External fixators usage in two hospitals in Delta State south-south Nigeria

Abstract

Objective: To present our experience in the use of various types of external fixators in two government owned hospitals in Delta State, Nigeria.Methods: A retrospective review of patients managed with external fixators over a period of 8 years – January 2012 to December 2019, in two government owned hospitals in Delta State, Nigeria. Relevant information including bio-data, indications for external fixation, types of external fixator applied, length of time fixators were applied, etc were collected and analysed using IBM SPSS version 22.Results: A total of 94 patients (56 males and 38 females) were included in this study giving a male: female ratio of 1.5 : 1. The mean age of patients was 33.7+ 15.9 years. Four types / designs of external fixators were used, the mono-planar AO design were the ones most commonly used (67.7%), followed by the linear rail system (LRS) type (17.2%). The most common indication for external fixator application was open fractures in 67.7% of cases, followed by bone gaps resulting from bone loss (11.1%). External fixators were used as adjunct to other treatment modalities in 59 applications (59.6%) and as the definitive treatment method in 40 applications (40.4%). The commonest solution used for pin site care was Povidone iodine in 53 patients (56.4%). The mean length of time patients were on external fixators was 124.8 days (17.8 weeks). Pin tract infection was the commonest complication encountered (26.6%). The commonest indication for removal of external fixators was the healing of the wounds in open fractures with conversion to other forms of treatment, commonly cast application (42.6%). The initial aim of applying the external fixator was achieved in 75% of cases.Conclusion: External fixators have become indispensable tools in the armamentarium of modern day Orthopaedic and trauma care. Our health facilities have also effectively keyed into this.