Use of external fixators for open tibial injuries in the rural third world: Panacea of the poor?

Padhi, Nihar Ranjan; Padhi, Poonam

doi:10.1016/j.injury.2006.08.053

Cited by 22 publications

(18 citation statements)

References 22 publications

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“…Operative fixation of long bone fractures can reduce hospital stay, provide a quicker return to work, and improve fracture healing. External fixation devices, such as the Ilizarov frame, are favoured in low‐resource settings because of their ease of application and low complication rates compared with internal fixation methods. Padhi and colleagues and Pulate et al .…”

Section: Exemplarsmentioning

confidence: 99%

“…External fixation devices, such as the Ilizarov frame, are favoured in low‐resource settings because of their ease of application and low complication rates compared with internal fixation methods. Padhi and colleagues and Pulate et al . demonstrated the safe and cost‐effective application of Ilizarov frame technology in LMICs including India, highlighting the importance of sourcing materials locally, local industry engagement, and reducing waste by resterilization, where safe and feasible.…”

Section: Exemplarsmentioning

confidence: 99%

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Disseminating technology in global surgery

Bolton

Aruparayil

Quyn

et al. 2019

British Journal of Surgery

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Background Effective dissemination of technology in global surgery is vital to realize universal health coverage by 2030. Challenges include a lack of human resource, infrastructure and finance. Understanding these challenges, and exploring opportunities and solutions to overcome them, are essential to improve global surgical care. Methods This review focuses on technologies and medical devices aimed at improving surgical care and training in low‐ and middle‐income countries. The key considerations in the development of new technologies are described, along with strategies for evaluation and wider dissemination. Notable examples of where the dissemination of a new surgical technology has achieved impact are included. Results Employing the principles of frugal and responsible innovation, and aligning evaluation and development to high scientific standards help overcome some of the challenges in disseminating technology in global surgery. Exemplars of effective dissemination include low‐cost laparoscopes, gasless laparoscopic techniques and innovative training programmes for laparoscopic surgery; low‐cost and versatile external fixation devices for fractures; the LifeBox pulse oximeter project; and the use of immersive technologies in simulation, training and surgical care delivery. Conclusion Core strategies to facilitate technology dissemination in global surgery include leveraging international funding, interdisciplinary collaboration involving all key stakeholders, and frugal scientific design, development and evaluation.

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Section: Exemplarsmentioning

confidence: 99%

Section: Exemplarsmentioning

confidence: 99%

Disseminating technology in global surgery

Bolton

Aruparayil

Quyn

et al. 2019

British Journal of Surgery

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show abstract

“…The versatility of this device has spawned local production: an Indian external fixator costs only c . US$12 [22]. Sadly, Ilizarov himself gained little financially from his innovation [23].…”

Section: Introductionmentioning

confidence: 99%

Value innovation: an important aspect of global surgical care

2014

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IntroductionLimited resources in low- and middle-income countries (LMICs) drive tremendous innovation in medicine, as well as in other fields. It is not often recognized that several important surgical tools and methods, widely used in high-income countries, have their origins in LMICs. Surgical care around the world stands much to gain from these innovations. In this paper, we provide a short review of some of these succesful innovations and their origins that have had an important impact in healthcare delivery worldwide.ReviewExamples of LMIC innovations that have been adapted in high-income countries include the Bogotá bag for temporary abdominal wound closure, the orthopaedic external fixator for complex fractures, a hydrocephalus fluid valve for normal pressure hydrocephalus, and intra-ocular lens and manual small incision cataract surgery. LMIC innovations that have had tremendous potential global impact include mosquito net mesh for inguinal hernia repair, and a flutter valve for intercostal drainage of pneumothorax.ConclusionSurgical innovations from LMICs have been shown to have comparable outcomes at a fraction of the cost of tools used in high-income countries. These innovations have the potential to revolutionize global surgical care. Advocates should actively seek out these innovations, campaign for the financial gains from these innovations to benefit their originators and their countries, and find ways to develop and distribute them locally as well as globally.

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“…Flexibility of placing pins make external fixator an effective tool in case of open fractures, especially type 3 Gustilio and Anderson. 6 The simplicity of the procedure does not require steep learning curve and short procedure time make it perfect for poly trauma patients. Monoframe with sufficient space and flexibility of pin placement makes it suitable for complex plastic surgical procedure.…”

Section: Introductionmentioning

confidence: 99%

Dynamization of external fixator is single stage definitive procedure for open fractures both bone leg

Singh¹,

Kumar²,

Ranjan³

et al. 2017

Int J Res Orthop

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Background: Open fracture both bone leg is a common fracture present in orthopaedic causality. Treatment consists of I. V. antibiotics, debridement and external fixator. Judicious selection of the patients on basis of Gustilio and Anderson classification leads to external fixator as a definitive and single stage procedure with dynamization. It reduces the risk of infection at time of definitive procedure and number of hospital stay and surgery.Methods: In school of medical sciences and research, We treated 68 patients with open both bone fracture (Gustilio and Anderson type 2 and 3b) with debridement and external fixator. All patients underwent dynamization depending upon fracture pattern. Majority of our cases were road traffic accident involving male. Average duration of union was 22 to 26 weeks. There was no need for any major plastic surgery procedure. Removal of external fixator and Patellar tendon brace (PTB) was given for the period of 4 to 6 weeks at the time of clinical and radiological union.Results: Eighty eight percent of our cases united well. This reduces the burden of secondary definitive procedure, infection and cost of treatment. So careful selection of the patients and dynamization of external fixator hold the place for definitive surgical option for open both bone fractures.Conclusions: External fixator is simple effective surgical procedure for open fractures both bone leg. Staged dynamization of external fixator add in the better union with functional outcome and cost effective.

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Use of external fixators for open tibial injuries in the rural third world: Panacea of the poor?

Cited by 22 publications

References 22 publications

Disseminating technology in global surgery

Disseminating technology in global surgery

Value innovation: an important aspect of global surgical care

Dynamization of external fixator is single stage definitive procedure for open fractures both bone leg

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