Coya, Peru - April, 2010

Team Type: Children's Orthopedic

Campaign Summary: About 30 patients were seen, two surgeries were completed, and two cast changes were done under anesthesia.


Sponsors:
Americares, Stamford, Connecticut
One Child at a Time, Salem, Oregon

Team Members:
Dr. Kim Geelan, Anesthesiologist
Dr. David Shaw, Orthopedic Surgeon
Rita Shaw, Assistant

Narrative:
The purpose of this trip was to provide routine follow-up care on the patients from our January, 2010 trip. It was a whirlwind weekend. We left Friday, April 9 and returned Tuesday, April 13th.

We packed for doing a femur surgery on Roosevelt and doing cast changes under anesthesia. We ended up doing all the cast changes, an additional hip surgery, and triaging more patients.

Upon our arrival we were happy to find that the January flooding had subsided and that repairs were in progress, especially with the progress that had been made on the bridge connecting Pisac to Cuzco. Yet, the flooding's scars and mudslides remained. Please note the before and after flooding pictures of this town in the Urubamba Valley.

We saw most of the children we had done surgery on in January. There were no infections and no hardware problems.

During the triage and surgeries we were assisted by Dr. Dan and Megan Banigan. Dan is a family practice physician in New York who was able to assist Dr. Shaw during surgery. Dan and Megan were both excellent translators and helped fill in for Sandy and Guido Del Prado, the Directors and Founders of the Kausay Wasi Clinic, while they were in Florida.

Roosevelt, pictured with Dr. Shaw, was doing great. All the osteotomies are healing nicely, but three of the four were still a little tenuous. Dr. Shaw decided that they all better be healed well before femoral osteotomies are performed. Roosevelt was put in short walking casts and is now ready to start physical therapy.

We saw Maria Elena (dressed in black with Dr. Geelan) who had a total hip replacement in January. She was doing well with only a slight limp due to weakness of her muscles. This weakness will be remedied by physical therapy. She is pain free for the first time since her injury several years ago.

Vicky, who had an open reduction and Salter on one side of her body and a Psoas Tenotomy and closed reduction on the other side, had dislocated in the cast. An open reduction was done on the hip, but there were no hip instruments and pins so a Salter was not performed. (She may need one on a later trip.) She looked great a day after surgery and was happy to receive Dr. Geelan's fruit snacks.

Carmen, a nine year old girl from the flood-affected town shown on this page was brought in by her mother. She had a dislocated hip. She was initially put on the list for our visit here next year. Then it was decided they needed something positive in their lives now. So a femoral shortening and an open reduction was performed. She's pictured walking to the operating room for her surgery. During the procedure improvisations with instruments had to be made like using an ASIF plate as a retractor. Next year she will need a Chiari operation.

When Juan Diego was examined, he was still prone to dislocate his hip despite being in his cast for six weeks. A cast change was performed with the entire team helping out. In six weeks he will be put into his brace that was made for him during the January trip.


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