The Pattern of Hip Fractures Over A Ten-Year Period in A Major Referral Centre in Ghana

Abstract

Background: The incidence of hip fractures is projected to increase worldwide and so are the associated morbidity, mortality, and cost of managing patients with hip fractures. There is, however, scarcity of data on trend and incidence of hip fractures in sub-Saharan Africa making planning and management difficult.Methods: This is a retrospective study that involves all hip fractures seen and admitted to Korle-Bu Teaching Hospital in Accra, Ghana from 2007 to 2016. The demographic characteristic (sex and age), mechanism of injury, and the fracture type were documented. Association between age, sex, and mechanism of injury and type of fracture were determined by Chi-square, with p-value< 0.05 as the level of significance.Results: Nine hundred and twenty-nine patients were admitted over the 10-year period. There were 492 (53%) females and 437 (47%) males, a ratio of 1.1:1.0. The mean age was 72.2 ± 14.4 years. Falls which mostly were low energy constituted 726 (78.1%) of cases with 203 (21.9%) resulting from road traffic accidents (RTA). There was an increase in patients with hip fractures from 2007 to 2012 followed by a gradual decline. Approximately 490 (52.7%) and 439 (47.3%) of the cases were extracapsular and intracapsular respectively. There was strong association between age and mechanism of injury (X2 (2) =492.10, p < 0.001, Φ =0.73) and moderate association between sex and mechanism of injury (X2 (1) =37.50, p < 0.00, Φ =0.21). There was no significant association between sex or age and the type of fracture (p>0.05)Conclusions: This study shows a 10-year trend of hip fractures in a major referral hospital in Ghana. It will serve as a baseline information for a nationwide study on the incidence rate of hip fracture in the country. It also has a great implication for future planning and management.