Health Minister describes comments as ignorant; says screw surgery was standard

    The Minister of Health, Dr. Saia Piukala, has described comments posted on Facebook about a hip operation on a young girl as derogatory and based on ignorance.

    He said he was deeply concerned at the level of negative comments the people made about the Ministry as it greatly affect the morale of his staff.

    The online comments were made after a young girl from Pangaimotu underwent hip surgery in Tonga and then underwent further surgery in New Zealand.

    The girl suffered from Slipped Capital Femoral Epiphysis (SCFE), a condition that requires surgery to stop the head of the femur (thigh bone) from slipping out of alignment.

    Surgeons in Tonga performed the surgery on the girl and a screw was used before the girl was released to her home in Vava’u.

    Dr. Piukala said the use of a screw was standard and was used in many hospitals in New Zealand, Australia and the United States.

    The metal screw was to make sure it kept the femur in position.

    However, a group of Lottery volunteers from New Zealand visited Pangaimotu after the girl returned from surgery and noticed she was limping.

    They volunteered to take her to New Zealand for further treatment.

    During surgery in Hamilton the screw that had been used in Tonga was removed.

    After the operation a photo purporting to show the screw that was used in the young girl’s hip was posted to Facebook.

    The poster implied that the girl’s parents were shocked to learn that a screw had been inserted into their daughter’s body by the Tongan surgeons.

    This has sent shock waves among Facebook users and triggered a series of heated debate across social media.

    Some questioned the academic and professional background of the Tongan surgeons, why a screw had been used in the treatment of the girl and whether her limping had been caused by the screw.

    Dr. Piukala said the screw was specially manufactured to be used in such operations.

    He said if the girl had been sent to New Zealand for her initial treatment the surgeons would have used the same screw to help relieve her condition.

    Illustration and x-ray of in situ fixation. A single screw is inserted to prevent any further slip of the femoral head through the growth plate. (Left) Courtesy of John Killian, MD, Birmingham, AL. (Right) Reproduced from Weber MD, Naujoks R, Smith BG: Slipped capital femoral epiphysis. Orthopaedic Knowledge Online Journal 2008; 6(2). Accessed June 2016.
    Illustration and x-ray of in situ fixation. A single screw is inserted to prevent any further slip of the femoral head through the growth plate. (Left) Courtesy of John Killian, MD, Birmingham, AL. (Right) Reproduced from Weber MD, Naujoks R, Smith BG: Slipped capital femoral epiphysis. Orthopaedic Knowledge Online Journal 2008; 6(2). Accessed June 2016.

    Description

    According to the American Academy of Orthopaedic Surgeons (AAOS) SCFE or Slipped Capital Femoral Epiphysis is the most common hip disorder in adolescents. In SCFE, the epiphysis, or head of the femur (thighbone), slips down and backwards off the neck of the bone at the growth plate, the weaker area of bone that has not yet developed.

    The AAOS said CFE usually developed during periods of rapid growth, shortly after the onset of puberty. In boys, this most commonly occurred between the ages of 12 and 16; in girls, between the ages of 10 and 14.

    Sometimes SCFE occurred suddenly after a minor fall or trauma. More often, however, the condition developed gradually over several weeks or months, with no previous injury.

    Treatment

    “The goal of treatment is to prevent the mildly displaced femoral head from slipping any further. This is always accomplished through surgery,” the AAOS said.

    “Early diagnosis of SCFE provides the best chance of stabilizing the hip and avoiding complications. When treated early and appropriately, long-term hip function can be expected to be very good.”

    Procedures

    Surgery to deal with SCFE includes a procedure known as in situ fixation which is usually used for patients with a mild or stable condition.  In this procedure the surgeon makes a small incision near the hip, then inserts a metal screw across the growth plate to maintain the position of the femoral head and prevent any further slippage.

    According to the AAOS, over time, the growth plate will close, or fuse. Once the growth plate is closed, no further slippage can occur.

    The main points

    • The Minister of Health, Dr. Said Piukala, has described comments posted on Facebook about a hip operation on a young girl as irrational, derogatory and based on ignorance.
    • He said he was deeply concerned at the level of negative comments the people made about the Ministry as it greatly affect the morale of his staff.
    • The online comments were made after a young girl from Pangaimotu underwent hip surgery in Tonga and then underwent further surgery in New Zealand.
    • The girl suffered from Slipped Capital Femoral Epiphysis (SCFE), a condition that requires surgery to stop the head of the femur (thigh bone) from slipping out of alignment.

    For more information

    Slipped Capital Femoral Epiphysis (American Academy of Orthopaedic Surgeons)

    1 COMMENT

    1. Pehē mei he Potungāue Moʻuí ko e ʻū komeni fekauʻaki mo ha tafa ne kau ai ha foʻi sikalú ne fai ʻi he taʻeʻilo (ignorant) ki he anga e founga ngāué pea iku ai ki hono tukuhifo e Potungāué ʻaki ha ngaahi lea ne mole mei ai ʻa e fakaʻapaʻapá.

      ʻOku ʻoatu he ongoongo ko ʻení ha ʻata mei he kautahaʻa e kau toketā tafa ʻa ʻAmelika ko e AAOS ʻa ia ʻoku nau fakamahino ai ʻa hono ngāueʻaki ʻo ha sikalu makehe ki he faitoʻó ni ʻo hangē pe ko ia ne ngāueʻaki ʻi Tongá.

      Ko e hili ʻeni hano tafa ʻo ha kiʻi taʻahine ne heke hono vaʻe ko e tupu mei he mahaki ko e Slipped Capital Femoral Epiphysis.

      Ko e leka ʻeni mei Pangaimotu, Vavaʻu pea ne ngāueʻaki ai ha foʻi sikalu ke taʻotaʻofi ʻa e heke ʻa hono vaʻé.

      Ne ʻatā ʻa e kiʻi taʻahine ʻo foki ki Pangaimotu feʻunga mo e fou atu ʻa ha kau ngāueʻofa ʻa e Lōtalí mei Nuʻu Sila ʻo sio ki heʻene ketuketu holó.

      Ne nau ʻomai ai ki Nuʻu Silá ni ke toe faitoʻo ai pea toʻo ai pe ʻa e foʻi sikalú.

      Kaekehe ne tuku hake ai ha ʻata ia ʻo e foʻi sikalú ni ki he Feisipuká ʻo fakahuʻuhuʻunga e fakamatala ne ʻomi aí ke pehē ne ofoofo e ongo mātuʻá ia ʻi he mahino ne ʻi ai e foʻi sikalu ne fakahū ki he sino ʻena tamá.

      Ka ne pehē ʻe he Minisitā Moʻuí ne mei tatau ai pe ka ne muʻaki ʻomi e kiʻi taʻahiné ki Nuʻu Silá ni ʻo faitoʻo ai ʻe kei ngāueʻaki pe sikalu tatau.

      Ne ne pehē ko e sikalu makehe pe ʻeni ia ne faʻu ki he faʻahinga faitoʻo ko ʻení.

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