Skeletal Fluorosis can take several forms. Dr. Meyer and I try to concentrate on lower extremity deformities of the femur and tibia. Quite often the deformities affect the femurs and tibias, bilaterally. We then have to make decisions concerning how well the child can tolerate the procedures. Many times we have to operate on one leg at the beginning of the mission, and wait several days to operate on the other leg. This has to do with the fact that there is no blood bank, and even if there were, most Tanzanians will not allow the use of someone else’s blood. This is due, in large part, to the HIV epidemic in sub-Saharan Africa.

Although we have not conducted any surgical procedures concerning them, we have seen some involvement of upper extremities. Whenever possible, we try to conserve the few resources that we have in order to have the greatest impact on the children. If a child can still feed themselves, drink, and write, we use ours time and resources to help children who may not be able to walk.