Ativor Vincent, Konadu-Yeboah Dominic, O'Marr Jamieson, Brown Kelsey, Rodarte Patricia, Kumah Ralph, Quartey Ralph, Awariyah Dominic, Konadu Peter, Baidoo Paa Kwesi, Okike Kanu, Morshed Saam, Shearer David, Roberts Heather
Komfo Anokye Teaching Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti Region, Ghana.
Institute for Global Orthopaedics and Traumatology, University of California, San Francisco, San Francisco, CA.
OTA Int. 2024 Jul 12;7(3):e340. doi: 10.1097/OI9.0000000000000340. eCollection 2024 Sep.
Open tibia fractures are associated with substantial morbidity and impact on quality of life. Despite increasing incidence in low-resource settings, most open tibia fracture research comes from high-resource settings. This study aimed to assess the impact of socioeconomic status on treatment modality and evaluate predictors of health-related quality of life following open tibia fractures in Ghana.
A single-center prospective observational study was conducted in Kumasi, Ghana, from May 2020 to April 2022. Adults with open tibial shaft fractures presenting within 2 weeks of injury were eligible. Demographics, comorbidities, socioeconomic factors, and hospital course were collected at enrollment. Follow-up was scheduled at 8, 12, 26, and 52 weeks. A telephone survey assessing reasons for loss to follow-up was initiated on enrollment completion.
A total of 180 patients were enrolled. Most patients were employed before injury (79.9%), had government insurance (67.2%), and were from rural areas (59.4%). Fracture classification was primarily Gustilo-Anderson type 3A (49.1%). No relationship between socioeconomic predictors and treatment modality was identified. The largest barriers to follow-up were preference for bonesetter treatment (63.1%), treatment cost (48.8%), and travel cost (29.8%). Of the lost to follow-up patients contacted, 67 (79.8%) reported receiving traditional bonesetter care. Reasons for seeking traditional bonesetter care included ease of access (83.6%), lower cost (77.6%), and familial influence (50.7%).
No association was identified between socioeconomic predictors and choice of treatment. Bonesetter treatment plays a substantial role in the care of open tibia fractures in Ghana, largely because of ease of access and lower cost.
开放性胫骨骨折会导致严重的发病率并影响生活质量。尽管在资源匮乏地区其发病率不断上升，但大多数开放性胫骨骨折研究都来自资源丰富地区。本研究旨在评估社会经济状况对治疗方式的影响，并评估加纳开放性胫骨骨折后健康相关生活质量的预测因素。
2020年5月至2022年4月在加纳库马西进行了一项单中心前瞻性观察研究。受伤后2周内出现开放性胫骨干骨折的成年人符合条件。在入组时收集人口统计学、合并症、社会经济因素和住院过程。随访安排在第8、12、26和52周。在入组完成后启动了一项电话调查，评估失访原因。
共纳入180例患者。大多数患者在受伤前就业（79.9%），有政府保险（67.2%），且来自农村地区（59.4%）。骨折分类主要为 Gustilo-Anderson 3A型（49.1%）。未发现社会经济预测因素与治疗方式之间存在关联。随访的最大障碍是对正骨治疗的偏好（63.1%）、治疗费用（48.8%）和交通费用（29.8%）。在联系到的失访患者中，67例（79.8%）报告接受了传统正骨护理。寻求传统正骨护理的原因包括容易获得（83.6%）、成本较低（77.6%）和家庭影响（50.7%）。
未发现社会经济预测因素与治疗选择之间存在关联。正骨治疗在加纳开放性胫骨骨折的护理中发挥着重要作用，主要是因为容易获得且成本较低。
