Thursday, March 26, 2015

Day 4: Second Day of Surgeries

Our first surgery today was a patient the team treated on multiple previous missions. As soon as we saw him in the patient waiting area, Dr. Nyska started his exam since he's been working with him for so long. 

When the team first met him ten years ago, he was four years old and unable to go to school because he couldn't walk due to a significant deformity (tibial agenesis) of his right leg. The doctors performed his first surgery -- a procedure to transfer his fibula to his tibia -- during that mission. By the time they returned two years later, he was speeding around his house with a soccer ball as you can see in the video. 


Now 14, the IEP doctors have done additional procedures on subsequent missions. He walks with a prosthesis, but it's amazing to see how far he has come since then.


We started with seven surgeries on the schedule, but one of the afternoon surgeries -- a 53-year-old woman with right drop foot cancelled her procedure.

The more specific medical details...

Patient 1: 14-year-old boy
  • Return patient, first seen 2005 at age 4
  • Right lower extremity deformity; agenesis of tibia, grade II
  • Procedure: Right double osteotomy of the tibia with closing and opening wedge
Patient 2: 60-year-old man
  • Right sub-talar (heel) joint painful from previous surgery
  • Procedure: Removal of screw from previous surgery
Patient 3: 7-year-old girl
  • Inverted forefoot with equinus
  • Procedure: Right calcaneal-cuboid resection and gastroc recession and medial release
Patient 4: 8-year-old boy
  • Equinus on right
  • Procedure: Gastroc release
Patient 5: 31-year-old
  • Right plantar flex 1st ray/hindfoot instability; Left equinus with cavus foot
  • Procedure: Right triple, first-ray dorsiflexion osteotomy, and Steindler stripping; left tendo-achilles lengthening with Cole osteotomy
Patient 6: 5-year-old boy
  • Bilateral equinus
  • Procedure: Bilateral gastroc recessions

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