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World Cerebral Palsy Day - at Palakkad and Shoranur, 2018

World #CerebralPalsy Day – October 6, 2018


#WorldCerebralPalsyDay is afoot. Like last year, I am planning to conduct month long events across Palakkad and Shoranur to raise parental awareness on treatment of #CerebralPalsy.

Most of the parents who come for care of their children come late, unfortunately with joint contractures, hip subluxations, alteration in knee mechanics and foot deformities. Aside from these the problems these children have with upper limbs, hands and doing activities.

Many of these children have uncontrolled seizures, terrible difficulties communicating, speaking out their issues apart from ambulation.  Ambulation may in fact be least of their issues. This sad fact goes to show how important early referral is and how important it is to enroll the child under a care of a Pediatric Neurologist, Pediatric Physiotherapist who can then co-ordinate care with their colleagues in Pediatric Orthopedics, Pediatric Medicine, Occupational Therapy, Speech Pathology, Audiology etc ..

Cerebral Palsy care is a great team effort. No part of the team is greater than other, but the role of the General Practitioner / Pediatric Medicine Doctor, Pediatric Physiotherapist is central, at least in India. They determine the sole referral entity, a person with whom the parents spend their maximum time and trust with. They are the ones in whom they confide most of their issues with.

World Cerebral Palsy Day is a wonderful concept to reinforce these simple care giving principles. Parent education and empowerment being central to the cause of care of these children. Like 2017, we are organising activities across the district of Palakkad – in Palakkad town and neaby rural areas and Shoranur town to educate parents and also conduct early detection and intervention camps to identify children who need care.

World Cerebral Palsy Day - at Palakkad and Shoranur, 2018

World Cerebral Palsy Day – at Palakkad and Shoranur, 2018

Activities planned :

  • Free medical camps for underpriviliged children
  • Special clinics with Gait Analysis
  • Funded Orthotic programme for poor children
  • Pediatric Physiotherapy advice
  • Custom made Wheel Chair fitting
  • Parent awareness of Cerebral Palsy – lectures and symposias in rural areas
  • Notices and public handouts to improve general awareness
  • Involvement of other NGOs , social service organisations to improve public outreach

These activities would be done throughout Ocotober 2018 under aegis of the Cerebral Palsy Clinic at Rajiv Gandhi Cooperative Hospital & Research Centre and ICCONS, Shoranur

Contact Numbers for Clinic bookings  and more information:

  1. Rajiv Gandhi Cooperative Hospital, Kallekkad, Palakkad : 0491-250-9000
  2. ICCONS, Shoranur, Palakkad                                                   : 0466-222-4869
  3. Contact me                                                                                  : EMAIL

 

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Developmental Dysplasia of Hip - Left hip is dislocated

DDH – Its June !! It’s Dysplasia Awareness Month


DDH otherwise called Developmental Dysplasia of Hip is a condition where the ‘ball-and-socket-joint’ of the hip is not formed well at birth. It used to be called Congenital Dislocation of Hip.

The child is born with a slightly misfitting hip joint where the ball is slightly shifted out of cup or a hip joint where the ball is completely outside the cup and cup is also very shallow. This can occur on one side or both sides.

Developmental Dysplasia of Hip - Left hip is dislocated

Developmental Dysplasia of Hip – Left hip is dislocated

Why does it happen ?

Most times its ‘Idiopathic’ , a medical term which means – cause is not known. In many other patients, the child will be having one of the syndromes (a group of clinical features and disorders in other organs systems and external appearance) or neurological issues in the spine (like meningomyelocele) that also causes this. This second group is sometimes medically referred to as Teratogenic DDH and is much more difficult to treat.

We will discuss below the aspects as related to Idiopathic DDH. They don’t apply to Teratogenic or Neurological DDH.

How do we know the child has DDH ?

Most newborn screening procedures at the hospitals have doctors checking to see if the new born child has clinical signs of DDH. It is easiest to detect and treat it at that early stage.

Once a clinical suspicion of DDH is there the Neonatologist usually refers the child to a Pediatric Orthopedic Surgeon. In addition to establishing the clinical diagnosis by physical examination, the doctor will order an x-ray and an Ultrasound Scan of the Hips to check the dislocated hips. Several measurements need to be taken and ease of dislocation need to be established under Ultrasound scan by a procedure called Dynamic -Ultrasound. The treatment starts after these are done.

In many children, the initial diagnosis may not be made in the immediate post-delivery period. Children may be brought to the OPD by parents with complaints that the thigh skin fold dont look symmetrical and the hips don’t open out fully for parents to change diapers.

