Prevalence and patterns of ankle joint injuries amongst patients with musculoskeletal trauma at Mulago National Referral Hospital.

Abstract

Introduction: At Mulago National Referral Hospital, ankle joint injuries are common however, the magnitude of the problem they present and their specific clinical and radiological features which would aid in planning their management for better clinical and functional outcomes have not been documented. The aim of this study was to investigate the prevalence, the clinical and radiological features associated with ankle joint injuries seen at Mulago NRH. Methods: This was a cross-sectional descriptive study. All eligible patients with ankle joint injuries who presented to the Mulago Accident &Emergency department between 12th August and 14th December 2013 were consecutively recruited. Data was collected using a questionnaire and plain radiographs of the injured ankles were taken and interpreted by a radiologist. The data was entered into EpiData version 3.1 and exported to STATA version 11.0 for analysis. Descriptive (mean, standard deviation, frequency, percentage and 95% confidence interval) and inferential (logistic regression) statistics were used to analyse data. Alpha level was set at P< 0.05. Data were summarised in tables, pie charts and graphs. Results: Of 1626 musculoskeletal trauma patients, 162 had ankle joint injuries giving a prevalence of 9.96%. The highest prevalence was registered in the age group of 31-40 (3.01 CI: 2.18 – 3.84) years and in males 5.90 (CI: 4.76 – 7.05). Urban dwellers and small business owners were the most affected. Most injuries occurred as a result of Motor Vehicle Accidents and pedestrians were the most affected road users 53/109 (48.6%). Malleolar fractures were the commonest type of ankle injury in 118/162 (72.8%), most of which involved more than one malleolus 77/118 (65.3%). Open injuries constituted 23.5% (38/162) of the injuries. Conclusion and recommendations: Ankle joint injuries are common at Mulago NRH and are often associated with considerable soft tissue damage and severe fracture patterns. There’s a need to formulate public policies to protect the vulnerable road users against trauma as well as allocate more resources for efficient diagnosis and treatment of ankle joint injuries. Studies to evaluate the outcomes of treatment of ankle joint injuries as well as studies to describe the patterns of Paediatric ankle injuries at Mulago NRH need to be carried out.