Orthopaedic injuries In South African “zama-zama” gold miners: The Johannesburg West Rand experience with illegal gold mining

Abstract

Background: In South African local language, illegal artisanal gold miners are called “zama-zamas”, a slang word for “hustlers”. There is paucity of orthopaedic literature evaluating orthopaedic injuries associated with this sector of mining.

Objective: The aim of our study is to evaluate orthopaedic injuries associated with artisanal mining and the factors that influence them.

Methods: We undertook a retrospective study evaluating medical records and radiological images of patients treated for orthopaedic trauma injuries between January 2024 and April 2025. We evaluated patient demographic data, nature of injury, Mechanism of Injury (MOI), treatment instituted and nationality.

Results: The study population included 23 patients, 22 (95.6%) males and 1 (4.3%) female all of whom were black Africans. The mean age was 28.9 years old (19 - 41). Two (9%) of the patients were South Africans, 65% foreign nationals and 26% did not disclose. Seventeen (63%) of the injuries were to the lower limb while 14.8% were to the upper limb. One patient had a fracture-dislocation of the spine and we recorded three complex pelvic injuries. The most common mechanism of injury were rock falls (n=12) followed by gunshots (n=5). Two injuries were falls from height and one was from assault. Three patients had an unknown mechanism of injury. Majority of patients (61%) were treated surgically with two needing transfer to a tertiary centre.

Conclusion: Illegal gold mining is a cause of high energy orthopaedic trauma predominantly in male foreign nationals. Majority of these injuries require surgery and a long hospital stay.