Opening Doorz

By Dr Prakash Doshi | Opening Doorz Editorial | January 22, 2017

In past two decades there have been revolutionary changes in managing Orthopaedic issues.

When I started my private practice in the late 80s, a patient with multiple fractures was doomed for life. One look at the patient and his state and you knew that the road to recovery would be a long, painful process. It would be months and sometimes years before a patient would fully recover from the trauma of an accident with multiple broken bones. This, in turn, would wreak havoc in his lifestyle. He ended up in bed, recuperating, all the while looking at the ceiling!

In ‘recovery mode’, the patient remained unemployed and at times, financially drained out because of the costs incurred and his or her inability to be useful and resourceful!

Today, the situation is not the same. Science has turned the lives of an accident victim downside up! The world of medicine has taken a giant leap, in all areas, and especially so in the Orthopaedic field.

What has changed in past two decades?
With newer research and technological advancement, there is a sea change in managing the problems of Multiple Fractures and Severe Osteoarthritis. There is a fair amount of pain, no doubt; one cannot escape that, but the road to recovery is quick and full-proof as opposed to the earlier days.

Take the case of Rahul, a Mechanical Engineer by profession. This 36-year-old met with a major Road Traffic Accident (RTA). He was treated by me for his Multiple Fractures involving all the bones in both his legs. It looked like a lost case but thanks to the advancement in techniques, Rahul was up and about within three months.

With the art of Minimal Invasive Surgery, all his broken bones were fixed with plates and rods. Due to so much metal in his legs, he was nicked name the ‘Metal Man’. This marvel in Morden technology helped him back on his feet doing his normal work within two months. In the third month, he was back to his old self.

Twenty years ago, Rahul would have taken a year to 14 months to be his normal self and get back to his routine.

• More case studies
  Ashutosh Desai (80-years-old) came to me with a Complex fracture in his shoulder joint. It was a trivial fall but because of his age and since he was an Osteoporotic patient, it worsened his situation. In the normal circumstance, Desai would have been treated by sacrificing the shoulder joint and replacing it with an artificial one. In this case, with my newer technique, his own joint was preserved with the help of a Titanium Nail and full function was achieved.

• A young 19-year-old boy had not walked for past the past four years. Both his Hips were destroyed because of Rheumatoid Arthritis. With Special implants, his hips were reconstructed, and he was back on his feet, doing what he did earlier.
• A 62-year-old lady was able to travel all over Europe four weeks after a knee replacement surgery.

What is Minimum Invasive Surgery?
In this procedure, small key holes are made in the affected area and the fractures are fixed with plates and rods. This precision is availed with the control of Imaging. In this technique, the healing process is faster because biology of the bone is not compromised. There are smaller cuts in the skin so there is relatively faster healing and less infection. There is less loss of blood and a feel-good factor for the patient with good pain compliance. Moreover, the psychological factor is huge: The patient gets an early discharge from the hospital and there is a vacant extra bed to avail for a needy patient.

Joint Replacement Surgeries over the years have shown amazing results. With superior technology and newer Joint Material, the life of the Knee and the Hip implant is prolonged for more years. With Minimal Invasive Surgical Techniques, the Hip or Knee surgery patients start walking on the same day of the surgery.

In both, the hip and knee replacement surgeries, the procedures are similar and the average life of the implant is 18-20 years.

My Moto in treating a fracture patient: “It is important to add Life to Years, than Years of Painful Life.”

Minimal Invasive Surgery is all about early Mobility, because Life is Motion and Motion is Life.

(Names of patients have been changed on request).

(Dr. Prakash Doshi is Consultant and Chief of Orthopedics and Traumatology at Dr. B Nanavati Hospital, Mumbai, India)

.