Yale School of Medicine, Department of Orthopaedics & Rehabilitation, 800 Howard Avenue, New Haven, CT, USA.
Institute for Global Orthopaedics and Traumatology, University of California, San Francisco 2550 23rd Street, Building 9, 3rd Floor, San Francisco, CA, 94110, USA.
Injury. 2019 Jul;50(7):1371-1375. doi: 10.1016/j.injury.2019.06.005. Epub 2019 Jun 3.
Road traffic injuries disproportionately affect low- and middle-income countries (LMICs) and are associated with femur fractures that lead to long-term disability. Information about these injuries is crucial for appropriate healthcare resource allocation. The purpose of this study is to estimate the incidence of femoral shaft fractures in Tanzania and describe the unmet surgical burden.
Study sites included six government hospitals across Tanzania. Investigators collected data from hospital admission and procedural logbooks to estimate femoral shaft fracture incidence and their treatment methods. Semi-quantitative interviews were conducted with relevant hospital personnel to validate estimates obtained from hospital records. Investigators gathered road traffic incident (RTI) statistics from national police reports and calculated femur fracture:RTI ratios.
Femoral shaft fracture annual incidence rate ranged from 2.1 to 18.4 per 100,000 people. Median low and high femur fracture:RTI ratio were 0.54 and 0.73, respectively. At smaller hospitals, many patients (5-25%) were treated with traction, and a majority (70-90%) are referred to other centers. Barriers to surgery at each hospital include a lack of surgical implants, equipment, and personnel.
The incidence rate is similar to previous estimations, and it is consistent with an increased femoral shaft fracture incidence in Tanzania when compared to higher income countries. The femur fracture:RTI ratio may be a valid tool for estimating femur fracture incidence rates. There is an unmet orthopaedic surgical burden for femur fractures treatment at rural hospitals in Tanzania, and the barriers to treatment could be targets for future interventions.
道路交通伤害不成比例地影响低收入和中等收入国家（LMICs），并与导致长期残疾的股骨骨折有关。这些伤害的信息对于适当的医疗保健资源分配至关重要。本研究的目的是估计坦桑尼亚股骨骨干骨折的发生率，并描述未满足的手术负担。
研究地点包括坦桑尼亚的六家政府医院。研究人员从医院入院和程序日志中收集数据，以估计股骨骨干骨折的发生率及其治疗方法。对相关医院人员进行半定量访谈，以验证从医院记录中获得的估计值。研究人员从国家警察报告中收集道路交通伤害（RTI）统计数据，并计算股骨骨折：RTI 比值。
股骨骨干骨折的年发生率范围为每 100,000 人 2.1 至 18.4 例。中位数低和高股骨骨折：RTI 比值分别为 0.54 和 0.73。在较小的医院，许多患者（5-25%）接受牵引治疗，大多数（70-90%）转介到其他中心。每家医院手术的障碍包括缺乏手术植入物、设备和人员。
发生率与之前的估计相似，与高收入国家相比，坦桑尼亚的股骨骨干骨折发生率有所增加。股骨骨折：RTI 比值可能是估计股骨骨折发生率的有效工具。坦桑尼亚农村医院治疗股骨骨折的骨科手术负担未得到满足，治疗障碍可能是未来干预措施的目标。
