The Department of Orthopaedic Surgery provides state of the art treatment ,world-class, evidence-based treatment in all fields of Orthopaedic Surgery including Trauma and Accident Surgery, Spine Surgery, Joint Replacements, Sports Medicine and Arthroscopy. The facilities provided in the department have expanded steadily and today it performs more than 500 major surgeries per year . We have a modern rehabilitation department with dedicated team of rehabilitation specialists that provides excellent pre, intra and post-operative care. We have experienced and dedicated Rheumatologist for managing Arthritis patients. Our team of doctors is supported by highly experienced physiotherapists and occupational Therapist that provide out-patient, in-patient as well as domiciliary care to the patients.
Clavicle fractures are one of the most common fractures seen in outpatient department they occur due to fall on outstretch hands, RTA. Most of the times clavicle fractures are treated conservatively. The surgical treatment is indicated in patients with tenting of skin over the fracture site, open fractures, nonunion and if neurovascular deficit is present. Patients who are treated conservatively will require 3 weeks of immobilization followed by shoulder strengthening exercises. The surgical treatment is in the form of plate fixation and immediate mobilization of the shoulder joint.
Proximal humerus fracture are common both in young and elderly patients, which occurs due to either trivial fall or due to RTA. In all age groups the proximal humerus fractures are treated by open reduction and internal fixation with locking plate. The aim of fixation is to achieve good range of movements and quick recovery. The most common complication encountered are stiffness of the shoulder for which prolonged physiotherapy is advised. Other complications include avascular necrosis of the humeral head which may require joint replacement surgery at a later date.
Simple fractures of shaft of humerus are commonly treated by Open reduction and internal fixation, which is a gold standard method followed till now. In situations of segmental comminuted fractures of humerus, minimal invasive surgery is indicated in the form of interlock nailing. Fixation of humerus fractures gives us the opportunity to mobilize the shoulder and elbow joint early and stiffness is avoided. All the patients are immediately subjected to physiotherapy so that the stiffness the joints is avoided. However, the most common complication in humerus fracture fixation is radial nerve palsy which usually recovers over a period of time.
Fractures around the elbow are notorious fractures which results in stiffness of the elbow which is very difficult to treat. Most common mode of treatment for distal humerus fractures is open reduction and internal fixation with contoured locking plates. Extra articular distal humerus fractures are treated with either special locking plates or Ender's nails and additional plate fixation. After surgery the patients are advised immediately to do physiotherapy in the form of active and passive elbow mobilization.
The neck of femur fractures are common in elderly age group due to osteoporosis and trivial fall results in fractures. They are best treated by joint replacement surgery in the form of either hemi or Total hip arthroplasty. The main aim is to mobilize the patient as early as possible so that we can prevent prolonged bed ridden complications like hypostatic pneumonia, bedsores, sarcopenia, decreased cardio respiratory reserve. On the second day of surgery patient is mobilized with full weightbearing with walker support.
The neck of femur fractures in young patients usually results due to high velocity injury. In young patients the femoral head is preserved and stabilized with cancellous screws. If the patient presents late with neck of femur fracture, treated with valgus osteotomy, bone grafting and DHS fixation.
Trochanteric fractures results due to trivial fall in elderly patients, high velocity injury in young patients. In all age groups, trochanteric fractures are stabilized with either DHS or proximal femoral nail. If the trochanteric fracture is found to be grossly comminuted in elderly patients, they are better treated with cemented bipolar hemiarthroplasty. All the patients are mobilized immediately on second day after surgery with full weight bearing walking.
Femur fractures often results due to high velocity injuries, especially RTA. Subtrochanteric fractures are treated with open reduction and reconstruction nailing. Shaft fractures are well managed with inter locking nailing, distal third femur are managed well with locking compression plate and retro- grade nail too. Patient who underwent nailing are mobilized immediately from the 2nd day onwards with full weight weight bearing. Those who are plated are mobilized early with weight bearing after 6weeks. Most dreaded complication is ARDS- Adult respiratory distress syndrome, hence femur fractures need careful evaluation especially in youngsters.
