Issue No. 38 - November 2011
The Late Impact of my SICOT Fellowship
I am Dr Orimolade Elkanah Ayodele, a young Orthopaedic Surgeon from the Obafemi Awolowo University Teaching Hospital Ile-Ife, Osun State in Nigeria.
I was privileged to beÂ at theÂ Assiut University Teaching Hospital between March and August 2009 following my selection as a beneficiary of the Assiut University/SICOT TrainingÂ Fellowship.
I was well received and I was allowed to assist virtually in all surgeries of interest to me, ranging from arthroplasty, arthroscopy, spine, paediatric orthopaedics, pelvic and acetabular fracture fixations, a variety of general orthopaedic and trauma procedures as well as some limited exposure in the field of microsurgery which is well developed in Assiut. It was marvellous to see the number of Orthopaedic and Trauma cases that were operated on a daily basis in Assiut.
Prof Galal Zaki Said and Dr Orimolade Elkanah Ayodele at Assiut
I have been able to improve my practice with the knowledge gained from the fellowship. Shortly after returning to my country, I was made the co-ordinator of academic programmes for trainees in my department. The wide exposure that I had in different areas of Orthopaedics have greatly improved my understanding and teaching of the subject and it also helped me to function well in my position. I am very fortunate to have another SICOT trained fellow,Â Dr Abiodun Adeleke, working together in the same institution. We have tried to advance the practice of orthopaedics and fracture treatment in my centre and we now do a lot more than before. We currently do some lumbar spine surgeries such as application of pedicle screws, laminectomy and reduction of spondylolisthesis, among others. We also use C-arm in femoral neck fracture fixations and spine procedures. In the area of Arthroplasty, despite the good training, I have not been able to do my first total hip or knee because we are yet to get the equipment to do this.
However,Â I have been able to do bipolar hemiarthroplasty, in addition to the application of the Austin Moore prosthesis, which I was used to doing before the fellowship. I have successfully used telescopic non vascularized fibular grafting in the management of tibia bone gap. Limb lengthening is now done in my centre with the use of the linear rail system and this has been used to achieve success in the management of some pseudoarthrosis and infected non union. Plating of fractures and tension band wiring are routine. Ponseti technique has now become the only method for clubfoot in my centre and there has been improvement in tendon transfer procedures.
Despite the relative development of other endoscopic procedures in my hospital, we are just in the process of acquiring an arthroscope for our use. There will be a need to have another exposure to refresh my knowledge when we acquire Arthroscopy and Arthroplasty equipments which we are hoping to get soon from our hospital management. A second and shorter exposure of willing trainees, say 3 months, should be considered to enable fellows who wish to perfect certain skills. The fellowâs second exposure will allow a more focused learning in the area he/she is deficient and he/she will be able to master what is needed to function back home. If it is possible to work together with a second trainee in the same institution, this would enhance their confidence to start new procedures as they will be able to share ideas and encourage each other, which is whatÂ happened when I worked with Dr Abiodun.
I would like to express my appreciation to SICOT for providing me with my first international exposure in the field of Orthopaedics and Trauma, to Prof Galal Zaki Said, Prof Essam Sheriff, the Head of Department, and to all the wonderful professors and doctors in Assiut, too numerous to mention, keep up the good work for humanity.