Prevalence and Associated Factors of Femoral Shaft Fractures Among Patients With Extremity Fractures at AaBET Hospital, Addis Ababa, Ethiopia, 2023–2024

Purpose Femoral shaft fractures (FSFs) are major longbone injuries that cause substantial morbidity and disability. In low and middleincome settings, RTAs and falls are important causes. This study quantified the prevalence of FSFs and identified factors associated with shaft involvement among adult patients with extremity fractures admitted to Addis Ababa Burn, Emergency, and Trauma (AaBET) Hospital between September 2023 and August 2024. Methods We performed a hospitalbased crosssectional review of medical records. From 419 charts sampled by simple random sampling, 388 complete records were analyzed. A structured checklist captured sociodemographic, injury, fracture and clinical variables. Descriptive statistics summarized patterns. Bivariate and multivariate logistic regression (SPSS v27) identified factors associated with femoral shaft fractures; variables with p < 0.25 in bivariate analysis were entered into the multivariate model. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) are reported; p < 0.05 considered statistically significant. Results Among 388 patients with extremity fractures, 192 (49.5%) had a femur fracture and 56 patients had femoral shaft fractures — a prevalence of 14.4% (95% CI: 10.9–17.9) among all extremity fractures and 29.1% (95% CI: 22.7–35.6) among femur fractures. Proximal femur fractures predominated (54.7% of femur fractures). RTAs (42.0%) and falls (40.7%) were the leading causes. Patients aged 19–45 years accounted for most shaft fractures; compared with this group, age 46–65 years (AOR = 0.029; 95% CI: 0.002–0.376; p = 0.007) and > 66 years (AOR = 0.018; 95% CI: 0.001–0.247; p = 0.003) had significantly lower odds of shaft fracture. Groundlevel falls were much less likely than falls from height to produce shaft fractures (AOR = 0.034; 95% CI: 0.004–0.307; p = 0.003). Conclusions Femoral fractures constituted a large proportion of extremity fractures at AaBET Hospital, and nearly onethird of femur fractures involved the shaft. Younger adults and highenergy mechanisms were associated with shaft fractures. Strengthening roadsafety measures targeting young adults, fallprevention strategies for older adults, and continued trauma system development are recommended.