Off-label use of orthopedical trauma implants in a low-income country.
Austere environment
Complex injuries
External fixators
K-wires
LIC
NGO surgery
Off-label treatment
Journal
International orthopaedics
ISSN: 1432-5195
Titre abrégé: Int Orthop
Pays: Germany
ID NLM: 7705431
Informations de publication
Date de publication:
01 2022
01 2022
Historique:
received:
02
02
2021
accepted:
17
02
2021
pubmed:
28
2
2021
medline:
11
3
2022
entrez:
27
2
2021
Statut:
ppublish
Résumé
Lack of resources, severe injuries, and logistical flaws force surgeons in low-income countries (LIC) to improvise during surgery and use implants "off-label." These off-label treatments are specific for the work of trauma surgeons in non-governmental (NGO) hospitals in LIC. The aim of this study is to show the need of off-label surgery in an environment of low resources by means of typical examples. Off-label treated fractures, the implant used instead, and the reason for off-label treatment were investigated in 367 injuries over a three month period in an NGO hospital in Sierra Leone. Twenty-seven fractures were treated off-label with mostly K-wires (88.89%) and external fixators (51.85%). Three reasons for off-label use could be defined: no suitable implants (N = 14), the condition of soft tissues that did not allow internal osteosyntheses (N = 10), and implants not ready for surgery due to logistic flaws (N = 3). The implants needed were mostly locking plates. Surgeons in similar settings must use K-wires and external fixators to treat complex fractures. Using implants off-label can help surgeons to treat fractures otherwise left untreated.
Identifiants
pubmed: 33638004
doi: 10.1007/s00264-021-04990-x
pii: 10.1007/s00264-021-04990-x
pmc: PMC7909735
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
21-27Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2021. The Author(s).
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