Healing time of tibial fractures in Ugandan Africans.

It has often been said that fractures unite more rapidly in Af’ricans than in Europeans. To test this hypothesis, we Stildied tihial fractures treated in Kampala over a threeyear period. We excluded fractures involving the knee or ankle, those in patients aged less than 19 years or who had multiple injuries and those treated by internal fixation. as well as patients who were irregular in their fol IOWup. There remained 125 fractures in I 13 patients, of whon 82 had been involved in motor vehicle accidents. Three had bilateral injuries. seven had segmental fractures, and two of those were triple. There were 31 fractures ofthe upper third ofthe tibia, 49 ofthe middle third and 45 of the lower third. Fifty-three of the fractures were open ( 10 Type I, 23 Type II and 20 Type III; Gustilo and Anderson 1976); 26% were severely cornminuted, 33% moderately and I 5% mildly comminuted. The open fractures were treated by debridement and in all cases, after manipulation and reduction, an aboveknee plaster cast was applied with the knee 1 5 flexed. Weight-bearing was supposed to be delayed until the fracture was considered to be stable, but only about 10% of the patients complied with this instruction. The criteria for union were absence of mobility, tenderness t: r pain on stress at the fracture site, the ability to walk without plaster or crutches and radiological