Assessment of Functional Limitation and Associated Factors in Adults with Following Lower Limb Fractures, Gondar, Ethiopia in 2020: Prospective Cross-Sectional Study

Figures & data

Table 1 Socio-Demographic Characteristics of Lower Limb Fracture Patients in Gondar, Ethiopia, (n=226)

Variables	Categories	Frequency (n)	Percentage (%)
Sex	Male	190	84.1
	Female	36	15.9
Age in Year	18–35	131	57.9
	36–55	69	30.5
	>55	26	11.5
Marital status	Married	113	50.0
	Single	101	447
	Divorced	9	4.0
	Widowed	3	1.3
Level of education	No formal school Primary school Complete secondary school Diploma and above	59 85 51 31	26.1 37.6 22.6 13.7
Religion	Orthodox Christian	209	92.5
	Muslim	14	6.2
	Others^a	3	1.3
Residence	Rural	95	42.0
	Urban	131	58.0
Monthly income in ETB	<1500 1500–2000 2000–2500 2500–3000 >3000	81 34 15 23 73	35.8 15.0 6.6 10.2 32.3
Occupation	Farmer	63	27.9
	Government. Employed	32	14.2
	Driver	33	14.6
	Student	35	15.5
	Military	15	6.6
	Construction worker	14	6.2
	Others^d	34	15.0
BMI (kg/m^2)	<18.5	23	10.2
	18.5–24.9	175	77.4
	25–29.9	25	11.1
	>30	3	1.3
Currently smoking	Yes No	14 212	6.2 93.8
Currently alcoholic	Yes No	42 184	18.6 81.4

Notes: ^aProtestant, catholic, Jewish. ^dHouse wife, daily labour.

Abbreviations: ETB, Ethiopian birr; kg, kilogram.

Table 2 Clinical Characteristics of Lower Limb Fracture Patients in Gondar, Ethiopia, (n=226)

Variables	Categories	Frequency (n)	Percentage (%)
Cause of fracture	Road traffic accident	82	36.3
	Gunshot	64	28.3
	Fall down injury	52	23.0
	Stick/axe injury	23	10.2
	Others^c	5	2.2
Duration of the onset	Less than one month	31	13.7
	1–3 months	74	32.7
	Greater than 3 months	121	53.5
Duration of hospitalization	Less than 2 weeks	95	42.0
	2–4 weeks	79	35.0
	Greater than 4 weeks	52	23.0
Body side involved	Right lower limb	148	63.3
	Left lower limb	77	34.1
	Both lower limb	6	2.6
Segment of fracture	Above knee (Femur#)	108	47.8
	Below knee (tibia and fibula)	107	47.3
	Both above and below knee (femur, tibia and fibula)	11	2.7
Types of fracture	Open	114	50.4
	Closed	112	49.6
Types of fracture management	Traction	21	19.3
	External fixation	35	15.5
	Intramedullary nailing	82	36.3
	POP cast	71	31.4
	Traditional bone setter	12	5.3
	Others^b	5	2.2
Getting Physiotherapy treatment during inpatient	Yes	63	27.9
	No	163	72.1
Getting Physiotherapy treatment during outpatient	Yes	50	22.1
	No	176	77.9
Complication during hospitalization	Yes	82	36.3
	No	144	63.7
Medical Comorbidity	Yes	41	18.1
	No	185	81.9
Pain in VAS	Mild	101	44.69
	Moderate	88	38.64
	Severe	37	16.37
Range of motion of the joint
Hip flexion	Full range	150	66,4
	Decreased by quarter	29	12.8
	Half of range	34	15.0
	Quarter of the range	13	5.8
Hip extension	Full range	153	67.7
	Decreased by quarter	35	15.5
	Half of range	29	12.8
	Quarter of the range	9	4.0
Hip Abduction	Full range	210	92.9
	Decreased by quarter	35	15.5
	Half of range	4	1.8
	Quarter of the range	4	1.8
Hip Adduction	Full range	212	93.8
	Decreased by quarter	8	3.5
	Half of range	3	1.3
	Quarter of the range	3	1.3
Hip internal rotation	Full range	201	88.9
	Decreased by quarter	14	6.2
	Half of range	7	3.1
	Quarter of the range	4	1.8
Hip external rotation	Full range	204	90.3
	Decreased by quarter	22	9.7
	Half of range	0	0.00
	Quarter of the range	0	0.00
Knee flexion	Full range	93	41.2
	Decreased by quarter	37	16.4
	Half of range	55	24.8
	Quarter of the range	41	18.1
Knee extension	Full range	104	46.0
	Decreased by quarter	62	27.4
	Half of range	37	16.4
	Quarter of the range	23	10.2
Ankle plantar flexion	Full range	120	53.1
	Decreased by quarter	18	8.0
	Half of range	26	11.5
	Quarter of the range	62	27.4
Ankle dorsiflexion	Full range	117	51.8
	Decreased by quarter	23	10.2
	Half of range	30	13.3
	Quarter of the range	56	24.8

Notes: ^cStone injury, osteoporosis. ^bPosterior slab, screw. ^#Fracture.

