Enhancing Cranio-Maxillofacial Fracture Care in Low- and Middle-Income Countries: A Systematic Review

Area of Science:

• Medical Sciences
• Public Health
• Surgical Innovation

Background:

• Cranio-maxillofacial (CMF) injuries pose significant challenges in low- and middle-income countries (LMICs).
• Inadequate infrastructure, resources, and training hinder effective CMF fracture care in LMICs.
• Existing CMF care strategies in LMICs require evaluation and improvement.

Purpose of the Study:

• To systematically review strategies for improving cranio-maxillofacial (CMF) fracture care in low- and middle-income countries (LMICs).
• To evaluate solutions focusing on education, patient transfer, and off-label techniques for CMF injuries in LMICs.
• To identify sustainable approaches for enhancing CMF fracture management in resource-limited settings.

Main Methods:

• A systematic literature review was conducted using PubMed/Medline (January 2000 - June 2023).
• Studies were selected adhering to the Preferred Reporting Items for Systematic Review and Meta-analysis Statement (PRISMA).
• Solutions were categorized into education, patient transfer, and off-label/non-operative approaches.

Main Results:

• Twenty-three articles were included, highlighting the critical need for enhanced education and training for local surgeons.
• Digital platforms and on-site teaching emerged as key educational delivery methods.
• Patient transfer to specialized clinics and innovative off-label techniques were identified as immediate solutions for quality care.

Conclusions:

• Effective cranio-maxillofacial (CMF) fracture care in LMICs necessitates a multifaceted strategy.
• Prioritizing local healthcare professional education, facilitated patient transfer, and adoption of off-label solutions is crucial.
• Collaboration between international organizations, local providers, and educational institutions is essential for improved patient outcomes.