Limb reconstruction in a resource-limited environment

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dc.contributor.authorFerreira, Nandoen_ZA
dc.contributor.authorSabharwal, Sanjeeven_ZA
dc.contributor.authorHosny, Gamal Ahmeden_ZA
dc.contributor.authorSharma, Hemanten_ZA
dc.contributor.authorJohari, Ashoken_ZA
dc.contributor.authorNandalan, Vasudevan P.en_ZA
dc.contributor.authorVivas, Mauroen_ZA
dc.contributor.authorParihar, Mangalen_ZA
dc.contributor.authorNayagam, Selvaduraien_ZA
dc.contributor.authorFerguson, Daviden_ZA
dc.contributor.authorRolfing, Jan Duedalen_ZA
dc.date.accessioned2023-03-31T08:28:48Zen_ZA
dc.date.available2023-03-31T08:28:48Zen_ZA
dc.date.issued2021en_ZA
dc.descriptionCITATION: Ferreira, N. et al. 2021. Limb reconstruction in a resource-limited environment. SICOT-J, 7:66, doi:10.1051/sicotj/2021066.en_ZA
dc.descriptionThe original publication is available at https://www.sicot-j.orgen_ZA
dc.description.abstractIntroduction: 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.en_ZA
dc.description.versionPublisher's versionen_ZA
dc.format.extent9 pagesen_ZA
dc.identifier.citationFerreira, N. et al. 2021. Limb reconstruction in a resource-limited environment. SICOT-J, 7:66, doi:10.1051/sicotj/2021066.en_ZA
dc.identifier.issn2426-8887 (online)en_ZA
dc.identifier.otherdoi:10.1051/sicotj/2021066en_ZA
dc.identifier.urihttp://hdl.handle.net/10019.1/126746en_ZA
dc.language.isoen_ZAen_ZA
dc.publisherEDP Sciencesen_ZA
dc.rights.holderAuthors retain copyrighten_ZA
dc.subjectLimb salvageen_ZA
dc.subjectExternal skeletal fixation (Surgery)en_ZA
dc.subjectSurgery, Plasticen_ZA
dc.subjectMedical suppliesen_ZA
dc.subjectSurgical implantsen_ZA
dc.titleLimb reconstruction in a resource-limited environmenten_ZA
dc.typeArticleen_ZA
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