Senhor Eduardo was riding his tiny motor cycle down one of Angola’s “unimproved” roads when he struck a pot hole and landed on a boulder. What results was the injury in this X-ray above. Most concerning is that this fracture occurred five months ago. Eduardo was treated with 3 months flat on his back in traction to hold the bones in position for healing. This 1950’s style orthopedic management is usually successful. But in Eduardo’s case the fracture failed to healed.
Last night I took a break from my normal public health and primary care duties to assist our surgeon, Annelise Olsen, with an internal fixation of this fracture. Four hours later the bones were properly aligned with screws and a metal plate. Add a couple of months to heal, plus some physical therapy, and chances are that Eduardo will be once again be able to walk on this leg. He’s a very fortunate man, for such standard surgical orthopedic therapy is essentially unavailable in this nation.