Epidemiology and Treatment of Distal Radius Fractures at Four Public Hospitals in Malawi

J Am Acad Orthop Surg Glob Res Rev. 2024 Mar 26;8(4):e23.00282. doi: 10.5435/JAAOSGlobal-D-23-00282. eCollection 2024 Apr 1.

Abstract

Background: Little is known about the burden or management of distal radius fractures (DRFs) in low- and middle-income countries. The purpose of this study was to describe the care of DRFs in Malawi.

Methods: We retrospectively reviewed a registry of all patients with fractures who presented to the orthopaedic departments at four public hospitals in Malawi.

Results: Totally, 1,440 patients (14.5%) were with a DRF. Average age was 40, and 888 (62.0%) were male. Surgery was done for 122 patients (9.5%). Patients presenting to Queen Elizabeth Hospital, patients presenting after a fall, and patients initially evaluated by an orthopaedic registrar or orthopaedic clinical officer had lower odds of receiving surgical treatment. Meanwhile, open injuries had the greatest odds of receiving surgery.

Conclusion: The most common musculoskeletal injury among patients in the Malawi Fracture Registry was fractures of the distal radius. These most affected young adult male patients may benefit from surgery; however, the majority were managed nonsurgically. Lack of access to surgical fixation and conservative follow-up may have long-term functional consequences in a predominantly agrarian society. Outcomes-based research is needed to help guide management decisions and standardize patient care and referral protocols.

MeSH terms

  • Female
  • Hospitals, Public
  • Humans
  • Malawi
  • Male
  • Radius Fractures* / surgery
  • Retrospective Studies
  • Wrist Fractures*
  • Young Adult