By Quraysha Ismail Sooliman
Simon Malatjie is grateful for the opportunity to have a bone deformity corrected.
In a few minutes he will be admitted to theatre at Netcare Unitas Hospital where orthopaedic surgeon Dr Frank Birkholtz will fit a Taylor Spatial Frame device to correct damage caused when a wooden door fell on him, crushing his leg.
Simon has a malalignment of about 20 degrees on his ankle from the accident.
Confident hands make an incision and then clamp the wound open as the scissor-like self-retractor holds the skin apart.
Birkholz explains the procedures and technique he is using via a video camera in the theatre, allowing visiting doctors the opportunity to learn from the procedure.
The Taylor Spatial Frame is an external fixator used by orthopaedic surgeons to treat complex fractures and bone deformities.
Unitas recently became the first facility in Africa and the third in the world to be granted the privilege of hosting the Taylor Spatial Frame visiting surgeon programme.
As the skin is lightly burnt around the wound, the disinfected theatre air is temporarily polluted. The large pin is removed and the needle and thread moves rapidly to sew shut the skin.
A few staples to reinforce the seam and, finally, the superglue of surgery, "dermo-bond", is applied.
Birkholtz, whose eyes shine with enthusiasm as he addresses the visiting doctors, started his training at the Deformity Correction Clinic at Steve Biko Academic Hospital and regularly donates used frames to the hospital.
A Taylor Spatial Frame procedure costs approximately R80 000 and requires extensive patient participation.
Dr Fred Babumba, from Uganda, is an orthopaedic surgeon from the Hibiscus Private Hospital in Port Shepstone.
He queries the insertion of the two wires.
"The technique is versatile and will benefit many, but the cost factor is the hurdle the patient needs to cross," he adds.
By training surgeons from other hospitals, Birkholtz believes he can contribute to the less fortunate.
"Collaboration and the sharing of knowledge among local and international health care practitioners helps to improve the health care provided to all of our communities," he said.
Dr Chris Snyckers and Dr Nick Cocciuti are visiting orthopaedic surgeons from the Steve Biko and Chris Hani Baragwanath hospitals.
As they discuss the angle of the fracture on the x-ray, a drill pierces the flesh above Simon's ankle and two aluminium rings, which are connected by six, carefully marked struts, are screwed tightly into place.
"Information about the patient's bone deformity is inserted into an advanced web-based computer application," says Birkholz.
"The software then interprets the information and the Taylor Spatial Frame is adjusted according to the readings.
"The bone deformity correction can take four to six months and once corrected the frame is left on the leg till the bone heals.
"The Taylor Spatial Frame represents an important technological development for limb reconstruction and deformity correction and is used with considerable success throughout the world.
"While it is not a new device, the frame and the technology around it are constantly evolving, and it is important for medical practitioners to stay abreast of developments.
"The procedure is used in both adults and children, but is more common in young males who come in with severe trauma injuries."
The Taylor Spatial Frame was invented by Dr Charles Taylor and is manufactured exclusively by Smith & Nephew in South Africa.
Almost 300 of the frames are fitted annually in South Africa.