Decision-making algorithm for sequential treatment of diaphyseal bone gaps in war-wounded patients in the Middle East.

Introduction: Tibial bone gaps after war injuries are common and can be managed by different types of surgery, including compression, bone graft, tibialisation of fibula, bone transport, and free flaps. Here, we present an algorithm developed at a humanitarian surgical hospital to manage tibial bone gaps. We also identify some key factors affecting patient outcomes and describe some clinical considerations for choosing treatment strategy.

The short musculoskeletal functional assessment (SMFA) score amongst surgical patients with reconstructive lower limb injuries in war wounded civilians.

Background/objectives: The MSF programme in Jordan provides specialized reconstructive surgical care to war-wounded civilians in the region. The short musculoskeletal functional assessment score (SMFA) provides a method for quantitatively assessing functional status following orthopaedic trauma. In June 2010 the Amman team established SMFA as the standard for measuring patients’ functional status.

Reconstruction of nonunion tibial fractures in war-wounded Iraqi civilians, 2006-2008: better late than never.

Objective: To describe medical care and surgical outcome after functional reconstructive surgery in late-presenting patients who already had at least one prior operation.

Design: Retrospective review of medical care and surgical outcome from August 2006 to December 2008 using patient records for initial data with active follow-up for the latest outcome information.

Setting: Médecins sans Frontières surgical programme in Jordan Red Crescent Hospital, Amman, Jordan.