Cuenca and the SIGN Nail: Visiting the site of the second SIGN nail in South America

Thursday morning three of us were up early to catch the 0715h flight to Cuenca in the south of Ecuador.  Last year CAMTA placed a SIGN nail at the Hospital Vicente Corral Moscoso.  This institution is a large teaching

hospital but it is very poorly equipped. It is the primary clinical site for the students from the University of Cuenca, Faculty of Medicine. When we visited Dr. Telmo Tapia and toured his operating rooms last year we went home with a shopping list in mind for him.  There is no fluoroscopy available in theoperating room and therefore the SIGN nail is ideal for them.

The SIGN nail is one of CAMTA's 3 main projects.  The SIGN Nail at the Moscoso is only the SECOND SIGN in South America. 

The SIGN nail system provides an amazing improvement in care for all those young people who crash their cars and motorbikes in Ecuador.  Rather than sit in bed for weeks in traction and suffer the risk of all sorts of complications, the SIGN nail gets people out of bed and home the next day.

Cuenca is a beautiful city!  I shot a few pics as we walked to the Military hospital later in the day.

There are four rivers in the city.

But we stated the day at the Hospital Vicente Corral Moscoso.

Here's Marc as Santa Claus - unpacking the goodies.

The first goody is a fracture table for small children who need casts after surgery on their femur.  This was made a few years ago by Mr. Len Bourdin of Edmonton.  Telmo was so pleased!

Then out came the rest of the gear.  We brought down their very first tourniquet system that was made by Glenn Day and Blair Gallant from spare parts.  A tourniquet system eliminates blood loss during orthopedic surgery on the limb.

We also brought down an external fixator system - both large and small.  These were also spare parts from Edmonton.  On the left in this picture is Danillo, Medical Director of the Hospital and Telmo who is the head of orthopedics and the lead man for our SIGN nail system.

Here's a shot of the tourniquet bulbs and gauge.

And of course we poised for a picture.

L to R:  Drs. Luis Piedrahita, myself, Telmo Tapia, Marc Moreau and Danillo.

After the "Christmas Gift Opening" we visited Telmo's office and discovered his hobby!  He like design and photography.  Here's a poster commemorating our cooperation in the SIGN nail.

HVCM is the acronym for the Vicente Corral Moscoso hospital.

Then, in the afternoon we walked over to the Military Hospital.  This is a familiar place since we worked there in the early years of CAMTA.  There is a beautiful garden where patients can wait.

At the hospital, Dr. Carlos Bernal who is a longtime CAMTA participant and a surgeon at the Military Hospital introduced us to his boss,  Dr. Patricio Perez.  Patricio is a very business-like.  We described the SIGN nail and discussed the parameters around an agreement.  He dictated a six point memorandum to his Secretary and we signed an agreement to work towards placing a SIGN nail system in their hospital in two months time.

Then it was down to the main floor to Carlos Bernal's clinic to see two patients.  Here is a young family.  Father has an autosomal dominant bone disorder.  And sadly both kids have the same problem.  Marc and Luis examined the three year old girl.  She and her sister have a terrible limp. It's related to the length of their femur's and perhaps their hip joints.  More x-rays are needed to make a decision.

The next patient is a lady who received a hip from CAMTA in 2003.  She now has some pain in her hip.  We will discuss the x-rays with Dr. Ed Masson when we return to Quito.

After the clinic we had time to check into a hotel and wash up before heading over to a restaurant where the Cuenca Orthopedic Society were having their monthly meeting.

On the left here is Dr. Carlos Bernal of the military hospital.  He will do great work with a new SIGN nail system.

Marc spoke and Luis translated about the management of pediatric fractures.

I operated the laptop.

After Marc's presentation, Dr. Telmo Tapia presented his experience over the last year in placing 35 SIGN nails in a range of patients.  A number of children have received nails as well as many motor vehicle trauma patients and two who had fractures from metastasis of cancer to their bones.  I was impressed by his data.  This man is doing great work