October 6th we will join the world at ICCONS, Shoranur , Kerala in celebrating #WorldCerebralPalsy day.
What we are lining up this month ..
We are starting the programme by joining the #GoGree4CP movement to dedicate ourselves to the care of #CerebralPalsy affect children.
We will be lighting up the entire building in green for the entire month and put prominent placards, posters and banners in local language of Malayalam and English to spread awareness about CerebralPalsy among general public.
Lined up after that is our free medical camps in both Paediatric Oethopaedics and Paediatric Neurology and Developmental Paediatrics along with cultural activities, parents education seminars, assistive technology programmes, research on Cerebral Palsy, Counselling for parents and other events.
We have dotted the events across this October to keep the awareness and dedication alive.
Attaching below is a poster and a banner of our medical camp and GoGreen4CP initiative.
Clubfoot Care Team at Palakkad District Cooperative Hospital, Palakkad, Kerala, India
I am happy to announce that we successfully organised a Clubfoot Parental Awareness and Caregiving Programme at the Palakkad District Co-operative Hospital, Palakkad, Kerala on August 31st, 2019. This was done to organise parents into a self support group and to provide parents the necessary group counselling on Ponseti Method of Clubfoot treatment.
We have been organising World Clubfoot Day programmes, Free Medical Camps of Clubfoot and assiting children from underprivileged backgrounds get Ponseti standard of care Clubfoot along with CTEV Foot Abduction Orthosis via our charity trust https://mitratrust.org. We also described out #ArztForACause art and painting fundraiser which is undertaken originally to raise funds for children with Cerebral Palsy and now extended to children with Pediatric Orthopaedic Deformities.
The programme was well attended and was co-ordinated with our Obsterician colleague and all the staff nurses who are part of the Clubfoot Care team who counselled the young mothers on Breast Feeding, Child Nutrition, Clubfoot, Braces and Ponseti Exercises.
We were pleasantly surprised at the turnout on the day as it was organised in short notice. This programme will be followed up more such programmes on Clubfoot ( sometimes called CTEV : Congenital Talipes Equino Varus ) for Staff Nurses and train them in Ponseti Care .
#Clubfoot guide and interactive session for patents at #Palakkad Cooperative Hospital is being organized on August 31st.
The program includes a lecture by me on Clubfoot for parents and a interaction with our Clubfoot Care Team , Orthosis Check, Doubts about casting, checking recurrence of deformity and general clarification on Clubfoot care.
Parents will have an opportunity to interact with other parents exchange their experience about treatment, the issues and build a support community.
Attaching the Program details below. Please call the number for registration.
Clubfoot Parental Caregiving Interactive Session at Palakkad, Kerala
Cerebral Palsy is such a difficult disease to handle and treat for the health care professionals.
The treatment process needs to take the parents and family members along so that these children get optimal care. It’s important to reinforce on the parents and lift their morale throughout the course of long and arduous treatment.
I routinely arrange seminars and medical camps and arrange public events in association with groups serving these children to help them and keep caregiver morale high. It’s a fight, a relentless fight against Cerebral Palsy.
It never ceases to amaze and move me that the mother , however humble or rich , illiterate or well educated, they may be cares for the child and stays with child through thick and thin.
Wacom One CTL and MyPaint on Linux works like it’s a match made in heaven.
My Digital Art on a mother caring for her child with Cerebral Palsy – Drawn using Wacom One CTL 472 and MyPaint Open Source Software.
This painting is part of the #ArztForACause fundraiser for children with Cerebral Palsy , Autism and Movement Disorders
She literally is the guiding light of the treatment, showing the way and proving that she’s the true representative of the all giving , ever loving Divine Mother
A Mother leading and lighting the way of care for her child with Cerebral Palsy – Digital #Art
I am excited to be planning my upcoming project of #Clubfoot (details would be announced soon). As usual I design all my stuff (Little tuning at times from professionals).
This time I have decided to go all alone and paint my own artwork for use with the project.
I decided to go digital.
I used #Wacom One Tablet and #MyPaint #FOSS software. Superb combination.
So happy that we’ve had a very successful #PediatricOrthopedic and #CerebralPalsy #Medical camp today at #Palakkad, #Kerala. This is one of a kind medical camp, parent education drive and cross speciality clinic that we’ve been hosting at Palakkad since 2014.
