Management of Open Tibia Shaft Fractures in Ghana: A Prospective Longitudinal Study

Objective To evaluate patient and injury characteristics and functional outcomes of open tibial shaft fractures among patients treated at a tertiary hospital in Ghana. Methods We recruited consenting patients with open tibial shaft fractures over a 3-month period and followed-up each participant for at least 2 years. The functional status of each enrolled patient was assessed at 2 years following injury, using Short Form 36. Results Over the 3-month inclusive period of the study, a total of 55 open fractures of the tibia and fibula diaphysis were recorded in 55 patients. Most (52.7%) had Gustillo-Anderson grade III injury. External fixation was the mode of stabilisation (65.5%) At 2 years, 51.9% (28 of 54) had excellent functional outcome. In total, 52.7% of the participants were able to use the affected limb as before the injury, and 92.6% (50 of 54) had returned to their previous work. Conclusion The outcome of open tibial shaft fractures at the study site is good-to-excellent in most (92.6%) patients, with a return-to-previous occupation rate of 92.6%. Gustillo-Anderson grade III injury was the most predominant (52.7%) and sub-type IIIB, the most common among the grade III injuries. External fixation was the most common mode of stabilization of open tibial diaphyseal fractures.