{"id":1292,"date":"2019-04-04T10:08:06","date_gmt":"2019-04-04T10:08:06","guid":{"rendered":"https:\/\/blogs.bmj.com\/case-reports\/?p=1292"},"modified":"2019-06-25T08:09:29","modified_gmt":"2019-06-25T08:09:29","slug":"managing-traumatic-amputation-and-prosthetics-in-the-developing-world","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/case-reports\/2019\/04\/04\/managing-traumatic-amputation-and-prosthetics-in-the-developing-world\/","title":{"rendered":"Managing traumatic amputation and prosthetics in the developing world"},"content":{"rendered":"<p><span style=\"font-weight: 400\">In, \u201cClinical management of quadriplegia in low and middle-income countries: a patient\u2019s road to physiotherapy, prostheses and rehabilitation,\u201d Choong et al provide follow-up on a patient they had previously described. The follow-up was largely concerned with how the patient arranged chronic care after losing all four limbs in a traumatic electrical accident. Through a crowd-sourced fundraising campaign, the patient was able to receive all four limbs.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Management of amputees continues to be a problem for low and middle income countries globally (LMICs). Despite coverage from the national government health system, prosthesis for one limb along with physiotherapy and rehab are an insurmountable cost burden for the indigent in the Philippines, despite over 600,000 amputee patients being present. It is estimated that over 30 million people in need of prostheses reside in low income countries. This population is particularly challenging to reach due to the high percentage of rural populations in low-income countries as well as other challenges that disproportionately affect them including poor travel infrastructure, low life expectancy, remnants of civil unrest and conflict such as landmines, and the changing prevalence of diabetes.<\/span><a href=\"#_ftn1\" name=\"_ftnref1\"><sup>[1]<\/sup><\/a><\/p>\n<p><span style=\"font-weight: 400\">Obviously, the etiologies of limb amputation must be addressed. Innovative solutions are needed to prevent chronic disease such as diabetes. Healthcare professionals must invest themselves in social determinants of health, speaking out against civil unrest, improving infrastructure and workplace safety, and helping to eliminate poverty. In the meantime, however, delivery systems must adapt to meet current needs.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Some promise has been shown in the Philippines with the addition of Z MORPH to the national healthcare package.<\/span><span style=\"font-weight: 400\"><a href=\"#_ftn2\" name=\"_ftnref2\"><sup>[2]<\/sup><\/a><\/span><span style=\"font-weight: 400\"> Other countries, such as Malaysia, have also improved their models.<\/span><span style=\"font-weight: 400\"><a href=\"#_ftn3\" name=\"_ftnref3\"><sup>[3]<\/sup><\/a><\/span><span style=\"font-weight: 400\"> However in many circumstances, the cost is still prohibitive to patients in these low-income countries. While temporary solutions such as charity fundraising or NGO provided services may benefit a few, a more systemic approach is necessary for all.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Some of the possible innovative solutions are addressed by Choong et al. They describe 3D printed prosthetics as a more affordable option. There has been some success with this in multiple different prosthetic forms, and this solution \u201ccan potentially provide limbs for LMICs (low and middle income countries) where there is a significant demand for high quality and affordable products.\u201d<\/span><\/p>\n<p>BMJ Case Reports invites authors to submit global health case reports that describe solutions to the problems faced by amputees in low and middle income countries. These cases could focus on:<\/p>\n<p><span style=\"font-weight: 400\">-The factors contributing to these injuries and innovative ways to address them.<\/span><\/p>\n<p><span style=\"font-weight: 400\">-The ability of these patients to access care and prosthetics.<\/span><\/p>\n<p><span style=\"font-weight: 400\">-Interventions that \u00a0result in the successful management of these patients.