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. 2023 Nov-Dec;34(6):280-284.
doi: 10.1097/bco.0000000000001233. Epub 2023 Sep 5.

Upper Extremity Trauma in Costa Rica - Evaluating Epidemiology and Identifying Opportunities

Luis Miguel Castro Appiani  1 , Samuel Castro  2 , Brenda Romero  3 , Juan Diego Díaz Salas  4 , Paula Vindas  5 , Rolando Soto  5 , Cristhian Castro Artavia  6 , Robin Kamal  7 , Lauren M Shapiro  8
Affiliations

Upper Extremity Trauma in Costa Rica - Evaluating Epidemiology and Identifying Opportunities

Luis Miguel Castro Appiani et al. Curr Orthop Pract. 2023 Nov-Dec.

Abstract

Background: Traffic accidents and musculoskeletal injuries represent a major cause of morbidity and mortality in Costa Rica. To inform capacity building efforts, we conducted a survey study of hand and upper extremity (UE) fellowship-trained surgeons in Costa Rica to evaluate the epidemiology, complications, and challenges in care of UE trauma.

Methods: Aiming to capture all hand and UE trained surgeons in Costa Rica, we compiled a list of nine surgeons and sent a survey in Spanish using Qualtrics. Assessment questions were developed to understand the burden, complications, practice patterns, challenges, and capacity associated with care of UE trauma. Questions were designed to focus on opportunities for future investigation. Questions were translated and adapted by two bilingual speakers. Data were reported descriptively and open-ended responses were analyzed using content analysis.

Results: Nine (100%) surgeons completed the survey. Distal radius fractures, hand and finger fractures, and tendon injuries are the most frequently noted conditions. Stiffness and infection are the most common complications. About 29% of patients are unable to get necessary therapy and 13% do not return for follow-up care with monetary, distance, and transportation limitations being the greatest challenges.

Conclusions: The burden of UE trauma in Costa Rica is high. Identifying common conditions, complications, challenges, and capacity allows for a tailored approach to partnership and capacity building (e.g. directing capacity building and/or research infrastructure toward distal radius fractures). These insights represent opportunities to inform community-driven care improvement and research initiatives, such as Delphi consensus approaches to identify priorities or the development of outcome measurement systems.

Keywords: Costa Rica; epidemiology; hand and upper extremity; multi-center; orthopaedic trauma.

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Conflict of interest statement

Conflict of Interest Statement: No authors have any conflicts of interest related to this research and no benefits in any form have been received or will be received related directly or indirectly to the subject of this article.

References

    1. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med 2006;3(11):e442. doi:10.1371/journal.pmed.0030442 - DOI - PMC - PubMed
    1. World Health Organization. Global status report on road safety: time for action World Health Organization. 2009. Accessed 2021 Nov 25. https://apps.who.int/iris/bitstream/handle/10665/44122/9789241563840_eng....
    1. Holder Y, Peden M, Krug EG, et al. Injury Surveillance Guidelines. World Health Organization 2001. Accessed 2021 Nov 25. https://apps.who.int/iris/handle/10665/42451.
    1. Krug EG. Injury: A Leading Cause of the Global Burden of Disease. World Health Organization 1999. Accessed 2021 Nov 25. https://apps.who.int/iris/handle/10665/66160.
    1. GBD 2017 DALYs and HALE Collaborators. Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Lond Engl 2018;392(10159):1859–1922. doi:10.1016/S0140-6736(18)32335-3 - DOI - PMC - PubMed