'Surgery is often carried out amongst children with conditions thataffect their legs. However, in many of these conditions it is not knownwhich treatment works best. We reached out to everybody involved in caring for children with orthopaedic problems affecting their legs (from hips to toes), includingchildren, parents, carers, charity workers, and all the professional groups.We asked all for their views on identifying the most importantunanswered questions.'
This new study aimed to establish consensus on the most important barriers, within a Three Delays framework, to accessing injury care in Low and Middle Income Countries that should be considered when evaluating a health system.
Experience of global musculoskeletal research: considering the whole child when treating a single impairment. A case study of clubfoot in older children.by Johanna Mostyn, Tracey Smythe
In Ethiopia, which is a large country with poor infra structure, children who present with neglected Clubfoot to Cure hospital in Addis Ababa must remain in the capital throughout the duration of their treatment. On average they stay on the rehab ward at Cure or at Alemachen (a convalescent home which accommodates up to 40 children) for a minimum of four months. Frequently they remain in Addis for six to eight months. As a physiotherapist, Jo’s concern is to fully utilise this time.
Burden of disease in Brazil, 1990–2016: a systematic subnational analysis for the Global Burden of Disease Study 2016by GBD 2016 Brazil Collaborators published in The Lancet
Conducting good, ethical global health research is now more important than ever. Increased global mobility and connectivity mean that in today’s world there is no such thing as ‘local health’. As a collection, these stories offer a flexible resource for training across a variety of contexts, such as medical research organizations, universities, collaborative sites, and NGOs.
Do trauma courses change practice? A qualitative review of 20 courses in East, Central and Southern Africaby Grace Le
This article addresses the global burden of musculoskeletal trauma in particular in low and middle income countries.
Background: Disparities in the global availability of operating theatres, essential surgical equipment and surgically trained providers are profound. Although efforts are ongoing to increase surgical care and training, little is known about the surgical capacity in developing countries. The aim of this study was to create a baseline for surgical development planning at a national level.
Infectious Outcomes Assessment for Health System Strengthening in Low-Resource Settings: The Novel Use of a Trauma Registry in Rwandaby Global Musculoskeletal
Background: More than 90% of injury deaths occur in low-income countries where a shortage of personnel, infrastructure, and materials challenge health system strengthening efforts. Trauma registries developed regionally have been used previously for injury surveillance in resource-limited settings, but scant outcomes data exist.
Identifying the Unique Non-Technical Skills Used by Surgeons Operating in Low and Middle Income Contextsby Global Musculoskeletal
As surgical training and capacity increase in low- and middle-income countries (LMICs), new strategies for improving surgical education and care in resource-poor settings are required. Non-technical skills (NTS) have been identified as critical to high-quality surgical performance in high-income countries (HICs), but little is known about the NTS used by surgeons in LMICs. This study aims to identify the non-technical skills used by surgeons operating in a LMIC context.
Injury is a leading cause of death in many limited resource settings. This study aimed to measure the quality of trauma care at the largest referral hospitals in Rwanda, the University Teaching Hospitals in Kigali and Butare,compared to international trauma care standards.
Development of the International Assessment of Capacity for Trauma (INTACT) Index: An Initial Implementation in Sierra Leoneby Global Musculoskeletal
Injury remains a leading cause of death worldwide with a disproportionate impact in the developing world. Capabilities for trauma care remain limited in these settings. Previous attempts have been made to assess basic trauma resources but have been limited to essential care. We propose the implementation of the International Assessment of Capacity for Trauma (INTACT) index, which incorporates surgical capacity beyond initial resuscitation.
The ageing population presents with debilitating back pain and leg pain with a background of adult spinal deformity, after a protracted period of conservative care. Sagittal balance is required to achieve a good clinical outcome; however, the surgery is associated with a high incidence of complications.
Necrotizing fasciitis is an infectious process characterized by rapidly progressing necrosis of superficial fascia and subcutaneous tissue with subsequent necrosis of overlying skin. Necrotizing fasciitis is a rare but fatal infection. The worldwide incidence is at 0.4 per 100,000. Mortality is up to 80% with no intervention, and 30-50% with intervention. Delay in intervention is associated with poor outcome. The risk factors for necrotizing fasciitis are diabetes mellitus, HIV, malignancy, illicit drug use, malnutrition among others. The aim of this study was to describe the clinical presentation and early outcomes of necrotizing fasciitis amongst Ugandan patients.