Fixing fractures, rebuilding lives: frugal innovation in trauma care

A low-cost device with life-changing potential 

The AEFIX is a radically affordable low-cost external fixation clamp developed by SONA Global to treat open fractures and complex musculoskeletal trauma—often one of the first and most urgent steps in trauma surgery. Traditional gold-standard clampscan cost upwards of US$500 each. Since a full external fixation system typically requires six to eight clamps in addition to rods and pins, the clamps alone account for over 80% of the system’s total cost. 

AEFIX costs less than 2% of these popularly used clamps. Researchers at the Harvard Global Orthopaedics Collaborative and the Department of Orthopaedics, Beth Israel Deaconess Medical Center – a Harvard-affiliated teaching hospital - stress-tested the AEFIX device and found that it performs on par with, or better than, current gold-standard alternatives—if the prescribed technique adaptation guide is followed, including the addition of a neutralising stabilisation rod. 

Its lightweight, aluminium construction, cost-effective design, modularity, and potential for local manufacturing make it particularly suited to resource-constrained settings. Since May 2025, this innovation is in its next testing phase which consists of a randomised clinical trial conducted at the Jaffna Teaching Hospital, where 100 patients are being enrolled — half treated with the AEFIX clamp and half receiving standard care.  

“Since the trial began, the overall response has been positive. Patients and their families have shown a real willingness to participate, especially after understanding the potential benefits. Clinicians too have responded well—sharing practical feedback on ease of use and performance, which has been invaluable for ongoing monitoring.” says Ajeetha Jeevarajan from Regional Collaboration Centre (RCC) in Jaffna.  

A new model of innovation for global health   

Treating open fractures is one of six key surgeries that experts say every country needs to be able to do, as a basic part of having a working healthcare system. Yet in many low-resource settings, the tools required to perform them safely remain prohibitively expensive or simply unavailable. Globally, an estimated 5 billion people still lack access to safe, affordable surgery and anaesthesia when needed. 

From local pilot to national possibility  

If the AEFIX clamp is proven to work as well as current treatments, it could open up a pathway towards approved use across Sri Lanka and may come under consideration of the national procurement system for health service equipment. The pilot study in Jaffna is designed to verify the safety and efficacy of the AEFIX clamp, while also comparing how it performs against the usual care for this kind of injury. 

Local production could further reduce costs, supporting the integration of this innovation into routine surgical care. The initiative has already attracted attention from regional leaders, including the former Minister of Health for the Northern Province, and was recently showcased at the World Health Summit 2025 in New Delhi. 

Beyond Sri Lanka, the ambition is to extend AEFIX to other countries with similar unmet surgical needs. “This kind of innovation doesn’t always grab headlines,” Assoc Prof Jonas reflects. “But it’s the kind that changes lives—quietly, affordably, and for the better.”

Charting the future of affordable care   

This isn’t just about hardware. It’s about giving people the chance to heal properly and get back on their feet—literally and financially. 

Trauma kills more people each year than HIV, malaria, and tuberculosis combined. Yet, access to timely, quality surgical care remains among the most underfunded areas in global health. By tackling the cost barrier head-on, projects like AEFIX show how targeted innovation can drive equity and efficiency not only in developing countries but in health systems everywhere. 

“If patients can recover faster and return to work, it reduces strain on hospitals and helps families stay economically and socially stable. That ripple effect—economic, social and health-related makes innovations like AEFIX incredibly meaningful in our context.” Ajeetha Jeevarajan from RCC in Jaffna notes. 

The AEFIX project is just one part of a growing ecosystem of solutions aimed at strengthening surgical systems in low-resource settings. Another promising innovation developed by SONA Global is VATARA, a negative pressure wound therapy pump also costing <2% of the industry standard commercial models. Designed to support wound healing in patients with severe soft tissue injuries, VATARA has already shown excellent clinical results in a trial in Cameroon and is now being positioned for regional testing and adoption in Asia.  

By investing in smart, frugal innovation that preserves quality of care, we are working to reshape how surgery is delivered, prioritising equity, dignity and access. The future of global health innovation lies not only in what we invent, but in how far we go to ensure it reaches those who need it most.