{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T15:32:51Z","timestamp":1786635171445,"version":"build-2736575974"},"reference-count":63,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Halle (Saale)"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Musculoskelet Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Burundi remains one of the most socioeconomically challenged countries globally, facing profound limitations in healthcare infrastructure, workforce, and access. In this context, the Italian Medical Foundation for Central Africa (FIMAC) has conducted humanitarian orthopaedic missions for over two decades in Bubanza, addressing critical musculoskeletal conditions in both paediatric and adult populations. This essay provides a comprehensive overview of the operational, clinical, and ethical dimensions of these missions. Commonly treated pathologies include chronic osteomyelitis, neglected fractures, open injuries, and congenital or acquired limb deformities\u2014conditions frequently encountered in advanced stages due to delayed access to care. Resource-sensitive protocols guide interventions and rely heavily on collaboration with local healthcare workers, who receive targeted training in trauma management, postoperative care, and basic surgical techniques. The aim is not just to deliver urgent care but to foster sustainable improvements through capacity building and knowledge exchange. Major challenges include a lack of surgical infrastructure, limited availability of diagnostics and sterile equipment, as well as sociocultural barriers to care, such as language and traditional beliefs. Despite these constraints, the missions yield significant functional and psychosocial outcomes, particularly among paediatric patients. Ethical considerations, including informed consent, scope of practice, and cultural humility, are central to responsible practice in this setting. The personal and professional impact on participating surgeons is profound, often reshaping clinical priorities and reinforcing the humanistic foundations of the medical profession. The paper concludes by advocating for the establishment of permanent surgical facilities, structured deployments, and scalable innovations to enhance the continuity of care and address surgical inequities in low-resource settings.<\/jats:p>","DOI":"10.1007\/s12306-025-00934-5","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T12:33:48Z","timestamp":1762346028000},"page":"315-324","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Delivering orthopaedics in Burundi: a model for humanitarian surgery in resource-limited settings"],"prefix":"10.1007","volume":"110","author":[{"given":"Giulia","family":"Cenci","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Fidanza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Grasso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Migliorini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achille","family":"Contini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Falez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel Giovanni","family":"Mazzoleni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,5]]},"reference":[{"key":"934_CR1","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1016\/j.jss.2010.04.016","volume":"171","author":"F Abdullah","year":"2011","unstructured":"Abdullah F, Choo S, Hesse AA et al (2011) Assessment of surgical and obstetrical care at 10 district hospitals in Ghana using on-site interviews. J Surg Res 171:461\u2013466","journal-title":"J Surg Res"},{"key":"934_CR2","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1007\/s40719-022-00229-1","volume":"8","author":"B Alayande","year":"2022","unstructured":"Alayande B, Chu KM, Jumbam DT et al (2022) Disparities in access to trauma care in sub-Saharan Africa: a narrative review. Curr Trauma Rep 8:66\u201394","journal-title":"Curr Trauma Rep"},{"key":"934_CR3","unstructured":"Burundi's healthcare system (accessed on September 2025; accessed at: https:\/\/www.severemalaria.org\/burundis-healthcare-system. Accessed 28\/05\/25)"},{"key":"934_CR4","unstructured":"Burundi GDP and Economic Data (Accessed on September 2025; accessed at: