{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T18:26:01Z","timestamp":1761157561531,"version":"3.40.5"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Traffic accidents and musculoskeletal injuries represent a major cause of morbidity and mortality in Costa Rica. To inform capacity building efforts, we conducted a survey study of hand and upper extremity (UE) fellowship-trained surgeons in Costa Rica to evaluate the epidemiology, complications, and challenges in care of UE trauma.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Aiming to capture all hand and UE trained surgeons in Costa Rica, we compiled a list of nine surgeons and sent a survey in Spanish using Qualtrics. Assessment questions were developed to understand the burden, complications, practice patterns, challenges, and capacity associated with care of UE trauma. Questions were designed to focus on opportunities for future investigation. Questions were translated and adapted by two bilingual speakers. Data were reported descriptively and open-ended responses were analyzed using content analysis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Nine (100%) surgeons completed the survey. Distal radius fractures, hand and finger fractures, and tendon injuries are the most frequently noted conditions. Stiffness and infection are the most common complications. About 29% of patients are unable to get necessary therapy and 13% do not return for follow-up care with monetary, distance, and transportation limitations being the greatest challenges.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>The burden of UE trauma in Costa Rica is high. Identifying common conditions, complications, challenges, and capacity allows for a tailored approach to partnership and capacity building (e.g. directing capacity building and\/or research infrastructure toward distal radius fractures). These insights represent opportunities to inform community-driven care improvement and research initiatives, such as Delphi consensus approaches to identify priorities or the development of outcome measurement systems.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/bco.0000000000001233","type":"journal-article","created":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T15:13:22Z","timestamp":1693926802000},"page":"280-284","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Upper extremity trauma in Costa Rica - Evaluating epidemiology and identifying opportunities"],"prefix":"10.1097","volume":"34","author":[{"given":"Luis Miguel","family":"Castro Appiani","sequence":"first","affiliation":[{"name":"Orthopaedic Surgeon and Traumatologist, Department of Orthopaedic Surgery, Hospital Cl\u00ednica B\u00edblica, San Jos\u00e9, Costa Rica"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"Castro","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine, Stanford University, Stanford, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brenda","family":"Romero","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hospital Metropolitano, San Jose, Costa Rica"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Diego","family":"Di\u0301az Salas","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hospital La Cat\u00f3lica, San Jos\u00e9, Costa Rica"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula","family":"Vindas","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hospital del Trauma, San Jose, Costa Rica"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rolando","family":"Soto","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hospital del Trauma, San Jose, Costa Rica"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristhian","family":"Castro Artavia","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Centro National de Rehabilitatci\u00f3n, San Jos\u00e9, Costa Rica"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robin N.","family":"Kamal","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Stanford University, Redwood City, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5396-5488","authenticated-orcid":false,"given":"Lauren M.","family":"Shapiro","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of California \u2013 San Francisco, San Francisco, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2023,11]]},"reference":[{"key":"R1-20250508","doi-asserted-by":"crossref","first-page":"e442","DOI":"10.1371\/journal.pmed.0030442","article-title":"Projections of global mortality and burden of disease from 2002 to 2030","volume":"3","author":"Mathers","year":"2006","journal-title":"PLoS Med"},{"key":"R5-20250508","doi-asserted-by":"crossref","first-page":"1859","DOI":"10.1016\/S0140-6736(18)32335-3","article-title":"2017 DALYs and HALE Collaborators. Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017","volume":"392","year":"2018","journal-title":"Lancet Lond Engl"},{"key":"R6-20250508","first-page":"471","article-title":"Epidemiology of traffic accidents in Costa Rica","volume":"110","author":"Robles","year":"1991","journal-title":"Boletin Oficina Sanit Panam Pan Am Sanit Bur"},{"issue":"Supp 1","key":"R8-20250508","first-page":"i115","article-title":"Global trends of hand and wrist trauma: a systematic analysis of fracture and digit amputation using the Global Burden of Disease 2017 Study","volume":"26","author":"Crowe","year":"2020","journal-title":"Inj Prev J Int Soc Child Adolesc Inj Prev"},{"key":"R9-20250508","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1016\/0266-7681(93)90024-A","article-title":"Injuries to the hand and wrist. A study of 50,272 injuries","volume":"18","author":"Angermann","year":"1993","journal-title":"J Hand Surg Edinb Scotl"},{"key":"R10-20250508","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1177\/1558944717695749","article-title":"Burden of Hand Maladies in US Emergency Departments","volume":"13","author":"Colen","year":"2018","journal-title":"Hand NYN"},{"key":"R11-20250508","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1007\/s00264-013-2197-6","article-title":"The fifty most cited Latin-American articles in the orthopaedic literature","volume":"38","author":"Urrutia","year":"2014","journal-title":"Int Orthop"},{"key":"R12-20250508","doi-asserted-by":"crossref","first-page":"2318","DOI":"10.2106\/JBJS.21.00271","article-title":"Orthopaedic Trauma Research Priorities in Latin America: Developing Consensus Through a Modified Delphi Approach","volume":"103","author":"Roberts","year":"2021","journal-title":"J Bone Joint Surg Am"},{"key":"R13-20250508","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1136\/bmj.321.7264.827","article-title":"Moving to research partnerships in developing countries","volume":"321","author":"Costello","year":"2000","journal-title":"BMJ"},{"key":"R14-20250508","doi-asserted-by":"crossref","first-page":"e003758","DOI":"10.1136\/bmjgh-2020-003758","article-title":"How global is global health research? A large-scale analysis of trends in authorship","volume":"6","author":"Dimitris","year":"2021","journal-title":"BMJ Glob Health"},{"key":"R17-20250508","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/B978-1-4557-4801-3.00013-8","article-title":"Epidemiologic Principles","volume":"1","author":"Osterholm","year":"2015","journal-title":"Mandell, Douglas, and Bennett\u2019s Principles and Practice of Infectious Diseases"},{"key":"R18-20250508","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1177\/15589447211003183","article-title":"Barriers and Facilitators of Outcome Collection During Hand Surgery Outreach: A Quality Improvement Study","volume":"17","author":"Shapiro","year":"2022","journal-title":"Hand N Y N"},{"key":"R19-20250508","doi-asserted-by":"crossref","first-page":"e1196","DOI":"10.1016\/S2214-109X(18)30386-3","article-title":"High-quality health systems in the Sustainable Development Goals era: time for a revolution","volume":"6","author":"Kruk","year":"2018","journal-title":"Lancet Glob Health"},{"key":"R20-20250508","doi-asserted-by":"crossref","first-page":"e567","DOI":"10.1016\/S2214-109X(17)30180-8","article-title":"Research capacity building-obligations for global health partners","volume":"5","author":"Beran","year":"2017","journal-title":"Lancet Glob Health"},{"key":"R21-20250508","first-page":"00391","article-title":"GrUpo de estudio por extremidad Superior Traumatolog\u00eda y Orthopedico (GUSTO). Hand Surgery Outreach-From Short-Term \u201cMissions\u201d to Capacity Building","volume":"S0363-5023","author":"Shapiro","year":"2022","journal-title":"J Hand Surg"},{"key":"R22-20250508","doi-asserted-by":"crossref","first-page":"1348","DOI":"10.1016\/j.jhsa.2010.06.008","article-title":"Open fractures of the distal radius","volume":"35","author":"Jawa","year":"2010","journal-title":"J Hand Surg"},{"key":"R23-20250508","doi-asserted-by":"crossref","first-page":"1868","DOI":"10.2106\/JBJS.H.01297","article-title":"Trends in the United States in the treatment of distal radial fractures in the elderly","volume":"91","author":"Chung","year":"2009","journal-title":"J Bone Joint Surg Am"},{"key":"R24-20250508","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1016\/j.injury.2016.04.002","article-title":"Traumatic injury in the United States: In-patient epidemiology 2000-2011","volume":"47","author":"DiMaggio","year":"2016","journal-title":"Injury"},{"key":"R25-20250508","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1097\/TA.0000000000000169","article-title":"The epidemiology of trauma-related mortality in the United States from 2002 to 2010","volume":"76","author":"Sise","year":"2014","journal-title":"J Trauma Acute Care Surg"},{"key":"R26-20250508","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1016\/j.amjsurg.2022.10.015","article-title":"To decolonize global surgery and global health we must be radically intentional","volume":"225","author":"Foretia","year":"2023","journal-title":"Am J Surg"},{"key":"R27-20250508","doi-asserted-by":"crossref","first-page":"e44","DOI":"10.2106\/JBJS.21.00948","article-title":"International Orthopaedic Volunteer Opportunities in Low and Middle-Income Countries","volume":"104","author":"Miclau","year":"2022","journal-title":"J Bone Joint Surg Am"}],"container-title":["Current Orthopaedic Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/BCO.0000000000001233","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T15:01:42Z","timestamp":1746716502000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/BCO.0000000000001233"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,5]]},"references-count":21,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.1097\/bco.0000000000001233","relation":{},"ISSN":["1941-7551"],"issn-type":[{"type":"electronic","value":"1941-7551"}],"subject":[],"published":{"date-parts":[[2023,9,5]]}}}