Improving Fracture Care Begins by Ensuring Timely Treatment: Critical Barriers in Emergency Care Systems in Low-Resource Settings .

Global injury rates continue to outpace many major diseases, driven largely by rising road traffic accidents in low- and middle-income countries. Despite international targets aimed at reducing these harms, timely access to surgical care remains a major challenge. Recent data from a large multi-country study show that most open-fracture patients are unable to reach a treating hospital within recommended time frames, with interfacility transfers emerging as a major source of delay. These findings highlight critical gaps in emergency transport systems, diagnostic capacity, and referral pathways. Strengthening EMS networks and improving transfer protocols may offer meaningful opportunities to reduce preventable morbidity and mortality.