From Angola to Helios Berlin-Buch: Maria can walk again
Nobody really knows exactly how the persistent inflammation in Maria's left thigh developed. "It is unclear whether the inflammation was caused by an accident or whether there was a focus in the body from which the inflammation spread to the bone. It was probably a bacterial infection, presumably a chronic staphylococcal infection. However, this is the first time we have seen a case of this extent in an 11-year-old child," explains Dr. Matthias Rogalski. When Peace Village International, an aid organization that has been helping sick and injured children from war and crisis zones since 1967 and coordinates medical care in Germany, contacted Helios Hospital Berlin-Buch last year, it quickly became clear that there was an urgent need for action to save Maria's leg. For some time, her leg had been affected by fistulas and infections that had spread to her hip. "Maria came to Germany with this diagnosis and received acute treatment in Halle from November 2023 to January 2024. Repeated operations were performed there in an attempt to calm the inflammation and close the fistulas. This worked at first, but the infection then broke out again. Maria also received several blood transfusions, prolonged antibiotic treatments and vacuum sealing dressings - unfortunately with no lasting success," reports Dr. Rogalski. Peace Village International then turned to the Berlin colleagues, who finally started Maria's treatment at the hospital in Buch in August 2024.
Successful operations
"Our first step was to look at the findings and treat the infection in Maria's leg by flushing, removing inflammatory tissue and inserting bone substitute with antibiotics into the femur. In the end, we managed to close the fistula and put the infection to rest," reports Dr. Rogalski.
In a second step, once the infection had been treated, the aim was to improve the function of Maria's leg despite the pre-damaged bone. This was because the infection had not only damaged the hip joint and the femur, but also the so-called growth plates. As Dr. Rogalski explains, the growth zone on the upper thigh was completely destroyed, while the growth zone on the thigh near the knee was only still active in remnants. The additional hip joint contracture resulted in a difference in leg length compared to the unaffected right leg. With a second operation, in which the position of th The expert explains:
"Functionally, Maria has made progress with the second operation and has also gained some length in her left leg. It is now possible to compensate for the remaining leg length difference of around 1.5 centimeters using aids on the shoe."
Should the difference increase due to a growth spurt, it would theoretically be possible to surgically adjust Maria's right leg. However, Dr. Rogalski interjects: "As this is the healthy leg, we recommend adjusting the leg length by adjusting the height of the shoe if it remains acceptable."e left femur was corrected, stabilized with a plate and the contracture-related malposition reduced, Dr. Rogalski and his team were also able to reduce the difference in length between the right and left leg.
Small steps towards a new life
And how is Maria doing today? After many months in a wheelchair and successful operations at Helios Hospital Berlin-Buch, the 12-year-old girl can now walk again with the help of forearm supports. Her attending physician is satisfied:
"She has definitely made progress and has also improved her range of movement. Considering that she almost lost her leg due to the difficult-to-handle infection, we have now reached the point we wanted to reach."
The next check-up is due in a few weeks' time. Dr. Rogalski and his team will then check the healing process of the bone. The Buch experts will decide whether to remove the inserted plate again after around a year - depending on whether the femur has healed with sufficient stability without the implant. Until then, Maria is taking small steps through her new life - and has hopefully already overcome the biggest challenges.
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