Yemeni Orthopedic Association

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Muhammad Salem

Member

Joined Jul 2025

Jul 24, 2025 4:25 PM

Original Post

Colleagues, I have a challenging case: a 45-year-old male with a distal tibia shaft fracture that has developed a persistent non-union 9 months post-intramedullary nailing. He has significant pain and limited weight-bearing. What are your preferred management strategies for such complex non-unions, especially considering the local challenges in Sana'a? Would you consider revision nailing, plate fixation, or a biological augmentation technique? Any advice on the diagnostic workup to identify underlying causes would also be appreciated.

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Abdullah Al-Faqih Al-Wazir

Member

Jul 24, 2025 4:25 PM

#2

I favor the posterior approach for THA due to its excellent exposure and versatility in managing various deformities, which we often see in Yemen. While the dislocation rate can be a concern, meticulous capsular repair significantly mitigates this risk. Patient positioning is also simpler for our OR teams.

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Muhammad Al-Dawas

Member

Jul 24, 2025 4:25 PM

#3

Tele-rehabilitation for ACL patients has been a game-changer for us, especially in remote areas of Yemen. Patient compliance has actually improved because it removes transportation barriers. It requires a good internet connection and patient commitment, but the benefits outweigh the challenges.

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Faiq Al-Zarami

Member

Jul 24, 2025 4:25 PM

#4

For chronic low back pain in Yemen, I firmly believe non-surgical management should always be exhausted first, unless there are clear neurological deficits. A combination of targeted physical therapy, pain education, and lifestyle modification often yields good results. Surgical fusion should be a last resort given our resources.

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Majed Salem

Member

Jul 24, 2025 4:25 PM

#5

Excellent topic, Dr. Salem! For post-op pain, we've had great success with a multimodal approach combining regional blocks (femoral nerve block for knee, interscalene for shoulder) with scheduled NSAIDs and paracetamol, reserving opioids for breakthrough pain. This significantly reduces opioid consumption in our Yemeni patients.

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Khalil Al-Zarabi

Member

Jul 24, 2025 4:25 PM

#6

For chronic low back pain in Yemen, I firmly believe non-surgical management should always be exhausted first, unless there are clear neurological deficits. A combination of targeted physical therapy, pain education, and lifestyle modification often yields good results. Surgical fusion should be a last resort given our resources.

Pediatric Supracondylar Humerus Fractures: When to Refer, When to Manage Non-Operatively in Yemeni Hospitals? f119b

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