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3 rd  World  Orthopaedics Lee S.Segal, MD Phoenix Children’s Hospital
“ 3 rd ” world Definitions based on stage of economic and social development ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
2/3  world population “developing” (4 billion) Honduras – developing nation
Honduras ,[object Object],[object Object],[object Object],[object Object]
Health Statistics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Honduras ,[object Object],[object Object]
[object Object],[object Object]
Health Care Delivery ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
“ waiting room”
 
 
 
 
 
 
 
 
 
 
[object Object],“ The greatest republic of medicine knows and has known no national boundaries”  - Sir William Osler
 
Osteogenesis Imperfecta
OI ,[object Object],[object Object],[object Object],[object Object]
A 2000 Sesame Workshop newsletter mentioned Tarah's inclusion in the cast as one of the top ten significant ways Sesame Street has encouraged diversity:      1994 - Tarah Lynne Schaeffer joins the cast. Wheelchair-bound Tarah proves over and over again that all kids like to play, laugh, learn, and have fun! Her spunky presence has helped children learn about the needs (and strengths!) of children with disabilities
 
 
 
 
 
Why should you care? ,[object Object],[object Object],[object Object],[object Object]
Swine flu
Global health burden ,[object Object],[object Object]
Global health burden ,[object Object],[object Object]
Global health burden ,[object Object],[object Object],[object Object],[object Object],[object Object]
Local / cultural issues ,[object Object],[object Object]
Musculoskeletal disease ,[object Object],[object Object],[object Object],[object Object]
Supracondylar fracture/gunstock deformity
Global trends ,[object Object],[object Object],[object Object],[object Object],[object Object]
VDRR
VDRR ,[object Object],[object Object],[object Object],[object Object],[object Object]
VDRR ,[object Object],[object Object],[object Object],[object Object]
VDRR ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],After treatment  
 
 
 
The post-op ward
 
 
Chronic osteomyelitis ,[object Object],[object Object],[object Object],[object Object]
Weston PM: Care of the injured in the third world-What can we learn? Injury 18:297-303, 1987 ,[object Object],[object Object],[object Object]
Uganda Children’s Orthopaedic Rehabilitation Project 1996-2002 ,[object Object],[object Object],2001 Statistics
874 Surgical Procedures / 2001 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Why treat chronic osteomyelitis? ,[object Object],[object Object],[object Object],Norgrove Penny in Uganda
Why is chronic osteomyelitis such a major problem? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical presentation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
pathogenesis Sequestrum : avascular, harbor micro-organisms Involucrum : host response
Goals of treatment ,[object Object],[object Object],[object Object],[object Object]
Weston PM: Care of the injured in the third world-What can we learn? Injury 18:297-303, 1987 ,[object Object],[object Object],[object Object]
 
Weston PM: Care of the injured in the third world-What can we learn? Injury 18:297-303, 1987 ,[object Object]
Ilizarov /distraction osteogenesis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
 
 
Clubfeet ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
 
MF CAVUS HF VARUS MTA HF EQUINUS 4 components
 
 
1 2 3 4 5 SR 9 days old
Ponseti technique worldwide Avoid extensive surgery, untreated sequelae  + galosh sign
EA  1 week old
Ponseti technique ,[object Object],[object Object],[object Object]
EA at last follow-up
Orthopaedics  = “straight child”
 
72 o 51 o
 
 
 
 
Benefits volunteering 3 rd  world mission ,[object Object],[object Object],[object Object],[object Object],[object Object]
Share knowledge and skills
benefits ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
3 rd  world healthcare volunteering ,[object Object],[object Object],[object Object]
Appropriate, acceptable, sustainable ,[object Object],[object Object],[object Object],[object Object],[object Object]
"Give a man a fish and he will eat for a day. Teach a man to fish and he will eat for the rest of his life."
 
references ,[object Object],[object Object],[object Object]
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