https:\/\/gfmag.com\/country\/burundi-gdp-country-report\/)"},{"key":"934_CR5","doi-asserted-by":"publisher","first-page":"e182","DOI":"10.1371\/journal.pmed.0050182","volume":"5","author":"Anonymous","year":"2008","unstructured":"The PLoS Medicine Editors (2008) A Crucial Role for Surgery in Reaching the UN Millennium Development Goals. PLoS Med 5(8): e182. https:\/\/doi.org\/10.1371\/journal.pmed.0050182","journal-title":"PLoS Med"},{"key":"934_CR6","unstructured":"Data for Low income, Burundi (Accessed on September 2025; accessed at https:\/\/www.worldbank.org\/ext\/en\/home)"},{"key":"934_CR7","unstructured":"\u201cEmergency and Essential Surgery: The Backbone of Primary Health Care,\u201d WHO, 2013. http:\/\/www.who.int\/eht\/sb\/en\/index.html Accessed in September 2025"},{"key":"934_CR8","unstructured":"Anonymous FIMAC Onlus \u2013 International Foundation Doctors for Central Africa. https:\/\/www.fimaconlus.org\/en\/homepage\/. Accessed 28\/05\/25"},{"key":"934_CR9","unstructured":"The poorest Countries in the World 2025. https:\/\/worldpopulationreview.com\/country-rankings\/poorest-countries-in-the-world. Accessed 28\/05\/25"},{"key":"934_CR10","unstructured":"The Poorest Countries In The World 2025 - WorldAtlas. https:\/\/www.worldatlas.com\/gdp\/the-poorest-countries-in-the-world.html. Accessed 28\/05\/25"},{"key":"934_CR11","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1136\/medethics-2011-100488","volume":"39","author":"R Asgary","year":"2013","unstructured":"Asgary R, Junck E (2013) New trends of short-term humanitarian medical volunteerism: professional and ethical considerations. J Med Ethics 39:625\u2013631","journal-title":"J Med Ethics"},{"key":"934_CR12","doi-asserted-by":"publisher","first-page":"1589","DOI":"10.1016\/S0140-6736(18)30001-1","volume":"391","author":"BM Biccard","year":"2018","unstructured":"Biccard BM, Madiba TE, Kluyts HL et al (2018) Perioperative patient outcomes in the African surgical outcomes study: a 7-day prospective observational cohort study. Lancet 391:1589\u20131598","journal-title":"Lancet"},{"key":"934_CR13","first-page":"829","volume":"80","author":"SW Bickler","year":"2002","unstructured":"Bickler SW, Rode H (2002) Surgical services for children in developing countries. Bull World Health Organ 80:829\u2013835","journal-title":"Bull World Health Organ"},{"key":"934_CR14","doi-asserted-by":"publisher","first-page":"949","DOI":"10.1016\/j.suc.2007.07.018","volume":"87","author":"KM Casey","year":"2007","unstructured":"Casey KM (2007) The global impact of surgical volunteerism. Surg Clin North Am 87:949\u2013960","journal-title":"Surg Clin North Am"},{"key":"934_CR15","first-page":"94","volume":"28","author":"G Chilopora","year":"2016","unstructured":"Chilopora G, Pereira C, Kamwendo F et al (2016) Postoperative outcome of caesarean sections and other major emergency obstetric surgery by clinical officers and medical officers in Malawi. Malawi Med J 28:94\u201398","journal-title":"Malawi Med J"},{"issue":"Suppl 2","key":"934_CR16","doi-asserted-by":"publisher","first-page":"S17","DOI":"10.1016\/S0140-6736(15)60812-1","volume":"385","author":"L Chokotho","year":"2015","unstructured":"Chokotho L, Jacobsen KH, Burgess D et al (2015) Trauma and orthopaedic capacity of 267 hospitals in east central and southern Africa. Lancet 385(Suppl 2):S17","journal-title":"Lancet"},{"key":"934_CR17","doi-asserted-by":"publisher","first-page":"721","DOI":"10.1001\/archsurg.2010.137","volume":"145","author":"KM Chu","year":"2010","unstructured":"Chu KM, Ford N, Trelles M (2010) Operative mortality in resource-limited settings: the experience of Medecins Sans Frontieres in 13 countries. Arch Surg 145:721\u2013725","journal-title":"Arch Surg"},{"key":"934_CR18","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1186\/1478-4491-5-27","volume":"5","author":"A Cumbi","year":"2007","unstructured":"Cumbi A, Pereira C, Malalane R et al (2007) Major surgery delegation to mid-level health practitioners in Mozambique: health professionals\u2019 perceptions. Hum Resour Health 5:27","journal-title":"Hum Resour Health"},{"key":"934_CR19","volume-title":"Disease Control Priorities in Developing Countries","author":"HT Debas","year":"2006","unstructured":"Debas HT, Gosselin R, Mccord C et al (2006) Disease Control Priorities in Developing Countries, 2nd edn. The International Bank for Reconstruction and Development\/The World Bank, Washington (DC)","edition":"2"},{"key":"934_CR20","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1353\/hcr.2007.0096","volume":"37","author":"M Decamp","year":"2007","unstructured":"Decamp M (2007) Scrutinizing global short-term medical outreach. Hastings Cent Rep 37:21\u201323","journal-title":"Hastings Cent Rep"},{"key":"934_CR21","doi-asserted-by":"publisher","first-page":"1154","DOI":"10.2106\/JBJS.24.00997","volume":"107","author":"M Dworkin","year":"2025","unstructured":"Dworkin M, Woolley PM, Shahab F et al (2025) Access to orthopaedic devices in low and middle-income countries: challenges and opportunities. J Bone Joint Surg Am 107:1154\u20131160","journal-title":"J Bone Joint Surg Am"},{"key":"934_CR22","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1056\/NEJM200107193450310","volume":"345","author":"P Farmer","year":"2001","unstructured":"Farmer P (2001) The major infectious diseases in the world\u2013to treat or not to treat? N Engl J Med 345:208\u2013210","journal-title":"N Engl J Med"},{"key":"934_CR23","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1007\/s00268-008-9525-9","volume":"32","author":"PE Farmer","year":"2008","unstructured":"Farmer PE, Kim JY (2008) Surgery and global health: a view from beyond the OR. World J Surg 32:533\u2013536","journal-title":"World J Surg"},{"key":"934_CR24","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1186\/s10195-024-00778-y","volume":"25","author":"CS Fischer","year":"2024","unstructured":"Fischer CS, Floss M, Ittermann T et al (2024) Gender-specific factors influencing the glenoid version and reference values for it. J Orthop Traumatol 25:39","journal-title":"J Orthop Traumatol"},{"key":"934_CR25","doi-asserted-by":"publisher","first-page":"1055","DOI":"10.1016\/S0140-6736(10)60392-3","volume":"376","author":"LM Funk","year":"2010","unstructured":"Funk LM, Weiser TG, Berry WR et al (2010) Global operating theatre distribution and pulse oximetry supply: an estimation from reported data. Lancet 376:1055\u20131061","journal-title":"Lancet"},{"key":"934_CR26","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1186\/s10195-025-00835-0","volume":"26","author":"S Hausner","year":"2025","unstructured":"Hausner S, Kolb A, Ubelmesser K et al (2025) It is not waste if it is therapy: cellular, secretory and functional properties of reamer-irrigator-aspirator (RIA)-derived autologous bone grafts. J Orthop Traumatol 26:21","journal-title":"J Orthop Traumatol"},{"key":"934_CR27","doi-asserted-by":"publisher","first-page":"476","DOI":"10.1016\/j.otohns.2010.05.011","volume":"143","author":"G Isaacson","year":"2010","unstructured":"Isaacson G, Drum ET, Cohen MS (2010) Surgical missions to developing countries: ethical conflicts. Otolaryngol Head Neck Surg 143:476\u2013479","journal-title":"Otolaryngol Head Neck Surg"},{"key":"934_CR28","doi-asserted-by":"publisher","first-page":"2245","DOI":"10.1007\/s00590-024-03945-3","volume":"34","author":"M Jeyaraman","year":"2024","unstructured":"Jeyaraman M, Migliorini F, Balaji S et al (2024) Whole-body cryotherapy in orthopaedics: current concepts. Eur J Orthop Surg Traumatol 34:2245\u20132254","journal-title":"Eur J Orthop Surg Traumatol"},{"key":"934_CR29","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1001\/archsurg.2009.272","volume":"145","author":"I Khalil","year":"2010","unstructured":"Khalil I (2010) Surgical care delivery and world health. Arch Surg 145:160","journal-title":"Arch Surg"},{"key":"934_CR30","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1001\/archsurg.2008.540","volume":"144","author":"TP Kingham","year":"2009","unstructured":"Kingham TP, Kamara TB, Cherian MN et al (2009) Quantifying surgical capacity in Sierra Leone: a guide for improving surgical care. Arch Surg 144:122\u2013127","journal-title":"Arch Surg"},{"key":"934_CR31","doi-asserted-by":"publisher","first-page":"e1000242","DOI":"10.1371\/journal.pmed.1000242","volume":"7","author":"ME Kruk","year":"2010","unstructured":"Kruk ME, Wladis A, Mbembati N et al (2010) Human resource and funding constraints for essential surgery in district