This is the 6th year of my setting up Paediatric Orthopaedic clinic here at Palakkad Cooperative Hospital, Kerala and patient awareness of the problem of Cerebral Palsy, ClubFoot has increased tremendously over these years.
Sevabharathi volunteers were as usual wonderful and committed. None of this would have been possible if not for the commitment of Biju Bhasker and his team of LifeCare Physiotherapy Centre at Palakkad, Kerala. He has been the main organising force behind this over the years.
Today we had a Pediatric Neurologist Dr. Velmurugan and Pediatric Gastroenterologist Dr. Jaganandan join us for the camp. Both specialists are from Coimbatore. It was so nice of them to take time out and join our efforts.
With God’s grace we’ve been able to consistently raise the standard and tune the camp to make it more cross specialist so that patients can consult multiple specialists in the same visit. We try with every camp to make it better. I was discussing with Udayasankar CN of Sevabharathi, Palakkad that next camp should be much better in many ways.
I could identify some children who will require surgical procedure, plaster casts, Botox injections which could be funded, if approved, via the planned free surgery program at Palakkad for the #Bone and #Joint Day of #IndianOrthopaedicAssociation in the first week of August.
The small town of #Palakkad #Kerala state may be one of the biggest contributors to #Indian #Athletics. It’s a town predominantly know for its large expanse of rice fields and farming community. In the past athletes like Valsamma, PT Usha have trained here and succeeded. Recently PU Chitra bought laurels to this small town. Many children here look upon these heroes as they train daily.
Recently Palakkad got it’s own first synthetic athletic track and provided a field where young athletes could be groomed better. Several promising athletes are in training in this otherwise rustic, tucked away place. Athletes who’ve successfully represented India at the Asian and Olympic level belong here and have trained here.
Most of these athletes use what is locally available in terms of facilities, gears, coaches to train themselves. The fact that until recently they didn’t even have a change room where they could change themselves into or out of the sports gear after coming from their schools or colleges speaks volumes of the lack of a system in place. Many are from very humble backgrounds. Driven by the need to succeed, as it’s very often the only glimmer of hope from poverty.
Things are changing though. Changing rapidly. As I train and interact with these children while setting up my Sports Injury Clinic here, I realise a renewed vigour in children, coaches and parents where they are unafraid to take up their needs with local authorities and get it done.
With more training facilities promised and the track and field itself being in the process of a long overdue upkeep and upgrade as I type this, it is certain that with children in #India taking to #Sports early and training intensively , #Pediatric #SportsInjuries will become more common. Though there is difference in the pattern of these injuries from those in the west, nonetheless, these required specialised care.
Just in last week I have examined and treated children with old hamstring tears who’ve not rehabilitated well, old ankle injuries with pain, back pain due to stress and renal calculi as a result of training in summer heat with very poor hydration. None of these children received adequate on field or off field medical attention. All of them were not aware of the type of injury they are having and its potential for causing premature career collapse.
I have realised that along with adequate sports injury prevention counselling, these children require counselling for sports nutrition and diet tailored to the sports they are participating. It is sad that while these could be given, not many maybe able to afford such a nutrition on daily basis. Mr. Haridas the coach of the Olympic Athletic Club here at Palakkad is so kind. Everyday he brings these kids mangoes from his farm. It’s little things like these that bind the coaches, parents and kids together and goes beyond simple trainer-trainee contract. The fact that he does this training free of charge is really something laudable.
This is the story of sports in India….
We need better facilities, coaching , gears but most importantly these children need better nutrition. They also need better awareness of injuries as they push themselves to greater heights.
Enthused Children, Happy Children at Sports Track and Field
Mr. Haridas the large hearted coach or the Olympic Athletic Club, Palakkad
Pediatric Sports Injury …A large audience , but is anybody listening ?
Had a great start to the #Pediatric #Sports #Injury Clinic at Rajiv Gandhi Co-Operative Hospital, #Palakkad #Kerala.
It was inaugurated as a combined event conducted by the Olympic Athletic Club of Palakkad and Palakkad District Cooperative Hospital, Palakkad. The event was organized at the Athletic Track at Government Medical College Palakkad on 15th May 2019.
