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Today was day 2 in the OR. The team has acquired a comfort level very quickly as is usually the case on day 2. These are all medical professionals and they can orient themselves quickly. All the rooms operated smoothly with no significant issues. We did about 10 cases of varying complexity. Some relatively routine but some very challenging. Jose in an older gentleman who fractured his tibia, the large bone in the lower leg, 3 years ago. He was treated with an external fixation device. This is a construct involving inserting metal pins into the broken bone and applying an external metal frame that holds the bone in place while it heals. These pins and frame are typically removed at 6 to eight weeks. Jose for reasons unknown never had the pins and frame removed. He came to us 3 years later. Things can move slowly in Guatemala especially if you are poor. The bone had healed but at a 45 degree angle, not ideal. Today the frame and pins were removed, the bone was straightened, and a metal rod was inserted into the tibia bone to hold it straight until it heals properly. Jose was pleased with the results. We hope he will return for follow up appointments so his progress can be appropriately monitored. Sometimes that is a challenge. More to follow. Please know that we can feel your prayers and they are greatly appreciated. Blessings to you all.

-James Bruce

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