hospitals in Africa: a retrospective cross-sectional survey. PLoS Med 7:e1000242","journal-title":"PLoS Med"},{"key":"934_CR32","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1001\/archsurg.2009.263","volume":"145","author":"AL Kushner","year":"2010","unstructured":"Kushner AL, Cherian MN, Noel L et al (2010) Addressing the Millennium Development Goals from a surgical perspective: essential surgery and anesthesia in 8 low- and middle-income countries. Arch Surg 145:154\u2013159","journal-title":"Arch Surg"},{"key":"934_CR33","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1186\/s10195-022-00666-3","volume":"23","author":"A Laufer","year":"2022","unstructured":"Laufer A, Toporowski G, Gosheger G et al (2022) Preliminary results of two novel devices for epiphysiodesis in the reduction of excessive predicted final height in tall stature. J Orthop Traumatol 23:46","journal-title":"J Orthop Traumatol"},{"key":"934_CR34","doi-asserted-by":"publisher","first-page":"722","DOI":"10.1308\/003588407X209329","volume":"89","author":"C Lavy","year":"2007","unstructured":"Lavy C, Tindall A, Steinlechner C et al (2007) Surgery in Malawi - a national survey of activity in rural and urban hospitals. Ann R Coll Surg Engl 89:722\u2013724","journal-title":"Ann R Coll Surg Engl"},{"key":"934_CR35","first-page":"197","volume":"58","author":"T Lokossou","year":"2007","unstructured":"Lokossou T, Zoumenou E, Secka G et al (2007) Anesthesia in French-speaking sub-Saharan Africa: an overview. Acta Anaesthesiol Belg 58:197\u2013209","journal-title":"Acta Anaesthesiol Belg"},{"key":"934_CR36","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1186\/s10195-024-00763-5","volume":"25","author":"F Lu","year":"2024","unstructured":"Lu F, Groven RVM, Van Griensven M et al (2024) Polytherapy versus monotherapy in the treatment of tibial non-unions: a retrospective study. J Orthop Traumatol 25:21","journal-title":"J Orthop Traumatol"},{"key":"934_CR37","doi-asserted-by":"publisher","first-page":"604","DOI":"10.1111\/j.1365-3156.2009.02268.x","volume":"14","author":"S Luboga","year":"2009","unstructured":"Luboga S, Galukande M, Ozgediz D (2009) Recasting the role of the surgeon in Uganda: a proposal to maximize the impact of surgery on public health. Trop Med Int Health 14:604\u2013608","journal-title":"Trop Med Int Health"},{"key":"934_CR38","doi-asserted-by":"publisher","first-page":"e1000200","DOI":"10.1371\/journal.pmed.1000200","volume":"6","author":"S Luboga","year":"2009","unstructured":"Luboga S, Macfarlane SB, Von Schreeb J et al (2009) Increasing access to surgical services in sub-saharan Africa: priorities for national and international agencies recommended by the Bellagio Essential Surgery Group. PLoS Med 6:e1000200","journal-title":"PLoS Med"},{"key":"934_CR39","first-page":"137","volume":"12","author":"KA Mcqueen","year":"2010","unstructured":"Mcqueen KA, Ozgediz D, Riviello R et al (2010) Essential surgery: integral to the right to health. Health Hum Rights 12:137\u2013152","journal-title":"Health Hum Rights"},{"key":"934_CR40","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1186\/s12891-023-06478-8","volume":"24","author":"M Mederake","year":"2023","unstructured":"Mederake M, Eleftherakis G, Schull D et al (2023) The gap height in open wedge high tibial osteotomy is not affected by the starting point of the osteotomy. BMC Musculoskelet Disord 24:373","journal-title":"BMC Musculoskelet Disord"},{"key":"934_CR41","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1186\/s10195-025-00827-0","volume":"26","author":"I Menbari Oskouie","year":"2025","unstructured":"Menbari Oskouie I, Hakiminejad A, Yazdanmehr A et al (2025) Radiological outcomes of surgical techniques for spastic hip in cerebral palsy: a systematic review and meta-analysis. J Orthop Traumatol 26:13","journal-title":"J Orthop Traumatol"},{"key":"934_CR42","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1186\/s13018-023-03543-9","volume":"18","author":"F Migliorini","year":"2023","unstructured":"Migliorini F, Maffulli N, Bell A et al (2023) Midterm results after arthroscopic femoral neck osteoplasty combined with labral debridement for cam type femoroacetabular impingement in active adults. J Orthop Surg Res 