ArticleInternational orthopaedics2022
Off-label use of orthopedical trauma implants in a low-income country.
Article in International orthopaedics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 9 citations in OpenAlex.
- Development of a low-cost external fixation system: an off-label solution for resource-limited settings.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Impact of fracture table availability and usability on surgical decision-making: a national cross-sectional survey of Nigerian orthopaedic surgeons.International orthopaedics · 2026Article
- Migration of Two Broken K-wires into the Cervical Region following Lateral End Clavicle Fixation: A Rare Case Report and Literature Review.Journal of orthopaedic case reports · 2026Article
- Predictors of complications after intramedullary nailing for lower extremity fractures in low-resource settings: a 10-year experience with the SIGN nail in Nigeria.Patient safety in surgery · 2025Article
- Rare "double tragedy" and successful salvage strategy after failed bilateral humeral fracture fixation in a resource-constrained setting: a case report.Patient safety in surgery · 2025Article
- Standard or Fin SIGN® nail? which option is better for the treatment of femoral fractures in low and middle-income countries?International orthopaedics · 2024Article
- Comment on "Off-label use of orthopedical trauma implants in a low-income country".International orthopaedics · 2022Article
- Off-Label Treatment for Severe Craniomaxillofacial Fractures in Low-Income Countries-A Novel Operation Method with the External Face Fixator.Journal of clinical medicine · 2022Article
- Locally developed external fixators as definitive treatment of open tibia diaphyseal fractures: a clinical prospective study conducted in Ivory Coast.International orthopaedics · 2022Article
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeLack of resources, severe injuries, and logistical flaws force surgeons in low-income countries (LIC) to improvise during surgery and use implants "off-label." These off-label treatments are specific for the work of trauma surgeons in non-governmental (NGO) hospitals in LIC. The aim of this study is to show the need of off-label surgery in an environment of low resources by means of typical examples.
methodsOff-label treated fractures, the implant used instead, and the reason for off-label treatment were investigated in 367 injuries over a three month period in an NGO hospital in Sierra Leone.
resultsTwenty-seven fractures were treated off-label with mostly K-wires (88.89%) and external fixators (51.85%). Three reasons for off-label use could be defined: no suitable implants (N = 14), the condition of soft tissues that did not allow internal osteosyntheses (N = 10), and implants not ready for surgery due to logistic flaws (N = 3). The implants needed were mostly locking plates.
conclusionSurgeons in similar settings must use K-wires and external fixators to treat complex fractures. Using implants off-label can help surgeons to treat fractures otherwise left untreated.
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