It was attended by Mr Haridas the coach of the Olympic Athletic Club , Mr. Ashraf the Vice President of the Cooperative Hospital Palakkad, Sports Council of India-Palakkad dignitaries , Athletes who have participated in Olympics, Asian, Special Olympics or National Games.
The Pediatric Orthopedic and Sports Injury team from Palakkad comprising of Senior Orthopedic Surgeon Dr. Ravi G Nair, Pediatric Orthopaedic Surgeon Dr. Easwar T.R (myself !) , Dr. Nishanth V.S (Orthopedic Surgeon Fellowship trained in Arthroscopic Surgery ) and Physiotherapists Mr. Biju Bhaskar and Mr. Sivadas were present.
#Olympic, Asian, Special Olympic and National Game stars were a special attraction in the event, needless to say. Athelete stars Sree Shankar, Gokul, Abdul Rahman, Vishu Priya were honored for their achievements.
There is wonderful potential in the district and great coaching going on.
Had an excellent integration with the sports champions and kids there. It is wonderful that these athletes from very humble background are able to achieve so much from simple facilities provided to them. Gokul a Special Olympics Star and medal winner come from such a humble family that it is so awe inspiring.
The parents, coaches and athletes thought it was a wonderful initiative to set up this clinic. These children did not have such treatment facilities here at Palakkad till now and after injury have to travel long distances to other cities to get treated. The treatment is also very expensive in bigger cities.
Importance if #InjuryPrevention, early rehabilitation, sports specific physiotherapy and the difference of pediatric sports injuries from other types of injuries were counselled to these children. Impirtance of early injury detection, injury prevention and rehabilitation we’re stressed up on.
Children like Aniruddhan V (Roller Skater) who’s hard at practice with his cast on after fracturing his wrist is an inspiration to everyone. His father , Advocate Vinod , gave the introductory talk and introduced all the young athlete stars to the crowd and doctors. This was followed by talk by the other distinguished guests, athletes and Doctors.
We will be plunging into further activities soon to get the rehabilitation centre equipped for these pediatric athletes and organising camps, talks ….
Watch this space.
Meanwhile enjoy the scenes of the event ..
Dr. Easwar TR , Pediatric Orthopedic Surgeon speaking at the event
Mr. Ashraf ,Vice President Co-operative Hospital at the inauguration
Dr Ravi G Nair , Senior Orthopedic Surgeon, speaking at the event
Anirudhan V, Roller Skater National Junior Champion prospect ~ an inspiration !
Anirudhan V, Roller Skater National Junior Champion prospect ~ an inspiration !
Am writing below the inspiring story of Anirudhan V, studying in the 6th class at Bhavans Vidya Mandir, Chithali, Palakkad, Kerala.
Am writing below the inspiring story of Anirudhan V, studying in the 6th class at Bhavans Vidya Mandir, Chithali, Palakkad, Kerala.
He is the son of Advocate S. Vinod and Advocate M. Deepa of Kuzhalmannam, a sub-urb of Palakkad in Kerala State.
He is the son of Advocate S. Vinod and Advocate M. Deepa of Kuzhalmannam, a sub-urb of Palakkad in Kerala State.
Aniruddhan with his father. His latest fracture a minor blow in his quest
Aniruddhan with his father. His latest fracture a minor blow in his quest
Aniruddhan with his father. His latest fracture a minor blow in his quest
How I met Aniruddhan and his father He came in to my Outpatient Paediatric Orthopedic Clinic at Palak kad, Kerala, brought by a common friend who’s son is also a roller skater. Aniruddhan suffered a fall while practicing and had fractured his right wrist. With a competitive sports time away from tracks and practice is time somebody else could spend to improve and get ahead of you. I advised his father that since the fracture could be immobilised in a cast with artificial material giving it some strength that a regular plaster of paris would, he could get back to practice with his cast on the same day. We could always do weekly check-ups to see whether the cast is becoming loose or if the fracture is moving and alter treatment plans accordingly. Aniruddhan’s dedication is so much that he jumped at the idea. His father, who has been encouraging him also advised him to do the same. This simple act of dedication and ability to tolerate an adverse event inspired me to ask more about him. What I heard from his father about him merited a small story. I cannot divulge many of his early struggles because of patient confidentiality, but what ever his father found non-sensitive I am sharing with the world to inspire other kids (and parents) who dream. Hopefully it would make them dream bigger and reach higher.
