After 10 surgeries for congenital vascular malformation in her right leg in Cambodia, eight-year-old H. Silvy (her name has been changed for privacy) still couldn’t walk normally. Fortunately, after her 11th surgery at FV Hospital, she took her first steps.

Silvy, aged eight, girl couldn’t walk independently, even after 10 leg surgeries.
Unfortunately, H. Silvy was born with a congenital leg vascular malformation. At just one month old, she had to undergo surgery. Since then, Silvy has endured 10 surgeries in her home country. However, these treatments did not help her walk, and her leg developed more complications.

“For eight years, someone has almost always had to carry her, and Silvy could only move with support. Her leg was bent about 120 to 130 degrees, unable to straighten. When she moved, her back would tilt to one side, and walking was very difficult and painful,” said Ms S. Mary, Silvy’s mother, describing the challenging circumstances her daughter faced. Due to the pain she experienced during previous treatments, Silvy developed a fear of medical personnel, making her treatment even more challenging.

All of Silvy’s activities relied on her family members because she couldn’t walk normally. Her mother, in particular, was experiencing hardship. She carried and did everything for her in daily life. Despite not being wealthy, they searched tirelessly for expert doctors to treat their daughter. They were heartbroken seeing Silvy endure excruciating pain. Her condition severely impacted her physical and psychological development, leaving her in a constant state of fear, anxiety, and depression. Her family knew that if she couldn’t walk, her life in the future would be difficult.

Introduced to FV Hospital by acquaintances, despite the distance, Ms S. Mary was determined to bring her daughter to Vietnam in search of care.

Life-changing surgery

Dr Truong Hoang Vinh Khiem, a Specialist Level II at FV’s Bone & Joint Centre, was the physician directly responsible for examining Silvy. He determined that Silvy’s condition was a type of vascular malformation that caused an increase in blood vessels, leading to blood vessel enlargement in her leg. Additionally, Silvy’s case was complicated due to her many previous surgeries, which resulted in scarring and the development of fibrous tissue in her leg. Further surgery was challenging and risky. However, without prompt treatment, Silvy’s condition would adversely affect the development of her back and left leg, causing her spinal curvature to worsen.

“This is a very challenging case for orthopaedic surgeons. The area behind the knee, known as the popliteal fossa, is particularly dangerous and challenging for surgery. Additionally, operating on a vascular malformation in a region that has been operated on multiple times, creating scar tissue, and trying to dissect individual anatomical structures in the popliteal fossa is an extremely daunting task. The worst outcome is that accidental damage to an artery could result in the loss of the leg,” Dr Khiem emphasises.

After thoroughly examining Silvy, Dr Khiem decided to perform the surgery, which marked her 11th surgical procedure. “My main goal when conducting the surgery is to help Silvy regain the ability to walk on her own legs. Even if she can only walk with assistance, use walking frames, or crutches, she can at least become more self-sufficient and relieve the burden on those around her, especially her mother,” Dr Khiem states.

The surgery was primarily overseen by Dr Truong Hoang Vinh Khiem, Specialist Level II, and lasted more than four hours. Dr Khiem used surgical glasses to examine blood vessels, removed contracted soft tissue, eliminated vascular malformations, and delved deep into the joints to completely free them up. Subsequently, he used a technique to lengthen and straighten the child’s leg and fixed the joint.

After surgery, Silvy’s right leg had been straightened almost to its normal position. Just one day after the operation, she received physiotherapy, taking her first steps using both legs. Despite experiencing pain from the leg correction surgery, Silvy persevered in learning to walk, encouraged by her mother and the medical staff.

At the follow-up appointment on September 20th, about a month after the surgery, Silvy can walk with the help of a walker without assistance from family members. Her right leg, although still wrapped with a brace to prevent retraction, can almost be fully extended.

Ms S. Mary mentioned that her daughter is continuing with physiotherapy, and her condition is gradually improving. Looking at her daughter’s steps, she begins to dream of a brighter future for Silvy: she imagines Silvy running and jumping on her own two feet, carrying her schoolbooks to school like her peers. She expressed deep gratitude, saying, “We are very lucky that we decided to bring our child to FV for treatment. Our family is very grateful to Dr Khiem and the medical staff at FV Hospital for helping my daughter to have a new life.”

According to Dr Khiem, Silvy will need to undergo several more surgeries to achieve a more normal walking gait.

To learn more about surgeries at the Bone & Joint Centre, FV Hospital, please contact: (028) 54 11 33 33.