Global Orthopaedics

As Global Surgery Day 2017 (May, 25th 2017) approaches, InciSioN’s Advocacy team will be publishing a series of blogs in an effort to emphasize the global need for timely access to safe, and affordable surgical care.

Global Orthopaedics

<Varshini Cherukupalli>

Globally, musculoskeletal disease is a major cause of mortality, morbidity, and increasing health care costs. (1) In 2013, 973 million individuals sustained injuries and 4.8 million people died from injuries. (2) In particular, the burden of injuries is rapidly growing in low- and middle-income countries (LMICs). Reasons for this phenomenon include more road traffic crashes, fewer orthopedic surgeons in developing countries, and higher prevalence of obesity and sedentary lifestyles. (2)

Historically, orthopedic conditions were not included in public health agendas, as the focus was on communicable and nutritional illnesses. In order to address this paucity of data and insufficient infrastructure to treat orthopedic conditions, during the Bone and Joint Decade (2000-2010), the World Health Organization, World Bank, and United Nations emphasized that more research on musculoskeletal conditions in LMICs must be performed. (3)  Treatment of open fracture is also included as one of three Bellwether procedures, or essential procedures that any first-level hospital must be able to provide. (4)

A recent study revealed that, as compared to a Level I trauma center (highest level of care) in an industrialized country, a referral hospital in an LMIC handles a disproportionate amount of trauma cases, severe fractures, and infections. (1)  As such, the burden of orthopedic conditions continues to significantly affect the developing world.  Increased awareness and further research of the burden of musculoskeletal disease are necessary in order to effectively target injuries in LMICs.  
References:

  1. Brouillette MA, Kaiser SP, Konadu P, et al. Orthopedic surgery in the developing world: workforce and operative volumes in Ghana compared to those in the United STates. World J Surg. 2014;38(4):849-857.  
  2. Haagsma JA, et al. The global burden of injury: incidence, mortality, disability-adjusted life years and time trends from the Global Burden of Disease study 2014. Inj Prev. 2016;22(1):3-18.
  3. Lidgren L. The bone and joint decade 2000–2010. Bull World Health Organ 2003;81:629
  4. Meara JG, Leather AJ, Hagander L, et al. Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet. 2015;386(9993):569-624.

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