A cross sectional study of early functional outcomes of casting of tibial shaft fractures at the university teaching hospitals-adult hospital , Lusaka, Zambia.

Abstract

Tibial shaft fractures are a common presentation following high energy trauma such as road traffic accidents. The gold standard for the treatment of such injuries is by Intramedullary nailing, but in a resource-limited setting, the casting of such injuries is considered as appropriate. At the University Teaching Hospital most tibial shaft fractures were treated with casting due to several reasons including socioeconomic status and lack of theatre space. The functional outcome following such an intervention locally was assumed not to be as good as alluded to in literature. This was evidence by the indications of most of the Intramedullary nailing being failed non-operative management. The purpose of this study was to investigate the early functional outcomes of tibial shaft fractures treated by casting at the University Teaching Hospital. The results of the study will guide the rationale of continuing on the current path of treatment locally. Using a cross-sectional analysis, participants at three months post-injury with tibial shaft fracture presenting to the orthopedic clinic for their scheduled review appointment were randomized and 138 were enrolled and assessed using the Johner- Wruhs criteria. The results of this study were examined against those stated in the literature. The 138 participants comprised 102 (73.9%) males and 36(26.1%) females with an age range of 19-64years. The median age was 34.5 (IQR14). The result of the study showed that 75.4% of the participants had good to excellent results following casting at three months post-injury. Fair to poor results was seen in 24.6% of the participants The study demonstrates that the results of tibial shaft fractures treated with casting at the UTH are good. It is in tandem with the results that are shown in similar studies done elsewhere in a similar socioeconomic setting. Keywords: Functional outcomes; intramedullary nailing; Johner- Wruh criteria; Casting.