Analysis of Orthopaedic Injuries in Polytrauma Patients at Charlotte Maxeke Johannesburg Academic Hospital

dc.contributor.authorLaney, Wezley
dc.contributor.co-supervisorNaicker, Dharshen
dc.contributor.supervisorMilner, Brenda
dc.date.accessioned2025-04-11T13:22:50Z
dc.date.issued2022
dc.departmentOrthopaedic Surgery
dc.descriptionA research report submitted in partial fulfilment of the requirements for the degree of Master of Medicine in the branch of Orthopaedic Surgery, to the Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, 2022.
dc.description.abstractBackground: Traumatic injuries represent a significant burden globally, accounting for ten percent of the global burden of disease. In South Africa we commonly see patients who have sustained major trauma, often with multiple injuries. This significant burden of trauma necessitates the demand for rapid diagnostic assessment of injuries for appropriate therapeutic intervention. A whole body computed tomography (CT pan scan) allows for a rapid multisystem injury diagnosis of trauma patients. There is a scarcity of literature evaluating the extent of orthopaedic injuries in polytrauma patients. Study Aim: The aim of the study was to evaluate the local epidemiology of orthopaedic injuries in polytrauma patients who have undergone a CT pan scan. Methods: A retrospective, observational analysis, based at Charlotte Maxeke Johannesburg Academic Hospital, was done of polytrauma patients who underwent a CT pan scan, during a 2-year period from 01/01/2018 – 31/12/2019. A database was compiled by accessing the picture archiving and communication system for CT reports. The qualitative data was reported using frequencies and percentages. Categorical variables were analysed using the Chi-squared test (or Fisher’s exact test). Results: Over the two-year study period a total of 296 polytrauma patients had a reported CT pan scan performed. Of these, 85% were male and 15% were female with a median age of 33 years. The most common mechanism of injury was motor vehicle accidents (33.1%). The prevalence of orthopaedic injuries in polytrauma patients was 53.3%. A total of 1012 injuries were found. One hundred and ninety-six (196) spinal fractures were detected; a total of 137 pelvic/sacral fractures, 101 long bone fractures with 75% lower limbs and 25% were upper limb fractures. The most common non-orthopaedic injury sustained was a chest injury. The most common combination of orthopaedic and non-orthopaedic injuries identified in the study was a chest injury with an associated pelvic/sacral fracture secondary to a PVA. Interpersonal and intentional injuries were significantly associated with a higher risk of thoracic spine fractures (RR 1.8, CI 1.1-2.9). Road traffic accidents were significantly associated with a higher risk of scapular/clavicular fractures (RR 2.0, CI 1.2-3.5) and a higher risk of tibial/fibula fractures (RR 3.5, CI 1.2-10.3) Conclusion: The majority of polytrauma patients seen at CMJAH were young males, who sustained injuries during road traffic accidents. Fractures accounted for 94% of all orthopaedic injuries. The most common orthopaedic injury detected in our cohort, overall, was a spinal fracture, most commonly involving the cervical spine. A patient involved in a road traffic accident is 3.5 times more likely to sustain a tibia/fibular fracture as opposed to any other fracture. The most common non-orthopaedic injury sustained was a chest injury. Importantly, 1 in 4 of these patients sustained an associated cervical spine injury and 1 in 3 a pelvic injury, similarly with head injuries. The most common combination of injuries is a chest injury with an associated pelvic/sacral fracture secondary to a pedestrian vehicle accident. The findings highlight the significant burden of orthopaedic injuries in polytrauma patients. In addition, the findings of this study, highlight injury patterns that should be anticipated in polytrauma patients.
dc.description.submitterMMM2025
dc.facultyFaculty of Health Sciences
dc.identifier0000-0002-0663-6531
dc.identifier.citationLaney, Wezley. (2022). Analysis of Orthopaedic Injuries in Polytrauma Patients at Charlotte Maxeke Johannesburg Academic Hospital. [Masters dissertation, University of the Witwatersrand, Johannesburg]. WIReDSpace. https://hdl.handle.net/10539/44720
dc.identifier.urihttps://hdl.handle.net/10539/44720
dc.language.isoen
dc.publisherUniversity of the Witwatersrand, Johannesburg
dc.rights©2022 University of the Witwatersrand, Johannesburg. All rights reserved. The copyright in this work vests in the University of the Witwatersrand, Johannesburg. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of University of the Witwatersrand, Johannesburg.
dc.rights.holderUniversity of the Witwatersrand, Johannesburg
dc.schoolSchool of Clinical Medicine
dc.subjectCT pan scan
dc.subjectOrthopaedic injuries
dc.subjectPolytrauma
dc.subjectMEDICINE::Surgery::Anaesthetics and intensive care::Traumatology
dc.subjectWhole body computed tomography
dc.subjectUCTD
dc.subject.primarysdgSDG-3: Good health and well-being
dc.subject.secondarysdgSDG-4: Quality education
dc.titleAnalysis of Orthopaedic Injuries in Polytrauma Patients at Charlotte Maxeke Johannesburg Academic Hospital
dc.typeDissertation

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