Epidemiology and management of forearm bone fractures: Case study of patients treated at Mushie General Referral Hospital

Abstract

Introduction

Fractures of the forearm bones (radius and ulna) are common injuries in both children and adults and may result in functional limitations if inadequately managed. In low-resource settings such as Mushie, Democratic Republic of the Congo, limited information is available on their incidence, causes, and outcomes.

Purpose

This study aimed to describe the epidemiological characteristics, causes, management, and short-term outcomes of forearm fractures treated at Mushie General Referral Hospital in 2021.

Methods

We conducted a retrospective descriptive study including all patients admitted for a fracture of the radius and/or ulna between 1 January and 31 December 2021. Data collected from medical records included age, sex, fractured bone, affected side, fracture type, mechanism of injury, treatment modality, duration of treatment, and early outcomes (union, nonunion, malunion). Proportions were reported with 95% confidence intervals using Wilson’s method. Chi-square and binomial tests were applied to compare proportions.

Results

A total of 44 forearm fractures were recorded, representing 3.4% of all surgical procedures (n = 1278) and 21.1% of all fractures (n = 208). Most patients were boys (63.6%), with the highest frequency in the 6–10-year age group. The radius alone was involved in 56.8% of cases, the ulna alone in 25.0%, and both bones in 18.2%. The left upper limb was affected in 63.6% of cases. Road traffic accidents were the leading cause (50.0%), followed by falls from trees and play-related injuries. Orthopaedic management was used in 75.0% of cases, with a union rate of 84.1%; nonunion and malunion occurred in 6.8% and 9.1% of cases, respectively.

Conclusion

Forearm fractures represent a significant proportion of traumatic injuries at this semi-rural hospital, predominantly affecting young boys. The high incidence of road traffic accidents underscores the need for targeted prevention strategies and improved trauma care capacity in similar low-resource settings.