Analysis of Re-Operation Rates Following Orthopaedic Implant Fixation at National Orthopaedic Hospital, Igbobi, Lagos

Re-operation following orthopaedic implant fixation is a significant adverse outcome that increases patient morbidity, utilises scarce surgical resources, and reflects on the quality of primary surgery and post-operative care. This retrospective cohort study analyses re-operation rates and their determinants following internal fixation procedures at the National Orthopaedic Hospital, Igbobi, Lagos, South West Nigeria, over a five-year period. Theatre records, ward registers, and outpatient clinic logs will be reviewed to identify patients who underwent re-operation within twelve months of primary fixation. Re-operation indications including implant failure, infection, non-union, malalignment, and implant removal will be categorised. Patient demographics, primary fracture type, implant class, and surgeon grade will be documented and multivariate regression used to identify predictors of re-operation. The study hypothesises that infection and non-union are the leading indications for re-operation, with higher rates in patients who had prior traditional bone setter contact. Findings will be reported to the hospital's quality committee and the surgical audit committee. This research provides quality improvement evidence for a leading national orthopaedic institution and contributes to the benchmarking of implant fixation re-operation rates in Nigerian tertiary orthopaedic facilities. Keywords: re-operation, implant fixation, orthopaedic complications, National Orthopaedic Hospital, quality improvement.