​What kinds of symptoms do patients experience before receiving treatment?

Patients in need of open reduction internal fixation (ORIF) surgeries experience painful fractures or recurrent dislocations. Usually, these injuries result from traffic accidents or other trauma injuries.

​What is the impact on patients’ lives of living with these conditions?

Living with an abnormal or deformed bone limits function and can interfere with daily activities. It is also extremely painful.

What cultural or regional factors affect the treatment of these conditions?

1- Regional epidemiological factors: Low helmet use, insufficient enforcement of traffic laws, domestic accidents, occupational accidents of all kinds, and falls from heights. 2- Cultural factors influencing severity and delayed care: a) Priority use of traditional medicine. Many patients first consult traditional practitioners, healers, or marabouts. Use of vigorous massages, scarification, and local poultices. Consequences: worsening infection, delayed medical consultation, advanced bone destruction upon hospital arrival. b) Cultural perception of pain. Pain is often neglected, and severity is not recognized initially. c) Self-medication. Frequent and uncontrolled use of anti-inflammatories and antibiotics. This masks symptoms, delays diagnosis, and promotes infections and bacterial resistance. 3- Regional and geographical factors: a) Inequitable access to health facilities in remote rural areas: transport difficulties, scarcity of specialized hospitals, delayed referral to capable centers. b) Insufficient technical capacity: lack of bone radiography, bacteriology laboratories, and antibiograms. Treatment is often empirical and sometimes inappropriate. c) Socio-economic factors: poverty limiting prolonged hospitalization and the purchase of antibiotics, leading to premature treatment discontinuation and prioritization of family or professional obligations. 4- Factors related to local medical practices: a) Unsafe injections: non-aseptic intramuscular or intra-articular injections, risk of direct germ inoculation. b) Delayed diagnosis at peripheral levels: confusion with sprains or ligament ruptures, absence of suspected fracture, and lack of awareness of severity. Consequences: worsening infection, delayed medical consultation, advanced bone destruction upon hospital arrival. b) Cultural perception of pain. Pain is often neglected, and severity is not recognized initially. c) Self-medication. Frequent and uncontrolled use of anti-inflammatories and antibiotics. This masks symptoms, delays diagnosis, and promotes infections and bacterial resistance.

What does the treatment process look like?

The deformed bone is broken and correctly aligned, and any fragments are fixed. Following the realignment of the bone, metal plates, pins, rods, wires, or screws are attached to the bone for stabilization as the internal fixation.

What is the impact of this treatment on the patient’s life?

Patients will experience restored function and mobility and reduced pain. Patients regain independence and return to work, school, and family life.

What potential side effects or risks come with this treatment?

Complications from this surgery are rare but include infection, nerve damage, blood clots, and tissue irritation from the hardware.

How accessible is treatment in the area? What is the typical journey like for a patient to receive care?

Most patients (about 80%) first consult traditional healers due to belief systems, lack of financial means, or fear of surgery.

What are the alternatives to this treatment?

While traditional healers are consulted, there is no alternative medical care available for this treatment.