Background: Trauma has assumed a pre-eminent
epidemic proportion in the hierarchy of diseases afflicting the
growing population of many developing countries including
Nigeria competing with infections, cardiovascular diseases
and cancers for attention and funding. The spectrum,
quantum and future prospects of trauma and its practices
have continued to expand but the response towards
improving the current Nigerian situation is lagging behind.
Objectives: To examine the current situation of trauma
practice and the contribution of practitioners in the areas of
research, training and community service in Nigeria and
make suggestions for progress.
Methodology: Electronic and manual bibliographic search
was done using such words as trauma, injury, coupled with
morbidity, mortality, death or fatality from publications across
Nigeria. Personal contacts with colleagues for relevant
papers were also done. Papers were reviewed for content,
through the abstracts and all published works that provided
information relevant to the objectives were read fully.
Personal experience in the field was contributory.
Results: Eight hundred and three abstracts were selected
from the over 10,100 generated by the searches. Thirty four
articles were contributed by colleagues and eleven were
clearly used. Trauma from road traffic injuries and violence
(gunshot, assault) constituted 40-90% of emergency room
incidence with high rates in hospitals near highways.
Autopsy reports confirmed road traffic injuries as
commanding up to 80% of unnatural deaths in many
teaching hospitals in Nigeria. There is no organized
Emergency Medical Services but ambulance services are
common in some cities. Many patients are largely
transported by relations or bystanders when involved in
trauma. Preventable Trauma Death rate is reportedly high,
as much as 73.7% in one report.
Conclusion: the spectre of trauma as an epidemic is
receiving attention from practitioners and government but it
is a far cry from what is needed. The spectrum is elongated in
variety with the menace of motorcycle transport injuries
overtaking other vehicle injuries in the some major cities and
commanding an increasing prevalence in sub-urban areas.
All health Institutions in Nigeria especially the Orthopaedic
Hospitals and Federal Medical Centres need to improve on
trauma research and publications just as the Nigeria
Orthopaedic Association should intensify its championing of
research efforts. A committee to evaluate and classify
institutions on their level of trauma practice in order to guide
referrals and sanction erring practitioners and
establishments by complementing the Medical and Dental
Council of Nigeria is desirable.