Bone Infection

One of the first patients who arrived in clinic was a 40 year-old male who could barely walk to the intake table. He was assisted by his mother on one side and crutches on the other. At first our intake team didn't think much of it, considering the majority of our patients need assistance because of orthopedic pains. While I was setting up the medical room getting ready for a full day of patients, one of my students came in to inform me that we had a patient with a leg infection and we should see him immediately. We are used to seeing infections on this mission, however, what I saw when he walked through the door made me literally gasp. This patient was in an accident 3 years ago and broke his femur. What would occur in the US is that a metal bar would be placed in the femur to assist with the healing and provide stabilization. Well, what the doctors did here, was place screws through the lateral side of his leg and secure them with an external bar sticking out about 2-3 inches. He told us that this surgery occurred 3 years ago and he has had an active infection on and off ever since. He would take a short course of antibiotics but would never follow-up with any practitioner. To say the least, it took my breath away, just to witness the type of medical care that some of our patients receive. I looked at his face, which was one of dire need for help, and it broke my heart. Short of removing the implants and placing a "actual" replacement bar in his femur, we could only provide so much help. We cleaned, debrided, and and prescribed a long course of antibiotics. We will follow-up with him in a fews days to evaluate and clean the incisions again. Hopefully with our treatment, we can prevent him from one day soon being an amputee that we have to fit in years to come.