#fracturesaroundjoints

Trauma

In our Emergency & Trauma facility or injured patients with life-threatening conditions, are immediately taken under the care of a team of specialized emergency doctors and the patient is evaluated, resuscitated and stabilized as per protocols.

Trauma And Fractures Patients of all ages can experience trauma and fractures.These serious injuries can occur during auto accidents,Life-threatening falls,trival trauma and other scenarios.Unfortunately,they can have a long term impact on patients functionally and even affect their quality of life. We have pioneered surgical techniques and technology to improve results for patients who have experienced traumatic injuries Conditions Bone fractures are extremely common resulting in isolated fractures and dislocation, we treat the full range of these injuries, no matter how complex, including long bone fractures of upper and lower extremity. we also specialize in treating post-traumatic conditions such as malunions, non-unions and osteomyelitis (infection to bone). Trauma And Fractures Symptoms: Deformed bone accompanied by broken skin or visible bonepainswelling, bruising, tenderness, abnormal mobility Diagnosis: Fractures and post-traumatic orthopaedic conditions are typically diagnosed with a combination of a physical examination and imaging. Frcatures are usually diagnosed using X-rays other modalities might also be used CT-scan and MRI. Treatment Fractures of upperlimb, lowerlimb,pelvis and post traumatic conditions can be treated with surgical and nonsurgical procedures depending on the condition. Common nonsurgical procedures include:

Immobilizing devices such as casts,splints,braces and traction.

Medication such as antibiotics for infection

physiotherapy

Surgical is necessary to fractures which cannot be treated by conservative means of treatment.It can be External fixation and Internal fixation.

Open Reduction and Internal Fixation:

Frcature site is adequately exposed and reduction of fracture is done. Internal fixation is done using devices such as k-wires, plates, screws and Intramedullary nails.

External Fixation

Exfix is a procedure done in

Open fractures

Comminuted and unstable fractures

Limb lengthening procedures

Fractures with infections or non-union

We work with each patient to choose a personalized treatment likely to have the best long term outcome.

Internal Fixation

Most commonly done for all variety of fractures

BEST ORTHOPEDIC DOCTOR IN HYDERABAD DR. KIRTHI PALADUGU M.S.(ORTHO). After Endorsing the Degree “Master of Surgery in Orthopaedics”, with the support of my professor’s & Associated Staff had extensive unparalleled exposure to the Trauma (Accident & Fracture) Cases. With usual Curiosity & Perseverance in the field of Joints, to give back my Society & the Country at world class levels, been to Germany in 2014 for the Exclusive & Extensive Training in Computer Assisted navigation & Revision Joint Replacement Surgeries. Underwent training in AO Pelviacetabular Trauma in Bengaluru - 2014 Took extensive super speciality training in the feild of advanced Arthroscopy of Knee, Shoulder, Hip and Cartilage reconstructive surgeries, sports medicine at various reputed centers in Singapore, France & London. Now I have been Associated with SRIKARA HOSPITALS since 2013 at Secunderabad have emerged to be the Consultant Arthroscopy, Computer Assisted Navigation Joint Replacement & Revision Surgeon at SRIKARA MIYAPUR.

SPECIALITY

Arthroscopy

Joint Replacements

Revision Surgery

Trauma

EDUCATION

Master of Surgery in Orthopaedics

Joint Replacement Surgeon

Sports Medicine Surgeon

EXPERIENCE

10 Years Experience as Surgeon.

PHONE

+91 9177 679 797

WEBSITE

https://www.drkirthipaladuguorthosurgeon.com

Contact Us

KNOW ABOUT  KNEE

VITAMIN - D

Essential for healthy bones, teeth, muscles.

Vitamin - D is need to help body absorb calcium & Phosphate from our diet.

Lack of Vitamin - D

75% suffer deficiency

Rickets (Children)

Osteomalaria (Adults)

Rich Sources:

- Sunlight conversion of inactive from Vitamin - D to active form (UV-B Radiation) - At least 10 - 15 min of exposure to sunlight in essential per day, dark people need to spend longer than people with light skin

Other Sources:

Oily Fish, Mushrooms, Cheese, Cereal and Oatmeal egg yolks, MilkEveryone of us goes through the paediatric (childhood), adolescent /adulthood and gaediatric (elderly) phase of our life. We do encounter certain normal deviations, abnormal conditions, traumatic conditions (accidents), sports injuries and degenerative changes/arthritis, last but not the least infections.

