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FREE LIMB DEFORMITY CORRECTIVE SURGERY AND REHABILITATION PROGRAMME

FREE LIMB DEFORMITY CORRECTIVE SURGERY AND REHABILITATION PROGRAMME
BACKGROUND
The Lagos State Government, after a series of successful outings in her Blindness Prevention Programme, set up a committee in 2004 to fashion out a programme that would address the problems of inhabitants of the state who suffer from a wide range of limb deformities. The menace of large numbers of beggars in the streets poking various limb deformities in the faces of motorists and pedestrians, begging for alms, had to be addressed. It was thought that if many of the deformities could be corrected by surgery, the beggars could be encouraged to leave the streets and seek more honorable ways of making ends meet.
The result of a series of deliberations was the birth of the Lagos State Limb deformity Corrective Programme.

JUSTIFICATION & RATIONALE
The Lagos State Ministry of Health believes that the right to qualitative and efficient health care is the right of every citizen irrespective of age and socio economic status. Towards this end and in line with the poverty alleviation programme of the administration, the Ministry decided to take a look at the problem of limb deformities especially post polio paralysis in children. It is a fact that polio is almost a thing of the past in Lagos State, however it would be unfair to abandon the children/youth who have been paralysed by the virus.
It was discovered that many of such cases can be corrected by surgery and some by physiotherapy and use of simple walking aids like calipers, crutches e.t.c. It was however realized that majority of the afflicted had resigned to life of disability and some to begging and crawling on the streets of Lagos.

AIMS & OBJECTIVES
The aim of this programme is to improve the quality of life of the beneficiaries by:-
I. Reduction and in some cases elimination of the deformity in the patients through surgical intervention.
II. Rehabilitation of inoperable cases of Limb deformities through aggressive physiotherapy.
III. Provision of calipers, crutches and walking aids to assist otherwise immobile patients.
The main objective of this exercise is to increase the patients\’ feeling of self worth thereby making them of economic advantage to self, family and the society at large, at absolutely no cost (money wise) to potential patients.

METHODOLOGY
1. Massive media campaign on radio, television and print media, asking those with limb deformities to assemble on some given dates at a given venue (LASUTH, Ikeja) for screening.

2. Screening of all patients: history taking, physical examination, radiological and relevant laboratory investigations. Those who were considered as having surgically correctable deformities were screened by the anesthetists to ascertain their fitness for anesthesia and to choose the appropriate anesthetic method. Those who were found to be unfit for the programme were referred to the appropriate facility. Those who require physiotherapy were seen by combined team of physiotherapists and the surgeons to ascertain the need for surgery.

3. Those who meet the criteria for suitability for surgery were asked to return for final screening and counseling. The criteria include:

a. Absence of the other medical ailments that may make anesthesia difficult or impossible.

b. Surgeries that do not require more than 48 hours of hospitalization post operatively.

c. Procedures that could be undertaken quickly (maximum, 90 minutes operating time.)

4. Surgeries are carried out in General Hospital Lagos. A total number of 14 surgeons, 28 nurses and other personnel all working at the same time in two operating suites. The children were mostly given general anaesthesia, whilst the adults were given regional anaesthesia.

5. Rehabilitation: Patients were ambulated on crutches, calipers and other aids following surgery. They also had physiotherapy.

6. Follow-up: Two weeks after surgery, the patients returned for follow-up. The casts and sutures were removed, and they were assessed. They were then given dates to return for follow-up.

Since inception of this programme the following numbers of patients have been attended to:
1st phase (2004)
No of patients Screened 483
No of patients successfully operated 104
No referred to physiotherapist 206
No given mobility aid (calipers,etc) 102
No discharged 71

2ND PHASE 2005
No of patients Screened 1, 042
No of patients successfully operated 148
No referred to physiotherapist 286
No given mobility aid (calipers,etc) 124
No discharged 484
3rd phase (2005)
No of patients Screened 1,217
No of patients successfully operated 170
No referred to physiotherapist 261
No given mobility aid (calipers,e.t.c) 247
No discharged 539
4th phase (2006)
No of patients Screened 1,367
No of patients successfully operated 183
No referred to physiotherapist 498
No given mobility aid (calipers,e.t.c) 366
No discharged 320
5th phase (2006)
No of patients Screened 1,877
No of patients successfully operated 204
No referred to physiotherapist 369
No given mobility aid (calipers, crutches e.t.c) 566
No discharged 738
6th phase
No of patients Screened 750
No of patients successfully operated 110
No referred to physiotherapist 207
No given mobility aids � Calipers 158
– Crutches 162
– Wheelchairs 61
– Walking Sticks 37
– Knee Support 15
7th phase (oct)

No of patients Screened 850
No of patients successfully operated 95
No referred to physiotherapist 245
No given mobility aids � Calipers 164
– Crutches 181
– Wheelchairs 98
– Walking Sticks 47
– Knee Support 20
8th phase (May 2008)< br /> No of patients Screened 256
No of patients successfully operated 42
No referred to physiotherapist 84
No given mobility aids � Calipers 29
– Crutches 23
– Wheelchairs 24
– Walking Sticks 38
– Knee Support 16
9th Phase (Sept 2008)
No of patients Screened 386
No of patients successfully operated 36
No referred to physiotherapist 122
No given mobility aids � Calipers 39
– Crutches 27
– Wheelchairs 29
– Walking Sticks 48
– Knee Support 22
July – Aug 2009

No of patients Screened 304
No of patients successfully operated 60
No referred to physiotherapist 84
No given mobility aids � Calipers 50
– Crutches 23
– Wheelchairs 24
– Walking Sticks 45
– Knee Support 18
PROSTHESIS
JANUARY – NOVEMBER, 2009

Artificial Limbs given to amputees 34
Following the screening of patients at LASUTH, the Limb Deformity Corrective Surgery was carried out at the General Hospital,Lagos in June 2011.
• Patient screened=162
• Surgery=52

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