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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Hand surgery in a field hospital in Cox’s Bazar, Bangladesh

Meeting Abstract

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  • presenting/speaker Shalimar Abdullah - Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
  • Levin Kesu Belani - Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
  • Amir Adham Ahmad - International Medical University, Kuala Lumpur, Malaysia
  • Munir Osman - 96 Naval Hospital, Lumut, Malaysia

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-795

doi: 10.3205/19ifssh0497, urn:nbn:de:0183-19ifssh04973

Published: February 6, 2020

© 2020 Abdullah et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: Cox's Bazar is a border town in Bangladesh currently supporting approximately 1 million Rohingya refugees from Myanmar. The Malaysian government has sent the Malaysian army field hospital as part of a government to government initiative supporting the influx. The army orthopaedic surgeon had requested a hand surgeon to perform four difficult cases of hand surgery in May 2018.

Methods: The four cases were all children ranging in age between 1 year 3 months, 2.5 years, 3 years and 6 years old. They all involved the right hand. One case was due to the 6-year-old child being allegedly thrown into a fire by the military of a neighbouring country and suffered right ring and little finger severe dorsal contracture with ulnar deviation. The other three cases were domestic injuries of holding a burning charcoal, being involved in a burning house and an electrical burn. Two cases were categorized as severe such as the case above and a severe right wrist contracture with right 2nd -4th MCPJ hyperextension.

Results: The average time for operation was 2 hours. All surgeries required full thickness skin grafts from the groin / antecubital fossa. Instruments needed include a sharp Steven's tenotomy scissors, Adson's toothed forceps, K-wires of various sizes from 1.0 - 1.4 and a good K-wire driver. The K-wires are left for 2-3 weeks to allow the skin grafts to adhere. Caution is needed during the healing period as the dressings are changed as the patients' level of hygiene is questionable in a refugee camp.

Conclusion: Hand surgery for wrist and finger contracture release can be comfortably done in a limited orthopaedic setting with minimal levels of sterility.