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首页> 外文期刊>Open Journal of Urology >Long Bone Non-Unions and Malunions: Risk Factors and Treatment Outcomes in Calabar, Southern Nigeria
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Long Bone Non-Unions and Malunions: Risk Factors and Treatment Outcomes in Calabar, Southern Nigeria

机译：长骨骨不连和畸形：尼日利亚南部卡拉巴尔的危险因素和治疗结果

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Background: Diaphyseal non-unions and malunions constitute significant morbidities in fracture care. Fracture treatment modalities seek to restore anatomic orientation and functional rehabilitation as soon as possible after a fracture incident. Malunions and non unions present a treatment challenge with the need for prolonged hospitalization, multiple surgical interventions and economic burden. In the developing world, traditional bonesetting practices are popular and these often result in a host of preventable complications. The added socioeconomic costs of treating these complications present a considerable strain on the resources of these already fragile economies and households. Aim: To document the risk factors, treatment options and outcomes for diaphyseal non-unions and malunions in our environment. Patients and Methods: Fifty-two consecutive patients comprising 37 non-unions and 15 malunions who presented in the orthopaedic unit of a tertiary hospital in Southern Nigeria were evaluated. Information sought included biodata, location of pathology, type of incident fracture, local risk factors including traditional bonesetting; treatment options and final outcomes. Information obtained was analyzed using SPSS version 20 (IBM, New York). Results are presented in simple frequency tables. Results: There were 34 males and 18 females (M:F = 1.9:1) with a mean age of 38.76 ± 14.55 years. There were 37 non-unions and 15 malunions. The femur was the commonest site of pathology in 21 (40.4%) cases, and among the non-unions, the atrophic variety was the commonest type (n = 26; 70.3%). The mean fracture-to-surgery interval was 11.35 ± 7.95 months and traditional bonesetting was the commonest risk factor (n = 36; 69.2%). Plate and screw Osteosynthesis with bonegraft augmentation was the commonest treatment modality and the overall union rate was 94%. Conclusion: Traditional bonesetting plays a major role in the health seeking behaviour of many African societies. The complications are varied and add to the overall socioeconomic burden of fracture care in these developing economies. Identification of traditional bonesetting practices as an important risk factor should translate into a focus on these practices in preventive public health decisions in fracture care. Continuing public health education backed by political will and can potentially drive a paradigm shift in health seeking attitudes in the developing word.
机译：背景：骨干骨不连和畸形畸形构成了骨折护理中的重大并发症。骨折治疗方法试图在骨折发生后尽快恢复解剖学方向和功能康复。残肢和非工会组织面临着治疗方面的挑战，需要长期住院，多次外科手术和经济负担。在发展中国家，传统的固定方法很普遍，这些方法通常会导致许多可预防的并发症。治疗这些并发症的增加的社会经济成本给这些本已脆弱的经济体和家庭的资源带来了极大的压力。目的：记录环境中骨干骨不连和畸形畸形的危险因素，治疗选择和结果。患者和方法：对尼日利亚南部一家三级医院骨科的52例连续患者进行了评估，包括37例不愈合和15例畸形畸形。寻求的信息包括生物数据，病理部位，骨折类型，局部危险因素，包括传统的植骨;治疗方案和最终结果。使用SPSS 20版（IBM，纽约）分析获得的信息。结果显示在简单的频率表中。结果：男34例，女18例（男：女= 1.9：1），平均年龄为38.76±14.55岁。有37个不工会和15个畸形人。在21例（40.4％）的病例中，股骨是最常见的病理部位，在不愈合的病例中，萎缩性变型是最常见的类型（n = 26; 70.3％）。平均骨折到手术间隔为11.35±7.95个月，传统的植骨术是最常见的危险因素（n = 36; 69.2％）。钢板螺钉加植骨联合植骨是最常见的治疗方式，总联合率为94％。结论：传统的整骨术在许多非洲社会的寻求健康行为中起着重要作用。并发症多种多样，并增加了这些发展中经济体中骨折护理的总体社会经济负担。将传统的整骨方法确定为重要的危险因素应转化为在骨折护理中预防性公共卫生决策中将这些方法作为重点。在政治意愿的支持下继续进行公共卫生教育，并有可能在发展中的词语中推动寻求健康态度的范式转变。

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