Background:

As road traffic crashes (RTCs) continue to rise in the developing world, the current growth rate and true burden of orthopaedic injuries are unknown. In 2015, we characterized the orthopaedic burden at Kilimanjaro Christian Medical Center (KCMC) in Tanzania. In this study, we re-evaluated the burden and growth-rate over three years in the absence of any system level changes. Additionally, we calculated the percentage of orthopaedic patients that received definitive fixation for their orthopaedic injury when surgery was indicated.

Methods:

We prospectively collected data for 190 patients admitted to the orthopaedic ward at KCMC during June/July 2018. We also retrospectively reviewed available records for patients presenting to the KCMC emergency department, orthopaedic outpatient clinic and orthopaedic ward.

Results:

Prospective data: RTC (48.6%) was the most common etiology and femur fractures (31.0%) the most common type of injury. Almost 96% of admitted patients were indicated for surgical fixation, but only 44.5% received definitive fracture treatment. Retrospective data: KCMC treated an average of 15,117 orthopaedic patients per year, representing a 35.3% growth in the orthopaedic burden compared to 2015.

Conclusion:

The burden of orthopaedic surgical disease at KCMC continues to grow. Throughout the developing world, multiple system level constraints preclude delivery of definitive treatment for most patients. Without innovative strategies to address this situation, the discrepancy between the need for orthopaedic care and surgical care capacity in the developing world will continue to grow.