Radiological pattern of upper limb fractures among patients attending Muhimbili Orthopaedic institute from august 2016- February 2017

Abstract

The upper extremities are the second most common musculoskeletal injuries following lower extremities in the emergency department. Over the past few years due to economic and demographic variation, prevalence of upper extremities fractures has increased with simultaneously increase in relative mortality. The study aimed to describe fracture patterns of upper extremity long bones and its associated mechanism of injuries.

METHODOLOGY This was a hospital based descriptive cross sectional study, conducted at MOI from August 2016 to February 2017. A structured questionnaire was used to collect clinical information and radiologic findings from radiographs were extracted. SPSS (version 20) was used for data analysis, Chi-square test was used and P-value of 0.05 was considered statistically significant.

RESULTS A total of 210 patients participated in the study. Male to female ratio was 2.6:1. Majority of fractures were observed in age group 0-15. Fall from height and slip were the common mechanisms of injuries observed in age group 0-15 and RTA was observed in young adults age group 16-30 and 31-45. Radius was the most frequently fractured bone (39.3%) and humerus was the least fractured (26.7%). Distal segments of both radius and ulna were most commonly fractured with prevalence of 57.1% and 51.5% respectively. For humerus, middle segment was commonly fractured at 41.3%. Simple transverse fracture pattern was the most prevalent (51.8%), followed by oblique fractures (28.6%), comminuted fractures (11.8%) and the least common was segmental fractures (1.8%). Humerus fracture was significantly associated with RTA (p=0.019) and significantly not associated with sport (p=0.0032). The radius fracture was significantly associated with RTA (p=0.001), sports (p= 0.002) and slip (p=0.005). Ulna fracture was not significantly associated with any mechanism of injury.

CONCLUSION Children 0-15 years were commonly involved, mainly due to fall from height or slip. Humerus fractures were associated RTA and significantly not associated with sports. Radius fractures were associated with RTA, sports and slip. No injury mechanism associated with ulna fractures.