Fracture Healing in Patients with Human Immunodeficiency Virus In South Africa: A Prospective Cohort Study

Description

In this presentation, Simon Graham, a consultant trauma surgeon from Liverpool, discusses his research on fracture healing in HIV-positive patients. With extensive experience in global health research focused primarily on musculoskeletal trauma in sub-Saharan Africa, Simon outlines the objectives and findings of his study conducted in South Africa.



He begins by addressing a common belief in the field of orthopedic surgery regarding HIV as a potential risk factor for delayed bone healing. Despite this, he notes the lack of substantial clinical evidence backing such claims. Intrigued by this gap, Simon aimed to investigate whether HIV indeed influences the healing process and if it increases the risk of complications such as delayed union and nonunion post-fracture.



The study involved a sizable cohort of 636 patients presenting with tibia or femur fractures at two major hospitals in Cape Town, South Africa. Simon highlights the methodology, including the criteria for patient inclusion, the rigorous follow-up schedule, and the metrics used to assess healing outcomes with the RUST score.



He reports promising results showing that a significant percentage (over 82%) of the fractures healed within six months, and a notably low nonunion rate of 5.8% was observed at nine months. Intriguingly, the data reveals no discernible difference in the healing rates between HIV-positive and HIV-negative patients, with HIV-positive individuals exhibiting better healing outcomes in some respects.



Ultimately, Simon emphasizes the importance of critically analyzing established beliefs in medical literature and challenges preconceived notions surrounding HIV and fracture healing. The session concludes with an invitation for questions from the audience, encouraging further engagement on this critical topic.

DOI: 10.1302/3114-221678

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