Prevalence and Risk Factors Associated With Neuropraxic and Genitoperineal Complications Following Fracture Table Use at Kenyatta National Hospital

Abstract

Background Fracture tables are frequently used in lower limb surgeries, but they can result in complications like genitoperineal and neuropraxic injuries. These injuries include lower limb nerve damage, skin death, pudendal nerve injury, and urethral injuries. Recovery time varies, and patients may have partial or permanent dysfunction. Prolonged use of the perineal post is the main cause of these severe complications. However, there is limited data on the occurrence and complications of using fracture tables in developing countries like Kenya. Study Objective: To determine the prevalence and risk factors associated with neuropraxic and genitoperineal complications following the use of fracture tables in Kenyatta National Hospital. Study setting: The study was conducted at the orthopaedic surgery wards and theatre of Kenyatta National Hospital. Methodology: The study used an analytic cross-sectional design to explore the relationship between the use of fracture tables and the perineal post duration, age of patient, and surgery duration. The target population were all patients admitted for hip, femur, or pelvis surgical procedures. A purposive sampling was used to identify the appropriate sample size from a pre-set inclusion and exclusion criteria. Data Analysis: The data was entered into an excel sheet and exported to the Statistical package (SPSS version 27) for analysis. Descriptive statistics were applied and continuous data summarization was done using mean, median, mode and standard deviation. The incidence of genitoperineal and neuropraxic complications after operative procedures utilizing a fracture table was calculated as a percentage of the total number of procedures performed. A p-value of less than 0.05 was considered in determining the association between risk factors and complications, as well as the link between fracture table use and the occurrence of complications. Data is also presented in figures and tables where applicable. To analyse the risk of complications in relation to the duration on fracture table, inferential statistics were used. Logistic regression analysis was used to identify any risk factors associated with the complications. The results of the logistic regression analysis were presented using odds ratios and confidence intervals. Significance of the Study: The study promoted evidence-based care in Kenyan Hospital facilities by advancing knowledge on the prevalence, types, and factors of fracture-table related complications. The findings should help health providers provide timely management of soft-tissue and neurological sequelae, eventually contributing to improved patient outcomes. The study is also significant to the state of healthcare research in developing countries, where empirical evidence is lacking substantially. Results: The most occurring complication was pudendal nerve neuralgia (93.3%) with perineal pain that worsens while sitting down being the most occurring symptom. Of the three female patients two had vulval swelling. Perineal dysthesia occurred in two patients, while no one experienced scrotal swelling...