By Zuleihat Owuiye, Nigeria

Orthopaedic and trauma specialists have called for a more coordinated approach to treating patients with traumatic and musculoskeletal injuries in Nigeria, saying successful surgery alone does not necessarily mean that a patient has fully recovered.

The experts stressed that trauma care should involve a multidisciplinary team made up of surgeons, nurses, anaesthetists, physiotherapists, occupational therapists, nutritionists, psychologists, pharmacists and other healthcare professionals.

According to them, these professionals should work together from the time a patient arrives at the hospital through treatment, rehabilitation and eventual reintegration into society.

The specialists made the call at the 47th Annual Scientific Conference of the National Orthopaedic Hospital, Igbobi, Lagos, which focused on “Multidisciplinary Team Care in the Management of Musculoskeletal Diseases,” with burn injuries also receiving special attention.

Representing the Medical Director of the hospital, Dr Wakil O. Lawal, at the opening ceremony, the Head of Clinical Services, Dr F.C. Nwachukwu, said the traditional system in which one doctor handled an injury almost entirely had changed.

He explained that the complexity of modern trauma cases made teamwork necessary, adding that even patients with relatively simple injuries could achieve better outcomes when different healthcare professionals contributed to their care.

Consultant Orthopaedic Surgeon and Chief Executive Officer of Redeemer’s Health Village, Dr Adedamola Dada, said the definition of successful treatment should go beyond performing a successful operation or seeing a healed fracture on an X-ray.

He illustrated this with the case of a young man who suffers multiple fractures in a road accident. Although surgeons may successfully repair the broken bones, the patient may still be unable to work, provide for his family or return to his previous way of life.

Dada said healing a fracture should therefore not be regarded as the final goal of treatment.

He explained that a patient could have a technically successful operation while still facing physical, psychological, social and economic difficulties.

According to him, multidisciplinary care should begin as soon as the patient presents at the hospital, with the various professionals working around shared treatment goals.

He warned that the traditional approach, in which a surgeon manages a patient and calls other specialists only when problems arise, could contribute to delayed intervention, inadequate rehabilitation, complications and repeated hospital visits.

Dada also pointed out that the circumstances a patient returns to after discharge could affect recovery.

For example, a patient who loses employment because of an injury may require occupational rehabilitation to help them return to work or develop alternative employment opportunities.

He added that family members and caregivers should be involved in treatment decisions because they often play a major role in supporting patients after discharge.

Dada cited the example of a patient who might return home to a building several floors above ground without a lift, saying such environmental factors should be considered when planning discharge and rehabilitation.

He also called for better communication among healthcare professionals, stressing that team members should be able to contribute to decisions regardless of their professional rank.

He identified strong leadership, clear treatment protocols, effective communication and patient involvement as important requirements for successful multidisciplinary care.

The surgeon further advocated regular multidisciplinary meetings, electronic medical records and digital imaging systems that would allow healthcare professionals to share patient information more efficiently.

He also urged hospitals to monitor and publish patient outcomes, saying attention should move from individual professional performance to the effectiveness of the entire healthcare team.

Speaking on burn injuries, Consultant Plastic Surgeon at the University College Hospital, Ibadan, Dr Ayodele Olukayode Iyun, described burns as a major public health concern because they can result in death, permanent disability, scarring and significant social and financial difficulties.

Iyun said the pattern of serious burn injuries was changing, with domestic gas explosions becoming an increasingly important cause.

He noted that patients injured in gas explosions were being treated at the University College Hospital regularly, while children under five remained particularly vulnerable to burns, especially scald injuries.