Wednesday, June 15, 2016

Fix what was "broken"

This boy's mother brought him to clinic with little to no use of his left arm. He is 11 years old and broke his arm a few months ago playing with his friends. The local physician and hospital provided care for him, resetting his bones and casting him. The follow-up x-ray, in the cast, shows the quality of the resetting. The bones reset crooked, causing the nerves to be damaged, pain, and little to no movement. What occurred next would seem barbaric to some, but life changing to others. Bac Si Ha decided he would have to re-break the arm at the place where it healed inappropriately. After he would reset it straight, make a splint to stabilize it and confirm with another x-ray.
I was expecting loud yelling, crying pain, and screaming during this procedure.
After injecting about 20 ml of lidocaine 1% into the surrounding tissue and muscles, Bac Si Ha starting to manipulate the boys arm. A few winces, but not a single tear fell from his eyes as the manipulation became more rigorous. Finally, and suddenly, I heard a pop. Bone re-broken. I assisted in the splinting of the newly reset arm with four random bars of metal from our prosthetics supply and tightly wrapped medical gauze and bandages. All the while, the team watching the procedure looked more uncomfortable that our brave young man!!!
A reconfirmation x-ray showed a better reset. We provided the local clinic instructions for follow-up in the next few days. Our hope is that this will set normally, providing the patient with better range of motion, less pain, and proper use of his arm.
Your stronger than most ban toi!! (my friend).

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