Risk Factors for Delayed Management of Open Tibial Fractures in Tanzania

In a recent report in JBJS, Holler et al. investigated risk factors for delayed management of open tibial fractures in Tanzania. As the authors note, musculoskeletal injuries are a leading cause of disability globally, and they disproportionately affect people in low- and middle-income countries (LMICs). Open tibial fractures are associated with high complication rates and poor long-term quality of life for individuals in LMICs. Access the report here. 

  • The authors analyzed risk factors for delayed hospital admission and surgical treatment of open tibial fractures in adult patients treated at a tertiary referral center in Tanzania. A total of 249 patients met the inclusion criteria. 
  • Road traffic accidents were the primary mechanism of injury (92%). Only 12% of the patients used an ambulance, and 75% of the patients were referred to the treatment hospital from another facility. 
  • 41% of the patients presented to the first hospital ≥2 hours after injury, and 95% of the patients presented to the treatment hospital after 2 hours. 10% of the patients had a delay of ≥12 hours from admission to surgery.  
  • After adjusting for injury severity, the researchers found that having insurance, and wounds with approximated skin edges were associated with a decreased risk of delayed presentation to the hospital. Interfacility referrals and a rural injury location were associated with greater median times to admission to the treating hospital. Older age, single-person households, and an educational level greater than pre-primary were associated with fewer delays to surgery after admission. 

Reflecting on their study, the authors say: 

“Our study’s findings demonstrate that prehospital network and socioeconomic characteristics are associated with delays to open tibial fracture care in Tanzania. Reducing interfacility referrals and implementing surgical cost-reduction strategies may help to reduce delays to open fracture care in LMICs. We believe that this work substantially contributes to a growing body of research aimed at improving global musculoskeletal care.” 

Click here for the full JBJS report. 


One thought on “Risk Factors for Delayed Management of Open Tibial Fractures in Tanzania

Leave a Reply

Related Posts

Discover more from OrthoBuzz

Subscribe now to keep reading and get access to the full archive.

Continue reading