Scottsdale surgeons are donating their services to save a young girl’s injured leg, utilizing a rarely used procedure.
Annabel Espinoza-Cardoza, a 15-year-old Nicaraguan, faced certain amputation of her left leg, until Scottsdale orthopedist Vincent J. Russo came to her rescue.
Espinoza-Cardoza visited with Russo on Thursday afternoon for follow-up treatment for her Aug. 18 surgery. "We discovered her laying in a hospital room where she had been for six months," Russo said. "Her leg was infected from surgery and she had no access to antibiotics."
Russo was in Nicaragua in July as part of an annual medical mission by Amigos de Salud, or Friends of Health. The Amigos are a group of about 20 Scottsdale Healthcare System medical providers that makes trips to Nicaragua to administer health care to a population that typically doesn't have access to basic care.
July's trip was unusual from past trips, however. This time, Amigos de Salud returned with an additional traveler — Annabel. The teen was injured in January when she was hit by a car while riding her bicycle.
Because of the infection and lack of trained physicians, the only course available in Nicaragua was to amputate Annabel’s leg, Russo said. The doctor knew he could save the leg by a complicated procedure called bone transport. He said he also knew he couldn't perform the procedure under the Third World medical conditions.
That's when the group decided to take the teen to Scottsdale, where she had surgery at Scottsdale Healthcare Shea hospital, which also is donating its services. The combined value of the donated services, hospital stay and medical equipment is between $25,000 to $30,000, Russo said.
The surgery was the first part of a lengthy medical effort that will keep Annabel in the Valley for six to eight months.
The bone transport is a complicated procedure that will work for only a handful of patients, Russo said. When a person is a candidate, however, Russo said he's had a 100 percent success rate.
The infected area of the bone is removed and antibiotic pellets are placed inside the remaining sections of bone to clear up infection. At the time of surgery, pins are placed through the skin into the separated bone fragments. The pins hold the bone in place so surgeons can ensure proper alignment.
Surgeons will gradually move the bone fragments together, a millimeter at a time, with an external device. As the bones are fused together, normal bone function returns and the bone regenerates.
Annabel doesn't speak English, but her caretaker for the next six months, Lynn Cook, said she has expressed gratitude to the Scottsdale medical community. "She's surprised by how nice everyone is here," Cook said, "She was not treated well in Nicaragua after the accident because she was viewed as a burden."
Annabel was back in Russo's office Thursday morning for her first millimeter bone movement. She smiled easily and answered questions posed to her in her by a Spanish television correspondent.
She remained in good spirits until it was time to begin the procedure, which Russo explained is "quite painful."
As she pleaded for television cameras to leave the room, her cries were ignored. Cook asked the crews to turn off the cameras and to give the girl privacy. Her requests were denied. "We just need to get some of her interacting with the doctor," a cameraman said as Annabel's cries were heard outside the room.