Advanced Orthopedic Services

Dr Ujwala from Kamothe Navi Mumbai is pathologist working with microscope. She also does lot of travelling. She has cervical spondylosis. This condition affects after the age of 30. Patient usually has pain in neck which is more with long sitting, travelling or with abnormal posture needed for certain professions (like computer Operator, beauticians, dental surgeons, pathologists etc.) Occasionally patient may have pain going in hands with tingling and numbness.
Diagnosis is done with x ray / MRI. Treatment includes training for proper posture, exercises, analgesic tablets. For those patients having more pain hospitalization may be needed for continuous supine traction and bed side physiotherapy with injections.

Mrs Susheela is senior citizen from Vashi Navi Mumbai with severe pain and restriction of movements at right shoulder. Frozen shoulder is commonly associated with Diabetes. Patient becomes disabled for routine activities like eating, combing hair. Frozen shoulder is diagnosed clinically. Here x ray does not show any bony problem. Treatment is usually control of pain with tablets and active exercises by patient herself. In selective patients injection of steroid inside joint gives good result. For advanced cases gentle mobilization under anesthesia is considered.

Mr Malhar from Nerul Navi Mumbai is sportsman having pain on outer aspect of Elbow. This tennis elbow is over use of hand particularly associated with frequent forearm rotations. Avoiding aggravating activities and painkiller tablets are must. Selective patient responds nicely to local injection of steroid.

Mr Kishore fromSanpada Navi Mumbai is in forties and obese. He travels a lot and his sitting job aggravates his pain. Lumbar spondylosis usually gives pain in low back and occasional radiation with tingling or numbness in legs. Treatment aims at exercises, weight reduction and change of lifestyle. Pain killer tablets are given as per need. Occasional patient needs injection in spine (epidural injection). Some patients particularly ladies after multiple deliveries and after menopause should go for thorough check up including bone density and vitamin levels to rule out osteoporosis (weakness of bone).

Mr Mahesh from Ghansoli Navi Mumbai is bank officer and does lot of writing work. Pain in the wrist area in the line of thumb is because of over use activities of thumb. Thumb is most important digit of hand particularly dominant side (the story of Guru Drona and Eklavya in Mahabharat is known). The tendon moving the thumb passes through small tunnel and gets inflamed because of overuse. Patient has to avoid heavy activities which involve use of thumb. Many patients respond to local injection to reduce inflammation.

Manali from Belapur Navi Mumbai is young lady in her twenties with multiple joint pains including small joints of hands. This pain of rheumatoid arthritis is more in morning time with stiffness. There is no definite cause for rheumatoid arthritis and so there is no definite treatment for this condition which can cure this disease at root level. Patient has to do regular check up, take regular drugs and do exercises to get optimum benefit. For more affected joint fluid removal and local injection of steroid and occasional surgery is justified.

Mrs Manju is from Kharghar Navi Mumbai. She has pain in her both heels without any history of injury. She can not put weight on heels in the morning time. This is painful heelpad. A suitably padded footwear, analgesic tablets, ointments is likely to give relief. For resistant cases local injection of anti inflammatory drug is justified. Painful heel pad is commonly associated with Obesity, Diabetes, rheumatoid arthritis and these associated conditions should be treated.

Master Anuj from Panvel Navi Mumbai is growing child having pain both knee areas. This epiphysities of tibia tuberosity is seen in children involved in sports.

Mr Mihir from Uran Navi Mumbai is executive working in company. His job involves long sitting with computer. This postural backache is tender at mid dorsal and lumbosacral junction of spine. Proper posture and exercises are to be considered. Patient should be assessed to rule out other serious illness.

This itself is a big subject. Child having deformed foot (CTEV / CDH etc) are congenital deformities and need early treatment by plastering or by surgery. Many growing children do not keep leg in proper way. They may have developmental deformities like Genu Varum or Genu Varus or Internal Tibial Torsion. Child’s fracture is usually easy to treat but parents are always in worry. Metabolic disorders like Rickets / Scurvy need special treatment. Many Primary Bone tumors are common in second decade of life.

For most undisplaced fracture plastering done on OPD basis is treatment of choice. Some of the displaced fracture needs proper reduction and plastering and this work is done in operation theatre under anesthesia and x ray control. Synthetic casting materials are costly as compared to traditional plaster of paris bandages but are costly.

Many displaced fractures can not be properly reduced of immobilized by plaster only and need surgical fixation. Open Reduction is commonly done for Ankle fracture and for Forearm fracture where bones and exposed with large incision and fixation done with plating. This technique allows early mobilization of affected limb.

This technique is commonly done for long bones like Humerus, Femur, Tibia, Radius, Ulna. Here the fracture is not opened with traditional long incision. Fracture is reduced manually and a small hole is made at one end of bone and nail is passed under Surgical C Arm Image Intensifier machine. Interlocking screws are passed through bone and nail proximal and distal to fracture are to control rotation. Because this surgery is done without big incision chances of infection are rare.

When fracture is associated with large wound where wound also need proper and frequent care external fixation is done. Here pins and passed through the bone and connected outside the body to give stability to fracture site. For comminuted fracture of lower end of radius external fixation applied after traction reduces the fracture with ligamentotaxis.

Total knee replacement and total hip replacement are established techniques for advanced knee arthritis and hip arthritis. Here the damaged joint surfaces (articular surfaces) are removed and replaced with suitable material (like metal, plastic, ceramic etc.). Those who have suffered the pain of arthritis get very good relief with this surgery.

Examination of joint usually Knee / Shoulder can be done by small telescope of 4 mm size which is connected with camera and t.v. Surgery for damaged cartilage (Medial and Lateral Meniscus) can be done with a small hole. Because this surgery is free from big incision (button hole surgery) rehabilitation is very fast. Patient can go home next day. Arthroscopic Knee Ligament Reconstruction is also very established technique (like Anterior and Posterior Cruciate Ligament Reconstruction). Recurrent dislocation of shoulder needs surgical repair of torn glenoid labrum.

Slipped disc (prolapsed intervertebral disc) in advanced stage usually do not respond to conservative treatment and can be nicely treated by discectomy. Many elderly patients have spinal canal stenosis and do not respond to rest. They need laminectomy for nerve decompression.

Mr Vasudev from Turbhe Navi Mumbai is having pain in right knee joint with occasional fluid collection. This osteoarthritis (knee arthritis) gives more pain while getting up from squatting, climbing, getting down staircase, kneeling (for household work or for namaj purpose). More advanced cases can have difficulty even in walking. The aim of treatment is to control pain and make patient comfortable. Since this is age related problem and in real sense can not be reversed. Early cases respond to exercises and change in life style. Slightly advanced cases need fluid removal from knee joint and injection of locally acting anti inflammatory drug. Walking stick can reduce the load on affected knee make patient comfortable. Weight reduction is always desirable for obese patients. Very advanced cases not responding to all other options are considered for knee replacement surgery. Surgery is costly and risky.