His story, a simple inspiration
His story of how he overcame hurdles in his early education and learning difficulty by complete dedication to his sports and earned peer recognition is wonderful to hear. Not only did it help him achieve laurels in sports it also helped him overcome his difficulty in learning and progress there too. I suppose sports does that to people. With intense training in balance, coordination, fitness, struggle against odds, facing the exhilaration of success and depths of failure character builds.
Doubtlessly.
Tough Life of practice, dedication to sports and educationAniruddhan is now 11 years, in 6th class has been religiously getting up at 3 am every morning for the past 4 years. His father accompanies him to Coimbatore, a nearby town about one and half hour by road, where there are facilities for roller skating practice. After practicing for 2 hours he returns at 8 am and then does his full days school and then in the evening does his road practice on Roller Skates. It is no wonder then that Anirrudh is a National Level Skater and deserves every bit of encouragement he can get. He sustained an unfortunate accident and fractured his wrist last week. Aniruddhan has a cast on him now, but his spirit has not been dampened. I have recommended to practice roller skating with his cast on !Aniruddhan’s story has just begun. He is at the Junior National level now with mile of hard training struggle ahead of him to get ahead of the tough competition. However, if what I have seen is the attitude he keeps then his success is sure, in time. He has now moved to inline skates and is entering the world of elder children with some tough competition ahead of him. I am sure that with his dedication to the sport and will to practice in spite of odds he will shine through and bring laurels to his loved ones and country !The story of Aniruddhan is one among the many who have come out of all odds and made it to the top. Watch this space for more inspiring stories of child athletes, their battle against sports injuries towards victory.How I met Aniruddhan and his father He came in to my Outpatient Paediatric Orthopedic Clinic at Palak kad, Kerala, brought by a common friend who’s son is also a roller skater. Aniruddhan suffered a fall while practicing and had fractured his right wrist. With a competitive sports time away from tracks and practice is time somebody else could spend to improve and get ahead of you. I advised his father that since the fracture could be immobilised in a cast with artificial material giving it some strength that a regular plaster of paris would, he could get back to practice with his cast on the same day. We could always do weekly check-ups to see whether the cast is becoming loose or if the fracture is moving and alter treatment plans accordingly. Aniruddhan’s dedication is so much that he jumped at the idea. His father, who has been encouraging him also advised him to do the same. This simple act of dedication and ability to tolerate an adverse event inspired me to ask more about him. What I heard from his father about him merited a small story. I cannot divulge many of his early struggles because of patient confidentiality, but what ever his father found non-sensitive I am sharing with the world to inspire other kids (and parents) who dream. Hopefully it would make them dream bigger and reach higher.
His story, a simple inspiration
His story of how he overcame hurdles in his early education and learning difficulty by complete dedication to his sports and earned peer recognition is wonderful to hear. Not only did it help him achieve laurels in sports it also helped him overcome his difficulty in learning and progress there too. I suppose sports does that to people. With intense training in balance, coordination, fitness, struggle against odds, facing the exhilaration of success and depths of failure character builds.
Doubtlessly.
Tough Life of practice, dedication to sports and educationAniruddhan is now 11 years, in 6th class has been religiously getting up at 3 am every morning for the past 4 years. His father accompanies him to Coimbatore, a nearby town about one and half hour by road, where there are facilities for roller skating practice. After practicing for 2 hours he returns at 8 am and then does his full days school and then in the evening does his road practice on Roller Skates. It is no wonder then that Anirrudh is a National Level Skater and deserves every bit of encouragement he can get. He sustained an unfortunate accident and fractured his wrist last week. Aniruddhan has a cast on him now, but his spirit has not been dampened. I have recommended to practice roller skating with his cast on !Aniruddhan’s story has just begun. He is at the Junior National level now with mile of hard training struggle ahead of him to get ahead of the tough competition. However, if what I have seen is the attitude he keeps then his success is sure, in time. He has now moved to inline skates and is entering the world of elder children with some tough competition ahead of him. I am sure that with his dedication to the sport and will to practice in spite of odds he will shine through and bring laurels to his loved ones and country !The story of Aniruddhan is one among the many who have come out of all odds and made it to the top. Watch this space for more inspiring stories of child athletes, their battle against sports injuries towards victory.
