Paediatric fractures in a sub-saharan tertiary care center: a cohort analysis of demographic characteristics, clinical presentation, therapeutic patterns and outcomes

Guifo, Marc Leroy; Tochie, Joël Noutakdie; Oumarou, Blondel Nana; Tapouh, Jean Roger Moulion; Bang, Aristide Guy; Ndoumbe, Aurélien; Jemea, Bonaventure; Sosso, Maurice Aurélien

doi:10.11604/pamj.2017.27.46.11485

Cited by 12 publications

(23 citation statements)

References 13 publications

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“…For example, one study from Cameroon documented a mean delay of 7 days range 30 minutes to 120 days from initial consultation to definitive management of paediatric fractures. 18 Increased attention to patient triage, effective use of operating room resources and manpower are potential solutions to alleviate the burden of morbidity identified in ours and previous studies.…”

Section: Discussionmentioning

confidence: 72%

Delayed surgery leads to reduced elbow range of motion in children with supracondylar humeral fractures managed at a referral hospital in sub-Saharan Africa

et al. 2019

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Background: Supracondylar humeral fractures (SHFs) in children are associated with morbidity due to elbow stiffness. Timely operative management and/or physiotherapy are thought to reduce this complication, but pose challenges in settings with limited resources for health.Methods: This prospective cohort study included 45 pediatric patients with isolated SHF at a large tertiary hospital in Nairobi, Kenya. Patients were managed non-operatively or operatively with varying wait times to surgery, with or without physiotherapy. The measurement of elbow ROM was done up to 12 weeks after removal of Kirshner wires and/or backslab.Results: Elbow ROM increased in the follow-up period, yet residual restricted mobility in the flexion-extension plane was common. Delayed surgical management ≥7days was associated with reduced elbow ROM in the flexion-extension plane at 12 weeks median IQR 105° 92°-118° vs 120° 108°-124°, p=0.029. Physiotherapy was associated with reduced ROM at 12 weeks p=0.003, possibly due to the use of prolonged immobilization.Conclusion: In this study of pediatric SHFs at a resource-limited hospital, elbow flexion was restricted at 12 weeks follow-up and was associated with major delays in operative management. Quality of orthopedic surgical care and physiotherapy services in low-resource settings deserves further attention.Keywords: Delayed surgery, reduced elbow range, supracondylar humeral fractures, sub-Saharan Africa.

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Section: Discussionmentioning

confidence: 72%

Delayed surgery leads to reduced elbow range of motion in children with supracondylar humeral fractures managed at a referral hospital in sub-Saharan Africa

et al. 2019

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“…Non-operative fracture treatment was also observed to be the most common modality of fracture management in similar studies done. 11,24,25 Operative intervention involved the use k-wire, external fixator where such are extensively opened and plates for mid shaft fractures in long bones. The availability of newer imaging devices needed to assess fracture reduction and fracture treatment in children will make surgical treatment of pediatric fractures more common subsequently.…”

Section: Discussionmentioning

confidence: 99%

Incidence of pediatric long bone fractures at the university college hospital Ibadan

et al. 2020

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Background: Individuals within the paediatric age group sustain different types of fractures, as such the need to determine the incidence and pattern of long bone fractures among patients 16 years and below admitted through the different wards of admittance of the university college hospital Ibadan.Methods: This was a retrospective hospital-based study involving patients 16 years and below admitted through the accident and emergency department, the children emergency department, the neonatal ward and labour ward of the hospital between January 2013 and December 2018 at the university college hospital Ibadan. Using a proformal completed from the electronically stored data that captured the patient’s history, examination findings, X-ray film and treatment offered which was collected on a weekly basis.Results: 25.13% of the patients reviewed within the study period were paediatric patients. A total of 337 paediatric patients were reviewed. There were 124 female and 213 males with ratio (F:M-1:1.7). The fractures were mostly secondary to fall and road traffic crash accounting for 68.54% and 23.15% respectively. 65.12% of the fractures involve the bone of the upper limbs while 34.98% occur in the bones of the lower limbs. The radius and the ulnar bones are the most affected. Transverse fracture is the most common pattern observed.Conclusions: More than 20% of the reviewed population was in the paediatric age group and the radius and ulnar bones were the most commonly fractured bone in this age group. They usually follow trivial falls.

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“…The outcome was evaluated as poor if there was mal-union that couldn't be corrected by bone remodeling; acceptable when insufficient reduction was corrected by bone remodeling without resultant functional impairment and good when reduction was anatomical. 11 Ethical consideration was approved from Nepal Health Research Council (NHRC) prior to study. Data was analyzed using SPSS v 22.…”

Section: Methodsmentioning

confidence: 99%

Cause, Pattern and Outcome of Fractures Occurring in the Pediatric Population of Rural Tertiary Health Care Center of Nepal

Karki¹,

Rokaya²,

Rawal³

et al. 2018

J. Karnali Acad. Health Sci.

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Introduction: Pediatric trauma is a significant burden to health care worldwide. In Karnali province, most of the cases present late. The aim of this study is to determine demographic characteristics, cause, pattern, treatment and outcome of pediatric fractures in tertiary health care center in Jumla. Methods: This is a retrospective study done in patients younger than 16 years who presented to our hospital between January 2016 to December 2017. We analyzed demographic data, injury characteristics, fracture pattern, time of presentation, treatment modalities and outcome. Results: There were total of 1028 patients out of which 60% were males. Mean duration of presentation to hospital was 4.8 days. Most common mechanism of injury was fall from height. 85.60 % were managed conservatively and 14.40% were managed operatively. Postoperative outcome was good in 71 % of the cases, fair in 28% and poor in 1% cases. Forearm fracture was the most common presentation, accounting for 358 cases (34.82%) followed by Supracondylar humerus fracture accounting 23.34%. Conclusions: Pediatric fractures constitute a huge proportion of cases in our hospital. As pediatric bones unite readily, the treatment outcome is good in most of the cases even after conservative management and after delayed presentation.

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Paediatric fractures in a sub-saharan tertiary care center: a cohort analysis of demographic characteristics, clinical presentation, therapeutic patterns and outcomes

Cited by 12 publications

References 13 publications

Delayed surgery leads to reduced elbow range of motion in children with supracondylar humeral fractures managed at a referral hospital in sub-Saharan Africa

Delayed surgery leads to reduced elbow range of motion in children with supracondylar humeral fractures managed at a referral hospital in sub-Saharan Africa

Incidence of pediatric long bone fractures at the university college hospital Ibadan

Cause, Pattern and Outcome of Fractures Occurring in the Pediatric Population of Rural Tertiary Health Care Center of Nepal

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