title: A Retrospective Case Series of Surgical Implant Generation Network (SIGN) Placement at the Afghan National Police Hospital, Kabul, Afghanistan.
abstract: In Afghanistan, adequate and cost-effective medical care for even routine conditions is lacking; especially for complex injuries like long-bone fractures. The Surgical Implant Generation Network (SIGN) intramedullary nail is used for treatment of long-bone fractures from blunt injuries and does not require imaging. We are reporting for the first time results of the SIGN intramedullary nail at the Afghan National Police Hospital, a tertiary care facility in Kabul. 71 records from the SIGN Online Surgical Database were reviewed for gender, age, date of injury, implant date, patient's home of record, and type/ mechanism of injury. Mean age was 26.7 years, all but one being male; time from injury to implant ranged 1 to 401 days, with mean of 40.6 days. Long-bone fractures from motor vehicle accidents remained constant, and war injuries peaked in summer. Follow-up is limited because of security and financial burdens of travel. However, personal communication with Afghan National Police Hospital surgeons suggests that patients included in the current study have not experienced any adverse outcomes. While it remains to be seen if the SIGN Online Surgical Database will facilitate more comprehensive outcome studies, our results provide support for the efficacy of SIGN nails in treating long-bone fractures from war injuries.
authors.affiliation: NATO Training Mission-Afghanistan/Directorate Command Surgeon, Afghan National Police Hospital, Kabul, Afghanistan.
authors.forename: Christian W
authors.initials: CW
authors.lastname: Ertl
authors.affiliation: NATO Training Mission-Afghanistan/Directorate Command Surgeon, Afghan National Police Hospital, Kabul, Afghanistan.
authors.forename: David
authors.initials: D
authors.lastname: Royal
authors.affiliation: NATO Training Mission-Afghanistan/Directorate Command Surgeon, Afghan National Police Hospital, Kabul, Afghanistan.
authors.forename: Humayoon Abdul
authors.initials: HA
authors.lastname: Arzoiey
authors.affiliation: NATO Training Mission-Afghanistan/Directorate Command Surgeon, Afghan National Police Hospital, Kabul, Afghanistan.
authors.forename: Azizullah
authors.initials: A
authors.lastname: Shefa
authors.affiliation: NATO Training Mission-Afghanistan/Directorate Command Surgeon, Afghan National Police Hospital, Kabul, Afghanistan.
authors.forename: Salim
authors.initials: S
authors.lastname: Sultani
authors.affiliation: NATO Training Mission-Afghanistan/Directorate Command Surgeon, Afghan National Police Hospital, Kabul, Afghanistan.
authors.forename: Mohammed Omar
authors.initials: MO
authors.lastname: Mosafa
authors.affiliation: NATO Training Mission-Afghanistan/Directorate Command Surgeon, Afghan National Police Hospital, Kabul, Afghanistan.
authors.forename: Safiullah
authors.initials: S
authors.lastname: Sadat
authors.affiliation: NATO Training Mission-Afghanistan/Directorate Command Surgeon, Afghan National Police Hospital, Kabul, Afghanistan.
authors.forename: Lewis
authors.initials: L
authors.lastname: Zirkle
mesh_terms: D000328:Adult; D000346:Afghanistan; D001134:Arm Injuries / Q000209:etiology / Q000601:surgery*; D001858:Bone Nails; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation* / Q000379:methods; D050723:Fractures, Bone / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007869:Leg Injuries / Q000209:etiology / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D061665:Time-to-Treatment; D016896:Treatment Outcome; D000067398:War-Related Injuries / Q000601:surgery