Publication:

Timing of surgical interventions for open lower limb long bone fractures as a determinant of the length of hospital stay in a tertiary hospital in Nigeria

Background Open fractures are major orthopaedic emergencies with known complications such as infections, amputations and death. Fractures involving the long bones of the lower limb are usually more common. Surgical interventions range from basic debridement to major surgery and vascular repairs. The timing of these interventions is debatable, with medical bodies developing differing standards to improve overall patient outcome. The aim was to determine the effect of the timing of surgical interventions on the length of hospital stay in patients with open lower limb long bone fractures.

Methods This was a retrospective cross-sectional study of 45 patients who presented in a tertiary facility over a 5-year period with open fractures involving the long bones of the lower limb. Patients’ time to presentation/initial debridement, time to surgery, and length of stay post-surgery were evaluated. The obtained data were analysed using the IBM statistical package for social sciences (SPSS) Statistics version 26 for Windows (SPSS Inc., Chicago, IL, USA).

Results This study revealed that all our patients fell between Gustilo-Anderson I and IIIA. Sixty-nine percent underwent initial debridement within 6 hours of injury. Forty-two percent had surgery within 1–3 days postinjury. Majority (62%) left the hospital within 1 week of surgery. Multivariate analysis revealed no significant correlation between the time of injury to surgical intervention and length of hospital stay (ρ=-0.087; p=0.590).

Conclusions This study concluded that while the timing of surgical interventions may be important, it did not significantly affect the length of hospital stay.