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Doctor develops new way to treat fractures in children

Treating fractures can leave a patient with debilitating lifelong complications because of the tools used. Hip Spica table is making the treatment less painful and lessening recovery time

Evelyn Makena @evemake_g

Zecharia Kimengich has seen myriads of broken bones in the course of his 15-year career as an orthopedic trauma technician.

He has watched patients, particularly children get wheeled into hospital in excruciating pain and after undergoing treatment, leave with the fractured bones properly aligned and in the process of healing. Such days are some of his happiest.

Take for instance a three-year-old boy he treated last month. He had fallen from a second floor balcony while playing and severely fractured his legs. “The boy was treated and discharged on the same day and is now recovering at home,” says Kimengich.

Other days, however, he has seen children come to the hospital with broken limbs, endure the pain and fail to heal, but instead go home with deformities that debilitate them for life. These occurrences are devastating for the 35-year-old doctor who is passionate about treating fractures.

“For the longest time, the orthopaedic practice in Kenya, especially in public hospitals has relied on outdated methods to treat femur fractures.

Some rely on improvised tools such as jerry cans to support children and others simply hold the patient in their hands as another medical personnel aligns the bones and applies the cast on the limbs,” says Kimengich, who works at Kenyatta National Hospital.

The referral hospital, for instance, used a simplistic hip rest in treating factures for over 50 years. Reliance on these methods has led to misalignment of bones due to lack of stability and caused lifelong disabilities in many children. Besides, complications, which come as a result of misaligned bones necessitate surgery on the children leading to longer hospital stays and increased health costs.

These experiences motivated Kimengich to devise a solution to improve treatment of fractures. An innovation he came up with last year is changing how paediatric femur fractures are treated and significantly saving the cost of treatment.

He first introduced a wooden hip spica table to the hospital to replace the hip rest in 2015. “I came across the design at Kijabe Cure Hospital and decided to replicate it in KNH. It was more comfortable for the patients compared to the hip rest we had been using,” he says.

He later improved the model to include a cushion before later introducing a stainless steel version of the hip spica table. A unique extension incorporated into the design of the stainless hip spica table last year supports the leg of a patient instead of doing it manually.

“Initially, we required three medical personnel when applying the cast on a patient with fractured bones – one to hold the head, the other the legs as the third person applies the cast,” he says. But holding the legs oftentimes did not help achieve bone alignment due to lack of stability.

Use of the new equipment ensures that acute pain of a fracture is reduced. “It eliminates the need to pull the leg using a traction to straighten the bones, which is usually a painful process,” he adds.

The prototype developed in partnership with Dr Kamau Njoroge, orthopaedic trauma and knee reconstruction surgeon, KNH has effectively treated 100 patients in the referral hospital since last year. Patients like the three- year-old baby treated recently, do not have to undergo admission due to fractures as was the case before.

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