The prevalence of hand pathology in regional orthopaedic hospitals in KwaZulu-Natal: a cross sectional study.

Abstract

Hand pathology in the international context is common, and contributes to; time off work, loss of income, change or loss of occupation and residual dysfunction. In South Africa, investigation has been performed into traumatic and infective hand pathology and its ramifications for occupation. The broader burden of hand pathology, other than traumatic and infective pathology, had not been investigated locally. This observational cross-sectional study aimed to quantify the burden of hand pathology on regional hospitals in KwaZulu-Natal (KZN) that offer orthopaedic services, over the course of a single week. In addition, the investigation determined which patients are affected by these pathologies and which pathologies cause the greatest burden, by number, to the KZN health system. The results of which identified focus areas that need more attention and directs future research to address areas of concern. Hand pathology broadly encompasses infection, degenerative and inflammatory arthropathy, trauma, peripheral neuropathies, tumours, and congenital deformities. We conducted an observational, cross-sectional data collection, from patient and hospital records, for the course of a week at all 10 regional hospitals that offer orthopaedic services in KZN. Data was captured for all patients who presented to the orthopaedic services at these facilities. With this information, we calculated the prevalence of hand pathology at regional health facilities that offer orthopaedic services in KZN. We were able to describe the patients most commonly affected by hand pathology, and determined which pathologies occur most commonly. This epidemiological study provides important insights. Hand pathology represents around one fifth of the presentations to regional orthopaedic facilities in KZN, and nearly a quarter of trauma cases presenting to these facilities occur in the hand. Resource allocation and training should be directed toward awareness, education and management of these common pathologies.