Prevalence and associated factors of infection after intramedullary nailing of long bone fractures among patients attending St. Paul’s Hospital Millennium Medical College, AaBET Hospital, Addis Ababa, Ethiopia
Objectives: The intramedullary nailing of long bone fractures is a major challenge for orthopedic surgeons, with increased risk of infection in third-world countries. Research gaps remain in Ethiopia, determining the magnitude of the problem. This study aimed to determine the prevalence and associat...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2023-06-01
|
| Series: | SAGE Open Medicine |
| Online Access: | https://doi.org/10.1177/20503121231181648 |
| _version_ | 1797801915711488000 |
|---|---|
| author | Tilahun Desta Teshale Lodamo Habtewold Mulat Dereje Bayissa Demissie Kalkidan Ayalew |
| author_facet | Tilahun Desta Teshale Lodamo Habtewold Mulat Dereje Bayissa Demissie Kalkidan Ayalew |
| author_sort | Tilahun Desta |
| collection | DOAJ |
| description | Objectives: The intramedullary nailing of long bone fractures is a major challenge for orthopedic surgeons, with increased risk of infection in third-world countries. Research gaps remain in Ethiopia, determining the magnitude of the problem. This study aimed to determine the prevalence and associated factors of infection after intramedullary nailing of long bone fractures in Ethiopia. Methods: This was a descriptive, cross-sectional, retrospective design study with a total census of 227 cases of long bone fractures treated with intramedullary Surgical Implant Generation Network nails at Addis Ababa Burn Emergency and Trauma Hospital from August 2015 to April 2017. Data were collected from 227 patients and descriptive analyses were done to summarize the study variables. Binary and multivariable logistic regression analyses were performed at a p value of 0.05 with a 95% confidence interval and adjusted odds ratio. Results: The mean age of patients was 32.9 years, with a male-to-female ratio of 3.5:1. Only 22 (9.3%) of the 227 patients with long bone fractures treated with intramedullary nails developed a surgical site infection, and 8 (3.4%) were developed deep (implant) infections requiring debridement. Road traffic injuries were the leading cause of trauma (60.9%), followed by falls from a height (22.7%). Debridement was done within 24 h for 52 (61.9%) and within 72 h for 69 (82.1%) patients with open fractures. Only 19 (22.4%) and 55 (64.7%) patients with open fractures and tibial long bone fractures received antibiotics within 3 h. Open fractures and tibial fractures had higher percentages of infection, 18.6% and 12.1%, respectively. Previous use of an external fixator (44.4%) and prolonged surgery (12.5%) were associated with higher proportions of infection. Conclusion: This study found that the prevalence of infections after intramedullary nailing of long bone fractures in Ethiopia was 44.4% after external fixation, compared to 6.4% after intramedullary nail was inserted directly. Proper control measures are needed to reduce morbidity and complications related to long fracture treatment, such as open fractures, tibial fractures, the use of an external fixator, delayed debridement and skin closure, and prolonged surgery developed surgical site infection rate. |
| first_indexed | 2024-03-13T04:57:47Z |
| format | Article |
| id | doaj.art-842eb44a9f444eda9a12ea562602bb47 |
| institution | Directory Open Access Journal |
| issn | 2050-3121 |
| language | English |
| last_indexed | 2024-03-13T04:57:47Z |
| publishDate | 2023-06-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | SAGE Open Medicine |
| spelling | doaj.art-842eb44a9f444eda9a12ea562602bb472023-06-17T13:33:59ZengSAGE PublishingSAGE Open Medicine2050-31212023-06-011110.1177/20503121231181648Prevalence and associated factors of infection after intramedullary nailing of long bone fractures among patients attending St. Paul’s Hospital Millennium Medical College, AaBET Hospital, Addis Ababa, EthiopiaTilahun Desta0Teshale Lodamo1Habtewold Mulat2Dereje Bayissa Demissie3Kalkidan Ayalew4Consultant Orthopaedic Surgeon, St. Paul’s Hospital Millennium Medical College (SPHMMC), Addis Ababa, EthiopiaConsultant Orthopaedic Surgeon, Sodo University Hospital, Sodo, Wolayita, EthiopiaConsultant Orthopaedic Surgeon, St. Paul’s Hospital Millennium Medical College (SPHMMC), Addis Ababa, EthiopiaSchool of Nursing, St Paul’s Hospital Millennium Medical College, Addis Ababa, EthiopiaConsultant Orthopaedic Surgeon, St. Paul’s Hospital Millennium Medical College (SPHMMC), Addis Ababa, EthiopiaObjectives: The intramedullary nailing of long bone fractures is a major challenge for orthopedic surgeons, with increased risk of infection in third-world countries. Research gaps remain in Ethiopia, determining the magnitude of the problem. This study aimed