Nathan N O'Hara1, Rodney Mugarura2, Jeffrey Potter3, Trina Stephens4, M Marit Rehavi5, Patrick Francois5, Piotr A Blachut3, Peter J O'Brien3, Alex Mezei6, Tito Beyeza2, Gerard P Slobogean1. 1. Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland. 2. Department of Orthopaedics, Makerere University, Kampala, Uganda. 3. Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada. 4. Faculty of Medicine, Queen's University, Kingston, Ontario, Canada. 5. Vancouver School of Economics, University of British Columbia, Vancouver, British Columbia, Canada. 6. Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Abstract
BACKGROUND: The purpose of this study was to determine the socioeconomic implications of isolated tibial and femoral fractures caused by road traffic injuries in Uganda. METHODS: This prospective longitudinal study included adult patients who were admitted to Uganda's national referral hospital with an isolated tibial or femoral fracture. The primary outcome was the time to recovery following injury. We assessed recovery using 4 domains: income, employment status, health-related quality of life (HRQoL) recovery, and school attendance of the patients' dependents. RESULTS: The majority of the study participants (83%) were employed, and they were the main income earner for their household (74.0%) at the time of injury, earning a mean annual income of 2,375 U.S. dollars (USD). All of the patients had been admitted with the intention of surgical treatment; however, because of resource constraints, only 56% received operative treatment. By 2 years postinjury, only 63% of the participants had returned to work, and 34% had returned to their previous income level. Overall, the mean monthly income was 62% less than preinjury earnings, and participants had accumulated 1,069 USD in debt since the injury; 41% of the participants had regained HRQoL scores near their baseline, and 62% of school-aged dependents, enrolled at the time of injury, were in school at 2 years postinjury. CONCLUSIONS: At 2 years postinjury, only 12% of our cohort of Ugandan patients who had sustained an isolated tibial or femoral fracture from a road traffic injury had recovered both economically and physically. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
BACKGROUND: The purpose of this study was to determine the socioeconomic implications of isolated tibial and femoral fractures caused by road traffic injuries in Uganda. METHODS: This prospective longitudinal study included adult patients who were admitted to Uganda's national referral hospital with an isolated tibial or femoral fracture. The primary outcome was the time to recovery following injury. We assessed recovery using 4 domains: income, employment status, health-related quality of life (HRQoL) recovery, and school attendance of the patients' dependents. RESULTS: The majority of the study participants (83%) were employed, and they were the main income earner for their household (74.0%) at the time of injury, earning a mean annual income of 2,375 U.S. dollars (USD). All of the patients had been admitted with the intention of surgical treatment; however, because of resource constraints, only 56% received operative treatment. By 2 years postinjury, only 63% of the participants had returned to work, and 34% had returned to their previous income level. Overall, the mean monthly income was 62% less than preinjury earnings, and participants had accumulated 1,069 USD in debt since the injury; 41% of the participants had regained HRQoL scores near their baseline, and 62% of school-aged dependents, enrolled at the time of injury, were in school at 2 years postinjury. CONCLUSIONS: At 2 years postinjury, only 12% of our cohort of Ugandan patients who had sustained an isolated tibial or femoral fracture from a road traffic injury had recovered both economically and physically. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Authors: Daniel K Kisitu; Nathan N O'Hara; Gerard P Slobogean; Andrea L Howe; Piotr A Blachut; Peter J O'Brien; David J Stockton Journal: J Orthop Trauma Date: 2022-09-01 Impact factor: 2.884
Authors: Sheila Sprague; Diane Heels-Ansdell; Sofia Bzovsky; Radovan Zdero; Mohit Bhandari; Marc Swiontkowski; Paul Tornetta; David Sanders; Emil Schemitsch Journal: Bone Jt Open Date: 2021-01-05
Authors: Dennis J Zheng; Patrick J Sur; Mary Goretty Ariokot; Catherine Juillard; Mary Margaret Ajiko; Rochelle A Dicker Journal: PLoS One Date: 2021-01-22 Impact factor: 3.240