Orthopaedic Trauma Management in Developing Countries: A Narrative Review of Clinical Practices, Socioeconomic Challenges, and Healthcare Outcomes

Orthopaedic trauma imposes a disproportionate clinical and socioeconomic burden on developing countries, where rising injury rates intersect with fragile health systems and limited financial protection. This review synthesises evidence from 2015 to 2025 to examine epidemiological patterns, clinical practices, system-level constraints, and socioeconomic determinants shaping orthopaedic trauma outcomes in low- and middle-income countries (LMICs). Using a narrative-synthesis methodology and drawing from major global databases and grey literature, the review identifies persistent deficiencies across the trauma care continuum, including inadequate pre-hospital response, limited diagnostic capabilities, inconsistent surgical management, shortages of trained orthopaedic and rehabilitation personnel, and severely underdeveloped postoperative physiotherapy services. High rates of infection, malunion, non-union, and delayed functional recovery were found to primarily reflect systemic weaknesses rather than intrinsic clinical complexity. The unique contribution of this review lies in its integrated analysis of clinical, infrastructural, and social dimensions-an approach rarely applied collectively in LMIC trauma literature, thereby demonstrating how structural inequities and policy gaps drive preventable disability. The findings underscore the need for context-adapted treatment protocols, strengthened trauma workforce development, national trauma registries, expanded financial protection mechanisms, and coordinated multisectoral policy reforms. By providing a narrative and actionable framework, this review offers critical guidance for policymakers, clinicians, and global health stakeholders working to improve trauma systems and advance equitable, high-quality orthopaedic care in resource-limited settings.