A young boy is up and running with Immediate Post Operative Prosthesis (IPOP)

Twenty-year-old Donald Shibombo smiles thoughtfully when asked what he likes to do in his spare time.

‘One of the things I really enjoy is soccer,’ he firmly states; and despite his relaxed demeanour, it would appear that the pensive Grade 12 pupil is not only on the ball but has his eye on the ball in more ways than one when it comes to achieving his goals.

Yet, unprecedented challenges often present themselves, even with the best game plan. Nine years ago, at the age of eleven, Donald broke his leg while playing a soccer game and was taken to the Alexandra Clinic where his leg was set in a cast, as is the standard treatment following an injury of this nature. But, three weeks later, despite the fact that the swelling following the break had initially subsided, Donald noticed that further swelling had since begun to develop at a distinctively alarming rate.

He was subsequently admitted to the Edenvale Clinic. Upon further investigation into Donald’s condition, doctors realised that there was a great deal more to Donald’s condition than a mere football injury.

Following a series of tests, Donald was then transferred to the Johannesburg General Hospital where he was rapidly diagnosed with Osteosarcoma, a form of cancer that has a tendency to develop in young children. In particular, Osteosarcoma affects boys who are experiencing a growth spurt.

It was further revealed that the cause of Donald’s injury was not at all attributed to sports activities, rather the cancer in Donald’s bones had weakened them to such a degree that they had become extremely brittle, causing the break in his leg.

Donald’s overall symptoms, together with the broken bone, formed the diagnosis for this type of cancer. It was also found that Donald exhibited a typical case, in that the cancer affected the knee. Like any other type of cancer, Osteosarcoma has a tendency to spread throughout the body and affects major organs such as the heart and lungs, as well as other organs.

Chemotherapy alone was insufficient in healing the disease and in order to prevent it from spreading, Donald’s surgeons decided that the best option for Donald would be to amputate his leg mid-thigh.

An orthotist in training in for a great surprise

Yet, Yolandi Engelbrecht, an orthotist in training who was working at the hospital and who had been assigned to look after Donald, was in for a great surprise. Only days after his surgery, Donald was already up and running on his peg leg, enthusiastically climbing chairs in the hospital ward.

Immediate Post-Operative Prosthetis (IPOP)

Donald’s rapid recovery was attributed to a technique used in prosthetics known as Immediate Post-Operative Prosthesis (IPOP) which involves fitting the patient with a rigid plaster cast immediately following surgery.

The Immediate Post-Operative Prosthesis (IPOP)I technique is not new. In fact, the first reports of the use of the Immediate Post-Operative Prosthesis (IPOP)  technique date back to 1893, when a German surgeon, von Bier, reported accelerated rehabilitation with the use of a rigid plaster cast to which a wooden peg leg was attached immediately following surgery.

Explains Roger Wolfson, Donald’s Medical Prosthetist:

‘Amputation is a critical salvage procedure when it comes to septic and tumour patients. Due to the process of ‘coning’ of the residual limb, which is undertaken in order to facilitate the application of a primary prosthesis, the rehabilitation process post-surgery is often delayed; which can be extremely costly both to the patient as well as the health system.

It is also during this time that muscle strength, tone, general fitness and co-ordination may be reduced, which further retards the rehabilitative process.

The Immediate Post-Operative Prosthesis (IPOP) technique attempts to address these problems with the application of a rigid cast immediately post-surgery while the patient is still in the operating theatre. This ensures that the healing of the wound and the rehabilitation process occur in tandem, thereby diminishing the effects of muscle wasting and enabling more rapid mobilisation with the primary prosthesis.’

However, in South Africa, as far as Government patients are concerned, the waiting period for a prosthesis can be more than six months in most cases and can even take up to one year.

Yolandi Engelbrecht springs a surprise of her own

When Yolandi first noticed Donald climbing chairs so soon after surgery, she felt the need to spring another surprise of her own. Having realised that she needed to do something to help Donald achieve his goal – to once again become actively mobile as soon as possible; she arranged for the required parts for Donald’s prosthetic leg to be shipped to Johannesburg from Prosthetic Solutions, a company located in George, at her own expense. For this remarkable young woman, what initially began as a commitment to help a boy in need, also led to her establishing a charity organisation aimed at raising funding through the sale of art for amputees who require prosthetics.

Thus, with Yolandi’s financial aid and Roger’s commitment towards the best prosthetic outcomes, Donald’s journey towards recovery was well underway.

The adjustments that need to be made to the prosthetic device on a regular basis in line with a child’s growth are in line with standard treatment. Donald’s progress over the past nine years is testament to Roger’s commitment to Donald’s complete recovery.

The triumph of the human spirit

Now, almost a decade into his recovery, Donald assertively maintains that the human spirit triumphs over everything.

When asked what motivates him he confidently affirms:

‘I believe that everything is possible, even a fancy car. In achieving my long term goals, I aim to do everything in my power to do my best.

I really love soccer. Orlando Pirates is my team! I love going to stadium matches and enjoy watching the game on television. I am also keen on reading poetry, particularly Shakespeare; and enjoy listening to House Music and chilling with friends, especially my girlfriend, Liezel. Liezel is very understanding, supportive and encouraging.’

Donald lives with his uncle and guardian and is currently writing Matric exams. Despite his initial intention to one day study towards a career in civil engineering, he has since decided to turn his attention towards helping those with needs similar to his own in pursuing a career as a prosthetist.

Advises Roger:

‘To achieve his goal of becoming a prosthetist, Donald will need to study Biology in addition to his current Matric subjects. From there, he will start off as a prosthetic technician while pursuing his Prosthetics studies.   I firmly believe that Donald has great potential and definitely has what it takes to be successful in whatever field he chooses. I will do everything in my power to help Donald achieve his goals,’ Roger concludes.

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