Photo: Dr. Leversedge visiting with his young patient the day after a Hoffer transfer for a birth brachial plexus injury.
Fraser Leversedge, MD, served as Team Leader for a 17-person mission trip to San Pedro Sula, a city in northwestern Honduras in Central America. The week-long mission trip, March 30-April 6, 2019, was coordinated through the Touching Hands Project and the American Society for Surgery of the Hand (ASSH) to provide life-changing hand surgeries, rehabilitation, and medical training in the world’s underserved communities.
Dr. Leversedge has been leading the team to San Pedro Sula twice a year since 2014, and the continuity of care has provided wonderful opportunities to take care of complex injuries that require staged procedures and to assess post-surgical patients with meaningful follow-up. Each trip brings together 4-5 attending hand surgeons from around the country, many of whom bring a resident or hand surgery fellow to gain experience in outreach and international patient care.
"It is a highlight to hear different perspectives about the management of different clinical challenges and refreshing to learn from each other. We are fortunate to have included numerous members of our Duke Anesthesia Department, Duke Nursing staff, and Duke Hand therapists, which speaks to the collegiality and teamwork of such a mission."
-Dr. Fraser Leversedge
During the Sunday clinic, they see between 120-150 patients, some of whom have had previous surgery and many are new patients who travel from as far away as 6 hours to be evaluated. On this trip, they saw a patient who had one of the two free, innervated gracilis muscle transfers for reanimation of elbow flexion following a brachial plexus injury, during the November 2018 brigade. The patient was able to contract the transferred muscle, which was extremely exciting for the team and for the patient! The procedures were done and the post-operative care was coordinated with extensive pre-planning and with the efforts of the entire team.
Over the week, the team performed 48 surgical procedures at the Ruth Paz Foundation Hospital and Clinic. Most of the procedures were complex in nature. Typically, approximately 50% of the cases involve pediatric/congenital conditions. In adults, they see a great number of tendon and nerve injuries and fracture malunions/nonunions – many cases presenting in delayed fashion due to the lack of access for patients and a lack of expertise in the medical community for caring for such injuries.
According to Dr. Leversedge, "The gratitude and the appreciation demonstrated by our patients for our mission is inspiring and, combined with the spirit of teamwork among all of us who participate, the trip reinvigorates all of us to find joy in what we do here at home."
In addition to treating patients, the mission trip also allows the team to experience the community.
Dr. Alex Lauder (Duke Hand Surgery Fellowship, 2018-2019), Fred Fesel, CRNA (Duke Anesthesia); Juli Hobbs, MD (Duke Anesthesia); Jennifer Flannigan, CRNA (Duke Anesthesia); Luke Nicholson, MD (current Duke Hand Surgery Fellow); and Fraser Leversedge, MD (Duke Hand Surgery).
The same group after playing soccer with the Casa Los Ninos (Boys Orphanage) following a day in surgery.
Dr. Nicholson (center) operating with Dr. Andrew Weiland (left; HSS) and Dr. Don Condit (right; Grand Rapids, MI).
Map of San Pedro Sula, a city in northwestern Honduras in Central America.