According to estimates, to perform surgeries for 600 children suffering from “wing droop” – deltoid muscle atrophy – in Ha Tinh, it would require 4.2 billion VND (approximately 300 USD per case).
Dr. Le Duc To has proposed a simplified surgical procedure that can be transferred to local doctors, with a cost of only… 600,000 VND (about 25 USD) per case! The doctor stated:
– On December 26, 2005, we traveled to Vinh City to continue our surgical program for children with movement disabilities. We encountered nearly a dozen cases of wing droop and performed six surgeries. These patients are not only from Nghi Xuan District but also from Cam Xuyen District in Ha Tinh Province and Anh Son, Hung Nguyen, and Dien Chau Districts in Nghe An Province.
During this surgical session, we also transferred surgical techniques to doctors at the Orthopedic and Rehabilitation Center in Vinh City, Nghe An Province, who can now fully handle the surgeries and can perform 30 cases a day.
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| Dr. Le Duc To (center) – a member of the Central Committee of the Vietnam Association for the Support of Disabled Children, also serving as the head of the Health Department of the Association in Ho Chi Minh City – during the surgery for a child suffering from “wing droop” at the Orthopedic and Rehabilitation Center in Vinh City (Photo: K.S/TTO) |
* Is it possible to cure “wing droop” with just a simple surgery?
– Yes. Surgery for wing droop – or “wing droop” – is one of the simplest procedures in the orthopedic field. For children over 10 years old, sedation and local anesthesia can be used. For children under 10 years old, general anesthesia is sufficient. The incision is about 3-4 cm long, made at the bottom of the groove to locate the tight fibrous band (this bottom is the gap between the two bundles of the deltoid muscle) and involves a small action of cutting and releasing this band.
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Dr. Le Duc To (Photo: TTO) |
Once the band is cut, the scapula is no longer pulled down, gradually returning to its original position, and the droop is eliminated. After a period of rehabilitation therapy, the droop is balanced again. During the surgery, blood loss is minimal, only moistening two or three small gauze pads, and the sutures require only 4-5 knots, which can be considered a minor surgical procedure – if not a simple surgery. If strict sterilization is maintained, postoperative care involves taking antibiotics for 4-5 days without the need for injections to minimize pain for the patients.
It is important to note the need for physical therapy and rehabilitation after surgery. Starting from the 10th day post-surgery, rehabilitation exercises can begin with shoulder joint movements to restore full muscle strength for the shoulder muscles, especially the deltoid that has been restrained by the fibrous band for a long time. Exercises should not only focus on the operated arm but also on the non-operated arm to prevent later contractures. It is very likely that the non-operated arm is also undergoing deformation, so this exercise is not superfluous. During the rehabilitation process, patients should be instructed on how to exercise at home, allowing them to balance both school and rehabilitation therapy.
* How can we expedite the treatment of many children suffering from “wing droop” scattered across various localities?
– The total number of children with “wing droop” currently in Nghi Xuan District, Ha Tinh Province, after thorough screening, has reached nearly 800 children. In Nghe An, nearly 200 children have come for examination, and there may be more in the community. With such a large number of patients, most of whom are from poor backgrounds, it is essential to find ways to perform surgeries locally to minimize travel costs for families.
Thus, during previous surgeries at the Orthopedic and Rehabilitation Center in Vinh City, we trained the doctors there, and they successfully performed surgeries. I have also proposed to the Ministry of Health and Ha Tinh Province to train lower-level doctors (district and provincial) to enable them to diagnose and perform surgeries, as well as guide rehabilitation therapy for patients – including inviting doctors from other areas for assistance. This approach will quickly address the situation and reduce travel costs for patients.
According to calculations from the Orthopedic and Rehabilitation Center in Vinh City, the total cost for surgery, including preoperative tests and medications, is 600,000 VND. If the patient stays for 3-4 weeks of rehabilitation, an additional 400,000 VND is required, bringing the total to 1 million VND (around 43 USD) per case. If patients from distant areas cannot stay for rehabilitation, they will be provided with detailed instructions for home exercises.
To address the 600 cases in Nghi Xuan District, Ha Tinh Province, as reported in the media, with a surgical cost of 600,000 VND per case, the total of 360 million VND will be easier to secure funding for compared to the initial estimate of 4.2 billion VND.
Thank you, doctor!
KIM SON conducted the interview