In older children parents may notice a limp when the child walks or a limb length difference may also be noted with the dislocated side being shorter.

Limb Length Difference in DDH

Limb Lengths may be noted to be different in DDH when child is older and walking. The limb with the dislocated hip will appear shorter.

How soon should the treatment start ?

As described in previous section, treatment should ideally start in neonatal period once the problem has been detected. After clinical examination and Ultrasound examination, your doctor will suggest usually a belt type device called Pavlik Harness to be applied on the child to keep the hip reduced inside the cup. This harness is to be worn full time. Parents are counselled on how this is applied and how the straps are tightened.

Ultrasound exam for a child with Hip and Knee dislocation

Ultrasound exam for a child with Hip and Knee dislocation

Once this harness has been applied, the hips are scanned with Ultrasound every 2 weeks to check for improvements. Ideally this has to be kept for about 3 months and taken off after the hip stabilizes inside the socket. A slow weaning period is there before the child can be fully taken off the Pavlik Harness. This is to ensure that the Ball ( head of femur ) stabilizes inside the socket (Acetabulum of Pelvis) and the hip is stable. The tissues around the hip also has to shrink and adapt to the new location of Head of Femur. Otherwise re-dislocation or partial slip (medically called subluxation) is a possibility.

In many cases the parents may not be willing for a device to be applied on the child full time post-delivery or the DDH itself may go undetected. This child eventually may be brought later in life by the parents with complaints necessitating surgical procedures.

What is the treatment options for DDH?

As previously described if the newborn is detected to have DDH the treatment is to apply Pavlik harness on the child after Ultrasound exam proves hip is reducible and stable in what is called a safe zone. Safe Zone is a zone where the position in which the harness has to be applied to the child does not compromise the blood supply the head of femur. This is very important decision to make.

Pavlik Harness for DDH hip needs to be fitted properly

Pavlik Harness for DDH hip needs to be fitted properly

Hip Spica Plaster in child with DDH

Hip Spica Plaster in child with DDH

Application of Hip Spica under anesthesia in DDH

Application of Hip Spica under anesthesia in DDH

If the child is brought later in life, before 1 year, the hip has to be checked for reducibility as the tissues around the hip would have become contracted and sometimes it is difficult to reduce the hip back into the socket. Usually anaesthesia would be required and the hip once reduced back into the socket is held there by application of the plaster of paris or POP called Hip Spica. This is kept for approximately 3 months until the hip has stabilised inside. A CT scan to verify whether the hip is reduced should be done while child is in POP as slippage of the hip socket is also seen when POP cast becomes loose with time.

Surgery is the only option in older children with DDH. These range from relatively simple procedures to complex hip reconstruction procedures depending on age of the child, slope of cup, angle of rotation of the neck of the thigh bone and shape of the head. These are best evaluated as per the needs of the child.

Arthrogram for DDH

Arthrogram for DDH

Generally these surgical procedures can be grouped into a few types :

  • Open Reduction of Hip and Capsulorraphy (medical term meaning stitching up of capsule or the covering around the joint)
    • This is basic necessity. Here the hip is reduced back into the socket and the covering, the capsule, which is loose is tightened with several sutures
  • Femur Derotation Osteotomy with shortening
    • This would involve a slight shortening of the hip bone and turning it around. The bone would then be stabilied with a metal plate and screws
    • The need for your child to have this done depends on the age of the child and the angle of the ‘neck of the femur’, something medically known as Anteversion. This procedure essentially de-rotates the femur neck and allows the head of femur (the Ball) to deeply sit inside the Acetabulum (the socket). A slight shortening of the thigh bone may be needed as the child , if old enough, would have developed tightness of the tissues and hip should be sitting inside the socket slightly loose than in tension.
  • Acetabular Osteotomy
    • In many children, when they present to the clinic their Acetabulum would be shallow and not deep enough to receive the Head of Femur. In such children deepening of the Acetabulum by a surgical procedure called Osteotomy (a type called Salter Osteotomy being the most popular) may be done.

The above procedures may be combined along with Open Reduction as the surgeon sees fit after evaulating the child. These options and its pros-and-cons would be discussed with the parents before the surgery.

What happens if we don’t treat DDH promptly ?

Best time to treat the child is in the newborn period. With time the tissues around the hip gets tighter and the bone structure of thigh bone and pelvis alters since the normal growth with moulding of the ball being inside the cup doesn’t happen.

