Orthopedic Surgeon Reflects on Haiti Experience

Following the devastating earthquake in Haiti, several LifeBridge Health employees have volunteered their time and services to earthquake victims. Among these are physicians Shawn Standard and Albert Aboulafia.

An orthopedic surgeon and co-director of sarcoma services at the Alvin & Lois Lapidus Cancer Institute, Aboulafia traveled to Haiti from Feb. 3-7 to work with Project Medishare. Before he left, fellow orthopedic surgeon John Herzenberg sent over 50 pounds of donations that included soap and blankets.

An estimated 300,000 Haitians were injured in the 7.0 earthquake. Once Aboulafia arrived, there were roughly 140 adults and 65 children and adolescents in the Medishare tents who were awaiting treatment.

He worked at a breakneck pace, estimating that he performed 50 operations over a two-day period, including wound care, skin grafts, amputations and fracture realignments. When a severe wound is left untreated, infection can develop, leaving no choice but to amputate.

“I think we did a lot of good,” he says. “There, you could really make an impact. Would I fix a fracture different in Baltimore? Yes. But there were no lab tests, no blood. We did the best possible care that we could under the circumstances.”

One patient who sticks in his mind is a 90-year-old woman with a femur fracture.

“She understood the risks of surgery, and we were able to help her,” he says. “She had a place to go home to, and we were able to get her thigh fixed, put her into a wheelchair, and send her with relatives to go home.”

Aboulafia said he was lucky to have physical therapists, nurses, physician assistants, and volunteers who were dedicated to helping treat patients.

“Lots of times it was the people who were very much out of their element who excelled,” he says. “It was a tense and emotional time, but you saw a lot of people who were at their best.”

He hopes to return soon. To learn more about Project Medishare, click here.

Sinai Hospital doctor treats clubfoot patients from around the world

Every year in the United States alone, it is estimated that 4,000 to 8,000 babies are born with idiopathic clubfoot, a foot deformity that effects otherwise healthy babies.

Clubfoot is one of the most common birth defects. The heel and toes turn inward to the extent that it looks like the feet are upside down, with the soles pointed upward. Frequently, the blood supply to this area is abnormal. During infancy clubfoot does not cause pain. However, a child who is not treated will grow up to have a severe functional disability. They will not be able to wear shoes and the foot will eventually become painful, prohibiting participation in most sports and even certain forms of employment.

For decades, the long-standing medical solution has been surgery. But there is a better way.

John Herzenberg, M.D., is head of pediatric orthopedics at Sinai Hospital of Baltimore where every Friday is Clubfoot Clinic and where almost every child is treated with a non-surgical technique called the Ponseti Method, named for the Spanish pediatric orthopedic surgeon, Ignacio Ponseti, M.D., who invented it.

One of Dr. Herzenberg's patients is Richard Jr., son of Richard and Amparo of the Dominican Republic. When their local doctor recommended surgery to correct their son's bilateral clubfoot, the couple hesitated, thinking there must be a less traumatic option available. They turned to the Internet where they discovered the Ponseti Method.

Not one orthopedist in the Dominican Republic practices or has heard of this method. Fortunately, Richard had family on the east coast and driving distance from Dr. Herzenberg's clinic. Family and relatives donated to the cause and in a few weeks, they were on a plane for their first consultation and Ponseti casting at Sinai Hospital.

Over the next weeks, Richard Jr.’s parents saw a dramatic difference in the position of their child’s feet. After a few weeks of casting, a tenotomy was performed and Richard was put in final casts for three more weeks. Once he was ready for shoes, the family was able to return to their home in the Dominican Republic.

Richard and Amparo feel fortunate to have discovered the Ponseti Method just in time to avoid surgery. Now, two years later, their son is walking and running just like any other child his age that was born with normal feet.

The family recently returned to Sinai Hospital for a two-year follow-up with Dr. Herzenberg. Richard Jr.’s feet are perfect. He has to wear his special shoes with the bar at night-time for another year, but there are no complaints. Richard Jr. is a very active toddler who loves to play and make his feet take him everywhere he wants to go.

Click here to watch a 10 minute video featuring Sinai clubfoot patients and their families. To learn more about Dr. Herzenberg and the Ponseti method for treating clubfoot, visit our Web site and order a free DVD.