Delay in Presentation and Its Effect on Fracture Healing Outcomes in Kano State Orthopaedic Hospital

Delayed presentation following fracture injuries is a well-documented challenge in Nigerian healthcare, frequently attributable to financial constraints, use of traditional bone setters, and inadequate emergency transport infrastructure. This cross-sectional study investigates the relationship between time to presentation and fracture healing outcomes among patients admitted to the Kano State Orthopaedic Hospital, North West Nigeria. Over a six-month data collection period, patients with closed limb fractures will be enrolled and classified according to time from injury to orthopaedic intervention: less than 24 hours, 24 to 72 hours, and greater than 72 hours. Outcome measures will include incidence of malunion, non-union, infection, and need for secondary surgical procedures at six-month follow-up. Logistic regression will be applied to determine the independent effect of presentation delay after controlling for fracture type, patient age, and bone setter prior contact. The study hypothesises that patients presenting after 72 hours will demonstrate significantly higher complication rates. Results will be presented to the hospital management and submitted to the Kano State Health Authority to guide public education campaigns on timely orthopaedic care. This study contributes to a growing evidence base on avoidable orthopaedic complications in Nigeria and supports advocacy for expanded emergency trauma services in the North West geopolitical zone. Keywords: fracture delay, malunion, orthopaedic outcomes, Kano, traditional bone setters.