Prevalence, Pattern and Treatment of Traumatic Bone Loss Following Long Bone Open Fractures at Kilimanjaro Christian Medical Centre

Abstract

Background: Bone loss resulting from open long bone fractures is a significant concern in low-income countries. This study aims to assess the prevalence, pattern, and treatment of traumatic bone loss in northeastern Tanzania.
Methods: A hospital-based cross-sectional analytical study was conducted at the Orthopedics and Trauma Department of Kilimanjaro Christian Medical Centre (KCMC) from August 2020 to February 2023. The sample size comprised 365 participants with 394 open injuries. Data collection involved a structured electronic questionnaire, and statistical analysis was performed using SPSS version 25.
Results: The study found that 14.7% of the patients treated at KCMC had traumatic bone loss following open long bone fractures. The majority of these patients were young males from rural areas involved in road traffic crashes. Comminuted fractures, especially in the tibia and fibula, were the most common fracture patterns associated with bone loss. Surgical debridement and external fixators were the primary treatment approach for patients with bone loss.
Conclusion: Traumatic bone loss following open long bone fractures is a significant issue in northeastern Tanzania. This study highlights the association between injury pattern, as per Gustilo classification, and the severity of the injury, consequently influencing the treatment plan and the potential for limb salvage. The factors significantly associated with bone loss were the Gustillo IIIB/IIIC classification of open fractures, fractures in the tibia and fibula, fibula fractures, and residence in an urban area.