2019 SLAOTI/POSNA TF - Córdoba - Day 8

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Last night we had an amazing dinner with most of the team from Sanatorio Allende (SA) including Drs. Victoria Allende, Javier Masquijo, Andres Ferreyera, Diego Tourn and pediatric orthopaedic surgery fellow, Paula Biolatto.  Dr. Baxter Willis and his wife Susan also joined us for the meal.  We were taken to a lively neighborhood called Guemes that had a numbers of bars and clubs that were blasting Coleen’s favorite 90s hip hop music.  We ate at the Standard 69 restaurant where the SA team had reserved a special section of the restaurant just for our group.  Of course, we enjoyed a couple of delicious bottles of Malbec as well as local craft beer.  We were then treated to a pre-fixed menu including a ginormous Tomahawk steak, which we devoured.  The dessert was a lovely lemon meringue dusted with matcha powder and assorted fresh fruit.  We finished dinner after midnight, which is actually pretty typical in this part of the world and walked back to the hotel enjoying the youth and night life around town.
 
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The next day started with a 7am breakfast, where the travelling fellows enjoyed some authentic salty “medialunas” or Argentine croissants with dulce de leche spread.  Dr. Diego Tourn came to pick us up at 7:20am and we headed to the old Sanatorio Allende (SA) to join the team in the operating room. 

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An interesting observation was how one of the SA staff walked into the operating room and gave the anesthesiologist a hug and two kisses to start the day.  While this is normal custom at every greeting in this country, we thought it would be a good way for us to reach across the curtain in our own ORs and bond with our colleagues back home. 

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After picking up our scrubs which were all a different shade of sunny yellow we started by observing an interesting epiphysiolysis case in a 5 year old child.  The patient had left knee and ankle deformity due to septic arthritis of the two joints and presented to SA after being treated with debridements and intravenous antibiotics at another facility.  He had undergone a previous medial distal femur physeal bar resection with lateral tension band plating and a distal tibia bar resection about one year prior.  The knee had corrected beautifully, however the ankle was not growing properly and a repeat MRI demonstrated a recurrent physeal bar.  Today he underwent removal of the tension band plate and revision physeal bar resection. We saw some interesting techniques of using an arthroscope to ensure complete resection of the bar as well as using contrast in the ankle joint and in the resection tunnel to ensure complete bar resection.  They obtained fat graft from the medial thigh and packed it into the resection defect. 

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We also observed a medial epicondyle open reduction internal fixation and a calcaneo-navicular coalition case.  Apurva had the opportunity to scrub into the medial epicondyle case and there were some interesting tips shared by both the SA team as well as the travelling fellows. 

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We left the operating room after 1 pm to walk into the oldest part of town and enjoy lunch at Novicento which is a restaurant located in the old town hall of Córdoba.  Dras. Allende and Biolatto stayed behind as Paula had to take an important examination after completing a two year didactic course of orthopedics and traumatology and Victoria had to proctor the exam.  Despite our attempts to minimize our daily red meat consumption, our main course at lunch included a large portion of tortilla, which was a baked dish make of eggs, milk and potatoes and a generous portion of bife de chorizo.  After finishing our meals and multiple large bottles of local Patagonia 24.7 beer we were ready for our city tour. 


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After our lovely lunch, we met up with a tour guide and bus driver that Dr. Allende had arranged to take us around the city for a tour. Over about 2.5 hours, we saw all sorts of sites around Córdoba, stopping at a few to take a closer look.  We saw Parque Sarmiento  which opened in 1911 and is the largest public park in Córdoba, named after Domingo Sarmiento.  He was the former President of Argentina from 1868-1874 and was a promoter of public education (not named for the orthopaedic surgeon Augusto Sarmiento). We walked about the “Jesuit Block” which is an UNESCO World Heritage Site and Plaza San Martín. There we saw the historic Universidad Nacional de Córdoba which was founded in 1613 and is the oldest university in Argentina and 6th oldest in Latin America.  Currently, the University serves more than 111,000 students. Of note, Argentina provides free education to all of its citizens at its public university as well as free education to anyone from other countries who wishes to study in Argentina.  So, large numbers of people from around South America and beyond attend university in Argentina.  (We have also learned during our travels that Argentina also provides free health care through its public hospital system to anyone who comes for care – whether they are from Argentina or another country – so a huge investment by the country in education and healthcare). We saw Colegio Nacional De Monserrat which was the first high school in Córdoba, established in 1687 and is considered one of the most prestigious preparatory schools in Argentina. 
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Of course, they had to show us the Estadio Mario Alberto Kempes – the local Futbol stadium which is mostly used for association futbol matches, but is a source of local pride as it hosted the 1978 World Cup. 
 
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After our tour, we headed back to the hotel for a much-needed rest. We were then picked up at 8:45 and taken to the home of Dr. Allende and her husband Carlos – an architect.  We were immediately impressed with the architecture of their home, which he designed, as well as their amazing modern art collection.  In general, we have been very impressed with our orthopaedic colleagues’ appreciation of art as we have traveled around South America – something to aspire to!  All five of the Sanatorio Allende pediatric orthopaedic surgery staff attended the gathering with their spouses, as well as Paula the fellow (who had passed her exam earlier in the day – so a call for celebration!) and resident Guillermo.  Dr. Allende had prepared a fantastic meal and we stayed past midnight sharing life stories, discussing orthopaedic life, and having some interesting political discourse about the current state of politics in Argentina.
 
As it passed midnight, we started to say our good-byes and headed back to the hotel for a much-needed night of sleep.
 
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