Paediatric Age Group

Briefing upon the kids commonly encountered conditions are the knock

KNEE

- most of the time physiological, bow knees &  growth pains (tibial splints) which gradually disappear as the child grows. Need to have a check on vitamin D levels and metabolic disorder, congenital abnormalities to be evaluated. If gross surgical intervention to be done such as growth plate pinning/staples and also the corrective osteotomies (Bony Procedures).

Adults

In adults we commonly encounter patients coming with accidents followed by fracture around the knee & ligament injuries either by accidents or while sporting and few incidents of self fall at home with sudden twisting force.

Trauma

Most common bony injuries around knee and distal femur fractures, Proximal tibia fractures, patella fractures. Intra articular fractures requires meticulous pre-op planning. Articular reduction is mandatory & should confirm intra op with arthroscopy.

Knee Arthroscopy

On contrary to the fracture, the ligament injuries & the cartilage defects will be neglected in the initial stage as they start troubling at later dates. Either the knee can be hurt/injured with ligament tears such as ACL tear, PCL, MCL/LCL injury, which mainly cause the instability(giving away). MRI does help in diagnosing the level of injury, grading of the ligament tear and need for the repair.

These ligament reconstructions are the minimally invasive arthroscopic surgeries. Where in the entire knee joint is addressed with 2 to 3 portals. Once the diagnostic scopy is done, and noted with the status of the meniscus, cartilage & the ligaments.

Meniscus repair can be done with the special implants such as fast fix, meniscal cinch, etc. Except for the complex  tears where the partial / subtotal meniscectomy will be done.

Most of the times, ligaments such as MCL & LCL injuries occur at the bony attachments and they do heal well with the conservative management with braces.

Stem Cell Therapy

In minimal traumatic conditions and in case of cartilage loss (PRP/BMAC)

In many of the cases in the early stages of osteoarthritis or small cartilage loss/defects, physiotherapy & some medications to prevent further damage and enhance recovery to a greater extent. In small percentage of cases it does require debridement &  the latest advent procedures such as STEM CELL THERAPY (PRP/BMAC). Following MRI if required an arthroscopic debridement (wash) will be done & for lesions approx less than 5mm PRP would be done & also if there is partial tear of ligaments PRP injection would enhance healing.

In cases upto 10mm lesions PRP along with fibrin glue would be sticked to the cartilage defect and allow it to heal. Knee bending can be done immediately after the procedure & if there is weight bearing area involved in the procedure, weight bearing will be delayed by 3-4 weeks.

In cases of large cartilage defects 1-3cm & depending upon the area of involvement OATS (Osteo Articular Transfer System/ Osteochondral Autograft Transplantation), if the lesion is smaller damaged cartilage is replaced & transfered from the non weight bearing  portions of the knee to retain the best functionality & biologics.

Total Knee Replacement

Who needs knee replacement·

Patients not able to stand/walk for 10-15 minutes· Pain more than 6 months to 1year· History of difficulty in day to day activity· X-Ray shows severely damaged joints (GradeIV)· Medical/Physical Therapy & preservation procedures have not been helpful· Patients without neurological deficits pain being the main cause for the disability.

Benefits of Knee Replacement

Total knee replacement can increase mobility and decrease pain in people who have an injured or arthritic knee joint. More than 90 percent of patients who have knee replacement surgery experience less pain and greater mobility in their knee after the procedure.

Unicondylar Knee Replacement

In very few percent of patients where in only the medial (most commonly) are the lateral compartment is involved a Unicondylar Knee Replacement can be done which restore the alignment & balances the Knee from further deteriorating & delaying in the arthritic changes in the other compartments of the knee joint.

Advantages of Unicondylar Knee Arthroplasty·

Smaller incision faster recovery· Retaining the ligaments retain the natural proprioception · High flex & patient can be made sit cross legged· Less bone loss/cuts --> less pain--> less time off the work

Contra indications·

Involvement of the multiple compartments· Inflammatory/Rheumatoid Arthritis· Obese patients/short patients· Ligamentous / Neurological deficits

When a patient has a grade IV OA knee with medial, lateral & anterior compartment involvement with gross deformities patients have to go for the Total Knee Replacement Navigation helps in determining the size of the implant & the balancing of the knee intra operatively also double checking with each and every cut taken. It has made the balancing more and more precise.

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KNOW ABOUT HIP 

Hip Joint is the largest and the most stable joint in the human body. It is the largest ball socket joint, socket cup formed by the Acetabulum, which is the part of pelvic bone and the ball is formed by the upper end of the thigh bone (Femur). The ligaments and the hip provide stability, acting in coordination during each and every degree of mobility in our day to day activities.

