| March 2012
- Case History - Nalwadda Juliet |
| Juliet was born
on 15th. January 2002. She was admitted to ACHERU on 26th.
November 2010. |
 |
| Juliet (May
2011), before & after surgery |
| Historical
background. |
| Juliet is the
fourth child in a family of five children and the last born of
her mother so far. Unfortunately the parents separated some
years back, Tracy (the mother), went back to stay with her
mother who is also single, so Juliet stays with her mother and
grandmother. |
| Last year she
was studying in primary 2 and this year she should be in primary
3 but due to the sickness she has not started yet. Last year
(2010) when Juliet was at school, she got a misunderstanding
with a boy over her age who gave her a direct hard kick on the
left lower limb around the knee joint. She never reported this
to anybody until after three days when the pain increased and
the limb had started swelling. She was taken to a nearby Health
Centre where she was given an injection. This made the situation
worse. They then tried some local healers who mismanaged the
fracture and the marrow was badly affected in the process. The
pain became very severe and the thigh swelled up. When the
father was informed of the situation, it happened that he had
heard of ACHERU so he directed them to here for treatment. By
the time we received the girl it had started discharging pus
seriously. |
| It was found
that the posterior aspects of the left femur had an immobility
to bear the weight. It had also developed Osteomyelitis with
pathological femur . She was admitted to the ward at ACHERU on
26th November 2010 and started on antibiotics and daily
dressing. Later she was Xrayed on the knee at CoRSU on 2nd
Dec.2010 and admitted to CoRSU on 9th Dec 2010. |
| Juliet was
operated on 15th Dec.2010 for ‘segestrectomy’ plus
external fixator. During the operation, there was a bone loss as
the fracture had developed Osteomyelitis. An external fixator
had to be applied to let the bones grow properly to cover that
gap. |
| After 11 days
stay at CoRSU she was discharged back to ACHERU for treatment.
She is now on a daily dressing. She has a great improvement! No
more discharge even the swelling disappeared. |
| Juliet was
re-admitted at CoRSU on 18th April 2011 for a review on her
chronic Osteomyellitis. She went through a sequestrectomy
operation on 18th April 2011. They also did a wound exploration
and screw adjustment on 20th. April 2011. Some particles of dead
bone were removed. During that time a blood slide for malarial
parasites was taken and it gave positive results, she was given
anti-malarial treatment. |
| Daily wound
dressing and physiotherapy done together with some antibiotics
and analgesia. She was discharged on 21st.April 2011. |
| After
discharge, we continue with daily dressing at ACHERU. |
| The sites of
operation have now healed but some sinuses have re-appeared and
the area in the first operation site has started oozing again.
Dressing continues. |
| Update
received 31/7/2011 |
| Juliet was
taken for a consultation clinic at CoRSU on 26th May where an
x-ray showed a non union of the femur - a change of fixator was
planned for 13/6/2011. |
| This time they
changed to an Illizarov. |
| She spent 13
nights in CoRSU. She was given a compensation shoe and is now on
daily dressing and antibiotics. |
| She is happy
with great improvement. |
