Establishing Consensus on Essential Resources for Musculoskeletal Trauma Care Worldwide: A Modified Delphi Study.

Area of Science:

• Orthopaedic Surgery
• Trauma Care Systems
• Global Health

Background:

• Formalized trauma systems improve patient outcomes and reduce mortality.
• A global disparity exists in the implementation of comprehensive trauma care systems.
• Resource availability for trauma care varies significantly by region.

Purpose of the Study:

• To identify essential resources for musculoskeletal trauma care.
• To establish consensus on critical supplies across diverse global resource settings.
• To inform the development of trauma care guidelines and resource allocation strategies.

Main Methods:

• Modified Delphi method with 3 rounds of electronic surveys.
• Expert consensus sought from 1 musculoskeletal trauma surgeon per country.
• Resources rated on a Likert scale; essential items defined by ≥75% consensus.

Main Results:

• 103 surgeons from 35% LMICs, 30% UMICs, and 35% HICs participated.
• 71 of 308 initially identified resources achieved consensus as essential.
• Differences in resource ratings between income groups were noted for general trauma care, not specific musculoskeletal needs.

Conclusions:

• International consensus was reached on a core list of essential musculoskeletal trauma care resources.
• Prioritizing locally available resources is crucial for effective trauma system development.
• Findings support the creation of guidelines, policies, and advocacy for global trauma care resource needs.