Background: Open tibial fractures are common injuries in low and middle-income countries, but there is no consensus regarding treatment with intramedullary nailing versus external fixation. The purpose of the present study was to compare outcomes initial or fixation adults open fractures. Methods: We conducted a randomized clinical trial (RCT) at tertiary orthopaedic center Tanzania. Adults acute diaphyseal were randomly assigned statically locked, hand-reamed uniplanar primary outcome death...

Background: The current gold standard for diagnosing acute compartment syndrome (ACS) is an assessment of clinical signs, invasive measurement intramuscular pressure (IMP), and local perfusion pressure. However, IMP measurements have several shortcomings, including pain, risk infection, technique error, plugging the catheter tip, lack consensus on diagnostic threshold, specificity sensitivity. objective this study was to evaluate muscle hemodynamics, oxygenation, pH as parameters in a human...

Introduction : Open tibia fractures are some of the most common types Orthopedics injuries in low- and middle-income countries (LMICs). In Tanzania, open treated either conservatively by prolonged cast or surgically external fixation (EF) intramedullary nail (IMN) when available. The cost treatment amount time patients spend away from work major economic concerns with casting EF. goal this study was to determine effectiveness IMN versus EF diaphyseal at Muhimbili Orthopaedic Institute (Dar...

Background: There are few validated instruments that serve as a proxy for fracture-healing after lower-extremity trauma in low-resource settings. The squat-and-smile test (S&S) has been under development by SIGN (Surgical Implant Generation Network) Fracture Care International to monitor outcomes of long-bone fractures intramedullary nailing resource-limited goals this study were develop and identify domains the S&S test. Methods: developed through an iterative process, consensus was...

The rise of diabetes and traumatic injury has increased limb loss-related morbidity in low- middle-income countries (LMICs). Despite this, the majority amputees LMICs have no access to prosthetic devices, magnitude prosthesis impact on quality life (QOL ) function not been quantified.Quantify prostheses QOL Tanzanian transfemoral amputees.A prospective cohort study was conducted. Transfemoral at Muhimbili Orthopaedic Institute were assessed twice before three times after fitting using...

Insurance status is important as medical expenses may decrease the likelihood of follow-up after musculoskeletal trauma, especially for low-income populations. However, it unknown what insurance factors are associated with care. In this study, we assessed association between plan benefits, end post-surgical global period, and injury.This a retrospective cohort study 394 patients isolated extremity fractures who were treated at three level-I trauma centers over four months in 2018. Paired...

BackgroundThe most common reason for lower extremity amputation in developing countries is trauma, which an increasingly recognised global epidemic. Despite the rising rates of traumatic injury and level disability experienced by amputees, there are few data focusing on this specific population low-income middle-income (LMICs). The purpose study to investigate causes health-related outcomes amputations Tanzania, socioeconomic barriers preventing access prosthetics.MethodsThis was...

Our goal was to compare the perceptions of overseas orthopaedic volunteers and their hosts in low- middle-income countries (LMICs) regarding role international volunteerism. We also sought determine if differences perception exist between trainee fully trained orthoapedic surgeon volunteers.Surveys with similar multiple-choice open-ended questions were administered 163 Health Volunteers Overseas (response rate 45%) 53 members host staff 40%). Fifty-four 20 contributed responses. Quantitative...

The burden of disability because traumatic limb amputation, particularly transfemoral amputation (TFA) is disproportionately carried by low- and middle-income countries. need for improved access to prosthesis services in these settings well-documented, but perspectives on the imposed TFA challenges associated with subsequent provision vary among patients, caregivers healthcare providers.To examine barriers as perceived patient, caregiver professional, at a single tertiary referral hospital...

Traumatic lower extremity injuries requiring multidisciplinary treatment pose a challenge in low- and middle-income countries, where access to specialists may be limited. The surgical management reconstructive training (SMART) course teaches orthopaedic surgeons muscle fasciocutaneous flap procedures address this scarcity. purpose of study is assess the effectiveness SMART improving competency comfort performing common among participants.Sixty-four from different regions Nepal Bhutan...

Appropriate management of soft tissue injury associated with orthopedic trauma is challenging in low- and middle-income countries (LMICs) due to the lack available reconstructive surgeons. The Surgical Management Reconstructive Training (SMART) course teaches surgeons techniques aimed at improving management. This study aims identify additional barriers implementing these for LMICs who have attended SMART courses.This a mixed-methods including Likert-scale-based survey administered 150 from...

Limb loss leads to significant disability. Prostheses may mitigate this disability but are not readily accessible in low- and middle-income countries (LMICs). Cost-effectiveness data related prosthesis provision resource-constrained environments such as Tanzania is greatly limited.This study aimed compare the cost-effectiveness of a intervention compared with that no for persons transfemoral amputations an LMIC.This prospective cohort study.Thirty-eight patients were prospectively followed...

Background: Open fractures, especially of the tibia, require prompt intervention to achieve optimal patient outcomes. While open tibial shaft fractures are common injuries in low- and middle-income countries (LMICs), there is a dearth literature examining delays surgery for these low-resource settings. This study investigated risk factors delayed management Tanzania. Methods: We conducted an ad hoc analysis adult patients enrolled prospective observational at tertiary referral center...

The modified Radiographic Union Score for Tibia (RUST) fractures was developed to better describe fracture healing, but its utility in resource-limited settings is poorly understood. This study aimed determine the validity of mRUST scores evaluating healing diaphyseal femur treated operatively at a single tertiary referral hospital Tanzania.Radiographs 297 were evaluated using score and compared with outcomes including revision surgery EuroQol five dimensions questionnaire (EQ-5D) visual...

Background: The effect that an anterior cruciate ligament injury requiring reconstructive surgery has on the professional advancement and performance of amateur baseball players selected in Major League Baseball draft is not known. Return to sports after reconstruction (ACLR) athletes been shown be high, but mixed results with regard return preinjury level have demonstrated other sports. Purpose: To (1) investigate highest among draftees a history ACLR before entering draft, (2) examine how...

Fracture repair is based both on the macrolevel modulation of fracture fragments and subsequent cellular activity. Surgeons have also long recognized other influences behavior: effect or surgery available pool cells present locally in periosteum, interrelated effects fragment displacement, construct stiffness healing potential, patient pathophysiology systemic disease conditions (such as diabetes), external regulators skeletal smoking medications). A wide variety approaches been applied to...

Background: In Nepal, the trend of rushing to orthopedic subspecialty fellowship is rising up. It’s debatable whether this pattern practice advancing orthopaedic care. There are issues with cost training and work satisfaction after it. Thus, study aims analyze surgeon’s prospect regarding in Nepal.Methods: This a cross sectional observational designed take opinion surgeons Nepal orthopedics. Structured closed ended questionnaire was form “Survey app” disseminated maximum possible via...