Abbreviation: VAS, visual analogues scale.

Table 3 Functional Limitation Among Following Lower Limb Fracture Individual at Gondar, Ethiopia (n=226)

Variables	Categories	Functional Activity
		Limited (%)	Not Limited (%)
Sex	Male	150 (82.4)	(90.9)
	Female	32 (17.6)	4 (9.1)
Age in years	18–35	102 (56.0)	29 (65.9)
	36–55	59 (32.4)	10 (22.7)
	>55	21 (11.5)	5 (11.4)
Residence	Urban	98 (53.8)	33 (75.0)
	Rural	84 (46.2)	11 (25.0)
Marital status	Married	94 (51.6)	19 (43.2)
	Single	77 (42.3)	24 (54.5)
	Divorced	8 (4.4)	1 (2.3)
	Windowed	3 (1.6)	0 (0.00)
Religion	Orthodox Christian	168 (92.3)	41 (43.2)
	Muslims	12 (6.6)	2 (4.5)
	Others^a	2 (1.1)	1 (2.3)
Level of education	No formal school	55 (92.3%)	4 (6.8%)
	Primary school	68 (80.0%)	17 (20.0%)
	Secondary school	40 (78.4%)	11 (21.6%)
	Diploma and above	19 (61.3%)	12 (38.7%)
Income (ETB/month)	< 1500	71 (87.7%)	10 (12.3%)
	1500–2000	28 (82.4%)	6 (17.6%)
	2001–2500	11 (73.3)	4 (26.7%)
	2500–3000	20 (87.0%)	3 (13.0%)
	>3000	52 (71.2%)	21 (28.8%)
BMI	Under weight	20 (11.0)	3 (6.8)
	Healthy weight	143 (78.6)	32 (72.7)
	Over weight	16 (8.8)	9 (20.5)
	Obese	3 (1.6)	0 (0.00)
Co-morbidity	No	147 (80.8)	38 (86.4)
	Yes	35 (19.2)	6 (13.6)
Physiotherapy treatment	No	136 (74.7)	27 (61.4)
	Yes	46 (25.3)	17 (38.6)
Types of fracture management	Traction	19 (10.4)	2 (4.5)
	External fixation	32 (17.6)	3 (6.8)
	Intramedullary nailing	61 (33.5)	21 (47.7)
	POP cast	58 (31.9)	13 (29.5)
	Traditional bone setter	8 (4.4)	4 (9.1)
	Others^b	4 (2.2)	1 (2.3)
Location of fracture	Above knee	89 (79.4)	19 (20.6)
	Below knee	85 (82.4)	22 (17.6)
	Both above and below knee	8 (72.7)	3 (27.3)

Notes: ^aProtestant and Jewish. ^bPosterior slab, screw.

Abbreviations: BMI, body mass index; ETB, Ethiopian birr; POP, plaster of paris.

Table 4 Factors Associated with Functional Limitation with Following Lower Limb at Gondar University, Ethiopia (n=226)

Variables	Categories	Univariate COR (95% CI)	Multivariate AOR (95% CI)
Residence	Urban	1 ref	1 ref
	Rural	0.389 (0.185–0.817)	1.292 (0.344–4.854)
Level of education	Uneducated	0.231 (0.079–0.677)	5.503 (1.707–17.742)*
	Educated	1ref	1 ref
Complication during hospitalization	No	1ref	1 ref
	Yes	3.083 (1.356–7.009)	3.264 (1.147–9.294)*
Pain in VAS	Mild	1ref	1ref
	Moderate	2.8 (0.76–10.36)*	1.24 (0.08–19.8)
	Severe	0.094 (0.013–0.708)	3.18 (1.399–7.259)*
Duration from onset	Less than 3 months	0.120 (0.041–0.353)	9.512 (3.585–25.237)*
	>/=3 months	1ref	1ref
Knee flexion	Full range	1ref	1ref
	Decreased by quarter	1.007 (0.427–2.376)	0.721 (0.206–2.521)
	Half of range	0.333 (0.127–0.873)	4.379 (1.071–17.889)*
	Quarter of the range	0.215 (0.061–0.758)	7.127 (1.926–26.368)*

Notes: *Variables significant with p-value ≤0.05, 1 = reference category.

Abbreviations: VAS, visual analogous scale; COR, crude odds ratio; AOR, adjusted odds ratio; CI, confidence interval.