By Desire Uzochukwu
A leading orthopaedic surgeon, Dr Adedamola Dada, has warned that a technically successful surgery does not necessarily mean that a patient has recovered, stressing the need for multidisciplinary care to restore trauma victims to productive lives.
Dada, Consultant Orthopaedic Surgeon and Chief Executive Officer, Redeemer’s Health Village, Ogun State, said a fracture could unite successfully while the patient remained unable to work, feed his family or reintegrate into society.
He spoke while delivering the keynote lecture, “Multidisciplinary Approach to the Management of Musculoskeletal Disease,” at the 47th Annual Scientific Conference of the National Orthopaedic Hospital, Igbobi, Lagos, NOHIL.
The conference had the theme, “Multidisciplinary Team Care in the Management of Musculoskeletal Diseases,” with “Burn Injuries” as the sub-theme.
Dada said the traditional approach, where an orthopaedic surgeon treats an injury and subsequently refers the patient to other professionals, was inadequate for complex trauma cases.
“Technically successful treatment does not always mean recovery. A technically united fracture does not mean that the patient has fully recovered.
“The union of the bones is not the same thing as restoration of life. What multidisciplinary care targets is actually the restoration of life.”
He illustrated the point with the case of a young man who survived a serious road traffic accident involving multiple fractures.
According to him, although the patient’s fractures might be successfully fixed and X-rays show good healing, the patient could lose his job and remain unable to support his family.
“The surgery may be successful, but the patient may still be unable to work independently for some time. Nobody may be worried about how he is going to feed himself and his family.
“He may even become depressed. So, at the end of the day, to us as surgeons or health workers, the surgery is successful. But in truth, ladies and gentlemen, is that surgery truly successful?” he asked.
Dada said modern healthcare should place the patient at the centre, with surgeons, nurses, physiotherapists, nutritionists, anaesthetists, pharmacists, psychologists, social workers and other professionals jointly planning treatment from the outset.
He also stressed the importance of involving patients and caregivers in treatment decisions.
“The patient is not a wood log. We are planning for a human being, and that human being has a lot of factors , social factors, economic factors, family factors, that affect such patients,” he said.
Dada identified poor communication and the tendency of healthcare professionals to work in silos as major barriers to effective multidisciplinary care.
He said leadership commitment was also essential, urging healthcare institutions to develop clear protocols and standards that promote teamwork.
“The team must communicate in a free manner, not in a junior-senior manner,” he said.
Earlier, the Head of Clinical Services, NOHIL, Dr F.C.N. Nwachukwu, who represented the Medical Director, Dr Wakil O. Lawal, declared the conference open.
Nwachukwu said the theme was particularly relevant because complex injuries could no longer be effectively managed by one professional.
“Back in the days, it was largely a one-man affair, where one individual would manage injuries from beginning to end. But over the years, things have changed. Today, there is no single individual that can manage complex injuries alone,” he said.
He added that even simple injuries could have better outcomes when managed by a coordinated team.
The Chairman of the Local Organising Committee, Dr Oladimeji Ranti Babalola, said the conference was designed to examine critical healthcare challenges and develop innovative solutions suited to Nigeria’s practice environment.
He said multidisciplinary care could promote timely and comprehensive assessment, holistic treatment and improved outcomes, but acknowledged challenges including delayed presentation, inadequate equipment and low health-insurance coverage.
Also speaking at the conference, Consultant Plastic Surgeon, University College Hospital, Ibadan, Dr Ayodele Iyun, raised concern over the growing burden of burn injuries, particularly those linked to domestic gas explosions.
Iyun said burn care also required a coordinated team involving surgeons, nurses, nutritionists, physiotherapists and psychologists.
He urged Nigerians to use running water as first aid for burns, warning against the common practice of applying toothpaste, eggs, oil, butter or baking powder.
“If someone has sustained burns for whatever cause, what you should do is water. Running water usually should be for about 20 minutes,” he said.
Iyun also called for greater public education on domestic gas safety, noting that gas explosions could cause extensive burns and inhalation injuries that may rapidly become fatal.
He said preventing burns remained preferable to treating their often devastating consequences, while hospitals needed organised multidisciplinary teams capable of managing severe cases when prevention failed.