18:67","journal-title":"J Orthop Surg Res"},{"key":"934_CR43","doi-asserted-by":"publisher","first-page":"1686","DOI":"10.1007\/s43465-024-01205-4","volume":"58","author":"F Migliorini","year":"2024","unstructured":"Migliorini F, Schafer L, Simeone F et al (2024) Management of distal femoral non-union: a systematic review. Indian J Orthop 58:1686\u20131723","journal-title":"Indian J Orthop"},{"key":"934_CR44","first-page":"109","volume":"43","author":"C Motta","year":"2022","unstructured":"Motta C (2022) Chirurgia e umanesimo. G Ital Ortop Traumatol 43:109\u2013113","journal-title":"G Ital Ortop Traumatol"},{"key":"934_CR45","first-page":"111","volume":"15","author":"ETM Nyawawa","year":"2010","unstructured":"Nyawawa ETM, Ussiri EV, Chillo P et al (2010) Cardiac surgery: one year experience of cardiac surgery at Muhimbili National Hospital, Dar es Salaam- TANZANIA. East Cent Afr J Surg 15:111\u2013118","journal-title":"East Cent Afr J Surg"},{"key":"934_CR46","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1001\/archsurg.2008.567","volume":"144","author":"D Ozgediz","year":"2009","unstructured":"Ozgediz D (2009) Voluntarism and the global unmet need for surgery. Arch Surg 144:291\u2013292","journal-title":"Arch Surg"},{"key":"934_CR47","doi-asserted-by":"publisher","first-page":"1208","DOI":"10.1007\/s00268-008-9473-4","volume":"32","author":"D Ozgediz","year":"2008","unstructured":"Ozgediz D, Galukande M, Mabweijano J et al (2008) The neglect of the global surgical workforce: experience and evidence from Uganda. World J Surg 32:1208\u20131215","journal-title":"World J Surg"},{"key":"934_CR48","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s00268-008-9799-y","volume":"33","author":"D Ozgediz","year":"2009","unstructured":"Ozgediz D, Hsia R, Weiser T et al (2009) Population health metrics for surgery: effective coverage of surgical services in low-income and middle-income countries. World J Surg 33:1\u20135","journal-title":"World J Surg"},{"key":"934_CR49","doi-asserted-by":"publisher","first-page":"646","DOI":"10.2471\/BLT.07.050435","volume":"86","author":"D Ozgediz","year":"2008","unstructured":"Ozgediz D, Jamison D, Cherian M et al (2008) The burden of surgical conditions and access to surgical care in low- and middle-income countries. Bull World Health Organ 86:646\u2013647","journal-title":"Bull World Health Organ"},{"key":"934_CR50","unstructured":"Pereira C (2010) Task-shifting of major surgery to midlevel providers of health care in Mozambique and Tanzania: a solution to the crisis in human resources to enhance maternal and neonatal survival. Karolinska Institutet. Thesis"},{"key":"934_CR51","doi-asserted-by":"publisher","first-page":"3129","DOI":"10.1007\/s00402-024-05422-2","volume":"144","author":"A Pintore","year":"2024","unstructured":"Pintore A, Astone A, Vecchio G et al (2024) Percutaneous transverse pinning for metacarpal fractures: a clinical trial. Arch Orthop Trauma Surg 144:3129\u20133136","journal-title":"Arch Orthop Trauma Surg"},{"key":"934_CR52","doi-asserted-by":"publisher","first-page":"534","DOI":"10.1186\/s40001-024-02052-7","volume":"29","author":"M Pishnamaz","year":"2024","unstructured":"Pishnamaz M, Migliorini F, Blume C et al (2024) Long-term outcomes of spinal fusion in adolescent idiopathic scoliosis: a literature review. Eur J Med Res 29:534","journal-title":"Eur J Med Res"},{"key":"934_CR53","unstructured":"Response SCFH (1998) The sphere project. Geneva"},{"key":"934_CR54","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1016\/j.mcna.2015.09.001","volume":"100","author":"GS Stone","year":"2016","unstructured":"Stone GS, Olson KR (2016) The ethics of medical volunteerism. Med Clin North Am 100:237\u2013246","journal-title":"Med Clin North Am"},{"key":"934_CR55","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/s10195-020-00549-5","volume":"21","author":"T Ukai","year":"2020","unstructured":"Ukai T, Hamahashi K, Uchiyama Y et al (2020) Retrospective analysis of risk factors for deep infection in lower limb Gustilo-Anderson type III fractures. J Orthop Traumatol 21:10","journal-title":"J Orthop Traumatol"},{"key":"934_CR56","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1007\/s10730-011-9153-x","volume":"23","author":"LL Wall","year":"2011","unstructured":"Wall LL (2011) Ethical concerns regarding operations by volunteer surgeons on vulnerable patient groups: the case of women with obstetric fistulas. HEC Forum 23:115\u2013127","journal-title":"HEC Forum"},{"key":"934_CR57","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1007\/s00192-005-0056-8","volume":"17","author":"LL Wall","year":"2006","unstructured":"Wall LL, Arrowsmith SD, Lassey AT et al (2006) Humanitarian ventures or \u201cfistula tourism?