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Optimizing Post-Op Pain Management in Major Orthopedic Surgery in Yemen: Current Protocols? ea0cf

Essam Al-Najjar
Jul 24, 2025
2454 views
4 replies
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Essam Al-Najjar
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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Salem Al-Amri
Member
Jul 24, 2025 4:25 PM
#2
The new guidelines for osteoporosis screening are excellent. We've started implementing universal screening for women over 65 and post-menopausal women with risk factors, leading to earlier diagnosis and initiation of treatment, hopefully reducing fragility fractures, which are a growing concern in Yemen.
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Ammar Al-Hashimi
Member
Jul 24, 2025 4:25 PM
#3
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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Abdul Salam Al-Janid
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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