Saving the leg involved a series of procedures that required Lansana to wear a heavy brace -- first, to correct the deformity and then to undergo surgeries that were designed to lengthen the remaining healthy bone.
"We gradually pulled that piece of bone downward, towards the ankle, to fill in the defect," Rozbruch said. "And in that way, we [were able to] grow him new bone and essentially reconstruct his ankle, and attach what was left of his leg to his foot."
In stages, the bone was lengthened by nearly eight inches. Though his right leg is still shorter than the left, Lansana is able to walk without crutches and play soccer and basketball.
His emotional adjustment also was proceeding well, with help from Zlotolow and Cohen. "He was trying to figure out who we were, and were we going to be there for him," Cohen said. "Were we going to disappear?"
Zlotolow had a grown son and Cohen, a grown daughter. Their initial plans were to place Lansana with a young family. They took Lansana to an interview with an interested couple. But they soon realized they couldn't give up what they had started. In the process of breaking up, Zlotolow and Cohen had become more involved than ever in Lansana's life. Their commitment was dramatically illustrated by a decision that Zlotolow made. At the height of his career, he gave up his position at Sloan-Kettering Hospital.
"My job at Sloan-Kettering was the best," Zlotolow said. "I was the most privileged person in my specialty in the United States. But my job required 14 hours a day. I was in the operating room three, four days a week. And, you know, I just made this decision that it would be too hard to balance with raising this child and giving him the things that he needed."
Both Zlotolow and Cohen moved to where they previously had lived before working in New York -- Oakland, Calif. There, they reasoned, Lansana could have space, a house, and a yard to play in.
Zlotolow and Cohen didn't get back together as a couple. They live in separate houses, about a mile apart. In the two households where Lansana divides his time, he is involved in constant banter with his parents, who both work to help him catch up on years of missed schooling.
"Ian's more like the messy house, like a boy's house, and [Wendy] likes to clean house and keep everything organized," he laughed.
He also has learned the art of diplomacy. When asked which path he would follow when he grew up, he said, "I might split up the house -- messy in one corner, clean in the other corner."
The wartime traumas Lansana experienced still lurk beneath the surface of his emotions. He sees a therapist that Cohen calls the "worry doctor." There also are moments when he seems to be lost in the past, although they are becoming less frequent.
"There was one time we were driving down the highway, in silence, and there were tears coming down his eyes," said Zlotolow. "And I am sure there are times when he must be thinking of his family in Sierra Leone, and he gets quiet."
One more enormous adjustment remained, and came suddenly. In 2003, After Ian and Wendy had started the complicated paperwork to adopt Lansana, Lansana's father showed up at the hospital where the boy had been abandoned three years before and inquired after his son. Ian and Wendy arranged a phone call with the father, then told Lansana.