Prevalence and patterns of humeral fractures amongst patients presenting with upper limb fractures to Mulago National Referral Hospital.

Abstract

Introduction: Humeral fractures are some of the major orthopaedic injuries presenting to the Accident and Emergency unit among patients with musculoskeletal trauma. However, their true prevalence and patterns is not yet known given the increasing number of patients with musculoskeletal injuries in many health settings. This study aimed to determine the prevalence of humeral fractures and describe their clinical and radiological patterns amongst patients presenting with upper limb fractures to MNRH, a level 1 trauma centre. Methods: This was a descriptive cross-sectional study conducted among patients with upper limb fractures at MNRH. Participants were recruited from accident and emergency (A&E) unit and the Surgical outpatient department (SOPD) and were interviewed using structured questionnaires to ascertain their demographic characteristics and clinical patterns of the fractures sustained. X-ray and or CT scan images were used to ascertain radiological patterns of the fractures. The updated 2018 AO/OTA fracture classification was used to describe the patterns of humeral fractures in both adult and paediatric population. Data analysis was done using Stata (version MP 13) and the statistical significance level was set at 5%. Results: Out of a total of 459 participants with upper limb fractures, 62 (13.51%) had humeral fractures. children aged 0-10 years 20 (32.26%) and those adults aged 21-30 years 16 (25.81%) were the most affected. Road traffic accidents (56.45%) and simple falls (29.03%) were the leading causes of humeral fractures. The middle third of the humerus was most affected (56.45%), followed by the distal third (30.65%). Among adults, simple pattern humeral shaft fractures (47.22%) were most common, while paediatric cases mostly had distal metaphyseal fractures (61.54%). All cases were closed fractures, 77.42% isolated while 22.58% of patients had multiple injuries. Only 9.67% fractures involved peripheral nerve injury. Conclusion: This study reveals that the prevalence of humerus fractures amongst a total of 459 upper limb fractures is 13.51% slightly higher than what is reported globally. The male to female ratio was 5:1. And the paediatric population aged 0-10 constituted the majority of participants presenting with humerus fractures followed by the young adult population aged 21-30 years. Road traffic accidents was the predominant cause of injury in participants. These fractures however have a distinct pattern that vary radiologically and clinically. Proper evaluation for these fractures is crucial for effective diagnosis and management.