Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Oct 2008
ReviewThe global burden of musculoskeletal injuries: challenges and solutions.
Musculoskeletal injuries are a major public health problem globally, contributing a large burden of disability and suffering. This burden could be considerably lowered by implementation of affordable and sustainable strategies to strengthen orthopaedic trauma care, especially in low- and middle-income countries. This article summarizes the global burden of musculoskeletal injuries and provides several examples of successful programs that have improved care of injuries in health facilities in low- and middle-income countries. Finally, it discusses WHO efforts to build on the country experiences and to make progress in lowering the burden of musculoskeletal injuries globally.
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China is a developing country with a population over 1.3 billion with the second largest group of people in poverty next to India. There are about 159 million motor vehicles, with 163,887,372 drivers. From 2001 to 2004 over 100,000 people died each year in traffic accidents. With law enforcement and public education, traffic accidents have decreased, and the death rate is now less than 100,000 each year.
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Deficiencies in the delivery of musculoskeletal trauma care in low- and middle-income countries can be attributed to a variety of causes, all of which can be linked to failure of the health system to deliver the necessary services to prevent death and disability. As such, a "systems" approach will be required to improve the delivery of services. The goal of this review is to familiarize the orthopaedic surgeon with selected topics in public health, including health systems, burden of disease, disability adjusted life year (DALY), cost-effective analysis, and related concepts (eg, met versus unmet need, access, utilization, effective coverage).
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Clin. Orthop. Relat. Res. · Oct 2008
Comparative StudyDifferences in innervation and innervated neurons between hip and inguinal skin.
Pain originating from the hip may be referred to the groin and anterior thigh. We investigated sensory dorsal root ganglion neurons innervating the hip and the inguinal skin in rats using retrograde neurotransport and immunohistochemistry. A retrograde neurotracer Fluoro-Gold was injected into the left hip or inguinal skin of rats. ⋯ In the hip group, Fluoro-Gold-labeled neurons were distributed throughout the left dorsal root ganglions from T13 to L5, primarily at L1, L2, L3, and L4, and the percentage of calcitonin gene-related peptide-positive neurons was higher than that of isolectin B4-binding neurons. In the inguinal skin group, Fluoro-Gold-labeled neurons were distributed throughout the left dorsal root ganglions from T13 to L3, primarily at L1, L2, and L3, and the percentage of isolectin B4-binding neurons was higher than that of calcitonin gene-related peptide-positive neurons. These data suggest the sensory innervation pattern and characteristics of the sensory nerve of the rat hip are different from those of inguinal skin.