Determined little titanium man defies the odds

By ANNE BESTON

He was the boy who never smiled, who didn't know what a hug was.

Now he's a sports-mad 8-year-old who talks about competing in the Paralympics.

Andrey McNaughtan was shunted from one Russian orphanage to another for the first three years of his life after being abandoned by his biological parents soon after birth. He was born with only half a ribcage, a malfunctioning lung and a crooked spine, and there were few medical resources to treat Andrey in his native country. He seemed doomed to die young.

When New Zealand teacher Pam McNaughtan, 49, was thinking of adopting him, she was told he never left his room and never smiled.

She was not told the full extent of Andrey's disabilities when she made the decision to bring him to New Zealand, but now she is glad she didn't have the chance for second thoughts.

"I wouldn't change things for the world," she says.

When Andrey arrived in Auckland in 1996, Ms McNaughtan took him to paediatric orthopaedic surgeon Dr Stewart Walsh for treatment. But the surgery Andrey needed, to replace his missing ribs with rods made out of titanium, was in its infancy. Only one hospital, in the United States, could carry it out.

With fundraising under way to pay for the treatment Andrey will need as he grows up, he flew to Santa Rosa Children's Hospital, in San Antonio, Texas, to have a titanium ribcage implanted.

The operation was performed by Dr Robert Campbell and Dr Melvin Smith, the paediatric orthopaedic surgeons who pioneered the titanium rib procedure.

The "rib" is actually a titanium rod with varying curvature which conforms to the shape of Andrey's thoracic cage - the part of the body, including the lungs, which is normally protected by the ribcage.

The titanium rod is placed vertically along the chest wall by attaching each end to natural ribs above and below the site of the defect.

It then acts as a protective "patch" over areas where ribs are missing. The implanted rods also act as a brace and are designed so they can be expanded as the child grows.

Andrey has had 10 operations and will need at least 18 more as he approaches adulthood.

This year has been a rough time, with surgery in February followed by a virus which kept him out of his year four Epsom Normal Primary class for eight weeks.

But Andrey's physical problems don't stop him for a minute.

"He's incredibly competitive, he's sports-mad and he's got great determination," Ms McNaughtan says.

Andrey plays soccer at a grade a year below his age group and is a keen runner and swimmer.

He is also a bit of a celebrity. His story appeared in theReader's Digest earlier this year and the youngster is such a hit with Dr Campbell that the surgeon took time out from his honeymoon this year to visit his young patient in Auckland.

"I know I'm prejudiced but he's just such a great kid," Ms McNaughtan says.

Titanium rib surgery is so new that none of the children who have undergone the procedure have yet reached adulthood. Ms McNaughtan does not know whether Andrey will always need his artificial ribs.

"But hopefully he'll lead as normal a life as possible ... he'll have a great life."