The Prevalence, Aetiology and types of long Bone Fractures in Children 18 years and below as seen at Mulago Hospital.

Abstract

Children 18 years and below with fractures of long bones were studied prospectively over a period of 4 months from 1st of August to the 30th of November 2000 in the Accident and Emergency Department(AED) of Mulago Hospital(MH). The objectives of the study were to determine the prevalence and identify the aetiology and types of long bone fractures seen. During the study period a total of 2560 children were treated for various forms of trauma in the AED. In all, 321 of these children suffered a total loss of 331 long bone fractures, giving an overall prevalence of 12.5%. There were 207(65.4%) children with fractures treated as outpatients and 114(35.1%) were admitted for at least one day. The overall male: female ratio was 2.7: 1. Falls from heights were the most common causes of long bone fractures, 64(19.9%). The prevalence of open fractures and epiphyseal injuries was found to be 7.2% and 5.3% respectively. Pathological fractures were seen in 2.2% of all long bone fractures. The majority of fractures were transverse, 159(49.5%). Upper extremity fractures accounted for 66.5% of all fractures seen compared with 33.5% in the lower extremities. The most frequent fractured bone was the radius, 135(40.8%), followed by humerus, 78(23.6%). A total of 57 children sustained 69 associated injuries and 5 had multiple long bone fractures. The commonest associated injury was severe soft tissue injury. This study showed that the prevalence of long bone fractures in children 18 years and below at MH compares well with those observed elsewhere both in developed and developing countries. It is recommended that further studies be done to establish why there are marked differences in the reported prevalence of open fractures and epiphyseal injuries between Western countries and the findings in this and indeed other studies within the African Subcontinent.