Knowledge and Practice of Pelvic and Acetabular Fractures Management Among Orthopaedics and Trauma Surgeons in Nigeria

Abstract

Background: Pelvic-acetabular fractures are markers of high energy trauma and are associated with significant morbidity, mortality and management could be challenging. The inability to surgically manage these fractures appropriately in our centre and few publications on pelvic-acetabular fractures in Nigeria stimulated this study. Objectives: to find out how pelvic and acetabular fractures are managed and availability of investigating tools in Nigeria. Materials and methods: A questionnaire was uploaded for 7 weeks on the National orthopaedics and trauma surgeons’ forum. Questions on pelvic fractures management, knowledge and classification of pelvic fractures, preferred methods of pelvic fractures management- surgical or non-surgical, availability of advanced investigating tools and desire to acquire more skills /training were asked. Results: Eighty-five (33.2%) of the 256 members participated in the study. Preferred classification were Tile and Young-Burgess 46 (56.8%) and 29 (35.8 %) respectively. Thirty-six (43.9%) had Computerize Tomography scan (CT) while 19 (23.2%) had Magnetic Resonance Imaging (MRI) available in their place of practice. Twenty-eight (34.6%) would manage operatively, 8 (9.9%) would either operate or refer, while 23 (28.48%) would either manage non-operative or refer and outright non-operative in 7 (8.6%) of pelvic-acetabular fractures that require Open Reduction Internal Fixation (ORIF). Forty-six (56.8%) would refer patients; because of non-availability of skilled surgeon in 30(65.2%) and non-availability of operating tools in 32(69.6 %). Seventy-four (90.2%) would like to acquire skills in pelvic surgery. Conclusion: The health facilities were not adequately equipped with advanced imaging tools. Twenty-three percent of the respondents would consider managing pelvic fracture that requires ORIF non-operatively, while more than half would refer because of either non-availability of skilled pelvic surgeon or non-availably of operating tools.  Majority of the respondents are interested in acquiring skills in pelvic surgery.