Orthopaedic care in a southwestern Nigeria secondary level hospital: are patients' needs being met?

Afr J Med Med Sci. 2012 Jun;41(2):153-9.

Abstract

Objectives: Musculoskeletal conditions are a major cause of morbidity the world over but only a few orthopaedic surgeons are available to treat 40 million people worldwide with disabilities treatable by surgery. We analyzed patients seen in one year at the orthopaedic unit of a public general hospital in a developing country highlighting the spectrum and peculiarities of diseases, surgical management and its limitations.

Methods: The biodata, clinical features and diagnoses of 914 patients,as well as therapeutic modalities and complications of operated patients were extracted from case records and recorded.

Results: The mean age was 38.5 +/- 23.8 years and 440 were males (48.1%). Trauma accounted for 327 (35.8%) cases. The age of trauma cases was 33.4 +/- 22.3 years while orthopaedic patients were about 8 years older (p < 0.001). The average duration of symptoms before presentation was 106.4 days. Of the 15.5% who required operative treatment, 7.3% had the required procedure. Children who needed surgery were more likely to get it done than adults (p = 0.002). The commonest operative procedure was fracture fixation. There were four moderately-severe complications (6.0%).

Conclusions: The study showed a considerable patient-load with inadequate facilities for treatment when compared with contemporary practice worldwide. Although results of surgical treatment was acceptable, there was need for timely access and quality care to people with musculoskeletal problems.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Child
  • Female
  • Hospitals, Public / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Musculoskeletal Diseases / diagnosis
  • Musculoskeletal Diseases / epidemiology
  • Musculoskeletal Diseases / therapy*
  • Needs Assessment / statistics & numerical data*
  • Nigeria / epidemiology
  • Orthopedic Procedures / statistics & numerical data*
  • Secondary Care / statistics & numerical data
  • Wounds and Injuries / diagnosis
  • Wounds and Injuries / epidemiology
  • Wounds and Injuries / therapy*
  • Young Adult