At the moment the surgical department is not too busy because people cannot afford even our modest charges. However, incredibly in spite of less work than usual, within my first week here we have admitted three men with fractured necks.
The first was a policeman who had fallen down a pit. He was in a great deal of pain but he could move his limbs normally. His neck was stabilised by a rigid collar and because a government employee he was transferred to Nairobi for further treatment.
The next was a man who had a fight with his brothers over very scant resources in this country that has been so badly affected by the recent drought. He was hit by a stone which fractured his skull and broke his neck. This resulted in nearly a total paralysis of both arms and legs. At first he could just move his fingers but 3 days later that movement has even disappeared. Unfortunately there is little hope of recovery for this man.
The last case was a young man who had been cutting branches off a tree at 14metres [over 40feet] when the branch he was on broke. He had a fracture dislocation of cervical spine vertebrae 1 and 2 [sometimes referred to as a hangman’s fracture] with gross displacement. This commonly results in immediate death. In spite of this he has full movement of his limbs and we are hopeful that with immobilisation he will make a full recovery. He speaks good English and was happy to let me photograph him. He was full of smiles thankful that he was alive having had such a catastrophic fall.
The patient who had the paralysis of both arms and legs slowly deteriorated and died.
The other patient with the very high fracture of his cervical spine made very good progress. The appearance of his X-ray improved and he walked out the hospital with no untoward effects after complete rest on traction for four weeks. We gave him the strong advice to continue to wear his cervical collar. The patient realises that he is a very fortunate man and is grateful for the hospitals care. He appreciates that violent exercise should not be under taken in the near future as his neck is still vulnerable and should the cervical canal be narrowed further he could well die immediately