A Surgeon's Job


From my first experience in Ayacucho in 2012, I learned that  the city of Ayacucho has skilled orthopedic surgeons, but lacked the necessary equipment to handle common types of leg and thigh fractures in an ideal manner.  As a result, injured patients had to endure much more difficult, painful and less successful treatments that often resulted in long-term problems and disability.   

On this, my second mission, we decided to do something to make a lasting impact in this area.  Thanks to generous contributions of our supporters, Ayacucho Mission and the Peruvian American Medical Society partnered with SIGN Fracture Care International, an orthopedic non-profit, to provide the necessary equipment to enable the Ayacucho surgeons to offer their patients the best options for treatment of leg and thigh fractures.  

The initial phase of the program was the introduction of the equipment and instruction in the appropriate technique.  Alongside Dr. Cesar Aranguri, Director of the Mission, I led an instructional course for the orthopedic surgeons in Ayacucho.  Over the following week, I assisted two Ayacucho surgeons, Dr. Prado and Dr. Romero, on two cases.  The first was a 10 year old girl who had had a femur fracture 6 months earlier that had failed to heal despite previous surgery.  The second was an open tibia fracture in a young man who fell off a horse. Both cases were quite successful.  

During the first month after the Mission concluded, Dr. Prado and Dr. Romero did two more surgeries completely independently.  Both cases went very well, which is a testament to their skills as surgeons and the equipment and training provided by the Mission.  We believe this will be a very valuable program for the people of Ayacucho and the local medical community.  It will allow local surgeons to treat severely injured patients so that they can mobilize and return to their work and their families more quickly, with easier and more predictable recoveries and less short and long-term disability.  

- Jay Crary


Pre-operative x-ray of an 18 year-old man who fell off a horse and sustained open fractures of the tibia and fibula.  Local Ayacucho surgeons Dr. Prado and Dr. Romero worked alongside Mission surgeon Dr. Crary to apply the techniques and equipment introduced by the Mission to intervene on the patient.

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Post-operative x-ray from the same patient showing the successful placement of a SIGN intramedullary nail to stabilize the tibia.  This patient was able to walk with crutches immediately after surgery and will begin weight-bearing on the leg after about 6 weeks.