From Kaye E. Wilkins, MD: Some buildings had completely collapsed next to ones that were intact. Many temporary tent cities had been established as the citizens were afraid to stay in their previous dwellings …[at] Hôpital de la Comunitie Haitien (HCH) in Petion-ville, Scott C. Nelson, MD, and his team had established an orthopaedic surgical treatment program; for the first few days, they were operating literally 24 hours/day. Almost all of the surgery being performed was of an orthopaedic nature … The top priority in the first few days was to save lives and limbs. … Many of the fractures were stabilized first with casts before undergoing surgical stabilization. Initially, there were no devices to remove these casts in the surgical area. The first casts were removed carefully with a mallet and an osteotome (a chisel-like instrument used to shape bone). … The rebuilding effort has just begun. Most of the acute injuries from the earthquake have been stabilized. This has created a gigantic reservoir of individuals who will need the extremely vital but less glamorous post-treatment care. Thus we all need to be committed to the long-term needs of these victims.  

From Michael Vitale, MD: I went down with a loose group of organizations, including the United Aid Foundation and basically had a mobile team supported by 5 anesthetists and 2 nurses. At the beginning of the week, I was overwhelmed placing quick ex-fixes at hospitals on the Dominican Republic side of the border and then in Jimani on the border. Lots of neglected/ open long bone fractures but this slowed considerably even in 7 days. As we exit the phase of fracture care, the challenge will focus on limb salvage for open tibias, conversion of suboptimal ex fixes, and wound and amputation management.   

From Brian S. Parsley, MD: We completed 70 surgical procedures for the week but we touched the lives of many more. As the week progressed, we were even more efficient than at the beginning. By the 8th day, we are all aware that our trip would be ending but the work in Haiti is only beginning. … Where do we go from here? Currently we are managing broken bones and many open wounds, trying to salvage as many as possible. There is a need for hand, foot, trauma, and plastic surgeons. This will continue into the foreseeable future. The needs will then change to reconstructive trauma, infection management, and prosthetics. This has been an incredible experience and we all can make a difference.   

From Evan F. Eckman, MD: Just got back from Haiti, working at L'Hopital Lumiere in Bonne Finn up in the mountains... nonstop surgery and more than 80 patients. While it is a long trek up the mountains, the patients made it and they continue to come. We haven’t even begun on closed long bone fractures. Robert H. Belding, MD, did incredible work at this facility with minimal support in the first week. By the second week, we had 3 orthopaedic surgeons and a fabulous staff around us, and at times, still felt like we were barely making a dent. The isolation of this village makes things very difficult. If you can think of it, it is needed. We had a lady that completed an above-elbow amputation on herself to escape the rubble....WITH A ROCK. There is truly a heartbreaking story with every single patient. I have never seen anything like it.  

Source
AAOS Communication January 2010

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