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p>Manuscripts may be submitted by students, physicians, nurses and allied health professionals to BMJ Case Reports at www.bmjcasereports.com. For more information, review our guidance on how to write a global health case report and look through our online collection<\/p>\n<p>&nbsp;<\/p>\n<p><strong>To read more about traumatic injury and amputee management at BMJ Case Reports, please review:<\/strong><\/p>\n<p><span style=\"font-weight: 400\">&#8211;<a href=\"https:\/\/casereports.bmj.com\/content\/2017\/bcr-2016-218103.long\">Forensic investigation into a death: post-traumatic amnesia in a worker with a work-related head injury sustained in a coal0fired thermal power plant in India<\/a><\/span><\/p>\n<p><span style=\"font-weight: 400\">&#8211;<a href=\"https:\/\/casereports.bmj.com\/content\/2017\/bcr-2016-218188\">Clinical management of electrical burns in the developing world: a case of electrical burn injury left untreated \u00a0leading to amputation<\/a><\/span><\/p>\n<p><span style=\"font-weight: 400\">&#8211;<a href=\"https:\/\/casereports.bmj.com\/content\/2014\/bcr-2014-205756.long\">Landmines in the Golan Heights: a patient\u2019s perspective<\/a><\/span><\/p>\n<p>&nbsp;<\/p>\n<p><strong>To read more about traumatic injury and amputee management from other sources, please see below:<\/strong><\/p>\n<p><a href=\"#_ftnref1\" name=\"_ftn1\"><sup>[1]<\/sup><\/a><span style=\"font-weight: 400\"> Stevens P. Prosthetics in Resource-Limited Countries. The O &amp; P Edge. [internet] June 2015. Obtained from <\/span><a href=\"https:\/\/opedge.com\/Articles\/ViewArticle\/2015-06_02\"><span style=\"font-weight: 400\">https:\/\/opedge.com\/Articles\/ViewArticle\/2015-06_02<\/span><\/a><span style=\"font-weight: 400\"> on 9 March 2019.<\/span><\/p>\n<p><a href=\"#_ftnref2\" name=\"_ftn2\"><sup>[2]<\/sup><\/a><span style=\"font-weight: 400\"> WHO. A new leg, a new lease on life in the Philippines. 2018 <\/span><a href=\"http:\/\/www.who.int\/features\/2013\/new_leg_philippines\/en\/\"><span style=\"font-weight: 400\">http:\/\/www.who.int\/features\/2013\/new_leg_philippines\/en\/<\/span><\/a><span style=\"font-weight: 400\"> (cited 9 March 2019)<\/span><\/p>\n<p><a href=\"#_ftnref3\" name=\"_ftn3\"><sup>[3]<\/sup><\/a><span style=\"font-weight: 400\">Arifin N, Hasbollah HR, Hanafi MH, Ibrahim AH, Rahman WA, Aziz RC. Provision of prosthetic services following lower limb amputation in Malaysia. The Malaysian journal of medical sciences: MJMS. 2017 Oct;24(5):106.<\/span><!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>In, \u201cClinical management of quadriplegia in low and middle-income countries: a patient\u2019s road to physiotherapy, prostheses and rehabilitation,\u201d Choong et al provide follow-up on a patient they had previously described. The follow-up was largely concerned with how the patient arranged chronic care after losing all four limbs in a traumatic electrical accident. Through a crowd-sourced [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/case-reports\/2019\/04\/04\/managing-traumatic-amputation-and-prosthetics-in-the-developing-world\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":357,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[263],"tags":[],"class_list":["post-1292","post","type-post","status-publish","format-standard","hentry","category-global-health"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Managing traumatic amputation and prosthetics in the developing world - BMJ Case Reports blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/case-reports\/2019\/04\/04\/managing-traumatic-amputation-and-prosthetics-in-the-developing-world\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Managing traumatic amputation and prosthetics in the developing world - BMJ Case Reports blog\" \/>\n<meta property=\"og:description\" content=\"In, \u201cClinical management of quadriplegia in low and middle-income countries: a patient\u2019s road to physiotherapy, prostheses and rehabilitation,\u201d Choong et al provide follow-up on a patient they had previously described. 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