Common Causes Of Hip Pain  OSTEOARTHRITIS : Age related wear and tear seen in people of 50 years and beyond where bones rub against each other causing pain and stiffness.

Rheumatoid ARTHRITIS : An autoimmune disease in which the synovium in  the cartilage destroys the cartilage. It is also termed as Inflammatory Arthritis.

AVASUCLAR  NECROSIS  (AVN) Any  injury to the hip, previous dislocation, childhood disease, long term use of steroids smoking and alcoholism may result in lack of blood supply, leading to the collapse, deformation and arthritis of the Hip. 

Trauma: In old age, fractures are more commonly seen around hip due to trivial fall. Replacements are done like Intracapsular, where the replacements can be partial or total. In Extracapsular, expertisemobilize the 

fractured hip geriatric patients specially to prevent complications such as bed sores, chest infections, deep vein thrombosis, paralytic ileus (decreased bowel mobility) and painful toilet care, Surgery is performed taking overall condition of the patient into account.

Key Hole Surgery for Hip: Arthroscopy is a surgical procedure that allows to diagnose and treat problems inside a joint with the help of Arthroscope.Femoral Acetabular Impingement:Snapping Hip SyndromesLoose Bodies in the Hip Joint

BMAC: Avascular necrosis is another common condition seen in middle aged patients where patients need to get evaluated immediately and need to take proper treatment to prevent progression with minor surgeries. It is treated in early stage with core decompression of femoral head with bone marrow augmentation, where bone marrow is collected from iliac crest. Here, around 60cc of BM is obtained to produced 6ml of concentric BM. The collected cells are precursorsget activated when injected into joint and this has potential to enhance healing and recovery.

Middle age: Ankylosingspondylitisis seen in those who are middle aged with associated back pain. This usually require surgery and further medications to prevent stiffness and increased ROM (Range of Motion)

Old age: Most common conditions in old aged patients with hip pain are fractures due to Trivial fall, Osteoarthritis, Rheumatoid Arthritis, Avascular necrosis. Those with family history overweight, injury to hip andobese people are more prone to this.

Partial Hip Replacement In Partial Hip Replacement, fractured head is removed and replaced with prosthecis . Only the femoral head removed & replaced with metallic stem & ball.

Total Hip Replacement  In Total Hip Replacement surgery, the damaged bone and cartilage is removed and replaced with prosthetic components. The damaged femoral head is removed and replaced with a metallic stem that is placed in to the hollow center of the femur. A metal or ceramic ball is placed on the upper part of the stem. The damaged cartilage surface of the socket (Acetabulum) is removed and replaced with metal socket to allow for a smooth gliding surface. 

Is Hip Replacement For You? The decision to undergo hip replacement is made by you, your family and the treating Joint Replacement surgeon.

Candidates for surgery There is no age or weight restrictions for Hip replacement and is based on patient pain.

When is Surgery Recommended ? • Hip pain that limits everyday activities like walking stairs, bending etc. • Pain at rest – day or night • Stiffness • Inadequate relief from medication, physiotherapy and walking aids.

Surgery Evaluation Medical history of the patient is first checked. Physical examination includes hip mobility, pain score strength alignment. X-rays show degeneration/deformation while MRI is helpful in soft tissues condition and early stages of AVN.

Realistic Expectations Most patients who undergo Hip replacements experience significant/dramatic pain relief and improvement in the ability to perform daily activities. With aging, the prosthetis material between the head the socked (liner) begins to wear.  With appropriate activity and life style modification, hip replacements can last for years.

Surgical Protocol Once the need for surgery has been decided, the patient will undergo a set of surgical profile, medical /cardiology clearance and pre anesthetic evaluation. The implant to be used will be chosen according to the patient requirements and is based on the quality and strength of the bone.Patient will be staying in the hospital for 2-3 days initially for pain management. Wound heals after approximately 2 weeks of surgery.

Post Operative Care There has to be a graduated walking program followed by normal activities such as sitting, standing and climbing stairs in 3-4 weeks

Possible Complications of Surgery The rate of complications in hip replacements in as low as 2% world wide. These include infections, blood cots, limb length inequality, dislocation etc.Hip replacement in a boon for the patients with severe hip pains impacting the day to day activity. The success of the surgery is based on the selection of the patient, education of the patient before and after surgery, necessary evaluation and right expert intervention.

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