Orthopedic Trauma in Developing World: Does it Need a New Approach?
Journal of Orthopedic and Spine Trauma: September 28, 2015, 1 (1); e3948
September 23, 2015
Article Type: Editorial
August 30, 2015
September 5, 2015
S J. Orthopedic Trauma in Developing World: Does it Need a New Approach?,
J Orthop Spine Trauma.
Copyright © 2015, Persian Orthopedic Trauma Association.This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
More than a half of patients admitted to most trauma centers have musculoskeletal injuries. The number of patients with multiple injury is increasing in the world due to rise in natural disasters, motor vehicle accident, and other causes of trauma. This rise is more pronounced in developing countries as they are going to be industrialized. For example, according to the world health organization reports, some of developing countries like Iran and India have the highest number of mortality due to motor vehicle accidents (
Providing optimal care for these patients is an essential issue for all trauma centers and trauma systems. However, it seems that treatment of patients with fractures, dislocations and injuries of ligaments, muscles, tendons, and cartilage by orthopedic surgeons in developing countries is always not the same as what actually done in developed world (
2). There are several reasons for the differences in practice. First of all, in many developed countries, care of serious injuries and severely injured patients with (frequently multiple) musculoskeletal injuries has become an orthopedic subspecialty area. While orthopedic surgery residency training and board certification offer a general level of knowledge about evaluation and treatment of skeletal trauma, they do not provide orthopedic generalist, or subspecialist in another field, with all skills required for care of seriously injured patients. Sub specialization within orthopedics trauma has led to significant advances in treatment of musculoskeletal injuries. Secondly, there are limited resources in developing countries. This resource limitation affects all aspects of management if patients with orthopedic trauma including patients’ transfer to hospital, patients’ transfer to the operating room in hospital, multidisciplinary approach to patients and available devices and instruments to be used in the diagnosis and treatment of these patients. Thirdly, patients’ expectation and life expectancy is completely different in developing and developed countries ( 3, 4).
There are many prestigious journals in the field of orthopedic trauma with numerous high quality papers. They are providing high level of evidence articles for practicing orthopedic surgeons to improve care of patients with musculoskeletal injuries. However, most of these studies were performed in developed countries and as mentioned have a well-organized trauma system to ensure that each injured patient is promptly and safely delivered to a hospital that provides optimal, timely care for all injuries. Sometimes it is not easy for surgeons practicing in developing countries with different systems to apply those findings in their daily practice.
We launched Journal of Orthopedic and Spine Trauma to fill this gap in the knowledge of musculoskeletal injuries. The focus of this journal would be on orthopedic trauma and its challenges in developing world. We hope that all orthopedic surgeons from all over the world contribute in JOSTrauma and share their experience and knowledge to improve the quality of care of patients with orthopedic injuries.