Friday 29 August 2014

NAOMI HAS BLOUNTS DISEASE AND NEEDS YOUR HELP...SEE HOW #SUPPORTNAOMI



This is Naomi Arinze...
she desperately needs your help to live...Prayers,contributions,support and encouragement.
   

Ever heard of blounts disease? That is the situation young Naomi is facing today.  It could be any one. Please find Below a letter from her doctors.


LONDON LIMB 
RECONSTRUCTION
234 Great Portland Street London W1W 5QT
Tel: 02073908354 Fax: 02073908362

Secretary:
Tel: 020 7390 8354
Fax: 020 7390 8362
E-mail Address:
Londonlimbreconstruction@gmail.com

3 April 2012
Mr Chris Coates
Mount Alvernia Hospital
HarveyRoad
Guildford
Surrey
GUI3LX

Dear Chris
Re: Miss Naomi ARINZE - dob 10/05/02
34 Dettingen Crescent
Deepcut
CamberJey
GU16 6GN

Thank you for referring Naomi Arinze to the London Limb Reconstruction clinic at the Portland Hospital. I was able to see her today with her aunt.

As you are aware this 9 year old young lady presents with bilateral Blount's disease worse on the right than the left. She states that her legs have always been deformed and since the age of 6 have become painful with increasing deformity. She is able to transfer and walk only short distances due to discomfort felt on the lateral aspect of both knees. She normally crawls and as you state in your letter has significant callosities over the patella tendons.

She is currently not at school and there is no clear reason why. She has had surgery in the past age 7, she comments however that immediately after the surgery her legs were not straight. She states to be otherwise fit and well, takes no regular medication "and has no known allergies.

On clinical examination today she sits comfortably in the wheelchair. When she stands however she has a significant genu valgum bilaterally worse on the right than the left. She is able to take only a few steps with a lateral thrust on both knees.

In recumbency with the patellae pointing forward there is instability and I am easily able to open up the medial aspect of the joint. She flexes to 1300. There appears to be a fixed flexion deformity of possibly 10-15°.

The right leg is worse than the left. She otherwise has good range of motion of both hips and ankles with no distal neurovascular deficit.

I was able to review the radiographs that you kindly sent. The right knee has significant depression of the medial tibial plateau with a bony bar on the medial tibial physis. The lateral physis appears to be open. There is also a 500 varus deformity of the tibia at the metaphyseal diaphyseal junction.

The left knee again has significant medial tibial plateau depression, the varus deformity appears to be less and measured approximately 210 again at the metaphyseal diaphyseal junction. Both lateral views are a little difficult to interpret but do suggest posterior slope which would be in keeping with the clinical fmding of a lateral thrust.

I have been able to explain to Naomi's aunt today the principle of a hemi plateau elevation and correction of varus deformity. The hemi plateau will be done acutely with bone graft into the medial tibial space. I would then use gradual distraction osteogenesis to correct the varus, internal tibial torsion and potentially give some length to the tibia using a Taylor Spatial frame. I have been able to show her pictures of the frame and hemi plateau elevation surgery today. I have been able to draw diagrams for Mrs Hall to show to her family.

I have explained briefly the risks of surgery which include infection, bleeding, nerve injury, poor bone formation, joint incongruity, painful joints and stiffness. I have also discussed the principle of recurrence of deformity due to the growth plate remaining open on the lateral axis. Therefore following completion of treatment I would advocate an epiphysiodesis to complete the growth arrest of the proximal tibial physis and prevent recurrence.

As Naomi is from Nigeria I have explained that this will cost a considerable amount of money. We will supply a break down of costs. I would advocate CT scan to provide a 3D reconstruction for a planning of the correction of the tibial plateau, I would personally review Naomi again prior to a date of surgery to go over the principles. I would also advocate doing one leg at a time. Once we have corrected the deformity and the frames are stabilised then we could consider doing the second leg at that stage, she is already in a wheelchair and therefore would be able to mobilise with two frames on
her tibia which would obviously reduce length of treatment time. This however is likely to be at least six months if not closer to a year in total.

At this stage I have left Naomi with an appointment, and would be delighted to review her again in the future. Many thanks for referring her.

Yours sincerely
Dictated but not signed to avoid further delay
Mr Peter Calder FRCS (Tr & Ortb)
Consultant Ortbopaedic Surgeon
Cc Mrs Hall

 To #supportNaomi, please follow this link www.youcaring.com/medical-fundraiser/please-help-naomi-she suffers-from-bilateral-blount-disease.

You can spread the word for us, drop a donation and ora prayer. Every support is welcomed.

OneLove

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