This lack of moulding results in a shallow cup. Additionally the thigh bone’s upper end would be twisted out of shape and the ball also would be misshapen since it has not been moulded by the acetabulum.

All these result in a much more complex procedure to try and restore the hip.

Left untreated DDH causes osteoarthritis or the Hip joint and Hip pain in early adulthood often requiring complex reconstructive procedures.

It is best if the treatment is not postponed and done at the earliest.

Hip Dysplasia Awareness Month – June !!

The Hip Dysplasia Awareness Month of June is to educate parents on Hip Dysplasia and its treatment methods. We hope that parents would bring children to care centers at the earliest if suspicion of hip dysplasia is there.

For more information please visit : http://livingwithhipdysplasia.com/june/ or consult your Pediatric Orthopedic Surgeon.

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Cerebral Palsy Medical Camp at Shoranur, Kerala


A free medical camp for underpriviliged children suffering from Cerebral Palsy and Pediatric Orthopaedic disorders was organised by Dr. Easwar T.R and the administrative team at ICCONS, Shoranur, Kerala on 24th, May,2018.

A gamut of problems commonly seen in children with Cerebral Palsy was observed in OPD. While some parents had the good fortune of seeking medical care and intervention early in course of disease and others were not so fortunate. Lack of parental knowledge, distance / accessible care, financial cruch, normal siblings to care for and single parent challenges were the most important issues observed on casual data collection.

The medical camp was followed by an awareness class for parents, therapists and other care givers by Dr. Easwar T.R on the various aspects of Cerebral Palsy.

Custom wheel chair and mobility solutions for needy patients was discussed with Physiotherapists and low cost solutions for the same identified. Mobility solutions continue to be a major challenge for children in rural areas with poor roads, small homes with narrow doors and steps inside homes especially with outdoor toilets.

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World Clubfoot Day on June 3rd


This 2018, on June 3rd, we at Palakkad District Co-operative Hospital and Research Centre are celebrating the World Clubfoot Day.

We are planning special Outpatient Clinics for children with Clubfoot disorder in and around Palakkad, Kerala.

Please find below the Malayalam Poster for the #ClubFoot Day

Screenshot from 2018-05-25 16-07-28.png

 

#WorldCerebralPalsyDay event !! – wonderful experience at #Palakkad, #Kerala


It was a wonderful experience to be part of the team that organised #WorldCerebralPalsyDay event to bring parents, children, caregivers, NGOs, Doctors, Therapists, Counsellors together for a day and have fun and enrich themselves.

The event was organised by Lifecare #Physiotherapy Centre, #Palakkad, Kerala along with #Sevabharathi, #Kerala at Thrupthi Hall in the centre of town.

The choice of centre was superb as it was right in centre of town allowing easy transit for children coming in from rural areas and those with limited mobility.

We assembled at the centre around 10 am and crowd had already trickled in at that time. In another hour about 40 children, parents, caregivers and health care professionals had assembled. The inauguration was a minimal affair with Dr. Sreeram Shankar starting the welcome address with respects paid to the almighty and the parents who had taken time to get here. This was followed by a medical camp by me, a painting competition and a singing competition for the children. There was a talk after that by Dr. Deepa, Psychaitrist, District Hospital, Palakkad which was followed by my parental awareness on treating #CerebralPalsy children.

Cerebral Palsy inaugural address by Mr. Kalyanaraman, Palakkad, Sevabharathi

Cerebral Palsy Event inaugural address by Mr. Kalyanaraman, Palakkad, Sevabharathi

It was a red-alert day in many places for #Kerala because of fear of inclement weather. However, rain stayed away largely apart from slight drizzle. That was a relief.

About 40 children took part in the celebrations, competitions, talks and counselling sessions. It was well appreciated by all, many who are experiencing this for the first time.

Positive vibes which would rub off into the child’s care was the key. Parents took strength from one another and participated in the awareness session. Many misconceptions about Cerebral Palsy, Seizure Disorder, Autism, Global Developmental Delay were cleared.

We are planning sessions throughout this month and hopefully improve the quality and participation of these events in the next iteration.

 

#PySangamam presentation on #AuShadha done !


Had a lovely day at @PySangamam where I presented my experiences developing @aushadha_emr #ElectronicMedicalRecords or #EMR . Attaching below are some pictures of the event. https://t.co/hJteYzw822

I was pleasantly surprised on how open the crowd and organisers were to a talk delivered by a developer who’s primarily a doctor. It was organised beautifully and thanks specially Mr. Vijayakumar , Mr Abhishek and his team for all the encouragement.

