A young man with enormous tenacity and a luminous smile was born with several bones in his limbs shortened, fused or absent.
At last, he is walking comfortably – thanks to the lifelong and dedicated care and support of his mother and an innovative orthopaedic surgeon.
“I first met Keenan Petersen when he was only 15 days old, and it is wonderful to see the bright, well-adjusted and optimistic person he is today at 18-years-old,” said orthopaedic surgeon Dr Sietse Wouters, who has practised at Netcare Garden City Hospital for 23 years.
A genetic abnormality led to Keenan being born with shortened arms, no hip joint and no femur in his right leg, which as he grew, resulted in this leg being considerably shorter than his left leg. In 2005, when Keenan was only a year old, Dr Wouters performed the first in a series of operations to develop Keenan’s capacity for mobility.
When he was born, his mother, Rowena Cohen, was told by doctors he probably wouldn’t be able to walk, so they did not try and teach him to walk. He quickly figured out his own way around by shuffling on his bottom.
Having always had to figure out his own method to doing things, an ambitious Keenan, who is now in matric, plans to pursue tertiary studies in information technology. “I see myself as differently-abled, and I never let it hold me back from anything. I find my own way, and this has become part of my approach to life.”
About seven years ago, he and his mother went back to the hospital due to back pain. “He was growing up and developing physically, mentally and emotionally and was suffering from positional scoliosis, which is an abnormal side curvature of the spine,” explained the surgeon.
He had developed a way of walking with the left knee steeply bent to 110 degrees, to accommodate the straight, but too short right leg. The resulting pelvic tilt and awkward gait affected his back badly. “Keenan’s case was unique, very few doctors had seen something quite like this in South Africa. I did a lot of painstaking research and consulted highly experienced international colleagues before we decided on the most feasible approach to surgery.”
In a seven-hour procedure at the same hospital where he was born, Dr Wouters and the medical team did a Steel’s Ilio-femoral fusion in which Keenan’s right knee was fused into the pelvis, which allowed his knee to function as his hip.
“Now that he had a ‘hip’ and could bear weight on the right side, we were closer to establishing a stable leg for him, but it was still 27cm shorter than the left leg. The next challenge was that Keenan’s normal right foot could not accommodate a prosthetic leg.”
Dr Wouters explained to Keenan and his mother that amputating the foot on Keenan’s affected leg would finally allow him to use a prosthesis to walk upright, relieving the pressure on his spine when walking. “For each procedure he suggested, Dr Wouters would explain the benefits, ask for Keenan’s input and give us time to think it over. The amputation was a big decision, but when we could see what Dr Wouters had in mind, we decided it was the best option,” said Rowena.
The doctor performed a procedure known as a Syme amputation, where the foot was removed, and Keenan’s heel was stabilised in line with his hip to create a cushioned stump that would more comfortably fit a prosthesis.
Keenan thinks this was a hard decision, yet worthwhile in the end, “The journey with my surgeries was a scary experience; I would get nervous and feel sad sometimes. None of this would have been possible without Dr Wouters, and I cannot thank him enough.”
He recently attended his matric dance.
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