Anatomical determinants of injury severity of motorcycle attributable femur fractures at two teaching hospitals in uganda

There is paucity of data on anatomical determinants of motorcycle related femoral fracture injury severity in Uganda. Such data are clinically relevant to guide treatment options. We conducted a cross sectional descriptive and analytical hospital based study of consecutively recruited patients to establish the anatomical patterns and determinants of injury severity of motorcycle related femoral fractures, presenting at Accident and Emergency Departments of two Ugandan teaching hospitals, between December 2016 and June 2017. Ethical clearance was obtained from Mbarara University of Science and Technology Research and Ethics Committee (IRB No.19/10-16). Using investigator-administered questionnaire, we recorded radiological patterns of femur fractures and used the Kampala Trauma Score II to determine injury severity. We conducted multiple logistic regression analysis and computed odds ratios using IBM SPSS 20.0. statistics for windows (Armonk. NY: IBM Corp) at 95% Confidence Interval and P<0.05 as statistically significant, to determine anatomical sites of femur fracture significantly associated with a severe Kampala Trauma Score II. Of 230 patients, the femoral shaft 72.6% (n=167) was the most fractured anatomical site. Sustaining an open femoral fracture (OR 2.124; 95% CI [1.885-2.427], particularly involving the femoral neck (OR 4.222 [1.294-13.776] 95% CI, P=0.016) and femoral shaft (OR 1.155; 95% CI [1.101-1.902]; P=0.024) were significantly associated with a severe Kampala Trauma Score II. Prospective studies are required to determine how these anatomical determinantsof femoral fracture injury severity impact on long term functional outcome.