Looking forward to #pysangamam next year at #Coimbatore , my home town

My Presentation : Creating Pluggable Electronic Medical Records

Git Hub : AuShadha Open Source Electronic Medical Records 

https://www.linkedin.com/feed/update/urn:li:activity:6443989732329394176

Ode to The Monkey


India’s tryst with Yoga is deep rooted in symbolism and runs deep into its spiritual classics, poetry, theory, ritualistic practice, grand-mother story telling and visual art forms. The pervasive, repetitive and at times outwardly silly, unreal, mythical symbolism is probably one of the factors that has prevented the pillages, marauders and missionaries from destroying what India now offers to the world. They probably thought its too silly to be having anything worth annihilating.

Breath, the Monkey mind are common symbolisms in the epic written by sage Valmiki – The Ramayana. Hanuman,  the ‘monkey God’, is literally  Hanu (kill) and Man (mind).  He is the symbol of Yoga and since he is the son of Wind ( Vaayu-Putra) . He is also the symbolism for halting the mind, going beyond it by practicing breathing techniques and meditation which enables the union of estranged devotee ( the Sita, literally born of earth) and eternal soul (Rama, The God, literally one who charms) held apart in an Island by the forces of darkness ( habits of body, mind and the Ego )

All observing non-changing soul bound is thus dipped into the erroneous identity with the body by the chord of breath. This identity can be reclaimed by tracing its origins back via the breath, the Hanuman, and killing the mind enables the realization that one is nothing but the never changing, unborn, undying unary eternal soul.

This is union we seek. This is the union that brings peace.

To the Monkey Mind and quietening breath which kills it then , 

ode-to-monkey

I am Shiva : A tribute to an unmoving belief


It has been a tough month for the home state of Kerala, which is grappling with the worst flood in a century.  It has been a testing time for humanitarian work, for beliefs, for politics … for everything.  Theories abound as to what caused the floods ranging from human disruption of natural ecosystem, divine wrath, Solar Minimum year, weak El-Nino/a effect, a mix of these and several other variations of these theories.

I distinctly remembered on morning in #Palakkad as it rained. This was before the floods. The first day of several that were to follow that first drenched and then drowned the state. As I drove from Coimbatore, a border city of Tamil Nadu to Palakkad, Kerala for work at about 8 am. As I drove past the western ghats I saw that the rain clouds hung so low and it was an eerie drive to say the least. Never in my memory have I seen clouds so low. I knew something was amiss. I called my wife and told her something was not right. Nothing however prepared me or my state for what was to come.

The rains started barely minutes after I drove into Palakkad. It had been drizzling the night before, but it just got heavier and heavier. Pounding continued for 2 days and flooded north Kerala first. Then it subsided for a day over Palakkad on Saturday leaving it in floods, something that the natives bragged they’d never seen.

But still nothing prepared Kerala for the destruction they were about to witness in the coming week. Rain pounded Kerala (especially middle Kerala) in coming days and left it battling floods, death and destruction.

In midst of the destruction speculation emerged that this maybe a divine wrath (specifically of Sabarimala deity Ayyapan) and other exhorting people to ‘pray for Kerala’. Needless to say, the non-believers camp rejected these with their own rebuttals and even some going to the extent to labelling prayer as useless. Their argument being that prayer at this hour of crisis is useless. What is required is working hands at ground zero.

Of course, these arguments represent a variant of the believer non-believer clash that has been there since time immemorial. At times of crisis like this where any argument of a merciful divine force does not appeal with rampant, apparently unreasonable destruction all-around, it is a time to reflect on ones belief.

These lines were penned before the flood, on the day of heavy rains in Palakkad that preceded the flood. Even just seeing the rains it was amply clear that something was grossly wrong. These rains were not normal. I knew it as going to be trouble. The lines was also partly meditative, as I prayed for rain to ease.

These lines are a tribute to the constant tug of war in nature and in spirit that tests our beliefs : whether it be theistic or atheistic. Man constantly asks God, but…

This was also penned before, this a tribute to the my home state.

 

I_am_shiva_r.png

Kerala Flood : A Tribute to my land


It was late in the day, i was standing at driveway gate turning off the lights to my clinic. I just glanced across the road where the indoor stadia is. This is where young college kids are working round the clock , selflessly for the flood victims. They receive relief materials sent across the border and sort it. Authorities are scant, but I’m told the work is supervised.

