ABSTRACT
Pediatric orthopedic surgery in humanitarian aid is conducted mainly in cooperation with emerging countries. Each mission is different, and depends on numerous parameters such as the country, the frequency of such missions, the pathologies encountered, the local structure and team, and the non-governmental organization (NGO) involved. Pathologies vary in etiology (tuberculosis, poliomyelitis) and severity. Each mission requires the presence of an experienced surgeon. Working conditions are often rudimentary. Surgical indications should be restricted to procedures that are going to be effective, with minimal postoperative complications, without any surgical "acrobatics". Teaching should be in association with the local university, and adapted to local needs. Mission objectives need to be realistic. Surgical indications should be adapted to local conditions, and the surgeon needs to be able to say "no" to procedures involving undue risk. The surgeon on mission should cooperate with local teams and be able to adapt to unusual situations. Assessment of results is essential to improving efficacy and evaluating the success of the mission.
Subject(s)
Altruism , Medical Missions , Orthopedics/organization & administration , Pediatrics/organization & administration , France , Global Health , Humans , Societies, Medical/organization & administrationABSTRACT
The authors wish to show the difference between hand burns in children and adults. Throughout a group of 201 observations, they confirm the predominance in children of hands burns on palmar face. For them, the directed cicatrization by fat dressing associated with splints set in position of maximum cutaneous stretching is the first therapeutic. The early tangential excision and grafting is suitable only in rare indications, for instance in electric burns.
Subject(s)
Burns/surgery , Hand Injuries/surgery , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Infant , Male , Tissue TransplantationSubject(s)
Anesthesia, Epidural , Orthopedics , Adolescent , Anesthesia, Inhalation , Bupivacaine , Child , Child, Preschool , Humans , Infant , LidocaineABSTRACT
Two replantations of nearly completely amputated limbs are presented. In both cases there were young children. These two success explain the necessity of limb preservation if the nerve integrity is respected. In the young child, the vital risk is lower because of the vessels, the local immunologic defense. The bone union is normal. The vascular suture with venous grafts is made with simple interrupted sutures rather than with continuous over and over sutures. The fasciotomy avoid a compartment syndrome. The bone graft growth is unforeseeable. These two case reports are nearly experimental because of the young age of the patients.
