Categories
ddh Deformity Correction and Limb lengthening Pediatric Orthopedics

DDH Revision Surgery – The Arthrogram Advantage


DDH is a challenging Pediatric Orthopedic problem. The earlier the treatment is started better the result generally..

In many cases even with early care and even surgery the hip still tends to deviate away from acetabulum. This results in persistent Dysplasia.

When we attempt reconstruction one of the problems we face is whether to do the osteotomy of femur and acetabulum or wait and watch for acetabulum to remodel when child is young.

Arthrogram is an excellent tool to evaluate the state of cartilage over the lateral aspect and superolateral aspect of femoral head and then decide whether we want to do the acetabular osteotomy at the same sitting or defer it.

Illustrating below a case whether the Derotation osteotomy was done first and the we decided the acetabular osteotomy based on the cartilage cover on arthrogram.

This is useful in a child younger than 2 and half years as acetabulum has good remodelling potential at that age. In older children we will need to combine the procedures.

The state of hip before the osteotomy. Open reduction was done elsewhere about a year ago. Persistent hip dysplasia was observed.
The Derotation osteotomy improved the coverage but we still have to decide about the acetabular procedure.
An arthrogram reveals a large cartilage cover on superolateral acetabulum. The cartilage bump is pointed to by the forceps.
The C Arm image is superimposed and an artist’s impression is drawn showing what the cartilage would look like in 3D. This offers an excellent teaching tool and a 3D orientation for young surgeons and pediatric orthopedic trainees to decide whether an acetabular osteotomy is needed

The surgeon would then discuss with parents and opt to continue an acetabular procedure of take a staged approach

Advertisement
Categories
Cerebral-palsy Deformity Correction and Limb lengthening Pediatric Orthopedics

Cerebral Palsy – a talk and discussion with parents in Block Resource Center, Palakkad Kerala


It was so nice to meet and talk to the parents about #cerebralpalsy and #developmentaldelay in #children at the #puthur #brc in #palakkad yesterday

Stress was on the need for #earlyintervention and adherence to #treatment especially #physiotherapy. The challenges parents face while continuing care is an eyeopener everytime I hear them out.

As in most diseases, treatment challenges in #cerebralpalsy is more to do with #social, #familial and #accessibility issues than actual lack of desire.

Most parents are willing to face the #financial challenges if it means the child will improve. Many are disillusioned with existing treatment methods and fall out because of slow progress, lack of motivation from professionals around and also pure financial pressure. Many have siblings who are healthy and would like to divert their limited resources to that child. This is such an unfortunate choice , but many parents make it.

Such talks and interaction are a wonderful opportunity to break the ice, motivate and also clear their apprehensions on the treatment of cerebral palsy.

A big thanks to Puthur BRC for organising this meeting. More to follow 🙂

Attaching below a few pictures and also a short video which the BRC officials had shared.

A compilation of photos of the day
Categories
Pediatric Orthopedics

Pediatric Hip disorders CME in Kerala


Wonderful to visit #MESmedicalcollege, #Perinthalmanna, #Kerala, #India and deliver a lecture on #SCFE and #CurrentConcepts . This year the focus is #Pediatric #Hip #Disorders #MOTSCON This #CME is held in memory of beloved Prof. #DrGopakumar, #Paediatric #orthopaedics #surgeon who was much loved and is sadly no more. #ChildsHip #Hip #Disease #FAI #SafeSurgicalDislocation #Chondrolysis
Categories
Cerebral-palsy Orthopedics Pediatric Orthopedics

Cerebral Palsy : Treatment Possibilities , a talk


Excited to address the #Calicut #Orthopaedic Club this Friday and speak to stalwarts, teachers and trainees on #CerebralPalsy and the #orthopaedic treatment possibilities.

I will speak on the need for early detection, treatment and also about the newly released hip surveillance guidelines.

The trainees and general orthopaedic surgeons need to understand the importance of early referral and the benefits of early treatment.

In India with its exploding healthcare facilities and young population, we need to be aware, equipped and future ready when it comes to cerebral Palsy care.

