Some reflections on the Paediatric orthopaedic module

Dr. Haynes Rasin, Buka, Bougainville

The week was very informative for me. I appreciated a lot of new knowledge gained in this section.

An example, that there is a condition called Blount’s disease which is similar to rickets. However, have certain features that a characteristic of each and thus differentiates from the 2.  In Rickets, there is diffuse bowing, but in Blount’s disease there proximal tibial deformity with medial beaking.  Also cupping, fraying and metaphyseal splaying are present in Rickets but absent in Blount’s disease.

 I also appreciate the knowledge to guide growth in children. The techniques involved which I think that if I can assist to do at least 2, I can confidently do them in our setting provided our theatre meets the requirements, eg. need for II. As the simple, basic plate and 2 screws for use can be readily ordered for such. The other new thing I learnt here was the presence of the bars that affect the bone growth and lengthening. Now I know how to identify the bars, also know the pathology they will cause. Perhaps, in the past I did see some of them but just passed them since I did not know what they signify.

I would have thought that perhaps, having the pediatric module for 7 days then having the exam on the following Monday morning would have given ample time for me to grasp the ideas and principles well before the exam.

I really appreciated the club feet talk. I used to have trouble understand the Pirani score and the serial casting methods that go with it. I now have better understanding at least to do the casting in the order required.  

The correct method of application of a hip spica on a traction bed.  Having the right equipment makes it easier to do the procedure.

So now the challenge is for me to submit proposals for 2 traction beds for our hospital, 1 for children and 1 for adults.

I sincerely thank the visiting lecturers for their time, effort and commitment to impart on us the paediatric orthopaedic knowledge.

Perhaps, an overseas attachment would reinforce further this knowledge as I would have the opportunity to observe, assist in such procedures and gain confidence in doing them.

Thank you

Haynes Rasin