Femoral Fractures: A Retrospective Survey on 12-month Prevalence, Patient Characteristics and Aetiology at Parirenyatwa Hospital, Harare. Mwadziwana Loiuslaw Co authors: Chiwaridzo M, Naidoo N, Dambi J, Tadyanemhandu C University of Zimbabwe

Background The femur is one of the strongest bones in the body designed for weight-bearing. The prevalence of femoral fractures is reported to be increasing globally (Adnan et al 2013; Anyaehie et al 2015).

Why the interest in femoral fractures? High cost to individuals and to healthcare agencies (Bhat et al 2015) Patients may fail to regain their pre-morbid functional status Protracted rehabilitation care. Reduction of quality of life.

Background In Zimbabwe, no studies have looked at the incidence or prevalence of femoral fractures. This is a significant shortcoming against the background of increasing prevalence of the condition reported in literature.

Justification This information forms the first step in documenting the evidence on prevalence of femoral fractures among patients at PGH in a bid to craft measures to minimise their occurrence

Objectives To determine the 12-month prevalence of femoral fractures among orthopedic patients admitted at Parirenyatwa hospital from June 2014 to May 2015. To determine the aetiology, patient characteristics, comorbid conditions and type of management administered to patients with femoral fractures.

Method and material All cases of fractures admitted into orthopedic wards at PGH from June 2014 to May 2015 were retrospectively reviewed. For patients with femoral fractures, data extracted included Socio-demographic characteristics Cause of injury Type of fracture Co-morbid conditions.

Cont’d Chi-square test was used to assess for associations between categorical variables (p≤0.05). STATISTICA version 13 was used for data analysis. Ethical and institutional approvals were obtained before data collection (JREC 283/14; MRCZ/B/970)

Results Participant characteristics 616 orthopedic records retrieved. 560 (90.9%) had complete data and were analysed. The median age of the participants with femoral fractures was 34 years (IQR= 19.5-63.5 years). 66.1%, n=370 were males. 72% came from urban areas in Harare and surrounding cities

Cont’d The one-year prevalence of femoral fractures was 39.4% [95 CI=36.9-41.9%]. There was no significant difference in the one year prevalence of femoral fractures between gender [χ2 (1) =2.06, p=0.15].

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RESULTS Seventy-one (13%) of the participants admitted with femoral fracture had other comorbid conditions. The main comorbid conditions were hypertension (30%) osteoporosis (24%) and cancer (21%).

RESULTS In the majority, femoral fractures were managed surgically with internal fixation (68%, n=369).

DISCUSSION Femoral fractures are a common feature at Parirenyatwa hospital with approximately four out of ten orthopaedic patients admitted with it. These results are consistent with results of other studies from other countries.

DISCUSSION All age-groups are affected indiscriminately with the prevalence increasing from paediatrics to geriatrics. The majority of the femoral fractures were secondary to falls and road traffic accidents; a result in accordance with literature.

DISCUSSION The proximal third of femur was the most common region affected by the fractures. Comorbid conditions associated with femoral fractures included cancers, osteoporosis and hypertension. Femoral fractures were managed mainly by surgery (open reduction internal fixation).

CONCLUSION Femoral fractures are prevalent at Parirenyatwa Hospital, falls and RTA being the main causes. Although occurrence was not gender biased, the prevalence seemed to increase with age showing that age could be an important factor associated with femoral fractures.

CONCLUSION Attempts should be made to educate patients on dangers of falls and prevent them and in treating comorbid conditions such as hypertension and cancer as these were linked to having femoral fractures. Future studies are needed to further understand the causes of femoral fractures and the associated factors

ACKNOWLEDGEMENTS

References 1Mue D.D, Yongu W.T, Elachi I.C, Kortor J.N, Igbudu T.J, Utoo P.M 2014, ‘Mechanisms of Hip Fracture in a Nigerian Tertiary Hospital’, Online Journal of Medicine and Medical Science Research, 3(4), pp.37–43. 2Bhat S.A, Farouqi R.R, Kirmani T.T, Kangoo K.A, Baba A.N, Zahoor A 2015, ‘Epedimiology of hip fractures in the Kishmir Valley, International Journal of Recent Scientific Research, Vol. 6, Issue, 4, pp.3449-3452.