How I met Aniruddhan and his father
He came in to my Outpatient Paediatric Orthopedic Clinic at Palak kar, Kerala, brought by a common friend who’s son is also a roller skater. Aniruddhan suffered a fall while practicing and had fractured his right wrist. With a competitive sports time away from tracks and practice is time somebody else could spend to improve and get ahead of you. I advised his father that since the fracture could be immobilised in a cast with artificial material giving it some strength that a regular plaster of paris would, he could get back to practice with his cast on the same day. We could always do weekly check-ups to see whether the cast is becoming loose or if the fracture is moving and alter treatment plans accordingly. Aniruddhan’s dedication is so much that he jumped at the idea. His father, who has been encouraging him also advised him to do the same.
This simple act of dedication and ability to tolerate an adverse event inspired me to ask more about him. What I heard from his father about him merited a small story. I cannot divulge many of his early struggles because of patient confidentiality, but what ever his father found non-sensitive I am sharing with the world to inspire other kids (and parents) who dream. Hopefully it would make them dream bigger and reach higher.
His story, a simple inspiration
His story of how he overcame hurdles in his early education and learning difficulty by complete dedication to his sports and earned peer recognition is wonderful to hear. Not only did it help him achieve laurels in sports it also helped him overcome his difficulty in learning and progress there too. I suppose sports does that to people. With intense training in balance, coordination, fitness, struggle against odds, facing the exhilaration of success and depths of failure character builds.
Doubtlessly.
Tough Life of practice, dedication to sports and education
Aniruddhan is now 11 years, in 6th class has been religiously getting up at 3 am every morning for the past 4 years. His father accompanies him to Coimbatore, a nearby town about one and half hour by road, where there are facilities for roller skating practice. After practicing for 2 hours he returns at 8 am and then does his full days school and then in the evening does his road practice on Roller Skates.
It is no wonder then that Anirrudh is a National Level Skater and deserves every bit of encouragement he can get. He sustained an unfortunate accident and fractured his wrist last week. Aniruddhan has a cast on him now, but his spirit has not been dampened. I have recommended to practice roller skating with his cast on !
Aniruddhan’s story has just begun. He is at the Junior National level now with mile of hard training struggle ahead of him to get ahead of the tough competition. However, if what I have seen is the attitude he keeps then his success is sure, in time.
He has now moved to inline skates and is entering the world of elder children with some tough competition ahead of him. I am sure that with his dedication to the sport and will to practice in spite of odds he will shine through and bring laurels to his loved ones and country !
The story of Aniruddhan is one among the many who have come out of all odds and made it to the top. Watch this space for more inspiring stories of child athletes, their battle against sports injuries towards victory.
This April I’d be starting my #Clubfoot clinic as part of the Pediatric Orthopedic Clinic at Sri Ramakrishna Ashrama Charitable Hospital, #Thiruvananthapuram, Kerala.
This hospital caters to poor patients in the city and a cost effective Clubfoot Clinic will add to the existing services run here.
Last month I had started my Paediatric Orthopaedic Clinic there officially and we plan to step up the services for Cerebral Palsy, Pediatric Sports Injuries and Pediatric Limb Deformities in coming months as more ancillary services are commissioned here.
Clubfoot Clinic at Thiruvanathapuram,Kerala
Pediatric Orthopedic & Cerebral Palsy Clinic at Thiruvanathapuram,Kerala
Do pass the news around to people who may benefit. Our main focus would be to keep it state of the art and cost effective.
Overtime we will add features to the clinic and ancillary services . Watch this space !!
After many years of work we finally have a #PediatricNeurologist ( Dr.Velmurugan, Hope Neuro Centre , Coimbatore ) (geared towards #DevelopmentalNeurology), Occupational Therapists, #Pediatrician (Dr. Lakshmi, Coimbatore), #Psychiatrist(Dr. Sajal), #Psychologist joining our team to treat Developmental Neurological issues in Children and Cerebral Palsy.
