10/30/2019 | by Coleen Sabatini, Apurva Shah and Salil Upasani
2019 SLAOTI/POSNA TF - Day 6
A nearly full night of sleep felt so good! We all had grand plans to make it down for breakfast, but we barely made it down in time to meet Dr. Juan Carlos Couto. He picked us up at our hotel with Dr. Daniel Yedlin and drove us over to the oldest children’s hospital in Argentina (and actually all of Latin America ) - Hospital Pedro De Elizalde. We were warmly greeted by Dr. Hector Klappenbach (host orthopedic surgeon) who welcomed us to the hospital and gave us a tour of their facilities.
The history of the hospital was interesting to hear. The hospital opened in 1779 as an orphanage. They had a metal turn-style where people could drop off babies and the hospital would accept them, no questions asked. The facility would take care of ill and healthy children and eventually grew into one of the biggest children’s hospitals in the city.
We also saw the cathedral that is on the facility grounds and a beautiful magnolia tree that has been on the grounds for more than 100 years.
We were then escorted to an auditorium, where we reviewed a number of cases presented by chief resident Dr. Perez Vargas Boris Ivan and fourth year resident Dra. Barbara Castro. They stumped us with a unusual case of a 6-year-old girl with arm pain that developed an osseous mass in the brachialis muscle - they promised to keep us updated on future information on the patient!
The differential diagnosis was quite large, but we narrowed it down to myositis ossificans, tumoral calcinosis, versus a benign bone-producing tumor. Additional cases permitted Apurva to discuss treatment principles for a child with a missed Monteggia injury and Coleen to review the management of a recurrent clubfoot in a teenage boy. Dr. Juan Pablo Albarracin also showed us some cases with excellent long-term outcomes. He presented the case of a 13-year-old boy with delayed treatment of a left dislocated hip. He was treated with an open reduction and Chiari osteotomy. At 14 year follow-up (27 years of age) the patient was doing extremely well with photos demonstrating excellent hip range of motion and a minimal leg length discrepancy. We were interested to learn about a technique to perform a longitudinal osteotomy of the talus to correct rigid cavovarus deformity. He also showed us some complicated cases of brachial plexus palsy that were treated with tendon transfers and/or humeral osteotomies. The clinical and functional outcomes were quite impressive.
After our morning visit at the hospital, we met up with Claudia (Dr. Couto’s wonderful wife whom we had the pleasure of dining with the night before as well) and spent a short period of time perusing the shops in Barrio Norte. Claudia was the perfect host to show us the best shops to go to and we were able to pick up some amazing gifts for ourselves and our families. The Couto’s treated us to a final meal in Buenos Aires at a local pizza shop called The Immortals (“Las Immortales”). Dr. Couto then drove us to the domestic airport to catch our flight to Cordoba. The visit in Buenos Aires was short – just about 30 hours – but Dr. Couto made it educational and tremendously enjoyable. We are greatly appreciative of his time and gracious hospitality. We particularly want to acknowledge his decades-long support of the POSNA/SLAOTI Traveling Fellowship program – a tremendous mentor to all of us who have had the opportunity to visit Buenos Aires.
Onward to Córdoba!
Our flight from Buenos Aires to Córdoba was only one and a half hours long. We were warmly greeted by Dra. Victoria Allende at the airport. Her effusive warmth and friendliness was evident from the moment we met her. She drove us to the heart of Córdoba to our swanky hotel to drop off our bags. On the drive to the hotel we learned about her family’s history. She was born in Córdoba and is a third-generation orthopedic surgeon. Multiple members in her family are in the field, including her grandfather who started as a general surgeon and then specialized in orthopedics in the 1970s. Her family has built two beautiful hospital in the city and provide cutting-edge treatment to the patients that they care for. Dra. Allende was a POSNA traveling fellow in 2005 and has been committed to making Córdoba an important destination for future traveling fellows to Argentina. We arrived at our hotel around 8:30pm and met up with Drs. Javier Masquijo, Diego Tourn, and Andrés Ferreyra along with Dr. Baxter Willis and his wonderful wife Sue. We quickly dropped off our luggage and went out to dinner to Sibaris, one of Dra. Allende’s favorite restaurants in town. Apurva could not get enough of the Argentinian beef, while Salil enjoyed a salmon ravioli dish and Coleen had a fabulous vegetarian pasta.
After finishing two beautiful bottles of Malbec from the north and south of the country and learning about the amazing team at Sanatorio Allende we were driven back to the hotel to get ready for a busy academic day in Córdoba.