Management of Open Leg Fractures at Zinder National Hospital

Abstract

Introduction: Open leg fracture is a diaphyseal or metaphyseal, extra-articular fracture of one or both leg bones, with communication between the fracture site and the external environment. To provide a broader context, studies conducted globally have highlighted the significance of understanding open leg fractures due to their complex management and potential complications. Previous research in Africa and Europe provides comparative data that emphasizes regional differences in fracture types, causes, and treatment outcomes. This study aims to contribute to improving the management of theses fractures in Niger. Materials and Methods: This was a prospective, descriptive study carried out in the Traumatology-Orthopedics Department of the Zinder National Hospital, Niger, from December 8, 2020 to June 8, 2022 (18 months). We included all patients over 15 years of age in whom an open leg fracture was diagnosed and managed. Inclusion criteria focused on patients aged over 15 years with confirmed diagnoses of open leg fractures. Results: Over an 18-month period, the frequency of open leg fractures was 16.28%. There was a predominance of males (85.93% or n = 116). The average age of patients was 31.79 years. Road accidents were the primary circumstance of occurrence (93.33% or n = 126). The fracture line was simple in 74 patients (54.81%) and complex in 61 cases (45.19%). Surgically, the external fixator was used in 78 cases (57.80%). Postoperative follow-up was mostly straightforward. The main complications were infection (4 cases) and delayed consolidation (4 cases). Conclusion: Open leg fractures in adults are frequent at Zinder National Hospital. Public road accidents were the main cause of occurrence. An external fixator osteosynthesis was the most commonly used surgical option. These findings have important implications for healthcare policy, particularly in improving trauma care infrastructure and road safety initiatives in Niger. Future studies should prioritize the development of standardized treatment protocols and investigate the long-term outcomes of different surgical approaches.