resulting from open long bone fractures is a significant concern in low-income countries. This study aims to assess the prevalence, pattern, and treatment of traumatic bone loss in northeastern Tanzania.

Methods: A hospital-based cross-sectional analytical study was conducted at the Orthopedics and Trauma Department of Kilimanjaro Christian Medical Centre (KCMC) from August 2020 to February 2023. The sample size comprised 365 participants with 394 open injuries. Data collection involved a structured electronic questionnaire, and statistical analysis was performed using SPSS version 25.

Results: The study found that 14.7% of the patients treated at KCMC had traumatic bone loss following open long bone fractures. The majority of these patients were young males from rural areas involved in road traffic crashes. Comminuted fractures, especially in the tibia and fibula, were the most common fracture patterns associated with bone loss. Surgical debridement and external fixators were the primary treatment approach for patients with bone loss.

Conclusion: Traumatic bone loss following open long bone fractures is a significant issue in northeastern Tanzania. This study highlights the association between injury pattern, as per Gustilo classification, and the severity of the injury, consequently influencing the treatment plan and the potential for limb salvage. The factors significantly associated with bone loss were the Gustillo IIIB/IIIC classification of open fractures, fractures in the tibia and fibula, fibula fractures, and residence in an urban area.

乞力马扎罗山基督教医疗中心开放性长骨骨折后创伤性骨质流失的发病率、模式和治疗。
背景:开放性长骨骨折导致的骨质流失是低收入国家非常关注的问题。本研究旨在评估坦桑尼亚东北部创伤性骨质流失的患病率、模式和治疗。方法:于2020年8月至2023年2月在乞力马扎罗山基督教医疗中心(KCMC)骨科和创伤科进行了一项基于医院的横断面分析研究。样本量包括365名参与者,394名开放性伤口。数据收集采用结构化电子问卷,使用SPSS 25进行统计分析。结果:研究发现,14.7%的患者在KCMC治疗开放性长骨骨折后发生外伤性骨丢失。这些患者大多数是来自农村地区的年轻男性,涉及道路交通事故。粉碎性骨折,尤其是胫骨和腓骨,是最常见的与骨质流失相关的骨折类型。手术清创和外固定器是骨丢失患者的主要治疗方法。结论:开放性长骨骨折后的外伤性骨丢失是坦桑尼亚东北部的一个重要问题。本研究强调了损伤模式(按照Gustilo分类)与损伤严重程度之间的关联,从而影响治疗计划和肢体保留的潜力。与骨质流失显著相关的因素是开放性骨折的Gustillo IIIB/IIIC分类、胫骨和腓骨骨折、腓骨骨折和居住在城市地区。
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