The prevalence of hand pathology in regional orthopaedic hospitals in KwaZulu-Natal: A cross-sectional study
Background. Pathology of the hand causes functional impairment, with downstream effects for patient occupation, and consequently presents a socioeconomic burden. Investigation of the epidemiology of hand pathology in KwaZulu-Natal (KZN) can help reduce the burden of disease. Identifying where t...
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South African Medical Association
2024-08-01
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| Series: | South African Medical Journal |
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| Online Access: | https://samajournals.co.za/index.php/samj/article/view/1246 |
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| author | S Thabit M O'Connor W Parker T Mashishi K Moodley A Peer K Matanzima A J de Villiers O Adewusi R Aboobaker A Rocher |
| author_facet | S Thabit M O'Connor W Parker T Mashishi K Moodley A Peer K Matanzima A J de Villiers O Adewusi R Aboobaker A Rocher |
| author_sort | S Thabit |
| collection | DOAJ |
| description |
Background. Pathology of the hand causes functional impairment, with downstream effects for patient occupation, and consequently presents a socioeconomic burden. Investigation of the epidemiology of hand pathology in KwaZulu-Natal (KZN) can help reduce the burden of disease. Identifying where the greatest need is can direct patient awareness initiatives, medical training and appropriate allocation of resources.
Objectives. To establish the prevalence of hand pathology at regional hospitals that offer orthopaedic services in KZN, to describe the patients most commonly affected by these pathologies and to identify the most common pathologies.
Methods. A cross-sectional investigation of hospital records and charts of patients presenting for orthopaedic care across all 10 regional hospitals in KZN that offer orthopaedic services was undertaken for 1 week’s duration (June 2022). Patients were categorised into hand pathology (HP) and general orthopaedic pathology (OP) groups, which were each subdivided into trauma and non-trauma subgroups. Demographic details were collected for all patients. For HP patients, additional detail was collected regarding diagnosis, mechanism, admission and management. The prevalence of HP was calculated as a factor of all orthopaedic presentations.
Results. During the investigation, 2 335 patients presented to orthopaedic services. HP represented 21% of these cases. The majority (17%, 406/2 335) were related to trauma and represented 23% of all the traumatic orthopaedic presentations. Distal radius (DR) fractures were the most common hand injury (46%, 188/406) and a large proportion of trauma to the bony elements of the hand were open injuries (23%, 93/406). The remainder of HP cases comprised the non-traumatic group (4%, 91/2 335) and were predominantly infections (68%, 62/91), and many patients with non-traumatic hand pathology required surgery (60%, 55/91) and admission (56%, 52/91).
Conclusion. HP represents approximately one-fifth of all orthopaedic presentations to regional health facilities in KZN offering orthopaedic care, and close to a quarter of orthopaedic trauma occurs in the hand. Based on these findings, targeted efforts to improve community awareness of precautions against trauma to the hand, osteopaenia and hand hygiene are suggested as preventive measures. Medical training should emphasise the appropriate management of DR fractures and hand infections, and resources should be differentially allocated to the management of these debilitating HPs to decrease the burden of disease.
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| format | Article |
| id | doaj-art-8cd7841e83ab4507aae171b62378c2c6 |
| institution | Kabale University |
| issn | 0256-9574 2078-5135 |
| language | English |
| publishDate | 2024-08-01 |
| publisher | South African Medical Association |
| record_format | Article |
| series | South African Medical Journal |
| spelling | doaj-art-8cd7841e83ab4507aae171b62378c2c62025-02-10T12:25:47ZengSouth African Medical AssociationSouth African Medical Journal0256-95742078-51352024-08-01114810.7196/SAMJ.2024.v114i8.1246The prevalence of hand pathology in regional orthopaedic hospitals in KwaZulu-Natal: A cross-sectional studyS Thabit0https://orcid.org/0009-0006-4250-6968M O'Connor1W Parker2T Mashishi3K Moodley4A Peer5K Matanzima6A J de Villiers7O Adewusi8R Aboobaker9A Rocher10https://orcid.org/0000-0002-9710-5591Discipline of Orthopaedic Surgery, Inkosi Albert Luthuli Central Hospital, University of KwaZulu-Natal, Durban, South AfricaDiscipline of Orthopaedic Surgery, Inkosi Albert Luthuli Central Hospital, University of KwaZulu-Natal, Durban, South AfricaDiscipline of Orthopaedic Surgery, Port Shepstone Regional Hospital, University of KwaZulu-Natal, Durban, South