Aetiology, patterns and treatment modalities of paediatric fractures at Bugando Medical Centre, Mwanza, Tanzania

Abstract

Background: Pediatric fractures are increasingly being recognized as a major public health problem worldwide. Little information is currently available on this type of injury in our local environment as there is a paucity of published data on this subject.  This study aimed to determine the aetiological spectrum, patterns and treatment modalities of pediatric fractures at Bugando Medical Centre. The study provides baseline local data for the establishment of prevention strategies as well as treatment guidelines.

Methods: This was a cross-sectional study of pediatric patients presenting with long bone fractures at Bugando Medical Centre from January 2019 to July 2019. Ethical clearance was sought from the relevant authorities before the commencement of the study.

Results: A total of 111 pediatric trauma patients (M: F ratio = 1.2: 1) with fractures were studied. The age peak incidence at presentation was 5-10 years accounting for 48.6% of cases. The majorities of the fractures (46.8%) were due to falls and commonly occurred at home (48.6%). Upper limb fractures predominated (57.7%) with the majority involving the supracondylar of the humerus (50.5%). Open fractures were observed in 15 (13.5%) cases and all of them were Gustillo-type II. Only 7 (6.3%) patients received pre-hospital care. The majority of the patients, 74 (66.7%) were treated surgically mainly with open reduction and internal fixation accounting for 53.2% of cases.

Conclusion: This study demonstrated that the majority of pediatric fractures in our setting occur due to falls around the home environment and commonly affect children aged 5-10 years. The most common site of fracture was the humerus, most involving the supracondylar. Preventive strategies targeting reducing the occurrence of fall injuries in children are necessary to reduce the occurrence of pediatric fractures in this region.