Honduras: Day Three

Source: Blog Post

Monday… Day 3 at La Providencia, Day 2 of surgery.   Our day started with flexibility once again when our first patient failed to show up.  Due to many family issues and transportation difficulties, we knew the patient was coming.  We simply adjusted our plan and moved forward.  We completed five cases today, including a closed reduction and pinning for a distal both bone fracture, a valgus osteotomy for supracondylar malunion, tendon transfers for a child with spastic quadriplegia, an open reduction for a proximal radius malunion and a distal tibia ORIF for nonunion who had been previously treated by another orthopedic mission team.


One of our more challenging cases was a 7 year-old boy that we saw during screening last year with a supracondylar malunion and a 35 degree cubitus varus deformity.  We were unable to complete his surgery because of the lack of fluoroscopic imaging.  He returned this year and we were excited to be able to help him.  Hand surgeon Apurva Shah, MD MBA and fellow Jonathan Katz, MD performed an ulnar nerve transposition and a lateral closing wedge osteotomy.  Three pins were placed to hold his osteotomy and he will remain in a cast for 6 weeks after surgery.  Additionally he had a custom orthoplast splint formed by OT Meagan Pehnke in the OR which will serve as a removable splint during his recovery.


We have traveled with a wonderful and skilled surgical team.  The team consists of two nurses from CHOP (Lynn Ann Gregorowicz and Michelle Friday), three nurses from University of Iowa (Paula Woods, Linda Wilson, Sandy Cox) and surgical technician Lynn Burleson from the University of Iowa.  We have asked them to share their thoughts on participating in the mission and the challenges they have encountered.


“From organizing supplies to sterilizing surgical instruments while also anticipating the wide variety of cases to tackle, it has been a busy but successful week thus far.”

The nursing team is a mix from Philadelphia and Iowa, all with different levels of experience and backgrounds, yet working together seamlessly to provide the best care possible.   


Today we took care of a six year old child with an impending proximal radial malunion, following forearm re-fracture, who had foregone other procedures.  He and his family had many concerns and were tearful when informed he needed to have surgery.  “With the help of all the nurses, anesthesia, occupational therapy and surgical team, we collectively eased his and his family’s fears and gathered the appropriate plan to treat his injury.  Seeing him so calm and smiley going into surgery and how well his procedure went has really been a highlight for all of us, and the week is still young…..”


“Nothing you do for children is ever wasted.”  Garrison Keillor