Deepa Adivasi a little girl of two years was facing a rare disability since birth that de-shaped her legs to an extent that walking would have been almost impossible for the child. The resident of Chhatarpur (MP), Deepa’s father, a manual laborer, visited multiple hospitals. Deepa’s surgery was denied by most hospitals. Along with, he could not afford the high cost of surgery. He then visited Narayan Seva Sansthan, Udaipur in March 2019 where the disease was immediately diagnosed, and she was admitted for surgery.
Deepa got operated for an Orthopedic Conditions called Congenital Pseudarthrosis of Tibia (CPT) in Narayan Seva Sansthan, Udaipur based non – profit organization. After the Blood tests and MRI was done to rule out other diagnoses. She was operated for 5-hour long surgery. During surgery, the abnormal segments of both left leg bones were cut leaving a gap of 8cm in the leg; 8cm of fibula bone from the right leg was cut out and put in the left leg to fill this gap. Additionally, bone pieces (bone grafts) and periosteum graft were taken from left pelvis bone and placed around the grafted bone to increase chances of the union.
Congenital Pseudoarthrosis is very rare disease and considered one of the most challenging diseases by orthopedic surgeons because of multiple surgeries involved, bones do not unite, or the bones get fractured again after uniting, and some shortening or deformity remains.
Dr. Ankit Chouhan, orthopedic surgeon-in-charge of this case mentioned that the most challenging part of this surgery is to completely remove the abnormal bone covering layer of soft tissue, called periosteum, failing which the disease tends to recur. This layer lies very close to major blood vessels and nerves, and its removal is a very meticulous job. The anesthesia part of this long surgery in a very young child was carefully managed by Dr. Vaibhav Ghadoliya, the senior anesthetist at Narayan Seva Sansthan.
Prashant Agarwal, President of Narayan Seva Sansthan, said, “As our motto is to serve Humanity. Narayan Seva Sansthan has operated over 3.7 lakh patients in the last 30 years and has provided them full socio-economic support by availing best of the medical services, medicines and technologies in free”.
Further Dr. Ankit said, “In the next step, the orthopedic team plans to apply the Ilizarov frame on the operated leg of the patient.”
Ilizarov is a Russian technique of external fixation of bone using wires, screws and metallic rings. With this method, the child can be made to walk on the operated leg, and its length can be increased to make it equal to the other leg. Finally, the bones were fixed with rods.
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