Medical first allows Blount's disease patient to walk upright

Orthopaedic surgeon, Dr Franz Birkholtz, assisted by his Russian counterpart, Dr Alexander Cherkashin, performed life-changing surgery on Trevor Mntungwa. Dr Cherkashin is credited with the design of the latest advancements in circular fixator technology, which was used to make it possible for Trevor to walk upright.

Outreach worker, despite disease

Mntungwa has never been able to enjoy the activities that most people take for granted. Even getting out of bed in the morning and taking a shower, mundane tasks for most of us, took him an inordinate amount of time. Blount's disease, a growth disorder of the shinbone that causes a severe inward angling of the lower legs, also made it impossible for him to do such things as riding a bicycle or playing soccer. Despite his disability, Mntungwa, who works for International Organisation of the Sword of the Spirit founded by Pastor Lloyd Peterson, would spend hours walking long distances in Welbedacht West in Chatsworth, KwaZulu-Natal, to help others.

"I always wanted to help people, but due to my condition I was struggling to walk and had difficulty getting to all the people in the community. My legs were getting progressively worse and I was scared I would lose them," he said.

While doing missionary work, both he and Pastor Peterson tried to find out what could be done to ensure that he would be able to walk with ease. "I asked God if there was something we could do and searched all over the world to get help for Trevor," says Pastor Peterson.

Surgical intervention

After several dead ends, Mntungwa found out about the work Dr Birkholtz had done on circular fixators at Netcare Unitas Hospital in Centurion, Pretoria. "We sent him a clip that I had filmed," says Pastor Peterson.

"The video clip struck a nerve," says Dr Birkholtz, who together with his team offered their services pro bono to ensure that Trevor received complex reconstructive surgery using the latest technology.

The surgery performed on Trevor on 7 December 2012, was one of the first of its kind using a new circular external fixator called the TL-Hex. It involved fixing the community leader's legs in advanced external fixation devices, which were donated by Macromed. "This was followed by carefully cutting through Trevor's bone and then gradually straightening out his legs using external fixators," explains Dr Birkholtz. The fixator adjustments were calculated using advanced computer software.

"The fixations are temporary and will be removed when Trevor's bones have become strong enough using his body's own healing powers, to carry the weight of his legs," says Dr Birkholtz.

Part of training week

His surgery was performed during one of Netcare Unitas Hospital's training weeks. Dr Birkholtz and his team at the hospital regularly host surgeons from across the globe to teach advanced limb reconstruction techniques. "By empowering more surgeons to become skilled in limb reconstruction, many more patients could benefit from this technology," says Dr Birkholtz.

Mntungwa has fully recovered and was discharged from hospital on Thursday 17 January 2013. "Our patient is doing extremely well and is going home to KwaZulu-Natal to resume his community work," said Dr Birkholtz.

Speaking upon his discharge, he said, "I am very happy. I underwent this operation by God's grace. I am so excited."

Doctor specialises in limb reconstruction

Dr Birkholtz is an orthopaedic surgeon with a special interest in trauma and limb reconstruction. He is considered a world authority in the field of circular fixators. His practice in Pretoria has been identified as an international centre for training in external fixation and limb reconstruction techniques.

Limb reconstruction involves the correction of deformities, treatment of non-unions, mal-unions and severe bone infections with specialised techniques, often involving special fixation devices such as mono-lateral or circular fixators that are inserted around the bone.

The centre of excellence - soon-to-be named the Walk-A-Mile Centre, is based at Netcare Unitas Hospital and comprises a multi-disciplinary team dedicated to quality care for patients requiring these highly intricate and specialised procedures.