Abstract
Machete cut fracture is an important component of morbidity associated with machete injuries although it is under reported. This was a retrospective study to assess machete cut fractures in patients seen in Federal Teaching Hospital Abakaliki and National Orthopaedic Hospital Enugu from 2009 to 2018. There were 91 patients with 154 fractures, male- to- female ratio was 10:1 and mean age was 31.6 ± 14.6 years. The aetiological factors were assault (57, 62.6%), armed robbery (29, 31.9%) and accidental injury (5, 5.5%). The three top bones involved were ulna, metacarpal and finger-phalanx. Fracture was communited in (17, 11.0%), and Gustilo Anderson grade IIIC in (22, 14.3%). Injury to hospital arrival interval later than 6 h was common and correlated with prolonged length of hospital stay (p < 0.001). Anaemia, wound infection and hemorrhagic shock were the three top complications. Nine (5.8%) fractures ended in extremity amputation. Eleven (12.1%) patients left against medical advice, and 5 (5.5%) were transferred. Normal union in 98.3% of the fractures treated and followed up for a minimum of one year. Case fatality rate was 2.2%; none of the patient that died had pre hospital care, and hemorrhagic shock accounted for all the mortality. These call for appropriate injury preventive mechanisms, and improved rates of early presentation of patients to hospital, and pre hospital care.
Highlights
This was a retrospective analysis of data on all the consecutive patients that presented with machete cut fracture at the Emergency room of two Nigerian tertiary hospitals, Federal Teaching Hospital Abakaliki Ebonyi State and National Orthopaedic Hospital Enugu from 1st January 2009 to 31st December 2018
Patients presenting to the hospitals with machete cut were admitted in the Accident and Emergency (A&E) unit for resuscitation using the Advanced Trauma Life Support (ATLS) protocol, initial wound care, and administration of empirical parenteral antibiotics and tetanus toxoid
Of the 5 patients with accidental machete cut fractures, 3 of them had it during farming activities whereas one victim had it while separating a fight and the other was an accidental injury from a machete wielded to kill a strange mad dog
Summary
The aim of this study was to determine the pattern and outcome of machete cut fractures seen in civilian trauma setting of a developing country
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