Related Experiment Video
Updated: Aug 14, 2025
A Teleoperated Robotic System-Assisted Percutaneous Transiliac-Transsacral Screw Fixation Technique
Published on: January 6, 2023
Special Report: The Moore Pediatric Surgery Center: An Evolving Model for Pediatric Orthopaedic Surgical Care in a
Zachary R Taylor1, Robert W Hamblin2, Brian A Shaw3
1Spectrum Health Lakeland Emergency Medicine Program, Michigan State University, East Lansing, MI.
Insights
This study details an 11-year pediatric orthopaedic surgical care model in Guatemala. The Moore Center provides sustainable, effective care for children in limited-resource settings, demonstrating a viable approach to global health challenges.
Area of Science:
- Global Health
- Pediatric Orthopaedics
- Surgical Care Delivery Models
Background:
- Limited-resource environments present significant challenges for delivering specialized pediatric orthopaedic surgical care.
- Short-term, focused surgical missions can be effective but require sustainable models for long-term impact.
Purpose of the Study:
- To describe an 11-year experience with a specific model for pediatric orthopaedic surgical care in Guatemala.
- To evaluate the evolution, financial aspects, and patient outcomes of this care model.
- To assess the safety and effectiveness of short-term surgical interventions in a limited-resource setting.
Main Methods:
- Retrospective review of financial records, case lists, patient charts (2014-2022), and photographic records.
- Analysis of patient follow-up data, including complications such as infection, wound dehiscence, and surgical outcomes.
- Inclusion of data from a local, fellowship-trained Guatemalan pediatric orthopaedic surgeon.
Main Results:
- A total of 297 pediatric orthopaedic surgical patients were identified over 8 years.
- 235 patient charts were reviewed, with 72% having at least one follow-up visit.
- Identified complications included recurrent hip dislocations, fracture, superficial infection, wound dehiscence, and graft failure.
Conclusions:
- The Moore Pediatric Surgery Center demonstrates a financially viable, sustainable, safe, and effective model.
- This model successfully delivers short-term surgical care for numerous pediatric orthopaedic conditions in a resource-limited environment.
- The 11-year experience highlights the feasibility of consistent, high-quality care delivery through such dedicated programs.
Abstract:
The authors describe their 11-year experience with 1 model for providing short-term (about 1 wk/y in country) pediatric orthopaedic surgical care in a limited resource environment. This paper provides a detailed narrative of 1 team's pediatric orthopaedic work at the Moore Pediatric Surgery Center in Guatemala City, how it has evolved over these 11 years, financial aspects of the model, and examines patient follow-up data for a consecutive 8-year period. The authors have reviewed financial records, case lists, patient charts from 2014 to 2022, and patient photographic records from The Moore Center and as provided via internet by a local contracted Guatemalan pediatric orthopaedic fellowship-trained surgeon to present a complete picture of how the service functions. Specific follow-up data included: last follow-up date, date discharged from follow-up, and major complications including infection, surgical wound dehiscence, return for unplanned surgery, major nerve injury, and recurrent hip dislocation for cases of closed or open reduction of developmental hip dislocation. A total of 297 consecutive pediatric orthopaedic surgical patients were identified from 2014 to 2022. Of these, charts were found for 235 patients (135 female, 110 male), of which 43% were from the urban Guatemala City region. Two hundred sixteen (72%) had at least 1 follow-up clinic visit, and 87 (37%) had at least 1-year follow-up or were discharged. All complications identified by this retrospective chart review included 4 recurrent hip dislocations (3 after closed reduction), 1 femur fracture after implant removal, 1 superficial infection requiring antibiotics, 1 partial dehiscence treated only with dressings, 1 thumb subluxation, and 1 failed graft with internal fixation for congenital pseudoarthrosis of tibia.
Conclusions:
The Moore Pediatric Surgery Center is a financially viable, sustainable, safe, and effective model for delivering short-term surgical care for many pediatric orthopaedic conditions in a limited resource environment.
Level Of Evidence:
None (descriptive).
More Related Videos
Related Concept Videos
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic...
01:20Acute Kidney Injury V: Interprofessional Care
01:19Standards of Care II
01:22Standards of Care I
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...