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Journal Article

Citation

Challa S, Wu HH, Cunningham BP, Liu M, Patel K, Shearer DW, Morshed S, Miclau T. J. Orthop. Trauma 2018; 32(Suppl 7): S43-S46.

Affiliation

Orthopaedic Trauma Institute, Institute for Global Orthopaedics and Traumatology, Department of Orthopaedic Surgery, University of California, San Francisco, Zuckerberg San Francisco General Hospital, San Francisco, CA.

Copyright

(Copyright © 2018, Lippincott Williams and Wilkins)

DOI

10.1097/BOT.0000000000001293

PMID

30247400

Abstract

PURPOSE: There are an estimated 1.2 million deaths from road traffic injuries annually, disproportionately affecting patients in low-resource settings. The purpose of this scoping review is to identify knowledge gaps in global orthopaedic trauma in an effort to help prioritize future research.

METHODS: Using the 6-stage Arksey and O'Malley framework for conducting a scoping review, orthopaedic trauma literature was reviewed over a ten-year period from 2004 to 2014. Studies from low-resource settings were included and categorized by geographic location, anatomic region, study type, and level of evidence.

RESULTS: Of 548 included studies, 51.4% were from low- and middle-income countries in South Asia and 33.7% were from sub-Saharan Africa. Therapeutic (53.3%), epidemiologic (26.4%), and qualitative (8.9%) studies were most common. Only 10.2% of the studies were considered high level of evidence, whereas the vast majority (89.8%) was level 3 or below. Overall, lower extremity injuries were much more frequently represented in the literature compared with upper extremity injuries (233 vs. 78). Pelvic and acetabular fractures were the least studied anatomic region of the lower extremity (3.4%).

CONCLUSIONS: Our study identified a lack of cost-effectiveness analyses pertaining to injury and intervention, paucity of high-quality research, and under-representation of pelvic, acetabular, and upper extremity injuries. Improved and prioritized research in low- and middle-income countries may help optimize care and inform policy makers of how to reduce the global burden of musculoskeletal trauma.


Language: en

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