Most commonly occurs due to high velocity injuries like RTA in youngsters and following a trivial fall in the elderly, these are managed with inter – locking tibial nailing , Expert tibial nail, locking plates and buttress plate especially for tibial condyles. Distal tibial fractures are know for its complication due to poor vascularity can also be managed well with nail and locking/ Dynamic compression plate.
Ankle fractures are very common both in younger and elderly age group, mainly following a simple twist and fall, which needs accurate reduction due to its articular involvement. It can be fixed with k-wires , malleolar screws, tension band wiring and plate, hence , patient can be mobilized earlier.
Foot injuries are very common following a trivial fall , fall from height , RTA – crush injuries etc. These can be managed well with small plates , k-wires and screws. Fractures like phalanges are usually treated with strapping.
Talus and calcaneum happens following fall from height, Talus can be fixed with cancellous screw and calcaneum can managed conservatively if without much displacement, if displaced needs k-wires, calcaneal plates.
Acetabulum fractures usually results due to dashboard injury. Posterior fracture dislocations are most common among all acetabulum fractures. Posterior dislocation is reduced immediately under anaesthesia and immobilized in Thomas splint. Post reduction , fractures are evaluated by CT and fixation planned accordingly are with reconstruction plates and screws.. Pelvis and acetabulum fractures are usually associated with complications like sciatic nerve palsy, deep vein thrombosis. Femoral head fractures are usually associated with fracture dislocations of the hip joint and are stabilized with either Herbert screws or cancellous screws . They are highly associated with risk of developing avascular necrosis of the femoral head which usually result in arthritis of the hip joint necessitating total hip replacement surgery.
Fractures of the forearm are considered as intra articular fractures and hence radius and ulna fractures are best treated by open reduction and internal fixation with dynamic compression plates.. Forearm fractures are immediately mobilised after fixation and in comminuted fractures iliac crest bone grafting is advised.
In elderly patients, Colles fractures are treated usually by closed reduction and either plaster application or percutaneous k-wire fixation. The wrist joint is immobilised in plaster for a period of 6 weeks followed by rigorous physiotherapy. The most common complications are wrist stiffness, pintrack infections, malunion, dinner fork deformity and shoulder hand syndrome. Wrist stiffness and shoulder hand syndrome are best treated by aggressive physiotherapy. Young patients usually present with comminuted fractures and volar bartons fractures which are treated with plate fixation through volar approach.
Most commonly due to high energy trauma or fall from height and associated with extremeties injury. Patient usually presents in a state of shock characterized by hypotension, tachycardia, difficulty in breathing and they can be associated with chest or abdomen injuries. They need immediate proper resuscitation in the form of I.V. fluids (colloids &crystolloids), emergency stabilization of pelvis. Pelvic fractures are often associated with high mortality and morbidity and need to rule out other internal organ injuries. Once the patients general condition is stabilized, both anterior and posterior ring stabilization is done in the form of plate fixation. After surgery patients are mobilized after a period of 6 weeks.
Arthritis of hip and knee are common crippling disorders which requires joint replacements Arthritis of shoulder, elbow and other joints are relatively rare. A well established joint replacement unit with state of the art operation theatres and team of doctors, occupational therapists, and physiotherapists to take care of these patients.
Our hospital has world class oncology department with dedicated orthopaedic and oncology team along with state of the art equipments and investigative tools to treat all types of cancers including bone and soft tissues tumours
Our orthopaedic department provides arthroscopic key hole surgery for sport injuries in young patients which are disabling. Rigorous rehabilitation is provided for such patients by our rehabilitation team enabling them back to sports activities.
Our hospital provides comprehensive spine care with dedicated neurosurgeon available round the clock .