Pattern and management of orthopedic pathologies consulting outpatient department at a referral level hospital, case of Rwanda Military Hospital: a cross sectional study

Abstract

Background: Musculoskeletal conditions are a common cause of long-term pain and physical disability affecting many people worldwide. Additionally, these conditions have an enormous economic and social impact on the individual, society and national health systems. Although the burden of disease due to musculoskeletal conditions is said to be on the rise in the developing world, the full extent of this burden remains unknown. Methods: This was a hospital-based cross-sectional study done from 1st to31st March, 2019. Relevant data on patient demographics, presenting musculoskeletal condition and treatment received was collected from 313 patients seen in the orthopedics Outpatient Department service at a referral hospital: Rwanda Military Hospital. Demographic data, orthopedic pathologies, and management of musculoskeletal diseases were all recorded and analyzed. The distribution of variables was measured using frequencies and percentages and where necessary, the association was analyzed using the Pearson’s chi-square test; which was considered statistically significant if the p<0.05. Results: the study consist of a total of 313 patients, with predominant number of male patients 216 (69.0%) whereas female patients were 31.0 %. Majority of patients were in the 15-65 year age group; accounting to 82.4 %. The 0-14 year age group accounted for 13.1%, whereas those above 65 years accounted for only 4.5% of the patients... Trauma was the leading cause of consultation followed by infection and degenerative pathologies accounting respectively 49.5%, 13.7% and 11.2%. The most affected body parts are tibia, femur, humerus and fibula respectively accounted 13, 1%, 10.5%, 6.7% and 4.8%. The majority of the patients in our study, 67% consulted late, at more than 3months from the onset of their condition. Conclusion: traumatic, infective and degenerative conditions were the most common musculoskeletal disorders. There were more male than female patients. As the individual diagnosis, tibia was the mostly affected body site and lumbar sacral segment was the commonest affected joint, followed by the knee. Looking on the prevalent disease category, majority of them are preventable. Most of patients present late, after three months from the onset of their conditions. One of the factors that can be attributed to this late presentation is the big number of patient waiting appointment of orthopedic surgeon; however this should be a subject of further studies.