I was struck how a fracturing society had gelled by a near cataclysm.

My two lines worth were penned then

I titled it my kerala (ente keralam )

My Kerala

AuShadha 2.0 , a re-write of AuShadha Electronic Medical Records


I am happy to inform as promised earlier that AuShadha 2.0, which is a complete rewrite of AuShadha using Python 3.x, PostreSQL, Django 2.x and Dojo1.1x has been started and first major commit pushed.

Please find the repository at https://github.com/dreaswar/AuShadha2.0 

AuShadha 2.0 will use GNU-GPL Version 3.0 License.

PySangamam , the first Python Conference at Tamil Nadu


I’m excited to participate at #PySangamam the first Python Conference in Tamil Nadu at chennai Next month to talk on AuShadha EMR

via #Townscript https://t.co/xipWgkYQDF via @townscript
#Python
#Django
#webdevelopment
@aushadha_emr

Spina Bifida and Hydrocephalus Conference 2018 NewDelhi


#IFSBHCON2018
#SPINABIFIDA
#hydrocephalus
#spinabifidafoundation
Lovely conference and lovely to see the so many families and patients viewing life with such a positive attitude https://t.co/eXqZWmuhoa

Dr. Santhosh Karmakar and Spina Bifida Foundation deserve credit for bringing together different professionals -doctors, physiotherapists and families, together for this event

MITRA Medical Trust … our little helping hand to the poor is 3 years old


Boy are we joyous !

Our MITRA Medical Trust is now 4 years old.

This August 5th we are marking this event with the first public function at #Palakkad, #Kerala with dignitaries and beneficiaries.

We started on this journey 4 years ago, just a little band of friends who managed to get together after 20 years of separation after high school thanks to the newly emerging social networking services of Orkut, Facebook and Whatsapp.

The joy of getting back together about 20 years after out 10th class was marked with a reunion function and post-reunion, we sublimated the camaraderie by resolving to form MITRA, a medical trust to help poor people with treatment.

MITRA stands for Medical Intervention Treatment and Rehabilitation Assistance. Our goal is to lend a helping hand via our internal contributions (as much as possible) to the needy for medical treatment and/or rehabilitation.

Overtime, with the grace of almighty, love of our well wishers we could achieve this and much more. We have been blessed to have the good fortune of delivering help to almost 75 poor patient across a range of diseases disbursing as much as 24 lakh of Indian Rupees. No mean effort considering most of this was from our own internal donations.

A celebration was in order !!

This is then the first ever public function of the Trust. Mr. P.R.Seshadri , MD, Karur Vysya Bank , Mr. M. B. Rajesh MP, Mr. Shaif Parambil MLA, Ms. Pramila Sasidharan, Municipal Chairperson, Palakkad and Father Paul Thekkiniyath will grace the function.

37964774_2390314557653176_541042944447086592_n

#CerebralPalsy and #PediatricOrtho #medical #camp at #Palakkad


Had a wonderful #CerebralPalsy and #PediatricOrtho #medical #camp at #Palakkad #Kerala organised by wonderful people at #SevaBharathi . It was well attended with parents and children braving the heavy rain.
@sevakeralam
@sevabharathitn https://t.co/Z3FT9C6RVO

AuShadha Electronic Medical Records Development update


AuShadha Electronic Medical Records at https://github.com/dreaswar/AuShadha has been seeing very slow development mostly due to pressures on my personal and professional front.

I could get back to development past few days and I have pushed a commit to master after some gap.

The Prescription App for Outpatient visits is ready.

Next stop is to implement Outpatient Reports.

Do check it out and let me know what you think.

You will need #Django1.7.2, #Python2.7x, #Dojo #Javascript Toolkit 1.13

Free Medical Camp for Children’s Orthopedic Disorders and Cerebral Palsy


I’m conducting a free medical camp for #Childrens #Orthopedic #Disorders and #BoneDiseases , #LimbDeformities and #CerebralPalsy at #Palakkad ,#Kerala . Event is organised by #SevaBharathi .

The event will be held in the premises of Life Care Cerebral Palsy Clinic which is in centre of Palakkad town enabling easy transport to the venue.

Patients and relatives are advised to bring all old records while seeking opinion. All old x-ray, other scans and will also be needed for evaluation.

