Background Delay in surgical treatment is often a reason for poor outcome in patients. An understanding of the causes of treatment delays is important in improving services.

Objectives We reviewed factors responsible for delay in carrying out planned operative orthopaedic procedures and disparities in perception between the surgical team and patients/relations on the causes of the delay.

Methods A questionnaire was administered to all patients who underwent operative orthopaedic procedures at our hospital. Dates decisions to operate were taken, operation dates, diagnoses and reasons for delaying surgeries from the point of view of the operating team and the patient were documented.

Results 161 patients were recruited. There were 83 males, mean age was 34.2±19.2 years. One hundred and twenty-four were emergencies. Twenty-five had comorbidities. The delay before the operative procedures was 18.1±36.8 days (8.9±22.4 days for emergencies; 51.1±57.1 days for electives; t=-6.261; p=0.001). Fifty percent of emergencies were operated on within 72 h, 84% within the first week; the figures were 13% and 23% respectively for electives. Lack of theatre space was the commonest cause of delay followed by lack of funds for treatment. There was full concordance between doctors and patients in only 71% regarding the causes of the delay and this was lower in the emergency group. There is significant delay before operative orthopaedic treatments in our facility.

Significance There is a need for better communication between doctors and patients/relatives about delays in surgical treatment. Theatre facilities should be expanded and efficiency of service delivery improved.