Haiti
Update: Surgery Program Update, Etienne and Choisil
March 29, 2013
Dr. Patrick Dupont
Etienne Cherly, 12 years old
PATIENT HISTORY
Injury sustained during the earthquake in January 2010 as the house she was in, collapsed to the ground. Étienne was on the balcony when the earthquake happened and fell one floor down. Later immobilized in a cast and relocated to the province. No follow-up on the injury and non medical cast removal ensued.
Could not find a facility to evaluate and address her problem after the earthquake, where she was located.
DIAGNOSIS
Evolutive Genu varum with post traumatic Femur, medial growth arrest and limb discrepancy of ~4cms
PROPOSED TREATMENT
Femoral correction osteotomy & external fixation
TREATMENT GOALS
Correction of current deviation to re-align the limb + external fixation and possible subsequent limb lengthening (2ndoperation)
PREOPERATIVE IMAGING
Severe intra-femoral medial deviation and limb length discrepancy
POSTOPERATIVE RESULTS
Improvement of knee joint alignment
Reduction of limb discrepancy to 2 cms
Better range of motion of the knee
External fixator still in place – To be removed in January
EX FIX removal done and normal ambulation reprised two weeks after. Small 1.5cm compensation wedge used to correct remaining discrepancy.
Choisil Stevenson, 5 years. old
PATIENT HISTORY
Little boy presenting with TIBIA VARA (congenital deformity inducing severe bowing of the upper tibia).
Lives in a provincial town and started to consult at St Vincent in 2012 after seeing many medical doctors and empiric healers. After many unsuccessful methods, he started consult at St Vincent in July 2012.
DIAGNOSIS
Severe left Tibia deviation
(Pathologic Genu valgum)
PROPOSED TREATMENT
Tibia corrective osteotomy
TREATMENT GOALS
Realignment of the lower limb and correction of the deformity
DATE OF OPERATION
January 2013
PREOPERATIVE EVALUATION
Unreduced spontaneously left Tibia Genu valgum
POSTOPERATIVE RESULTS
Re-alignment of the lower limb
Staples will remain in place until complete bone healing
Cast removal expected at 8 weeks post-op
No follow-up X-rays are yet available because of difficulty to come back for follow up visits in Port-au-Prince
