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Treatment of Long Bones with a Universal Intramedullary Nail-System in a Developing Country at Hôpital Albert Schweitzer Haiti

Stephen Addington, Jean Louis Rodolpheres and Andrej Maria Nowakowski

Objective: To evaluate long bone fracture care in a resource-poor hospital by a European midterm volunteer orthopedic surgeon, using a tactile intramedullary nail system without intraoperative image intensifier or fracture table.

Methods: The first twenty cases treated by a single orthopedic surgeon using a universal intramedullary nail system (SIGN-nail) were analyzed using six-week to three-month follow-up series. Clinical follow-up occurred two weeks postoperatively with additional clinical and radiological follow-up at six-week and three-month timepoints.

Results: All twenty cases were negative for signs of infection, broken interlocking screws, or need for revision at respective three-month timepoints. All patients were at full weight-bearing capacity after six weeks. The SIGN-nail system also provided succesfull management of a complex 3D-correctionosteotomy case.

Conclusions: The SIGN-nail system is an effective, tactile system that can be used with satisfactory results without the need for an intraoperative image intensifier or fracture table. Its practical and minimalist nature makes it a favorable solution for long bone fracture care in resource-poor settings. A six-month time period seems to be adequate for midterm volunteer orthopedic-surgeons, as it allows adaptation to new settings and unfamiliar systems.