Cerebral Palsy – Treatment Possibilities

#cerebralpalsyawareness
#kerala
#kozhikode
#child #ortho
#BabyMemorialHospital
#hipdysplasia

Categories
Deformity Correction and Limb lengthening Pediatric Orthopedics

Clubfoot : The basics for Parents


Recently at Baby Memorial Hospital, Kozhikode we recorded a talk to introduce parents and caregivers the basics about the treatment of Clubfoot.

I am sharing below the Facebook link of the talk

https://fb.watch/fTw6P75xg5/

Categories
Deformity Correction and Limb lengthening Orthopedics Pediatric Orthopedics

World Clubfoot Day @ Kerala


It’s #WorldClubfootDay in two days… June 3rd

In years previous to the #COVID pandemic we at Palakkad Cooperative Hospital used this day and weeks around it to raise awareness, plan fundraising via MITRA Trust and re-dedicate ourselves tot he cause of Clubfoot care. Unfortunately there has been a hiatus in our activities for over 2 years.

Clubfoot Care Team at Palakkad District Cooperative Hospital, Palakkad, Kerala, India
Clubfoot Care Team at Palakkad District Cooperative Hospital, Palakkad, Kerala, India

This year we are re-starting everything.

What is Clubfoot ?

#Clubfoot is a #congenital#deformity of the foot which can be fully treated in most cases. The children lead a normal life after a successful treatment course.

Events

We will be oraganising events this year after a hiatus of two years to mark this day and re-dedicate our team at #Cooperative#Hospital#Palakkad to cost effective, accessible, state of the art and evidence based #Clubfoot #Care .

We are planning :

  1. Medical camps
  2. Training for staff
  3. Subsidised / Free Foot Abduction Brace provision

Venues

  1. Rajiv Gandhi Co-Operative Hospital
  2. Palakkad District Cooperative Hospital, Palakkad, Kerala

#cooperativehospital#palakkad#kerala

Palakkad District Cooperative Hospital Clubfoot Clinic, Palakkad, Kerala
Categories
Cerebral-palsy Deformity Correction and Limb lengthening Orthopedics Pediatric Orthopedics

Combined Pediatric Neurology and Pediatric Orthopaedic Medical Camp for Children


We are restarting our yearly free combined #PediatricNeurology and #PediatricOrthopaedic #MedicalCamp for #CerebralPalsy, #autism, #orthopedic #Diseases in #children this May at #Palakkad, #Kerala.


The children can consult a Pediatric Neurologist Dr. Velmurugan and Pediatric Orthopaedic Surgeon Dr. Easwar TR and also get counselling from Psychologist Mr. Toji Joseph and Physiotherapy consult from Mr. Biju Bhasker

The Medical camp is being organised as usual by the wonderful people at #Sevabharathi , #palakkad and also #LifeCarePhysiotherapyClinic, Palakkad
Registration is free : 9495888879, 6238256073, 8891294916

Do share widely so that the news reaches the beneficiaries.
Thank you
Dr. Easwar TR
Pediatric Orthopaedic Surgeon

Categories
Art and Paintings Deformity Correction and Limb lengthening Pediatric Orthopedics

Knock Knees or Genu Valgum in Children


Categories
Cerebral-palsy Deformity Correction and Limb lengthening Orthopedics Pediatric Orthopedics

Using #STEM teaching as a rehabilitation tool in Disability – Karunya, Palakkad


Excited and so happy to be part of this attempt at @Karunyamvrc to teach #children with #disability #STEM #Electronics as a mean of #rehabilitation

More details at : https://t.co/nCvQ7ahUX1

Inauguration

Today I will be speaking at the inaugural function of this new effort by Karunya MVRC at Palakkad Kerala.

Last year the team at Karunya broke ground and made a sensor driven, no touch hand sanitizer dispenser. This was made by differently abled students.

Unfortunately COVID pandemic raging again meant that all events and celebrations had to be toned down and postponed.

Will post again on updates in a while …

Last year these specially abled children designed and built a sensor driven sanitiser dispenser.

Will post more pictures later today after the event.

