Bengaluru City hospital performs complex ortho surgery to save road accident victim
Dr Mahesh C Gonchikar, Consultant Orthopaedic Surgeon
Bengaluru: A 36-year-old man has got a new lease of life after undergoing a complex surgery at Prakriya Hospital. The patient sustained right hip posterior dislocation, head injury and ribs fracture after his car crashed into a truck.
Dr Mahesh C Gonchikar, Consultant Orthopaedic Surgeon (Sports Injuries and Arthroplasty Surgeon) at the hospital, said, "It was a head-on collision (seatbelted driver with dashboard injury). He was appropriately treated in Intensive Care Unit (ICU) for hydropneumothorax with intercostal drainage and head injury was dealt with by neurosurgeons appropriately."
The CT scan revealed posterior fracture dislocation of right hip.
He was taken to operation theatre after general stabilisation of lung functions and haemodynamic status.
"Under anaesthesia, closed reduction was tried which yielded no positive results and this was expected. It was done purely to overcome the viscoelasticity of hip muscles before doing open reduction. Watsons-Jones Lateral hip approach was used and femoral head (the highest part of the thigh bone) was found to be buttonholed through the capsule with the fractured head sitting behind the Acetabulum (encloses the head of the femur)," Gonchikar said.
In the process of opening up the hip joint the muscles were crushed and mashed up due to high velocity of injury and hence proved to be very difficult for the surgical approach,
"Regarding the fractured fragment of femoral head which was in pieces, smaller pieces had to be thrown in the bin and only significantly reasonable chunk of femoral head was reattached back to main femoral head with a novel technique of using ethibond sutures which otherwise normally would be fixed by headless screws called Herbert screws, which is another innovative technique which has no mention in literature," the doctor explained.
"It was a rare case and the surgery was complex. This is usually encountered two in a million case and this has yielded fruitful results. The patient is happily walking around without any problems a few weeks after surgery. Thanks to my orthopaedic team comprising Dr Gururaj Puranik, Dr Vinuraj, physiotherapist Dr Roma and Dr Shruti for their valuable inputs and expertise," Gonchikar said.