to determine the prevalence and associated factors of infection after intramedullary nailing of long bone fractures in Ethiopia. Methods: This was a descriptive, cross-sectional, retrospective design study with a total census of 227 cases of long bone fractures treated with intramedullary Surgical Implant Generation Network nails at Addis Ababa Burn Emergency and Trauma Hospital from August 2015 to April 2017. Data were collected from 227 patients and descriptive analyses were done to summarize the study variables. Binary and multivariable logistic regression analyses were performed at a p value of 0.05 with a 95% confidence interval and adjusted odds ratio. Results: The mean age of patients was 32.9 years, with a male-to-female ratio of 3.5:1. Only 22 (9.3%) of the 227 patients with long bone fractures treated with intramedullary nails developed a surgical site infection, and 8 (3.4%) were developed deep (implant) infections requiring debridement. Road traffic injuries were the leading cause of trauma (60.9%), followed by falls from a height (22.7%). Debridement was done within 24 h for 52 (61.9%) and within 72 h for 69 (82.1%) patients with open fractures. Only 19 (22.4%) and 55 (64.7%) patients with open fractures and tibial long bone fractures received antibiotics within 3 h. Open fractures and tibial fractures had higher percentages of infection, 18.6% and 12.1%, respectively. Previous use of an external fixator (44.4%) and prolonged surgery (12.5%) were associated with higher proportions of infection. Conclusion: This study found that the prevalence of infections after intramedullary nailing of long bone fractures in Ethiopia was 44.4% after external fixation, compared to 6.4% after intramedullary nail was inserted directly. Proper control measures are needed to reduce morbidity and complications related to long fracture treatment, such as open fractures, tibial fractures, the use of an external fixator, delayed debridement and skin closure, and prolonged surgery developed surgical site infection rate.https://doi.org/10.1177/20503121231181648 |
| spellingShingle | Tilahun Desta Teshale Lodamo Habtewold Mulat Dereje Bayissa Demissie Kalkidan Ayalew Prevalence and associated factors of infection after intramedullary nailing of long bone fractures among patients attending St. Paul’s Hospital Millennium Medical College, AaBET Hospital, Addis Ababa, Ethiopia SAGE Open Medicine |
| title | Prevalence and associated factors of infection after intramedullary nailing of long bone fractures among patients attending St. Paul’s Hospital Millennium Medical College, AaBET Hospital, Addis Ababa, Ethiopia |
| title_full | Prevalence and associated factors of infection after intramedullary nailing of long bone fractures among patients attending St. Paul’s Hospital Millennium Medical College, AaBET Hospital, Addis Ababa, Ethiopia |
| title_fullStr | Prevalence and associated factors of infection after intramedullary nailing of long bone fractures among patients attending St. Paul’s Hospital Millennium Medical College, AaBET Hospital, Addis Ababa, Ethiopia |
| title_full_unstemmed | Prevalence and associated factors of infection after intramedullary nailing of long bone fractures among patients attending St. Paul’s Hospital Millennium Medical College, AaBET Hospital, Addis Ababa, Ethiopia |
| title_short | Prevalence and associated factors of infection after intramedullary nailing of long bone fractures among patients attending St. Paul’s Hospital Millennium Medical College, AaBET Hospital, Addis Ababa, Ethiopia |
| title_sort | prevalence and associated factors of infection after intramedullary nailing of long bone fractures among patients attending st paul s hospital millennium medical college aabet hospital addis ababa ethiopia |
| url | https://doi.org/10.1177/20503121231181648 |
| work_keys_str_mv | AT tilahundesta prevalenceandassociatedfactorsofinfectionafterintramedullarynailingoflongbonefracturesamongpatientsattendingstpaulshospitalmillenniummedicalcollegeaabethospitaladdisababaethiopia AT teshalelodamo prevalenceandassociatedfactorsofinfectionafterintramedullarynailingoflongbonefracturesamongpatientsattendingstpaulshospitalmillenniummedicalcollegeaabethospitaladdisababaethiopia AT habtewoldmulat prevalenceandassociatedfactorsofinfectionafterintramedullarynailingoflongbonefracturesamongpatientsattendingstpaulshospitalmillenniummedicalcollegeaabethospitaladdisababaethiopia AT derejebayissademissie prevalenceandassociatedfactorsofinfectionafterintramedullarynailingoflongbonefracturesamongpatientsattendingstpaulshospitalmillenniummedicalcollegeaabethospitaladdisababaethiopia AT kalkidanayalew prevalenceandassociatedfactorsofinfectionafterintramedullarynailingoflongbonefracturesamongpatientsattendingstpaulshospitalmillenniummedicalcollegeaabethospitaladdisababaethiopia |