Audit of Orthopaedic Surgical Management and Theatre Utilization at University College Hospital, Ibadan: A 2-Year Retrospective Review

Abstract

Background: Effective surgical management and optimal theatre utilization are critical aspects of orthopaedic practice in resource-constrained settings. This study aimed to audit the patterns of orthopaedic surgical management and theatre utilization at the University College Hospital, Ibadan, Nigeria. Methods: A retrospective review of all orthopaedic surgeries performed over a two-year period was conducted. Data on patient demographics, diagnoses, surgical procedures, duration of surgery, and ASA classification were collected and analyzed. Results: A total of 301 orthopaedic surgeries were performed during the study period. The mean age of patients was 44.3 years (range: 2-94 years), with a nearly equal gender distribution (49.8% female, 50.2% male). Emergency procedures constituted 60.5% of all surgeries, while elective procedures accounted for 39.5%. The most common diagnoses were diabetic foot (7.6%), infected implants (2.7%), and open fractures (4.0%). The most frequently performed procedures were open reduction and internal fixation with plate and screw (10.6%), Ilizarov procedures (4.0%), and implant removals (4.0%). The mean duration of surgery was 2.6 hours. Spinal anesthesia was the most common anesthetic technique (50.8%), followed by combined spinal-epidural (28.9%). Conclusion: This audit revealed a high proportion of emergency surgeries, reflecting the significant burden of trauma in the region. Diabetic foot complications emerged as a leading cause of orthopaedic surgical intervention, highlighting the need for improved diabetic foot care services. The findings provide valuable insights for optimizing theatre utilization and improving orthopaedic surgical care at the institution.