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乞力马扎罗基督教医疗中心长骨开放性骨折后创伤性骨丢失的患病率、模式及治疗情况

Prevalence, Pattern and Treatment of Traumatic Bone Loss Following Long Bone Open Fractures at Kilimanjaro Christian Medical Centre.

作者信息

Mwanga Tangai E, Fabrice Lele M, Magembe Peter M, Temu Rogers, Massawe Honest, Shirima Octavian, Mandari Faiton N, Shoo Reginald R

机构信息

Orthopedics and Traumatology, Kilimanjaro Christian Medical Centre.

Kilimanjaro Christian Medical University College.

出版信息

East Afr Health Res J. 2024;8(3):426-431. doi: 10.24248/eahrj.v8i3.813. Epub 2025 Jan 30.

Abstract

BACKGROUND

Bone loss resulting from open long bone fractures is a significant concern in low-income countries. This study aims to assess the prevalence, pattern, and treatment of traumatic bone loss in northeastern Tanzania.

METHODS

A hospital-based cross-sectional analytical study was conducted at the Orthopedics and Trauma Department of Kilimanjaro Christian Medical Centre (KCMC) from August 2020 to February 2023. The sample size comprised 365 participants with 394 open injuries. Data collection involved a structured electronic questionnaire, and statistical analysis was performed using SPSS version 25.

RESULTS

The study found that 14.7% of the patients treated at KCMC had traumatic bone loss following open long bone fractures. The majority of these patients were young males from rural areas involved in road traffic crashes. Comminuted fractures, especially in the tibia and fibula, were the most common fracture patterns associated with bone loss. Surgical debridement and external fixators were the primary treatment approach for patients with bone loss.

CONCLUSION

Traumatic bone loss following open long bone fractures is a significant issue in northeastern Tanzania. This study highlights the association between injury pattern, as per Gustilo classification, and the severity of the injury, consequently influencing the treatment plan and the potential for limb salvage. The factors significantly associated with bone loss were the Gustillo IIIB/IIIC classification of open fractures, fractures in the tibia and fibula, fibula fractures, and residence in an urban area.

摘要

背景

开放性长骨骨折导致的骨质流失在低收入国家是一个重大问题。本研究旨在评估坦桑尼亚东北部创伤性骨质流失的患病率、模式及治疗情况。

方法

2020年8月至2023年2月,在乞力马扎罗基督教医疗中心(KCMC)骨科与创伤科开展了一项基于医院的横断面分析研究。样本量包括365名参与者,共394处开放性损伤。数据收集采用结构化电子问卷,并使用SPSS 25版进行统计分析。

结果

研究发现,在KCMC接受治疗的患者中,14.7%在开放性长骨骨折后出现创伤性骨质流失。这些患者大多是来自农村地区的年轻男性,因道路交通事故受伤。粉碎性骨折,尤其是胫腓骨骨折,是与骨质流失相关的最常见骨折类型。手术清创和外固定器是骨质流失患者的主要治疗方法。

结论

开放性长骨骨折后的创伤性骨质流失在坦桑尼亚东北部是一个重大问题。本研究强调了根据 Gustilo 分类的损伤模式与损伤严重程度之间的关联,从而影响治疗方案和肢体挽救的可能性。与骨质流失显著相关的因素包括开放性骨折的 Gustilo IIIB/IIIC 分类、胫腓骨骨折、腓骨骨折以及居住在城市地区。

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The management of fractures with bone loss.伴有骨缺损骨折的处理
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