Departments » Orthopaedics » Orthopaedic Trauma Surgery

MIOT started 10 years ago as a Centre for Trauma Care. Even today, this is a vital department in MIOT Hospitals.

Trauma does not affect one part of the body only. Today, because of the high velocity of accidents and injuries, trauma affects almost all the parts of the body. MIOT has the personnel and the equipment to resuscitate a poly traumatized patient who is critical. The Department is manned by qualified Surgeons, Orthopaedic Surgeons, Abdominal Surgeons, Vascular and Plastic Surgeons and Urologists.

Patients are received in resuscitation bays. Their contaminated clothes and dressings are removed. The accident victim is covered with sterile dressings, the general condition assessed, blocked airways restored, adequate fluid and blood transfusion given within a few minutes, and if all investigations including CT Scan and MRI are executed quickly, the patient is taken to the Operation Theatre for definitive treatment.

Sometimes, after a major accident we receive 30 to 40 patients and we are able to manage them without any problem, because of the availability of adequate staff and the right equipment.

Limb Lengthening and Reconstruction

Treatment Indications
Individuals with the following conditions may be candidates for Limb Lengthening and Reconstruction:

Leg Length Differences
Leg length differences (LLD) results from congenital, developmentat, posttraumatic or post-surgical causes. Congenital limb length discrepancy is present from birth and is associated with many birth defects and deformities.

Some examples include:

It occurs because the femur and/or tibia grow slower than on the other side. The rate of increase of the leg, length differences is progressive with one-fourth of the LLD present at birth, one-third by age 1 year and one-half bye age 3 years in girls and four years in boys.

Developmental LLD occurs during childhood secondary to alteration in growth of one or more growth plates of the femur or tibia. This may be as a result of injury to the growth plate from trauma or infection or slowing of the growth from disease processes such as polio, Blount;s disease or Ollier’s disease. Posttraumatic LLD occurs after fractures when bone heals in a shortened position after surgery.

Treatment goals are correction of LLD with associated deformity while preserving the function of muscles and joints.

Birth Defects (Congenital Deformities)
Congenital problems include limb length discrepancy as described above, contractures and stiffness of joints, angular and rotational deformities of bones, missing of bones, joints and parts of the limb )e.g. fingers, toes, hands and feet). In the lower extremity, foot, knee and hip deformities are commonly associated with congenital problems.

Treatment goals are correction of deformity and improvement of joint mobility and length discrepancy. In some cases, restoration of missing parts )e.g. fingers, foot can be achieved.

Post Traumatic Bone Deformities
Post traumatic bone deformities are fractures that heal in a displaced, angulated, rotated or shortened position. Gradually increasing deformity may result after fractures of the growth plate.

Treatment goals are accurate correction of deformities for limb realignment with simultaneous correction of associated problems (e.g. limb length discrepancy and infection)

Non- Healing Fractures (Non-Unions)
Fractures or osteotomies that do not heal result in non-unions. These may be associated with deformities, limb length discrepancy, infection and stiff joints.

Treatment goals are obtaining union with correction of associated deformity and limb length discrepancy.

Bone Loss from Tumour, Trauma or Infection
Tumour, trauma and infection can all lead to bone loss due to either the injury or resection. Bone loss may be manifested as a bone defect or as limb length discrepancy or both.

Treatment goals are re-establishment of the integrity of the bone with elimination of the bone defect and restoration of limb length.

Congenital Pseudoarthrosis
This rare disease leads to non-healing fractures of th tibia and more rarely, the forearm bones.

Treatment goals are to obtain but also maintain union of the bone and to correct deformity and limb length discrepancy

Joint Contractures
Joints may be limited in their movement from tight muscles or capsule or from scarring in the joint.

Treatment goals are correction and increasing the range of motion of the joint.

Bone Infections (Ostoemyelitis)
Bone infection may be a result of fractures or blood borne infection (usually occur during childhood).

Treatment goals are elimination of infection and associated problem such as non-union, deformity and limb length discrepancy.