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Mismanagement of fractures a major concern, say experts

Untreated osteoarthritis, spondylosis and badly treated fractures are some of the reasons why hundreds of people// in India suffer needlessly and are often laid up, according to orthopaedic experts here.

"Indian orthopaedics is at par with the world with many delicate and complicated surgeries being performed here daily," said Surya Bhan, head of the orthopaedics department at the All India Institute of Medical Sciences (AIIMS) here.

Bhan is also organising secretary of the 51st annual meet of the Indian Orthopaedic Association (IOA), being held in the capital Nov 9-15.

IOA will this year focus on new techniques and strive to raise awareness among the medical fraternity through continuing medical education about areas in which some of them are erring, leading to unnecessary hardship for the patients.

Over 5,000 delegates, including experts from overseas and representatives from SAARC countries, will be attending the meet being held here after 18 years.

With changing lifestyles, particularly sedentary habits and unhealthy food habits, more orthopaedic problems are on the rise, said Bhan Tuesday.

In India, apart form complications due to unhealthy lifestyles and large number of accident-related cases, there are an estimated 107 million people above the age of 65 suffering from orthopaedic ailments. In addition, 40 percent of people over 70 years of age suffer from osteoarthritis, particularly of knee.

Through timely treatment, many of them can improve the quality of life, said Bhan.

Bhan, along with experts from his team at AIIMS including P.P. Kotwal, who conducted the delicate surgery on Prime Minister Manmohan Singh's hands to correct his carpal tunnel or nerve problem, admitted that mismanagement of fractures is not uncommon in India with Bihar and Uttar Pradesh leading in the number of such cases.

"At least 50 percent of cases with complications due to mis management that we receive are from Bihar and Uttar Pradesh. Greater effort needs to be made to improve the treatment in these areas," said Bhan.

His team stated that most common cases of mismanagement are related to hip fractures and those of knee, shoulder and elbow joints.

"The complications are due to either infection, bones not being fixed in the correct position, wrong alignment or the joint surface not being made smooth again," said S. Rastogi, another expert.

The annual orthopaedic meet will focus on new treatment methods, including the frontier area of stem cells. For the last two years, the AIIMS orthopaedic team has been working on new ways to treat complicated cases using stem cells from the patients' spine.

While claiming to have had encouraging results in nine out of ten cases, the orthopaedic surgeons said research work was still in the preliminary stages and would take a few more years.

Having pioneered the concept of the bone bank in the country, the AIIMS team is also keen to promote this idea in the country through the meet as it offers new hope for patients, besides new techniques for implants of the knee, hip and other joints.


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