Dan, Heather, Jeremiah, Tory, Emma, Tye, Claire, Levi, Josie, Jane and Ethan

Saturday, October 13, 2012

Tools for the Toolbox

Patient walking the day after surgery, standing with Dr. Marakalala, orthopedic resident from Botswana training at Tenwek.

Young lady with bilateral femur fractures treated with SIGN nails.

Another patient, up walking the day after surgery.

Happy to have his leg fixed!

Another young man with retrograde SIGN nail.

16 year old boy with Russell-Taylor nail.

X-ray of retrograde SIGN nail.

Femoral Russell-Taylor nail.

Tibial Russell-Taylor nail.

Paul Whiting, orthopedic resident from Tufts, who visited Tenwek in March, presenting our data from Tenwek on open femur and tibia fractures.

Boxes and boxes of Russell-Taylor nails.

All-day job but totally worth it.

"Too-long" nails to be delivered to Cedarville team who will cut nails down to a more useable lengths.

The new orthopedic storeroom is underway! 

One of my most important jobs as a missionary orthopedic surgeon at Tenwek is to ensure that we have all the necessary implants and instruments we need to provide the best possible care for our patients.  Implants and instruments are to an orthopedic surgeon as nails and tools are to a carpenter…without them, our care for the poor here would be extremely rudimentary and subpar.

As the majority of our orthopedic work at Tenwek is trauma-related, we see an exorbitant number of femur and tibia fractures secondary to road traffic accidents.  The “standard of care” for these types of fractures is the intramedullary nail (a long rod placed down the center of the canal, stabilizing the bone while it heals).  At Tenwek, we have two major types of nails: SIGN nails and Russell-Taylor Nails.  Without getting too technical, both of these rods are extremely critical and essential (each with slightly different indications) for treating the numerous femur and tibia fractures we see at Tenwek.

My trip to the States began at the annual SIGN conference, where we presented data from Tenwek on open (bone through skin) tibia and femur fractures treated with the SIGN nail.  Since first introducing these nails to Tenwek in December 2008, just shy of 600 have been performed!  For every SIGN nail done at Tenwek and reported on the on-line database, the SIGN Company replaces these nails at no cost to Tenwek.   Thus, as I left the conference, I carried with me a duffel bag of over 50 lbs of nails and other tools for Tenwek.

After visiting my in-laws and two churches in Phoenix, AZ, I then flew to Indiana to visit our mission agency, WGM, and sort through a massive donation of Russell-Taylor nails provided by Hope Force International.  Donations such as these usually contain a number of “odd” sized nails, either too short or much too long to be used in the majority of patients (unless a dwarf or NBA player).   I segregated two 50 lbs duffel bags of the “choicest” nails (perfect size) for immediate delivery to Tenwek (thanks Todd and Bill!).  Also, I found over 300 nails, size 46cm or above (too long for our patients at Tenwek), which I brought to Dr. Timothy Norman, professor of Biomedical Engineering at Cedarville University in Ohio, who organized a student project to cut and re-machine these nails to more usable lengths.

After several other engagements, including a meeting with the executives of a major orthopedic manufacturing company in Warsaw, IN, I returned to Kenya with 10 checked bags full of orthopedic supplies (which, thankfully, ALL arrived and cleared customs with minimal questions).  And these supplies did not come too soon.  Just last week alone, I personally did 8 Russell-Taylor nails and “team ortho” did another 8 SIGN nails, all in people who would otherwise potentially be permanently lame without these implants.  Instead, these patients were up walking, even the day after surgery, and truly very thankful (see pics). 

These nails provide a significant, yet minority part of our total needs at Tenwek.  And we continue to trust God to provide.   I am humbled by the fact that God is the One who does the work…it seems the harder I personally try, the less fruitful the results.  On the contrary, the more we pray for His provision, the floodgates open.  Thanks again for partnering with us in serving the poor at Tenwek in Christ’s name.  We appreciate your prayers and support!

 Eph 3:20-21 “Now to him who is able to do immeasurably more than all we ask or imagine, according to his power that is at work within us,  to him be glory in the church and in Christ Jesus throughout all generations, for ever and ever! Amen.”


Mike said...


Great Work! Xrays look great, nice reductions. I'm sure in addition to being grateful for their legs being fixed, the patients know that Christ's love is behind those surgeries. I used the R-T nail in residency, haven't used it since, but those xrays bring back a lot of very weary memories. We're just starting at Kijabe Hospital, and would love to visit you some day at Tenwek. We're planning on being here for at least five years, so I'm sure our paths will cross.
Blessings, Mike Mara Kijabe Orthopedics marasafari.org

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