Journal Article > ReviewAbstract
Int Orthop. 12 May 2013; Volume 37 (Issue 8); DOI:10.1007/s00264-013-1904-7
Herard P, Boillot F
Int Orthop. 12 May 2013; Volume 37 (Issue 8); DOI:10.1007/s00264-013-1904-7
Journal Article > CommentaryAbstract
Quality orthopaedic care in sudden-onset disasters: suggestions from Médecins Sans Frontières-France
Int Orthop. 28 November 2015
Herard P, Boillot F
Int Orthop. 28 November 2015
Journal Article > CommentaryFull Text
Int Orthop. 15 May 2012; Volume 36 (Issue 10); 1979-1981.; DOI:10.1007/s00264-012-1552-3
Herard P, Boillot F
Int Orthop. 15 May 2012; Volume 36 (Issue 10); 1979-1981.; DOI:10.1007/s00264-012-1552-3
PURPOSE
The decision to amputate is always difficult but becomes even harder in emergency situations, which usually present extra complicating factors.
MSF EXPERIENCE
These include human factors (related to both the surgeon and the patient); poor or nonexistent medical facilities, especially in war conditions or resource-poor countries; and cultural and religious considerations. Médecins Sans Frontières (MSF) has developed a quick medical and logistical response that relies on surgical protocols adapted to emergency situations, together with complete "kits" of medical equipment, supplies and inflatable facilities.
CONCLUSION
Our response to Haiti's 2010 earthquake relied on these tools but also highlighted the need to develop more detailed protocols that will help our teams on the ground.
The decision to amputate is always difficult but becomes even harder in emergency situations, which usually present extra complicating factors.
MSF EXPERIENCE
These include human factors (related to both the surgeon and the patient); poor or nonexistent medical facilities, especially in war conditions or resource-poor countries; and cultural and religious considerations. Médecins Sans Frontières (MSF) has developed a quick medical and logistical response that relies on surgical protocols adapted to emergency situations, together with complete "kits" of medical equipment, supplies and inflatable facilities.
CONCLUSION
Our response to Haiti's 2010 earthquake relied on these tools but also highlighted the need to develop more detailed protocols that will help our teams on the ground.
Journal Article > ResearchFull Text
Int Orthop. 10 May 2014; Volume 38 (Issue 8); 1551-1554.; DOI:10.1007/s00264-014-2344-8
Boillot F, Herard P
Int Orthop. 10 May 2014; Volume 38 (Issue 8); 1551-1554.; DOI:10.1007/s00264-014-2344-8
PURPOSE
Carrying out osteosynthesis is challenging, and controlling for results and complications is necessary to define the limits of acceptable complications. Within the context of sudden-onset disasters, comparing internal with external osteosynthesis remains controversial.
METHODS
The most recent and significant Médecins Sans Frontières (MSF) experience with osteosynthesis was following the earthquake in Haiti in 2010: 353 external fixators were used in the 12 months following the catastrophe, 62 of which were used in the first month. Carrying out internal osteosynthesis was possible two weeks following the earthquake.
RESULTS
The most common indication for open tibial fracture was Gustillo grade 2 or 3. Conversion rate from external to internal osteosynthesis remains anecdotal for several practical reasons. Advantages and drawbacks of external fixators are discussed in the context of precarious situations frequently encountered by MSF.
CONCLUSIONS
External osteosynthesis as a primary and definitive treatment for open fractures, especially of the leg, remains the most frequently used and best-adapted procedure in the context of sudden-onset disasters, even though not ideal.
Carrying out osteosynthesis is challenging, and controlling for results and complications is necessary to define the limits of acceptable complications. Within the context of sudden-onset disasters, comparing internal with external osteosynthesis remains controversial.
METHODS
The most recent and significant Médecins Sans Frontières (MSF) experience with osteosynthesis was following the earthquake in Haiti in 2010: 353 external fixators were used in the 12 months following the catastrophe, 62 of which were used in the first month. Carrying out internal osteosynthesis was possible two weeks following the earthquake.
RESULTS
The most common indication for open tibial fracture was Gustillo grade 2 or 3. Conversion rate from external to internal osteosynthesis remains anecdotal for several practical reasons. Advantages and drawbacks of external fixators are discussed in the context of precarious situations frequently encountered by MSF.
CONCLUSIONS
External osteosynthesis as a primary and definitive treatment for open fractures, especially of the leg, remains the most frequently used and best-adapted procedure in the context of sudden-onset disasters, even though not ideal.