PATTERN, CAUSES AND DRUG MANAGEMENT OF CHILDHOOD FRACTURES AT NNAMDI AZIKIWE UNIVERSITY TEACHING HOSPITAL, OBA, SOUTH-EAST, NIGERIA

Ifezulike C. C., *Azikiwe C. C. A., Ezejiofo O., Modebe I. A. and Onyekachi J. J.

ABSTRACT

Background: A bone fracture is a medical condition in which there is damage in the continuity of the bone. Paediatric fracture remains a very significant cause of mortality and disability. Aim: The aim of this study is to look at the pattern of childhood fractures at the Nnamdi Azikiwe University Teaching Hospital (NAUTH), Oba. Method: The medical records of children between the ages of 2 and 14 who were admitted at the Orthopaedic unit of the NAUTH, Oba, between 1st day in January 2010 and 1st day in December, 2014 on account of fractures were retrieved. The sex of the child, cause and type of fracture were extracted from the case records. The first point of contact with healthcare providers where possible, was noted. Types of management at NAUTH were also noted. The data were analyzed using a one-way ANOVA. Chi square and student t-test where possible were used to determine the p-value. Results were presented as percentages while P-value ≤0.05 was adjudged significant. Results: A total of 174 children were admitted during the five year study period. The age range was 2-14 with a mean of 8.6±3.8 years. There was a male predominance, 103(59.2%) against females, 71(40.8%)(P<0.02). The causes of the fractures were diverse but, road traffic accident was the commonest 67(38.5%)(P<0.01). Thirty-five (20.1%) children fell from various heights. 33(19%) of the fractures occurred during school sports compared with that of 27(15.5%) that occurred at home (P<0.02). The most common site of injury was the femur (26%); this was followed by the tibia/fibula (16.5%), radius/ulna (16%) and humerus (14.2%). A good number of the cases 89(51.1%) presented fresh to NAUTH, 56(32.2%) presented initially to traditional bone setters (TBS), while 29(16.7%) was referred from private hospitals. Out of 174 cases under study, 118 presented first to medical facilities thus significantly, (P<0.01) higher than that of TBS. There is therefore increasing awareness among the people on the first point of call. All patients received varying doses of antibiotics, analgesics and fluids resuscitations while reductions and fixations were the main surgical pattern of management employed. Conclusion: Road traffic accidents remained the most common cause of fractures in children. Fractures were commoner in young males with femoral fractures being the most frequent type. Antibiotics, analgesics and fluids resuscitations were used for all patients.

Keywords: Childhood fractures, pattern, causes, Antibiotics, analgesics and fluids resuscitations Oba, Nigeria.