Building Orthopaedic Trauma Capacity: IGOT International SMART Course

Abstract

Orthopaedic injuries from trauma are increasingly common in Low to Middle Income Countries secondary to the increase in road traffic. These injuries commonly contain a soft tissue component, which complicates treatment of bony injuries and increases amputation rate. Specialized care using plastic surgery techniques is required to effectively treat these injuries. Historically medical mission models have been used to provide specialists to help provide soft tissue coverage where plastic surgeons are not available. This type of care is inherently unsustainable. We present an approach where a course was designed to teach soft tissue coverage techniques to orthopaedic surgeons. The course was given annually over 5 years, serving approximately 300 participants. Data collected from participants demonstrated that they found the course useful, learned techniques that allowed them to care for patients, and disseminate the knowledge further. Participants endorsed that they had performed 594 flaps with a 93% success rate at 1 year of follow-up from the course. We find that this type of intervention has the potential to address the need for soft tissue coverage in countries where this need is present, and resources are unavailable.