This is the first day of two day free medical camp. First day is dedicated to the neurological issues in children like #Autism, #Seizure disorders and second day for #PediatricOrthopedic Diseases, Limb Deformities like #ClubFoot and #CerebralPalsy.
This was in organised in association with #Sevabharathi who has been most kind in donating money, arranging volunteers etc.. The premises itself is a Lifecare Physiotherapy clinic of Biju Bhasker at #Palakkad, #Kerala.
Most kind have been Sevabharathi, it’s volunteers and Dr. Sreeram Sankar without whom this wouldn’t be possible. When me and Mr.Biju approached them with the idea 2 years ago they had a kind heart to go ahead and help us with much needed sponsorship and man power.
Watch this space. The next event would be bigger and better !!
As part of #CerebralPalsy Awareness day that just passed us we are organising a two day programme for children with #PediatricOrthopedic Disorders, #CerebralPalsy, #NeurologicalDisorders, #Autism .
The programme is slated to be held for 2 days April5th and 6th.
Timing is between 8 30am and 1pm.
Prior registration is mandatory. This can be done by calling +919495888879.
The first day April 5th Friday for Pediatric Neurological disorders like seizures, autism and second day on April 6th Saturday. The event would be marked by free medical examinations camps, art competitions for children, vocational training for mothers abs awareness programme of respective disorders. It is to be held at #Palakkad #Kerala on these two days.
The event is kindly organised by the selfless efforts of people at #Sevabharathi #Palakkad ably guided by Dr. Sreeram Sankar , Biju Bhasker of #LifeCarePhysiotherapyCentre, Palakkad and assisted by Vinod Kumar of NationalOrthotics, #Coimbatore and several other sponsors. Dr. Velmurugan , Pediatric Neurologist would be part of the event on April 5th and Easwar Tr Pediatric Orthopedic Surgeon will take part on April 6th.
Recently gave an interview to a popular news channel in #Kerala in #Malayalam.
The topic was “Common Children’s Orthopedic Disorders and Cerebral Palsy”.
It’s is in an interview format with patients who are interested phoning in the channel to discuss some of their doubts about these disease conditions.
The idea was to take up and discuss the most common children’s bone diseases that parents would need guidance on like Bow Legs, Knock Knees, Club Foot, TB infection of Bones, Perthes Disease of hip, Cerebral Palsy and interact with patients who may phone in.
I have great pleasure to announce that along with the launch of a Cerebral Palsy Clinic at Sri Ramakrishna Ashrama Charitable Hospital , Thiruvananthapuram, Kerala I am also starting an exclusive Pediatric Orthopedic Clinic.
This will cater to children suffering with bone and joint disorders, congenital deformities like Club Foot, Flat foot, Knock Knees and Bow legs among many others. Treatment advise for Spine problems in children like spina bifida, congenital and idiopathic scoliosis are also offered.
I am hereby attaching a video clip showing the many clinical conditions for which services are being offered here.
This hospital being a charitable one caters to the poor and these services would be of benefit to many.
Kindly share among your friends so that people are aware of the new service.
Dr. Easwar TR Pediatric Orthopedic & Spine Surgeon
I’m extremely happy to inform you that I am starting a Pediatric Orthopedic and Cerebral Palsy Clinic at Sri Ramakrishna Ashrama Charitable Hospital, Shasthamangalam, Thiruvanathapuram.
Please find below the video announcement of the same.
Cerebral Palsy Clinic at Sri Ramakrishna Ashrama Hospital, Thiruvananthapuram, Kerala
This is a subsidised care hospital which will serve the poor and help establish a sustainable care for children with Movement disorders, Cerebral Palsy and other Pediatric Orthopedic problems.
Appointments can be taken at the numbers or email listed below.
#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
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
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 )
Developmental Dysplasia of Hip - Left hip is dislocated
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
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 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
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
Hip Spica Plaster in child with 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
Generally these surgical procedures can be grouped into a few types :
Open Reduction of Hip and Capsulorraphy (medical term meaning stitching up of capsuleor 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.
Aniruddhan with his father. His latest fracture a minor blow in his quest 
Aniruddhan V , on Roller Skates
Dr. Easwar T.R 