Management, outcome and complications of fractures in Patients Living with HIV Aids (PLHA)

Objectives: To determine the incidence of infection, compare the rates of infection, union and functional outcome of fractures in 5 PLHA patients with that of various previous studies, determine the correlation of various parameters with 6 complications and to determine the final outcome and approach of treatment of fractures in HIV positive patients. Design: This is retrospective study of 70 PLHA(People Living with HIV/AIDS) patients. Setting: Patients treated operatively at our institute are included in our study. Patients: All the PLHA patients having fractures to be treated operatively and admitted in year 2014 are included in our study. Intervention: The patients were managed operatively depending on fracture type and age of the patient. Main Outcome Measurements: Infection and bony union assessed clinically and radiographically and functional outcome according to SF-12 scoring. Results: Mean CD4 count was 452 with a range of 150 to 682. 44 patients belonged to WHO stage 1, 23 belonged to 26 stage 2 and 3 belonged to stage 3. There were no stage 4 patients in our study. The SF-12 score pattern showed gradual increment in values. Out of the 14 patients who underwent debridement post-operatively, 12 patients showed an eventual good outcome. Conclusions: Although, HIV-positive male patients with fractures exhibited a higher incidence of wound complications and non- union compared to HIV-negative patients, almost all patients achieved satisfactory clinical and functional outcomes through correct, prompt and systematic interventions.