Characteristics and outcome of road traffic injured patients in the emergency department of a tertiary teaching hospital in Nigeria

Background: The exit modes from the emergency department (ED) for road traffic injury patients are namely planned discharge; admission to the wards/intensive care unit or transfer to the operating theatre; discharge against medical advice (DAMA). The aim of this study was to assess the characteristics and outcomes of non-poly-traumatized road traffic injury (RTI) related ED admissions of a tertiary health care facility in a developing country and the exit pattern from the ED.Methods: This was a retrospective hospital data-based study of outcome of RTI patients seen in the ED of a tertiary teaching hospital in Nigeria from January to December 2017.Results: 1120 RTI patients were recruited consisting of 774 males and 346 females with a male: female ratio of 2.24:1. The age range was 1 to 94 years with a mean age of 37.5±17.5 years.  Peak ages were in the fourth (24.2%) and third (20.4%) decades of life respectively.  85.5% of the patients were commercial vehicles passengers. Motorcycle accidents constituted 44% of the patients while 41.8% were in cars. The commonest injuries were head injuries (31% m:f 2.7) and fractures (21% m:f 3). There were 11.5% DAMA and 7.1% deaths. Motorcycles injuries had the highest mortality rate while the motorized tricycles injuries had the highest DAMA rates.Conclusions: Motorized tricycles may be considered as a safer means of commercial mode of transportation compared to motorcycles despite its own limitations. There is a need to educate patients against the common practice of discharge against medical advice

Epidemiology of fractures of the humerus at the university college hospital Ibadan

Background: The humerus is one of the long bones of the upper limb. It may be fractured following traumatic or non-traumatic injury. Humeral shaft fractures account for 1-3% of all fractures. However supracondylar fracture of the humerus is more common amongst children accounting for about 16% of all pediatric fractures. Trauma especially from falls especially in both children and geriatric populations has been known to cause humeral fractures. Other causes had been documented also. This study was aimed at determining the incidence, cause and pattern of humeral fracture in patients who presented to the accident and emergency department of the University College Hospital, Ibadan, Oyo state, Nigeria. Methods: Patients with radiologically confirmed humeral fractures who presented to the accident and emergency department of the hospital between January 2015 and December 2019 were included in the study. Data was obtained from the electronically stored data at the department of orthopedic surgery and trauma university college hospital Ibadan using a proforma and the data generated was analyzed using Statistical Package for the Social Sciences version 16. Results: A total of 167 patients with humeral fractures were seen during the study period. Most of these patients are within the age range of 0-15 years. Male to female ratio was 1.7:1. Most humeral fractures were due to fall and the distal humerus was most commonly affected. Conclusions: Humeral fractures occur in younger people and efforts should be geared towards preventing this trend in younger population