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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Analysis of outpatient trauma referrals in a sub-Saharan African orthopedic center
World Journal of Surgery, Volume 35, No. 5, Year 2011
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Description
Background: The purpose of this study was to characterize the orthopedic trauma workload in the Bedford Orthopaedic Centre (BOC), an orthopedic referral hospital in rural South Africa. Methods: Demographic data, injury data, and information about initial management were collected for two 6-week periods during both 2008 and 2009 from patients seen in the BOC outpatient department. Two primary outcomes were evaluated: (1) the interval between the initial outside evaluation and the BOC consultation and (2) the presence of established infection at the time of consultation. Secondary outcomes included assessments of the initial management at the referring facility. Results: Most patients were adult men. Almost half were referred from within a radius of 10 km, but more than one-third came from facilities in excess of 50 km away. The most frequent mode of transport was ambulance followed by taxi-van. Fractures accounted for most of the injuries. Motor vehicle accidents and assaults were more prevalent among adults than among children, for whom falls accounted for a large proportion of injuries. Referral was delayed more than 72 h in 41.4% of patients. Established infections were indentified in 12.2%. Deficiencies detected during prehospital care were common. Conclusion: The burden of orthopedic trauma in this rural referral center is sufficient to justify the manpower and resources needed for a major orthopedic trauma center. Because most of the injuries were fractures, efforts should be aimed at improving fracture care. Differences in the mode of injury and in the anatomical sites involved between adults and children highlight the need for focused preventive measures. Reducing both delays in referral and deficiencies in initial management might well reduce the cost and complexity of the definitive treatment required. © 2011 The Author(s).
Authors & Co-Authors
Jergesen, Harry E.
United States, San Francisco
San Francisco General Hospital and Trauma Center
Oloruntoba, David O.
South Africa, Umtata
Bedford Orthopaedic Centre
Aluede, Edward E.
United States, San Francisco
San Francisco General Hospital and Trauma Center
Grova, Monica
United States, San Francisco
San Francisco General Hospital and Trauma Center
Phillips, Jonathan
United States, San Francisco
San Francisco General Hospital and Trauma Center
Caldwell, Amber M.
United States, San Francisco
San Francisco General Hospital and Trauma Center
Statistics
Citations: 9
Authors: 6
Affiliations: 2
Identifiers
Doi:
10.1007/s00268-011-1001-2
ISSN:
03642313
e-ISSN:
14322323
Research Areas
Health System And Policy
Maternal And Child Health
Violence And Injury
Study Locations
South Africa
Participants Gender
Male