AfricaDiscipline of Orthopaedic Surgery, General Justice Gizenga Mpanza Hospital, University of KwaZulu-Natal, Durban, South AfricaDiscipline of Orthopaedic Surgery, Ngwelezana Hospital, University of KwaZulu-Natal, Durban, South AfricaDiscipline of Orthopaedic Surgery, Addington Hospital, University of KwaZulu-Natal, Durban, South AfricaDiscipline of Orthopaedic Surgery, Prince Mshiyeni Memorial Hospital, University of KwaZulu-Natal, Durban, South AfricaDiscipline of Orthopaedic Surgery, RK Khan Hospital, University of KwaZulu-Natal, Durban, South AfricaDiscipline of Orthopaedic Surgery, Ladysmith Regional Hospital, University of KwaZulu-Natal, Durban, South AfricaDiscipline of Orthopaedic Surgery, Harry Gwala Regional Hospital, University of KwaZulu-Natal, Durban, South AfricaDiscipline of Orthopaedic Surgery, Inkosi Albert Luthuli Central Hospital, University of KwaZulu-Natal, Durban, South Africa Background. Pathology of the hand causes functional impairment, with downstream effects for patient occupation, and consequently presents a socioeconomic burden. Investigation of the epidemiology of hand pathology in KwaZulu-Natal (KZN) can help reduce the burden of disease. Identifying where the greatest need is can direct patient awareness initiatives, medical training and appropriate allocation of resources. Objectives. To establish the prevalence of hand pathology at regional hospitals that offer orthopaedic services in KZN, to describe the patients most commonly affected by these pathologies and to identify the most common pathologies. Methods. A cross-sectional investigation of hospital records and charts of patients presenting for orthopaedic care across all 10 regional hospitals in KZN that offer orthopaedic services was undertaken for 1 week’s duration (June 2022). Patients were categorised into hand pathology (HP) and general orthopaedic pathology (OP) groups, which were each subdivided into trauma and non-trauma subgroups. Demographic details were collected for all patients. For HP patients, additional detail was collected regarding diagnosis, mechanism, admission and management. The prevalence of HP was calculated as a factor of all orthopaedic presentations. Results. During the investigation, 2 335 patients presented to orthopaedic services. HP represented 21% of these cases. The majority (17%, 406/2 335) were related to trauma and represented 23% of all the traumatic orthopaedic presentations. Distal radius (DR) fractures were the most common hand injury (46%, 188/406) and a large proportion of trauma to the bony elements of the hand were open injuries (23%, 93/406). The remainder of HP cases comprised the non-traumatic group (4%, 91/2 335) and were predominantly infections (68%, 62/91), and many patients with non-traumatic hand pathology required surgery (60%, 55/91) and admission (56%, 52/91). Conclusion. HP represents approximately one-fifth of all orthopaedic presentations to regional health facilities in KZN offering orthopaedic care, and close to a quarter of orthopaedic trauma occurs in the hand. Based on these findings, targeted efforts to improve community awareness of precautions against trauma to the hand, osteopaenia and hand hygiene are suggested as preventive measures. Medical training should emphasise the appropriate management of DR fractures and hand infections, and resources should be differentially allocated to the management of these debilitating HPs to decrease the burden of disease. https://samajournals.co.za/index.php/samj/article/view/1246epidemiologyhand traumahand pathologyprevalenceburden |
| spellingShingle | S Thabit M O'Connor W Parker T Mashishi K Moodley A Peer K Matanzima A J de Villiers O Adewusi R Aboobaker A Rocher The prevalence of hand pathology in regional orthopaedic hospitals in KwaZulu-Natal: A cross-sectional study South African Medical Journal epidemiology hand trauma hand pathology prevalence burden |
| title | The prevalence of hand pathology in regional orthopaedic hospitals in KwaZulu-Natal: A cross-sectional study |
| title_full | The prevalence of hand pathology in regional orthopaedic hospitals in KwaZulu-Natal: A cross-sectional study |
| title_fullStr | The prevalence of hand pathology in regional orthopaedic hospitals in KwaZulu-Natal: A cross-sectional study |
| title_full_unstemmed | The prevalence of hand pathology in regional orthopaedic hospitals in KwaZulu-Natal: A cross-sectional study |
| title_short | The prevalence of hand pathology in regional orthopaedic hospitals in KwaZulu-Natal: A cross-sectional study |
| title_sort | prevalence of hand pathology in regional orthopaedic hospitals in kwazulu natal a cross sectional study |
| topic | epidemiology hand trauma hand pathology prevalence burden |
| url | https://samajournals.co.za/index.php/samj/article/view/1246 |
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