Nepal: Day Two

Source: Blog Post

Hutch’s morning lectures have included congenital hand abnormalities and frostbite. Interestingly, Kirtipur sees few cold injuries; these are handled initially at the trauma center.

Dr. Shilu and Dr. Kiran were ready for the day.

Yesterday was hand clinic. We saw 26 patients for pre and postoperative care. Prior to Dr. Shilu establishing this clinic, care was very disorganized and inconsistent. Now patients are seen in a more formal way, with four physical therapists actively involved.

The medical record system and language issues often made care more difficult. Still, we arranged treatment for a patient with symbrachydactyly, and followed up on injuries secondary to major electrical injury.

Operative cases included a web space contracture release with local flaps and a boutonnières deformity pinned in the WALANT room.

The most interesting case was that of a butcher who had previously mangled his hand in a grinder accident. He wanted to be able to hold a pencil, so Dr. Shilu performed an arthrodesis at the MCP joint and pinned the digit in the place of desired function.

Alan scrubbed on the unfortunate case of a young man with an electrical injury requiring forearms amputation.

Dr. Shilu and her husband, a urologist, treated us to a traditional Newari dinner. Both the food and company were excellent!