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Limb reconstruction in a resource-limited environment
Introduction: Limb salvage and reconstruction are often challenging and even more so in the limited resource setting. The purpose of this narrative review is to explore the strategies for addressing the unique obstacles and opportunities of limb reconstructive surgery in resource-limited environment...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
EDP Sciences
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8725545/ https://www.ncbi.nlm.nih.gov/pubmed/34981739 http://dx.doi.org/10.1051/sicotj/2021066 |
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author | Ferreira, Nando Sabharwal, Sanjeev Hosny, Gamal Ahmed Sharma, Hemant Johari, Ashok Nandalan, Vasudevan P. Vivas, Mauro Parihar, Mangal Nayagam, Selvadurai Ferguson, David Rölfing, Jan Duedal |
author_facet | Ferreira, Nando Sabharwal, Sanjeev Hosny, Gamal Ahmed Sharma, Hemant Johari, Ashok Nandalan, Vasudevan P. Vivas, Mauro Parihar, Mangal Nayagam, Selvadurai Ferguson, David Rölfing, Jan Duedal |
author_sort | Ferreira, Nando |
collection | PubMed |
description | Introduction: Limb salvage and reconstruction are often challenging and even more so in the limited resource setting. The purpose of this narrative review is to explore the strategies for addressing the unique obstacles and opportunities of limb reconstructive surgery in resource-limited environments globally. Methods: We review (1) the global burden and dimension of the problem, (2) the relevance of orthopedic forums and communication, (3) free and open-access software for deformity analysis and correction, (4) bidirectional learning opportunities, and the value of fellowships and mentoring between resource-rich and resource-limited countries, and (5) how societies like SICOT can help to tackle the problem. Finally, case examples are presented to demonstrate the choice of surgical implants, their availability in regions with limited resources, and how the universal principles of limb reconstruction can be applied, irrespective of resource availability. Results: Limb reconstruction can often be life-changing surgery with the goals of limb salvage, improved function, and ambulation. The contradiction of relatively few severe limb deformities in high-income countries (HICs) with abundant resources and the considerable burden of limb deformities in resource-limited countries is striking. Free, open access to education and software planning tools are of paramount importance to achieve this goal of limb reconstruction. Bidirectional learning, i.e., knowledge exchange between individual surgeons and societies with limited and abundant resources, can be reached via fellowships and mentoring. The presented cases highlight (1) fixator-assisted wound closure obliviating the need for plastic surgery, (2) open bone transport, and (3) hinged Ilizarov frames for correction of severe deformities. These cases underline that optimal clinical outcome can be achieved with low-cost and readily available implants when the principles of limb reconstruction are skillfully applied. Discussion: Limb lengthening and reconstruction are based on universally applicable principles. These have to be applied regardless of the planning tool or surgical implant availability to achieve the goals of limb salvage and improved quality of life. |
format | Online Article Text |
id | pubmed-8725545 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | EDP Sciences |
record_format | MEDLINE/PubMed |
spelling | pubmed-87255452022-02-07 Limb reconstruction in a resource-limited environment Ferreira, Nando Sabharwal, Sanjeev Hosny, Gamal Ahmed Sharma, Hemant Johari, Ashok Nandalan, Vasudevan P. Vivas, Mauro Parihar, Mangal Nayagam, Selvadurai Ferguson, David Rölfing, Jan Duedal SICOT J Review Article Introduction: Limb salvage and reconstruction are often challenging and even more so in the limited resource setting. The purpose of this narrative review is to explore the strategies for addressing the unique obstacles and opportunities of limb reconstructive surgery in resource-limited environments globally. Methods: We review (1) the global burden and dimension of the problem, (2) the relevance of orthopedic forums and communication, (3) free and open-access software for deformity analysis and correction, (4) bidirectional learning opportunities, and the value of fellowships and mentoring between resource-rich and resource-limited countries, and (5) how societies like SICOT can help to tackle the problem. Finally, case examples are presented to demonstrate the choice of surgical implants, their availability in regions with limited resources, and how the universal principles of limb reconstruction can be applied, irrespective of resource availability. Results: Limb reconstruction can often be life-changing surgery with the goals of limb salvage, improved function, and ambulation. The contradiction of relatively few severe limb deformities in high-income countries (HICs) with abundant resources and the considerable burden of limb deformities in resource-limited countries is striking. Free, open access to education and software planning tools are of paramount importance to achieve this goal of limb reconstruction. Bidirectional learning, i.e., knowledge exchange between individual surgeons and societies with limited and abundant resources, can be reached via fellowships and mentoring. The presented cases highlight (1) fixator-assisted wound closure obliviating the need for plastic surgery, (2) open bone transport, and (3) hinged Ilizarov frames for correction of severe deformities. These cases underline that optimal clinical outcome can be achieved with low-cost and readily available implants when the principles of limb reconstruction are skillfully applied. Discussion: Limb lengthening and reconstruction are based on universally applicable principles. These have to be applied regardless of the planning tool or surgical implant availability to achieve the goals of limb salvage and improved quality of life. EDP Sciences 2021-12-31 /pmc/articles/PMC8725545/ /pubmed/34981739 http://dx.doi.org/10.1051/sicotj/2021066 Text en © The Authors, published by EDP Sciences, 2021 https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Article Ferreira, Nando Sabharwal, Sanjeev Hosny, Gamal Ahmed Sharma, Hemant Johari, Ashok Nandalan, Vasudevan P. Vivas, Mauro Parihar, Mangal Nayagam, Selvadurai Ferguson, David Rölfing, Jan Duedal Limb reconstruction in a resource-limited environment |
title | Limb reconstruction in a resource-limited environment |
title_full | Limb reconstruction in a resource-limited environment |
title_fullStr | Limb reconstruction in a resource-limited environment |
title_full_unstemmed | Limb reconstruction in a resource-limited environment |
title_short | Limb reconstruction in a resource-limited environment |
title_sort | limb reconstruction in a resource-limited environment |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8725545/ https://www.ncbi.nlm.nih.gov/pubmed/34981739 http://dx.doi.org/10.1051/sicotj/2021066 |
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