Another bustling day in the operating theatre concluded with a bone fracture fixation surgery for an eight-year-old girl. Upon her admission to the emergency room, we performed an initial consultation and physical examination. We found out that she was originally from Sudan, injured in a traffic accident while fleeing the conflict. Her left thigh bore horrific injuries, with scraped-off skin revealing muscles, blood vessels, nerves, and multiple bone fragments. In essence, it was severely mutilated, and the situation was dire.
The accident occurred over a week ago near the Sudan-South Sudan border. Hindered by challenging transportation, incessant rain, and the remote location of the accident from our hospital (the only nearby hospital with surgical capacities for such cases), her grave injury couldn't receive immediate treatment. Consequently, her wounds were heavily contaminated and infected with bacteria, necessitating emergency surgery.
Our local colleagues asked about her background and the accident before the surgery, unearthing a heartbreaking story: She lived with her family in Khartoum, Sudan, until the outbreak of conflict claimed the lives of her parents and siblings, orphaning her overnight. To escape, she joined her neighbours and friends on an overloaded truck to South Sudan, which unfortunately met with an accident. Hearing such a story, my eyes turned red and felt like crying! This narrative was more dramatic than any TV series; it was hard to believe that such a young girl had endured so much pain if I didn’t encounter it in person.
I thought her tears had been due to her painful wounds, but the emotional pain of losing her family was probably far more intense.
I suppressed my tears and emotions, and told myself to do my best to treat her wounds and help her move forward.
Treating her wounds was a daunting task. We first removed all necrotic tissue and drained the infected purulent discharge deep down her wound. Then came the complex external fixation for the bone fracture.
Her femur had a complex fracture, with multiple bone fragments near the knee. Thus, I performed a cross-knee fixation, extending the fixator from her femur across the knee to the tibia for maximum stability.
It took me more than two hours to carefully place each pin and constantly adjust the fixator, trying to restore the bone to its original shape. I thought everything was completed, but I suddenly discovered that a part of her femur near the knee was still not in the best position. I promised to do my best for her, so even though I was exhausted, I insisted on adjusting, adding pins, and readjusting the fixator to reinforce every bone fragment.
Finally, after another half-hour, the result was "flawless". My colleagues concurred that it was the most perfect outcome, bringing smiles to everyone in the operating theatre and a sigh of relief to me.
But this is just the beginning. Ahead lies repeated wound care, future skin grafts, long-term rehabilitation, and psychological counseling. Nevertheless, I'm confident that she will recover well and walk with confidence in the future! Hang in there!
