Yemeni Orthopedic Association

M

Mutahar Al-Eryani

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.

M

Muhammad Salem

Member

Jul 24, 2025 4:25 PM

#2

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.

M

Majed Al-Azani

Member

Jul 24, 2025 4:25 PM

#3

From a public health perspective in Yemen, such dilemmas highlight the need for stronger primary prevention programs to reduce the burden of preventable orthopedic conditions, thereby freeing up resources for more urgent cases. Advocacy for increased healthcare funding is also crucial.

T

Tawfiq Al-Maflahi

Member

Jul 24, 2025 4:25 PM

#4

I've personally seen good results with PRP augmentation in partial rotator cuff tears in my Yemeni patients, Dr. Al-Maflahi. While large-scale RCTs are still evolving, for select patients, it seems to enhance healing. The cost can be a barrier, but patient education on potential benefits is vital.

A

Ali Al-Zarqa

Member

Jul 24, 2025 4:25 PM

#5

I prefer the anterior approach for most primary THA due to faster initial recovery and lower perceived dislocation risk, which is important for patient mobility in Yemen. However, it does have a steeper learning curve and can be challenging in very muscular or obese patients. Exposure can be limited for complex femoral anatomy.

Pediatric Supracondylar Humerus Fractures: When to Refer, When to Manage Non-Operatively in Yemeni Hospitals? 1bc0b

Join the Discussion

Welcome!