Patterns of musculoskeletal injuries in multiple trauma patients admitted at Mulago Hospital

Abstract

BACKGROUND: Musculoskeletal injuries are the commonest injuries sustained following multiple trauma and are a major cause of morbidity, mortality and long bed occupancy in patients admitted at Mulago Hospital. This study was done to bring out more information on the pattern of the musculoskeletal injuries in multiply injured patients at Mulago Hospital that will enhance trauma research which is an adjunct to effective policy formulation and implementation. OBJECTIVE: To determine the patterns of musculoskeletal injuries in multiply injured patients at Mulago Hospital. METHOD: A cross - sectional descriptive study was done on 100 multiply injured patients with musculoskeletal injuries admitted in the Accident and Emergency (A&E) ward of Mulago Hospital from December 2011 to March 2012. Newly admitted patients were consecutively enrolled in the study. The data was collected using a coded questionnaire including the relevant history, physical examination and radiological findings. Data was entered into the Epi- data statistical programme and exported to SPSS statistical programme for analysis. RESULTS: A total of 100 multiply injured patients with 183 musculoskeletal injuries were recruited during the study period,70 (70%) were males giving a male to female ratio of 2.3 to 1, with a mean age of 31.3 +15.2 (range 4-77). The commonest causative agent was road traffic accidents in 82% of patients and this was involving motor vehicles, motorcycles and bicycles with drivers/ cyclists affected the most. Amongst the musculoskeletal injuries, lower limbs were injured most 108 (59%), upper limbs 51 (27.9%), pelvis 16 (8.7%) and spine 8 (4.4%). Associated injuries were head (54.3%), maxillo-facial (19.1%), abdomen (13.82%), chest and soft tissue injuries with (6.38%) each. Mean ISS and NISS were 19.41 and 22.75 respectively. CONCLUSION: Multiply injured patients with musculoskeletal injuries at Mulago are young male adults involved in Road traffic accidents and the most common injuries sustained are lower limb injuries. Research into appropriate strategies for prevention of injuries, especially RTA, is required but this must start with the establishment of institutional and regional trauma registries for complete documentation of relevant data.