ABSTRACT:

BACKGROUND: The demand for external fixation devices is growing due to the advantages of advanced products such as bioresorbable implants, drug-eluting implants, and nano-coated devices. The other driving factors also include growth in geriatric population, high prevalence of bone degenerative diseases, and increasing incidence of sports injuries worldwide. In Africa as seen in Nigeria external fixators are commonly used after open injury in trauma patient and those patient experience complication in which pin tract infection is the most common complication. In Tanzania external fixators are applied to trauma patient especially in tertiary hospitals but there is a limited reports and data regarding the complication of the application of external fixators in this region. This study aims at improving the data on such procedure which may lead to a buildup of better use of external fixators in orthopedics trauma patient in tertiary hospital.

OBECTIVE OF STUDY: to determine the complications of external fixator application in upper and lower limbs trauma patient at Bugando Medical Centre Mwanza Tanzania.

METHODOLOGY: The study was done using a hospital based descriptive cross-sectional study at the orthopedic ward and orthopedic clinics at Bugando Medical Centre. This study was conducted for a period of 8 months where 80 patients who underwent external fixator application in upper and lower limb were enrolled in the study. and data collected through questionnaires and check list, later were analyzed by using SPSS version 20 and results are presented in tables.

RESULTS: A total of 80 respondents were involved in this study. Minimum age was 9years, maximum age was 79years, mean age was 47years, range(9-79year); median age was 46.2years with the standard deviation of 16.8. 4(5%) were from age group 1-20years, 24(30%) from 21-40years, 34(42.5%) from 41-60years, 18(22.5%) from age group 61-80years. Of all respondents, only 9(11.25%) were females and 71(88.75%) were males. 61(76.25%) lives in town and 19(23.75%) resides in rural areas. There were 7 complication of external fixation that were observed in this study and complication of external fixator application occurred to 23(28.75%) of the respondents. The mean duration of hospital stay was 7.8 weeks (0.3 weeks-13 weeks), the mean waiting time was 17.4 days. They were 7 complication occurred 53 times in the 23 patient with complication. Some complication occurred together in one patient during the time of the study. Pin site infection was the commonest occurring in 21(91.3%) of patient with complication, followed by pin loosening in 20(86.96%) of patient with complication, in which they occurred together about 18(78.3%), Refracture around pin 4(17.39%), Neovascular injury 2(8.7%), Deep infection 3(13.03%), joint stiffness 2(8.7%) and a union problem 1(4.35%). Satisfactory result were achieved in 72(90%), unsatisfactory 8 (10%). The procedure was abandoned in 4 patient.

CONCLUSION: In conclusion the prevalence of complication of external fixator application in the upper and lower limb in BMC Mwanza Tanzania is 28.75% in which the commonest complication is pin site infection occurring among 91.3% of the complication. Also the complication of external fixator application may occur together or after the resolution of another or as a sequela of another complication as for instance pin loosening and pin site infection co-exist most of the cases with complication while neovascular injury and deep infection occurred after refracture around pin and pin site infection respectively.