Clinical outcomes of internal fixation orthopaedic surgery in humanitarian settings: a retrospective cohort study at the Médecins Sans Frontières (MSF) trauma centre in Aden, Yemen.
Rami Malaeb, Taha Hussain, Fares Ayyash, Abdulsalam Abdullah, Hameed S Ahmed, Khaled Abdulrahman, Adel Al Haj, Hesham Bin Shahna, Evgenia Zelikova, Ibrahim Hassanin, Elisabeth Poulet, Patrick Herard, Rasheed Fakhri
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引用次数: 0
Abstract
Purpose: The Aden Trauma Centre in Yemen, supported by Médecins Sans Frontières (MSF), introduced internal fixation (IF) procedures to address the high burden of fractures as a result of road traffic accidents and conflict-related injuries. This study aimed to describe the clinical characteristics of patients undergoing IF, evaluate their complication and healing outcomes, and explore factors influencing postoperative results.
Methods: A retrospective cohort design was employed, including all patients who underwent internal fixation-using SIGN nails or plates/screws-between January and December 2022. Demographic information, fracture characteristics, surgical techniques, and postoperative outcomes were analyzed. Cox proportional hazards models were used to identify key predictors of complications and bone healing.
Results: A total of 177 patients (208 fractures) were included. The overall complication rate was 14.4%. Open fractures and comorbidities were significant predictors of complications, while type of implant (SIGN nail vs. plate/screws) did not affect complication risk. Around three-quarters of fractures achieved radiographic healing at a median of five to six months. Infection and other complications emerged as major risk factors for delayed or impaired union. About a quarter of patients defaulted from care, potentially underestimating late complications and nonunion rates.
Conclusion: Findings indicate that IF is feasible and effective in this high-need, low-resource context, demonstrating complication rates in line with global estimates. Open fractures, comorbidities, and limited follow-up infrastructure remain the main challenges to optimizing outcomes in such contexts.
期刊介绍：
International Orthopaedics, the Official Journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) , publishes original papers from all over the world. The articles deal with clinical orthopaedic surgery or basic research directly connected with orthopaedic surgery. International Orthopaedics will also link all the members of SICOT by means of an insert that will be concerned with SICOT matters.
Finally, it is expected that news and information regarding all aspects of orthopaedic surgery, including meetings, panels, instructional courses, etc. will be brought to the attention of the readers.
Manuscripts submitted for publication must contain a statement to the effect that all human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.
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The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfil the above-mentioned requirements.
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