Orthopaedic Trauma in the Developing World: Where Are the Gaps in Research and What Can Be Done?

Sravya Challa, Hao Hua Wu, Brian P. Cunningham, Max Liu, Kushal Patel, David W. Shearer, Saam Morshed, Theodore Miclau

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Purpose: There are an estimated 1.2 million deaths from road traffic injuries annually, disproportionately affecting patients in lowresource 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 highquality research, and under-representation of pelvic, acetabular, and upper extremity injuries. Improved and prioritized research in lowand middle-income countries may help optimize care and inform policy makers of how to reduce the global burden of musculoskeletal trauma.

Original languageEnglish (US)
Pages (from-to)S43-S46
JournalJournal of orthopaedic trauma
StatePublished - Oct 1 2018

Bibliographical note

Funding Information:
This project was made possible with support from the Wyss Medical Foundation.

Publisher Copyright:
© 2018 Lippincott Williams and Wilkins. All rights reserved.


  • LMICs
  • Low resource
  • Musculoskeletal trauma
  • Quality research


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