What can we Expect from the ORTOJ?

Abstract

Indeed ORTOJ, with its wide vision, will be able to address all aspects of orthopedics 
and trauma, satisfying the interest of readers around the globe. We are aware that, different 
areas of the globe differ in their disease makeup, health care levels and systems. Although 
these differences apply for health disciplines in general, they are more obvious in orthopedics 
and trauma in particular. For instance in many areas in the developing world, Sudan as an example, seeing and managing neglected late presenting cases or cases seen by bone setters first 
is the rule. Even children disabilities are taken care of soon after birth by untrained personnel. 
Compared to other developed areas with good health system and people awareness were even 
tertiary care is available in a location accessible for almost all population. Thus researches 
addressing neglected cases although of little value at some parts of the developed world, is 
highly appreciated in the developing world. Indeed this difference in levels of the first care will 
affect publications and research topics. In most of European, American and other developed 
countries, a trained orthopedic and trauma surgeon will see the patient first, whereas a pediatric orthopedic unit will be usually the second if not the first level of health care, compared to 
developing countries where either a native bone setter or a general medical assistant is the first 
level of health care. Thus our training in such setup should be directed towards health personnel 
(paramedical staff), so that people will opt going to health centers and not to native bone setters 
if better service is offered by the available health personnel. In a study previously conducted 
in Sudan,1
 it was shown that clubfoot can be scored to comparable results when it is done by a 
pediatric orthopedic surgeon or an assistant physiotherapist (a nurse who had only on job training in physiotherapy). So we can trust these health personnel to deliver an acceptable quality 
service, because it will not be possible for the health system to make a trained orthopedic or 
pediatric orthopedic surgeon as it is in the developed part of the world. In such underdeveloped 
areas, even patient’s follow up is a challenge due to lack of awareness and cultural issues related to how disability is looked at in such communities and poor health system setups, leave 
alone financial constraints