Velin Lotta, Zhuang Alex, Bigirimana Simon P, Wladis Andreas, Mfura Heritier, Hakizimana Jean-Bertrand A, Barrett Ellen, Barth Cornelia, Bekele Abebe, Riviello Robert, Meunier Andreas, Niyinkunda Innocent, Iradakunda Jules, Alayande Barnabas T
Centre for Teaching and Research in Disaster Medicine and Traumatology (KMC), Department of Biomedical and Clinical Sciences, Linköping University, Linköping, SWE.
Center for Equity in Global Surgery, University of Global Health Equity, Kigali, RWA.
Cureus. 2025 Mar 27;17(3):e81323. doi: 10.7759/cureus.81323. eCollection 2025 Mar.
Introduction Sub-Saharan Africa is disproportionately affected by injuries, and short-term morbidity and mortality are high in this context. Lower limb fractures (LLFs) are a common type of injury that can lead to severe disability with extensive negative social and economic consequences. However, little is known about the long-term outcomes of LLFs in sub-Saharan Africa. In this pilot study, we describe the feasibility of assessing epidemiological patterns of LLFs, the state of care, and long-term outcomes in rural Rwanda. Methods This study was conducted from July to December 2021. It consists of retrospective data collection from hospital charts and a cross-sectional, phone-based follow-up. Functional outcomes were assessed using the World Health Organization Disability Assessment Schedule (WHODAS; World Health Organization, Geneva, Switzerland) 2.0, and health-related quality of life (QoL) was assessed using a 36-Item Short Form Health Survey questionnaire (SF-36). Results Eighteen patients were included in the study, of which the majority were males (n=11, 61%), young adults (mean age 29, standard deviation (SD) 25), and without any previous comorbidities (n=16, 89%). Most patients had a single fracture, although nearly one-third presented with multi-trauma (n=5, 28%). The most common injury cause was falls (n=10, 56%). Fractures were most common in the femur/hip (n=10, 56%), and most fractures were closed (n=14, 78%) and non-comminuted (n=9, 50%). Disability was described as high, with a total mean WHODAS summary score of 80 (SD 29), whereas health-related QoL varied across the SF-36 domains, with "general health" being the lowest rated domain with a mean score of 30 (SD 25). Conclusion This study highlights the challenges of long-term follow-up after LLFs in a rural, low-resource setting but demonstrates that such a study is feasible if planned with contextual considerations. Self-perceived disability is high, and health-related QoL is low at long-term follow-up, which should be viewed in light of the fact that it primarily affects a young, previously healthy population.
引言 撒哈拉以南非洲地区受伤害的影响尤为严重，在此背景下，短期发病率和死亡率很高。下肢骨折（LLF）是一种常见的损伤类型，可导致严重残疾，并带来广泛的负面社会和经济后果。然而，对于撒哈拉以南非洲地区LLF的长期结局知之甚少。在这项试点研究中，我们描述了评估卢旺达农村地区LLF的流行病学模式、护理状况和长期结局的可行性。
方法 本研究于2021年7月至12月进行。它包括从医院病历中回顾性收集数据以及基于电话的横断面随访。使用世界卫生组织残疾评估量表（WHODAS；世界卫生组织，瑞士日内瓦）2.0评估功能结局，并使用36项简短健康调查问卷（SF-36）评估健康相关生活质量（QoL）。
结果 18名患者纳入研究，其中大多数为男性（n = 11，61%），是年轻人（平均年龄29岁，标准差（SD）25），且既往无任何合并症（n = 16，89%）。大多数患者为单一骨折，尽管近三分之一的患者存在多发伤（n = 5，28%）。最常见的受伤原因是跌倒（n = 10，56%）。骨折最常见于股骨/髋部（n = 10，56%），大多数骨折为闭合性（n = 14，78%）且无粉碎性（n = 9，50%）。残疾程度较高，WHODAS总平均总结评分为80（SD 29），而健康相关QoL在SF-36各领域有所不同，“总体健康”是评分最低的领域，平均分为30（SD 25）。
结论 本研究突出了在农村低资源环境中LLF后长期随访的挑战，但表明如果结合实际情况进行规划，此类研究是可行的。自我感知的残疾程度较高，长期随访时健康相关QoL较低，鉴于其主要影响年轻的既往健康人群，应考虑到这一点。