\u201d: the ethical perils of pelvic surgery in the developing world. Int Urogynecol J Pelvic Floor Dysfunct 17:559\u2013562","journal-title":"Int Urogynecol J Pelvic Floor Dysfunct"},{"key":"934_CR58","doi-asserted-by":"publisher","DOI":"10.3390\/life12111754","author":"CD Weber","year":"2022","unstructured":"Weber CD, Migliorini F, Delbruck H et al (2022) Surgical management of an osteomyelitis associated subchondral bone defect in the Pediatric knee based on arthroscopy, \u201cOssoscopy\u201d and bone grafting-a case report. Life (Basel). https:\/\/doi.org\/10.3390\/life12111754","journal-title":"Life (Basel)"},{"key":"934_CR59","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1016\/S0140-6736(08)60878-8","volume":"372","author":"TG Weiser","year":"2008","unstructured":"Weiser TG, Regenbogen SE, Thompson KD et al (2008) An estimation of the global volume of surgery: a modelling strategy based on available data. Lancet 372:139\u2013144","journal-title":"Lancet"},{"key":"934_CR60","unstructured":"Wilkinson J (1990) Making men whole: the theology of medical missions. Maxwell memorial lecture, 1989. Published for the Medical Missionary Association by the Christian Medical Fellowship, London"},{"key":"934_CR61","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1186\/s10195-025-00836-z","volume":"26","author":"S Yang","year":"2025","unstructured":"Yang S, Lian Y, Yang L et al (2025) Fibular head osteotomy: a new technique for better exposure of postero-lateral tibial plateau fracture. J Orthop Traumatol 26:19","journal-title":"J Orthop Traumatol"},{"key":"934_CR62","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1186\/s10195-022-00667-2","volume":"23","author":"AI Zayda","year":"2022","unstructured":"Zayda AI, Mesregah MK, Zalalo SH et al (2022) Functional and radiological outcomes after treatment of congenital pseudarthrosis of the tibia using the Ilizarov technique: a retrospective single-center study. J Orthop Traumatol 23:48","journal-title":"J Orthop Traumatol"},{"key":"934_CR63","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1186\/s10195-023-00725-3","volume":"24","author":"A Zein","year":"2023","unstructured":"Zein A, Khalifa AA, Elsherif ME et al (2023) Are the outcomes of single-stage open reduction and Dega osteotomy the same when treating DDH in patients younger than 8 years old? A prospective cohort study. J Orthop Traumatol 24:43","journal-title":"J Orthop Traumatol"}],"container-title":["MUSCULOSKELETAL SURGERY"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12306-025-00934-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s12306-025-00934-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12306-025-00934-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T14:42:39Z","timestamp":1786632159000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s12306-025-00934-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,5]]},"references-count":63,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["934"],"URL":"https:\/\/doi.org\/10.1007\/s12306-025-00934-5","relation":{},"ISSN":["2035-5114"],"issn-type":[{"value":"2035-5114","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,5]]},"assertion":[{"value":"3 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 October 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 November 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":3,"name":"Ethics","label":"Consent to publish","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study complies with ethical standards.","order":4,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The present study was not registered.","order":5,"name":"Ethics","label":"Registration and protocol","group":{"name":"EthicsHeading","label":"Declarations"}}]}}