Club foot clinic today

More and more opportunities keep coming up here at the hospital and I am loving it. 

So every Monday one of the physios does a club foot clinic but he has been gone for 4 weeks and just came back last Friday. The clinic is in the theatre (OR section of the hospital). During the clinic I learned about how they diagnose and categorize the types of club foot from the Physio. After a few patients the only Orrho doctor in the hospital came in to the clinic. He treats all patients but has a set time to do club foot on Mondays. He has been practicing for 26 years and was very interesting to speak with. He teaches the Ponsetti Method of club foot treatment all over Ghana. Working on a few cases with him and talking about the biomechanics and lower extremity concept was very enjoyable and pushed my thinking.

While at CHKD on my last placement I did serial casting and AFO casting and learning a lot so I felt comfortable jumping right in. There are a few differences between serial casting here at and home. Here they only use one layer of padding and we use multiple at home, here they use plaster of Paris as the cast and at home use fiberglass. I got to do one cast for a patient at the end of the day with the ortho doc.

The doc is at the clinic to do Achilles' tendon releases if he feels it is necessary for a patient. Today he did one and I got to watch and he walked me through the entire procedure. There is a huge difference in standards of sterilization here compared to home. He also did not stitch up the incision but applied gauze and wrapped it in the Ponsetti casting. I asked him about the need of stitches for healing and risk of infection or worry that the incision cannot be examined for proper healing. He stated that the babies he has worked on heal fine and quick without stitches. I was still very worried about this method.

Patient before the second casting (her mother told me to take a picture so of course I took the opportunity) 

At the end of the day I thanked the doctor for his time but also spoke to him about the young girl I saw last week with the hard boney block in elbow flexion and was left in the cast for 9 weeks. It was a very professional conversation and felt that it went very well.