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

The common symptoms include extreme pain; inability/difficulty in using limbs; deformed limbs. This procedure corrects a severe, poorly aligned fracture where the ends of affected bones are far apart. Such a fracture that requires CRPP occurs mainly on the upper limbs in children usually as a result of trauma.

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

Untreated fracture leads to chronic disability, pain, and inability to work or move the limbs.

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

These fractures require specialised surgery which is not very common in the Kapsowar region in Kenya. Kapsowar Hospital serves a remote population where some people do not have money to pay for surgery. For this reason, the hospital has been incurring these costs without compensation.

What does the treatment process look like?

Before determining what treatment is best for the type of fracture, the doctor will order various diagnostic tests, such as an X-ray to assess surrounding ligaments. The patient is then booked for surgery and will be in the hospital for about 2 days.

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

This care is curative. A CRPP fixes the broken bone restoring it to complete function and thus, enabling the patient to be able to utilize the limbs.

What potential side effects or risks come with this treatment?

A medium surgical risk but most trauma patients are young and tolerate the procedure well. Overall, the risk of surgery is less than the risks of the alternative (traction) or doing nothing. The pins can be removed later on the outpatient visits when the fracture heals.

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

There are few quality orthopaedic centres in developing countries. In the developed world, a person would go to their local hospital and get this procedure relatively simply. Often patients have received initial care for a fracture at another hospital and may have been placed in “traction.” “Traction” involves placing the affected limb in a cast under tension for prolonged periods to try to re-align the bones. Those who have funds try to make their way to a place like Kapsowar Hospital. Most patients seen in Kapsowar who are in need of a CRPP are mainly patients who have been mismanaged in other hospitals. Usually, those hospitals lack adequate resources and expertise to treat them

What are the alternatives to this treatment?

As mentioned, traction is an alternative for some—but not all—cases. And traction requires a patient to be in the hospital, immobile, for months—leading not only to lost wages/time in school but the risk of bedsores, blood clots, and hospital-acquired infections.