GUATEMALA: DAY SEVEN

Source: Blog Post

What a day! The efficiency of the team was incredible with turnover times lasting less than 10 minutes and cases being completed with alacrity. The surgical team had quite the case load with 13 cases planned, but then two patients were added-on to the end of the day! It really was a testament to the group’s willingness to give as much back as possible in that the two add-on patients were screened, evaluated by a surgeon and anesthesiologist, received x-rays, and readied for surgery within hours. Room 1 started the day by teaming up to pollicize a two-year-old patient’s index finger, while the crew in Room 2 removed implants and released contractures about the elbow of a 15-year-old patient who had underwent fixation of her radial neck fracture and had limited range of motion from 45-100 degrees in passive flexion/extension and supination limited to 10 degrees. Both cases turned out wonderfully with a beautiful new thumb and full range of motion returned to the elbow!

Room 3 removed a golf-ball sized mass en-bloc that was deep to the triceps. Thankfully for the patient, this mass was a benign vascular malformation.

One of the add-on cases was a 17-year-old patient who had been treated with percutaneous pinning of a radius and ulna shaft fracture. Unfortunately, he went on to heal with a 90-degree rotational deformity of the radius with the radial bow angled volarly resulting in limited pronosupination.

He underwent correctional osteotomies of both the radius and ulna resulting in near-full range of motion.

The other cases for the day were as follows:

  • Valgus distal humerus osteotomy for varus malunion from supracondylar fracture (x2)
  • Humeral rotation osteotomy for brachial plexus injury
  • Syndactyly release (4 webspaces)
  • Thumb polydactyly excision (x2)
  • Proximal row carpectomy with wrist fusion
  • Trigger thumb release
  • Stiletto flap for clasp thumb

While the surgical team was working hard, the hand therapists were again spread out across Guatemala City helping teach hand therapists and therapy students and also treating patients perioperatively at the Moore Center. A team went back to the Roosevelt Hospital Burn Unit to give a lecture, while two therapists gave a preparatory course for the Certified Hand Therapy Examination.

As a small portion of our team was departing the next morning, we shared a wonderful dinner together and recounted our most meaningful and touching moments from this trip. Most stories centered around the wonderful patients and people of Guatemala or the bonding of our mission’s “family.” There was many a teary eye from hearing such moving stories.