Categories
Art and Paintings Cerebral-palsy Deformity Correction and Limb lengthening Pediatric Orthopedics

Cerebral Palsy – Detect Early, Intervene Early


This is my #NFT #Art to raise awareness on #Disability caused by #CerebralPalsy .

Importance of detecting it early and early intervention is stressed. Quite often we find that children are not referred early and treated. This results in very bad deformities that are difficult to mend.

This is part of the #ArztForACause effort by doctors to improve disease awareness among public via 🎨#Art #paintings #nftart https://t.co/OzZUu9FJCh

This will be available as #NFT on https://opensea.io/dreaswar shortly.

Major part of the sale proceed will go towards treatment of these children with #Deformity, #Disability and #cerebralpalsy .

The link to my NFT in the bio.

🌍https://linktr.ee/dreaswar

Early Intervention is the key

#WorldDisabilityDay

Categories
Art and Paintings Cerebral-palsy Deformity Correction and Limb lengthening Pediatric Orthopedics

#ArztForACause : Mother leading a Cerebral Palsy Child…


Cerebral Palsy is such a drastic turn of fortune for any family. The poorer the family, the more challenging. With her back to the closed door, symbolising all the lost life oppurtunities, a mother steadfastly leads her child along the well lit path of medical care with darkness of either side.

This tale repeats with so many children I see in my clinic. It is mind wrenching. Promise of quick cure lures any number of parents from that narrow path to dark streets of quackery and extorsion rackets who promise magical cures.

This is my tribute to so many parents who lead their child along the narrow lit path

Mother Leading a Cerebral Palsy Child

Even when treatment of cerebral palsy is widely available, it is not uncommon to see severe deformities due to improper or delayed referral to a treating centre, lack of awareness of simply neglect. Quite often patients live in far flung villages with poor access to healthcare or broken families compounding the difficulties.

Advanced deformity of the hand in Cerebral Palsy

I have seen that through these storms invariably the mother stands and guides the child unwavering.

This art is in dedication to that spirit. Available as #NFT here : https://opensea.io/assets/matic/0x2953399124f0cbb46d2cbacd8a89cf0599974963/75139301128692202745789003873188758042217057528859930189796240456315928838145/ on #opensea

Categories
Art and Paintings Deformity Correction and Limb lengthening Pediatric Orthopedics

#ArztForACause Art on World Disability Day


As part of our #ArztForACause effort to raise awareness of #PediatricOrthopaedic #Diseases and upcoming #WorldDisabilityDay I have made this #Art on #FibularHemimelia

fibular-hemimelia-art
Limb Deformity and Limb Deficiency #Art #NFT


Know more about the disease : https://dreaswar.wordpress.com/2021/11/13/fibular-hemimelia/

The NFT/#Art at:#opensea

https://opensea.io/assets/matic/0x2953399124f0cbb46d2cbacd8a89cf0599974963/75139301128692202745789003873188758042217057528859930189796240473908114882570/

#NFTCommunity

Categories
Cerebral-palsy Deformity Correction and Limb lengthening Pediatric Orthopedics

Tone Inhibiting Casts in Cerebral Palsy


Cerebral Palsy is a tough problem in Paediatric Orthopaedics. The children have spasm, contracture and variety of coordination issues , balancing issues, seizures and other symptoms like tremor, dystonia which makes treatment quite a challenge. This is more so in the younger children where we would like to have a tool that is non invasive and still helps relieve spasm.

Tone Inhibiting casts offer an invaluable tool to control spasm in a very young child that you would want to avoid surgery.

The dosage of surgery in cerebral palsy has to carefully titrated as muscle are inherently weak and over-lengthening can be disastrous.

We try to avoid overzealous initial surgery and but time when possible with plaster casting to reduce muscle spasm.

Tone Inhibiting Casts are a vanishing tool these days in medical professionals’ armamentarium but find it a great tool. In India with cost of Botox injections to relieve being very high and in the class of patients I treat many of who are from poorest strata this is a godsend.

Cast application is done under general anaesthesia so that adequate muscle relaxation is obtained and we take great care for a close , bespoke type fit with good pressure relief over bony prominences. Prevention of pressure sores is very important and technique of cast application – the fit, padding, tightness, joint position, strength of cast all play a role in the final result.