Phone number for Booking :+91-80759-21075

Contact the phone on last line of notice for appointment.
(Notice is in #Malayalam, local language of Kerala )

https://t.co/smNqhcYRRS

Free Medical Camp for Pediatric Orthopedic Disorders and Scoliosis

Free Medical Camp for Pediatric Orthopedic Disorders and Scoliosis

Moving to Gitlab


With the acquisition of Github by Microsoft, regardless of the promises made now, I thought it would be best to move my repos somewhere else. That somewhere right now seems to be GitLab. Im #MovingtoGitLab.

All my repos across GitHub and BitBucket have been moved there and I intend to continue development there.

AuShadha (Au) which I had worked on for so long had taken a back set for some years now as pressing personal and professional commitments caused interruptions.

ICD 10 parser, ICD10 PCS parser, FDA DrugBankCa medication list parser have all been moved there.

Three variants of AuShadha are being tried by me as I recode Au. These pertain to choices of the front end. All there are embryonic and will continue to remain so until I find more time.

When I started it in 2009 things were a lot different and Django was supreme choice in Python world. Things have gone more Javascript way with a confusing profusion of frontend frameworks , especially ones that play well with NodeJs but don’t play well or needs rewiring to play well with Django. Dojo which was my intial choice also has moved on from 1.7 when I started to 1.11 now and looking ahead at 2.0 with TypeScript usage.

I’ve chosen Dojo 2.0, EmberJS, Polymer as the three front ends to try and hang my hat on at the moment. The old Au with Django 1.7 and Dojo 1.10 would be kept but I don’t plan to update it to new the library versions as it’s too laborious.

I’ve moved Django to 2.x and Python to 3.5. This is a full rewrite. Infact if Django doesn’t play well with JS framework I am open to changing it some other backend.

To those who were wondering about Au and it’s fate -watch this space.

GitLab Repository

Free Medical Camp for World Clubfoot Day 2018


World Clubfoot Day free medical camp concluded well and many patients had the opportunity to consult free and take advise for their child.

Attaching below is the collage .

We have a lovely Clubfoot Care team that made this event and caring for these children over team so much easier.

World Clubfoot Day

World Clubfoot Day with Children, Parents and Clubfoot Care Team

World #Clubfoot Day is afoot ! – Free medical camp for children with Clubfoot


I’m organising a free medical camp on June 4th at Palakkad Cooperative Hospital, Palakkad, Kerala on World Clubfoot Day.

Please do spread the news so that anybody interested can seek care.

Attaching below is a poster in local language Malayalam.

Interested patients may contact hospital Reception on following phone numbers for registration :

+91 491 252 0391

+91 491 252 2805

+91 491 253 6293

Clubfoot medical camp

World clubfoot day free medical camp

Bracing and Orthotics for Clubfoot (CTEV)


Once clubfoot is corrected with Ponseti plaster application and tendoachilles tenotomy, it’s time to maintain the correction of foot till child is grown more and started walking well. There is risk of clubfoot recurring without proper bracing.

Recurrent clubfoot

Recurrent clubfoot without bracing

Types of braces

Steinbeck device, Iowa Brace and Dobbs Brace are commonly used clubfoot Foot Abduction Orthosis.

Dobbs brace in particular has the added advantage of providing extra mobility to the child potentially improving compliance. Comparatively it’s more expensive.

Compliance

In rural India it’s especially difficult to ensure compliance to orthosis for parents as many feel clubfoot treatment finishes with Ponseti casting. Social issues and sensitivity of going out of home with brace fitted is one of the issues that makes parent fall out. Some of them don’t spend enough time learning to put it on and take it off and give up once child starts crying. It’s an easy procedure that we teach aling with nurses and orthotists to help parents during initial days.

Steinbeck braces

Steinbeck bracing

Clubfoot Steinbeck braces

Fitting Steinbeck clubfoot brace

Foot inside Steinbeck clubfoot brace

Dobbs Bracing

Dobbs brace for Clubfoot

Dobbs brace allowing movement

Osteogenesis Imperfecta


Osteogenesis Imperfecta is a congenital disorder of bones that has varied types and presentations. Severity varies based on the type of the genetic mutation that causes this disorder.

Regardless of the type the genetic modification cause malformed and weak bones and in some cases malformed teeth. Bone bend and deform or break easily and heals in deformed position. This results in cosmetic deformity along with issues with walking , standing for the child.

The bend of the bone if significant can cause repeated fractures either due to poor handling by caretakers or when child tries to bear weight and stand up.

Fortunately for the milder variants there’s are medications to make bones stronger and surgery to straighten bent bones. This allows child with help of walking aids and/or splints to ambulate.

For the very severe variants unfortunately clinical breakthrough is still awaited.