Epidemiological And Clinical Aspects Of Neglected Fractures At The University Hospital Center Mitsinjo Betanimena Toliara

Abstract

Introduction: A neglected lower limb fracture is an initial fracture that has not been properly managed within a specific timeframe. Although the diagnosis is straightforward, treatment remains complex. The objective of this study was to analyze the epidemiological and clinical aspects of neglected lower limb fractures at the University Hospital Center, Mitsinjo Betanimena Toliara.

Methodology: This is a descriptive, retrospective, and analytical study conducted from 2017 to 2020 on 34 patients presenting with clinical and/or radiological signs of a neglected fracture.

Results: The average age was 36 years, with extremes ranging from 4 to 70 years, and a predominance of male patients. Individuals from low-income backgrounds were the most affected, with a low socio-economic status (73.52%) and illiteracy (39.28%). Half of the patients sought medical consultation late, after more than 90 days. The femur and leg were the most common sites of complications (80.03%). The majority of patients initially sought treatment from traditional healers (76.46%). The most common condition was non-union fractures, followed by pseudarthrosis, osteitis, and malunited fractures. Treatment involved both medical and surgical approaches. 

Conclusion: Neglected fractures remain a challenging complication to manage and represent a major public health issue in our region. Treatment is further limited by restricted access to modern therapeutic advancements.