Deformities of bone and joint in St. Vincent - abstract

ABSTRACT

This retrospective study assesses the types and incidence of bone deformities seen by a single surgeon from 1964 to 1983, in the island os St. Vincent, with a population of 107,000. The data were obtained from the clinical and operation records, the private library of clinical photographs, and x-ray films. The deformities were congenital (57 percent), post-traum (12.4 percent), infective (6.5 percent), neoplastic (0.8 percent), degenerative (15.3 percent), deficiency (0.2 percent) and idiopathic (7.8 percent). Many congenital deformities were not diagnosed in infancy and were acknowledged only in later childhood and hence were untreated. A notable example was congenital dislocation of the hip. Others, such as talipes equino-varus, though acknowledged, were either not treated or improperly treated. There was a surprising number of preventable acquired deformities. Many were the result of neglect or gross mismanagement of cases of trauma; while others were due to failure to diagnose and hence manage certain conditions such a Perthes' disease and adolescent coxa vora. The prognosis of many of these deformities could be improved by careful routine examination of the newborn infant by midwives and family and hospital practioners, by educating mothers to take their infants to the family doctor on suspicion of any abnormality, by the recruiting of poperly trained doctors for the districts and hospitals, and by the provision of orthopaedic sugeons preferably at the local level or even on a regional bais (AU)