Private Orthopedic service

1. Private Orthopedic service Yordanos Higher Clinic 1997-2007 Yordanos Hospital 2007-2015

2. Worku Mekonnen , • MSMI-1984 • AAU,Orth.,1994 • FCSorth(ECSA), • YHC,1997 • YH, 2007

3. Real Life Experience • Huge Extent of trauma and orthopedic problems in Ethiopia. • Specialized service just started • Experience in the establishment of private orthopedic service, a big challenge.

4. The start and progress of trauma and orthopedic service was a very difficult task being a pioneer in the private sector • Customers’ confidence started to build slowly on the services delivered.

5. YHC Yordanos Higher Clinic • Established in 1998

6. Starting was tough. Reasons: i. Limited resources: • Finance • Equipments, instruments, implants • Facilities • Professionals ii. Lack of experience iii. One specialist covering 24 hours a day, seven days a week, all year round

7. Building confidence iv. Winning patients minds and hearts • Love your job • Serious concern for every case • Trying to implement all the best of your knowledge • Having up-to-date information • Improvising methods • Money should not be of primary concern • Endurance • Self-reliance • On spot decision making • Confidence on tackling problems

8. YHC, activities • YHC-opd- >60 pts/d • upto 10 beds • Mostly closed manipulations, tractions • Surgeries were also done • General Surgeons,Internists, pathologists, ENT, ophthalmologists, radiologists, • Night duties have been covered by GP’s and Orthopaedic residents*

9. Yordanos Hospital

10. YH • Hospital-57 beds • Over 150 permanent workers • Over 25 part-time workers • OPD > 100 pts, new & repeat seen every day

12. Yordanos HospitalInauguration, 2007

13. Yordanos Hospital • Role of different consultants and contacts in the growth and development of our orthopaedic service: • Dr. Ralph Wolf • Prof.GW • Prof. J. Hauert and Clinic Dr. Guth of Hamburg, Germany. Prof Wolter of Hamburg Emergency Hospital • Dr. Paul Baxt

14. Yordanos Hospital Last 21 months • Did THR’s • Did Hemiarthroplasties • Interlocking Nails • Arthroscopic surgeries

17. Hemiarthroplasty

18. Interlocking nails

19. Hemiarthroplasty • Austin Moore

20. DHS, Angle Plates

21. Fixation of Femoral neck fractures • Screws

22. Covered most orthopedic problems(>50/d)

23. RTA- Third degree Rt. Leg Injury

24. Emergency Procedures

25. After Treatment

27. Arthroscopies

28. Short Term plan • Involve Experienced orthopedic surgeons • Improvise diagnostic facilities • Site Expansion

29. Short term plans(cont.) • Reorganize and intensify the quality of emergency service • Training paramedics • Assigning emergency doctors • Arranging fully equipped Ambulances • Triaging on the site of scene, ABC’s on the Go

30. Expand Trauma and Ortho. Services(cont.) • Closed manipulations( use C- Arm) • ORIF’s(implants, such as • ILN,DHS,Angle plates,Locking plates,etc. • TKR’s, SR’s, scoliosis surgery, Neurosurgery

31. Expand Trauma and Ortho. services • THR’s • TKR • Hemiarthroplasties • Arthroscopies • Correction of deformities of extremities: • Diff. surgical procedures • External Fixators • Ellizarov’s apparatus • Hexapods

32. Summary • RTA becoming the No.1 • problem in Ethiopia. • Machine injuries • Well organized emergency • service needed. • Well equipped, facilitated and staffed orthopedic center is required. • Important points to remember