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Orthopaedic injury patterns at a tertiary referral hospital in Ethiopia: a prospective observational study

  • Samuel Hailu
    Correspondence
    Corresponding author at: Black Lion Specialized Hospital, Department of Orthopaedics, P.O.Box 9086, Addis Ababa, Ethiopia.
    Affiliations
    Tikur Anbessa Specialized Hospital, Department of Orthopaedics, College of Health Sciences, Addis Ababa University, Ethiopia
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  • Hiwot Gebre
    Affiliations
    Tikur Anbessa Specialized Hospital, Department of Orthopaedics, College of Health Sciences, Addis Ababa University, Ethiopia
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  • Gabriel Alemayehu
    Affiliations
    Tikur Anbessa Specialized Hospital, Department of Orthopaedics, College of Health Sciences, Addis Ababa University, Ethiopia
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      Highlights

      • Motor vehicle collisions were the primary cause of orthopedic injuries in patients presenting to Tikur Anbessa Specialized Hospital in Ethiopia from 2018 to 2021.
      • The primary mechanism of injury for patients presenting from the capital city was falls instead of motor vehicle accidents.
      • Pelvic and hip trauma injuries accounted for 29% of cases.
      • 26% of patients had open fractures and 26% had multiple injuries.

      Abstract

      Objectives

      This study aimed to identify the composition of orthopaedic injuries in Ethiopia.

      Background

      Injuries are among the most common causes of death worldwide. This is especially true in developing countries, which lag in preventive efforts and have inadequate resources to treat injuries efficiently. As a result, understanding the trauma burden is crucial for future prevention and treatment accessibility initiatives.

      Methods

      We conducted an observational study using prospectively collected emergency orthopaedic trauma data between January 2018 and December 2021 from Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. The incidence of all fractures, demographic data, trauma mechanisms, and injury types were examined by stratifying cases based on patients presenting from Addis Ababa, the capital city, or outside of Addis Ababa. These groups were chosen to account for the demographic differences that exist between individuals living in the capital city and other regions.

      Results

      Our study included 4712 patients with similar distribution from Addis Ababa and outside of Addis. Overall, 70% were between 18 to 55 (median 30). Road traffic incidents accounted for the most overall injuries (41%), including 130 motorcycle injuries (2.8%), while falls were the predominant mechanism (51.3%) for patients from Addis. Injuries of the lower limb accounted for 66% of injuries (n=4262/6412), the femur being the most affected (22%), followed by the pelvis and acetabulum (16%). One-quarter presented with open fractures and another quarter had multiple injuries. Multivariate analysis further demonstrated patients outside of Addis were 37% more likely to have multiple fractures and 69% more likely to have open fractures.

      Conclusion

      Future directives should focus on preventive measures and address the management of complex injuries to overcome trauma injuries’ health and economic impacts. The initiatives shall focus on the varying primary mechanisms of injury for the different population groups in the capital city and in rural regions outside of the capital city.

      Keywords

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