Type of Document	MD Thesis
Author	Archer, Natasha
Author's Email Address	Natasha.Archer@yale.edu
URN	etd-06262006-125900
Title	Surgical Implant Generation Network Intramedullary Nailing of Femur & Tibia Fractures in Rural Haiti
Degree	MD
Department	Medicine
Advisory Committee	Advisor Name Title Trace Kershaw Committee Chair
Keywords	internal fixation disability mortality trauma Surgical Implant Generation Network (SIGN) femur tibia fractures Haiti SIGN nail post-trauma support
Date of Defense	0000-00-00
Availability	restricted
Abstract Trauma is the most common cause of mortality and disability among working aged adults in resource poor countries [1]. While injury prevention is crucial, epidemiologists and clinicians must also work to decrease mortality and disability that results from injury through cost-effective improvements in the entire system of trauma treatment. This review sought to determine if performing internal fixation using the Surgical Implant Generation Network (SIGN) intramedullary nail to treat femur and tibia fractures is feasible in rural Haiti; and which variables improve post-operative recovery, defined as weight bearing (WB) and range of motion (ROM). Sixty fractures, treated using the SIGN nail, were compared to 46 fractures that were treated prior to its advent. There was no significant difference between the groups based on OR time (p = 0.56) and LOS (p = 0.47). Within the SIGN group, a correlation was observed between weight bearing and age (p = 0.007), delays to surgery (p = 0.001), and polytrauma (p = 0.017). Age (p = 0.079) and delays to surgery (p = 0.010) were also found to influence knee range of motion. The low production cost of the SIGN nail and its design simplicity offer a potential solution to the multiple trauma fractures that frequently lead to disability in settings like Haiti. Its utility, in settings like Haiti, must be further studied. In addition, it is also essential that we continue to make efforts to improve post-trauma transport.
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