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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Complications after intramedullary nailing of femoral fractures in a low-income country
Acta Orthopaedica, Volume 84, No. 5, Year 2013
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Description
Background Some surgeons believe that internal fixation of fractures carries too high a risk of infection in low-income countries (LICs) to merit its use there. However, there have been too few studies from LICs with sufficient follow-up to support this belief. We first wanted to determine whether complete follow-up could be achieved in an LIC, and secondly, we wanted to find the true microbial infection rate at our hospital and to examine the influence of HIV infection and lack of follow-up on outcomes. Patients and methods 137 patients with 141 femoral fractures that were treated with intramedullary (IM) nailing were included. We compared outcomes in patients who returned for scheduled follow-up and patients who did not return but who could be contacted by phone or visited in their home village. Results 79 patients returned for follow-up as scheduled; 29 of the remaining patients were reached by phone or outreach visits, giving a total follow-up rate of 79%. 7 patients (5%) had a deep postoperative infection. All of them returned for scheduled follow-up. There were no infections in patients who did not return for follow-up, as compared to 8 of 83 nails in the group that did return as scheduled (p = 0.1). 2 deaths occurred in HIV-positive patients (2/23), while no HIV-negative patients (0/105) died less than 30 days after surgery (p = 0.03). Interpretation We found an acceptable infection rate. The risk of infection should not be used as an argument against IM nailing of femoral fractures in LICs. Many patients in Malawi did not return for follow-up because they had no complaints concerning the fracture. There was an increased postoperative mortality rate in HIV-positive patients. © Nordic Orthopaedic Federation.
Authors & Co-Authors
Young, Sven
Norway, Bergen
Haukeland Universitetssjukehus
Norway, Bergen
Universitetet I Bergen
Malawi, Lilongwe
Kamuzu Central Hospital
Malawi, Zomba
University of Malawi
Banza, Leonard Ngoie
Malawi, Lilongwe
Kamuzu Central Hospital
Malawi, Zomba
University of Malawi
Hallan, Geir
Norway, Bergen
Haukeland Universitetssjukehus
Beniyasi, Fletcher J.
Malawi, Lilongwe
Kamuzu Central Hospital
Manda, Kumbukani G.
Malawi, Lilongwe
Kamuzu Central Hospital
Munthali, Boston
Malawi, Lilongwe
Kamuzu Central Hospital
Dybvik, Eva Hansen
Norway, Bergen
Haukeland Universitetssjukehus
Engesæter, Lars Birger
Norway, Bergen
Haukeland Universitetssjukehus
Norway, Bergen
Universitetet I Bergen
Havelin, Leif Ivar
Norway, Bergen
Haukeland Universitetssjukehus
Norway, Bergen
Universitetet I Bergen
Statistics
Citations: 36
Authors: 9
Affiliations: 4
Identifiers
Doi:
10.3109/17453674.2013.850014
ISSN:
17453674
e-ISSN:
17453682
Research Areas
Health System And Policy
Infectious Diseases
Violence And Injury
Study Design
Cohort Study
Study Locations
Malawi