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Major Orthopaedic Procedures: 17 Year Trend Objective: This audit aims at determining recognizable trends in the proportions of major orthopaedic procedures performed in the department of orthopaedics, Addis Ababa University in the last two ‘decades’. It also describes the factors operating behind the trends and also their implications. Design: Retrospective analysis of major Orthopaedic procedures done between January 1988- January 2005. Settings: Addis Ababa University, Medical Faculty, Department of Orthopaedic Surgery. ‘Tikur Anbessa’ Hospital (Black lion Hospital). Patients and Methods: Medical Records and operation logbooks (OR – Registry) of 13,702 were audited. Minor and day case procedures were excluded from the study. Result: On average, 806 major orthopaedic procedures were done each year. Males accounted for 74% (10,104) and children 29% (3,974). The mean age for adults was 34 years. Eighty percent of the procedures were elective and trauma was the cause in 65%. Majority of the procedures were ‘septic’, 4,661 (34%) followed by different types of open reduction and internal fixation (ORIF), (14.5%) and amputations (11.7%). The commonest major procedure on children was postero-medial release (PMR) for clubfeet. Over the ‘two decades’, increasing trend in proportion of ORIF, bone biopsy, PMR and above knee amputations (AKA) was observed. On the contrary, proportion of septic operations, closed manipulations and procedures to correct post polio deformities have shown a decreasing trend. Conclusion: Over the decades passed, major orthopaedic procedures have shown significant changes in trends. The shift towards operative fixation of fractures demands importing expensive implants. Factors and facts operating behind need further investigations. |
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