We keep child on physiotherapy all through the time child is on cast to keep up muscle strength and also aid stretching. A cast usually is kept for 6 weeks. Sometimes in severe spasm we have staged application of casts to progressively apply it lesser flexion of joints as the muscle tone decreases.

Categories
Deformity Correction and Limb lengthening Orthopedics Pediatric Orthopedics

Fibular Hemimelia


Categories
Deformity Correction and Limb lengthening Orthopedics Pediatric Orthopedics

October 6 Painting To raise awareness..a memory


Memories of a more pleasant year in 2019. Before the pandemic struck and wrought drastic stop to treatment of children with cerebral palsy. That October we hosted a live painting workshop at ICCONS to raise awareness about Cerebral Palsy

Memories of a more pleasant year in 2019.

Before the pandemic struck and wrought drastic stop to treatment of children with cerebral palsy.

Two years have passed and we hobble back to restart our work and pick up pieces. Many children have lost the improvements that they had attained as they lost out of treatment due to lack of money, travel restrictions and physiotherapy.

This is October 2019 we hosted a live painting workshop at ICCONS to raise awareness about Cerebral Palsy.

We wish we can do a better job in 2022.

Categories
Art and Paintings Pediatric Orthopedics

Spilled Coffee 🎨 Painting NFT


https://bit.ly/2YDBbSS Spilled Coffee..
#Art
#NFT

Tired day at waiting room. Overslept. Drowsy. A hurriedly drunk coffee with spills in morning before the day’s at doctors’ office starts.

I see so many parents who wait and wait… The general conditions for stay and wait in most of the hospitals is below par, especially for the poor.

Most Pediatric Orthopedic Deformities need long drawn out care. It’s tough. Waiting makes it tougher.

Categories
Art and Paintings Cerebral-palsy Deformity Correction and Limb lengthening Pediatric Orthopedics

#Saksham. Hold your strength. Let’s be with them as they wait for healing..


Waiting Room Medicine is tough. Treatment slow, arduous. I feel for those who wait patiently in crowded poorly appointed waiting rooms, corridors in India's hospital for the poor. They spend their days here by the loved ones side.

Medicine is tough. Treatment slow, arduous. I feel for those who wait patiently in crowded poorly appointed waiting rooms, corridors in India’s hospital for the poor. They spend their days here by the loved ones

https://opensea.io/assets/matic/0x2953399124f0cbb46d2cbacd8a89cf0599974963/75139301128692202745789003873188758042217057528859930189796240465112021860353/

Categories
Art and Paintings Cerebral-palsy General

#ArztForACause – Art for health awareness


#ArztForACause a project by doctor to raise awareness on #PediatricOrthopedic Deformities, #CerebralPalsy 
#Art
#Ethereum
#NFTCommunity
 https://t.co/JElnnkqhfq via @opensea

ArztForACause a project by doctor to raise awareness on #PediatricOrthopedic Deformities, #CerebralPalsy

Art

Ethereum

NFTCommunity

https://t.co/JElnnkqhfq via @opensea

Categories
Art and Paintings General

My Art, Paintings and NFT have a home


See my 🎨 Art and NFT at 
https://opensea.io/dreaswar
Categories
Pediatric Orthopedics Spina Bifida Spine & Scoliosis Surgery

Paediatric & Adult Spine Clinic


Happy to announce that the Spine Clinic for Children and Adults will be functioning on all days except Thursday at Palakkad District Cooperative Hospital & Research Centre, Palakkad, Kerala.

This will cater to all variety of Spine diseases in Children and Adults.

Common diseases like Disc Problems, Infections of Spine ( Septic Spondylitis ) , Tuberculous Spondylitis, Scoliosis, Spina Bifida are treated here.

I am available for consultation on all days except Thursday from 10am to 4:30 pm. Please contact Palakkad District Cooperative Hospital for details and appointment.

Please find the location of the Hospital here

Paediatric and Adult Spine Clinic, Palakkad, Kerala