Femur fracture: characteristics of patients, treatment outcomes, and factors associated with good outcomes at Gulu Regional Referral Hospital in Uganda. A retrospective review of hospital records of 2022

Okwada, Isaac; Longoli, Isaac; Ukwang, Santo; Tumuhaise, Ludovico; Kitara, David Lagoro · 2026 · DOAJ

DOI: 10.1186/s13104-026-07722-9

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Summary

This retrospective study examines the epidemiology, treatment outcomes, and prognostic factors associated with femur fractures at Gulu Regional Referral Hospital in Uganda. The research addresses the significant public health burden of physical injuries in low- and middle-income countries, where trauma is a leading cause of morbidity and mortality. Specifically, the authors aimed to characterize patients with femur fractures, identify factors influencing fracture occurrence, and determine predictors of improved discharge status to inform clinical practice and policy. The study analyzed medical records of 154 adult patients (aged ≥18 years) treated for femur fractures in 2022. Using systematic sampling, researchers extracted data on socio-demographic characteristics, injury mechanisms, fracture types, and treatment methods. Statistical analysis included bivariate tests and multivariate regression to identify significant associations, with a significance threshold of p < 0.05. The results indicated that the majority of patients were male (58.8%) and aged 18–30 years (24.8%). Road traffic accidents (RTAs) were the primary cause of injury (63.0%), with passengers being the most affected group (60.6%). Most fractures were closed (88.4%) and located in the femur shaft (35.2%), with transverse fracture lines being the most common pattern (36.4%). Multivariate analysis revealed that older age groups (61–75 years and >75 years) and individuals with diploma or degree-level education were significantly more likely to sustain femur fractures. Regarding treatment outcomes, 75.1% of patients were discharged with an improved status. Factors significantly associated with improved discharge outcomes included specific occupations (peasant farmers and informal sector workers), open reduction treatment, and oblique, spiral, or transverse fracture lines. Conversely, patients with open fractures were significantly less likely to achieve an improved status at discharge (adjusted Odds Ratio = 0.13). The study concludes that femur fractures represent a critical surgical and public health challenge in the region, strongly linked to RTAs and specific demographic profiles. The findings highlight that open reduction and specific fracture patterns correlate with better recovery, while open fractures carry a poor prognosis. The authors recommend implementing policies to reduce motor vehicle accidents and increasing the supply of surgical implants to facilitate open reduction and internal fixation, thereby improving patient outcomes and reducing long-term disability.

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• demographic disparities