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Understanding and Addressing the Global Need for Orthopaedic Trauma Care

Agarwal-Harding, Kiran J. MD; von Keudell, Arvind MD; Zirkle, Lewis G. MD; Meara, John G. MD, DMD, MBA; Dyer, George S.M. MD

Journal of Bone & Joint Surgery - American Volume: 2 November 2016 - Volume 98 - Issue 21 - p 1844–1853
doi: 10.2106/JBJS.16.00323
Current Concepts Review

The burden of musculoskeletal trauma is high worldwide, disproportionately affecting the poor, who have the least access to quality orthopaedic trauma care.

Orthopaedic trauma care is essential, and must be a priority in the horizontal development of global health systems.

The education of surgeons, nonphysician clinicians, and ancillary staff in low and middle income countries is central to improving access to and quality of care.

Volunteer surgical missions from rich countries can sustainably expand and strengthen orthopaedic trauma care only when they serve a local need and build local capacity.

Innovative business models may help to pay for care of the poor. Examples include reducing costs through process improvements and cross-subsidizing from profitable high-volume activities.

Resource-poor settings may foster innovations in devices or systems with universal applicability in orthopaedics.

1Harvard Combined Orthopaedic Residency Program, Massachusetts General Hospital, Boston, Massachusetts

2SIGN Fracture Care International, Richland, Washington

3Program in Global Surgery and Social Change, Harvard Medical School, Boston Children’s Hospital, Boston, Massachusetts

4Department of Orthopedic Surgery, Brigham and Women’s Hospital, Boston, Massachusetts

E-mail address for K.J. Agarwal-Harding:

E-mail address for G.S.M. Dyer:

Copyright 2016 by The Journal of Bone and Joint Surgery, Incorporated
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