Dr Prateek Goyal – Orthopaedic Surgeon

Identifying And Treating Pain From Nerve Tension

Nerve tension is pain that occurs because a nerve is being compressed or stuck in its surrounding tissue which prevents it from moving within its tract like it normally does. This can happen for a variety of reasons. If a joint has been immobile for a period of time it increases the risk that a nerve can get a little stuck

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Revision Hip Joint Replacement Surgery Done Removing 10 Yr Old Joint

Dr. Prateek Goyal performed the revision hip joint replacement by carefully removing the old joint at Santokba Durlabhji Memorial Hospital, Jaipur. The patient got relief from the pain of 10 years. It is working and very soon in a few days, everything is done. Thank you very much for your trust in this. This highly complex operation was made possible because of this only.

Patient Name: Ravindra Kumar Bhatnagar

Location: Hanumangarh, Rajasthan

Treatment Given – Revision Hip Replacement Surgery Done By Removing 10 Year Old Hip Joint.

Pelvic Bone Fracture with Sacrailiac Joint and Sacrum Fractures

A young 25 yrs old patient sustained severe and multiple injuries in a road traffic accident.

Despite head injuries and chest injuries, He had life-threatening Pelvic bone fracture diastasis with sacrailiac joint and sacrum fractures. He Had femur fracture also on rt side. Presence of urinary bladder injury further aggravated the pelvic injury. There was profuse internal bleed led to haemodynamic shock.

After ensuring initial ABC and haemodynamic management patient survived and became stable within few days.

The presence of urinary bladder injury, scrotal injury, and internal degloving in the Pubic region preluded any internal surgical exploration and instrumentation in the injured area as it leads to high chances of infection. His pelvis was wide open at symphysis in open book fashion which required proper reduction to prevent future disability.

Thanks to intensivists And a Urologist’s at SDMH who resuscitated him primarily and treated his bladder injury with precision.

We had to address his pelvic displacement and SI joint problem simultaneously to reform his pelvic ring structure.

We could successfully fix the whole injury through the minimally invasive and newer modality of INTERNAL EXTERNAL FIXATOR (INFIX) For symphysis and percutaneous screw fixation for his sacroiliac joint injury.

Earlier these were fixed through an external fixator where the whole bulky apparatus lies outside the body in front of the abdomen.
It is unsightly, cumbersome, and associated with many complications. The patient can not sit and not even turn in bed for a period of 2-3 months. This newer procedure addresses all these problems. The implant is all inside body and the patient can be mobilized the next day.

This is a newer procedure and we can say with pride that we are lucky enough to execute this FIRST TIME IN OUR STATE.

We used Implant and instruments used for spinal surgeries and I thank Dr. D P Sharma for providing us with those.
These injuries if not complicated with soft tissue and other systemic injuries are treated with internal symphysis plating which is already being done in our dept since past many years.

He also had rt side femur fracture which was fixed with a nail as a routine procedure after pelvic fixation.
Once again we thank u all for all the love and support. Please continue to do so in the future and forever 🙏🏻😀.

Ankle

The ankle joint is a hinge type joint that is responsible for the lower limb stability. The ankle comprises of three bones, the tibia, the fibula, and the talus. As the major movement is dependent upon the foot and ankle these joints are also prone to many injuries.

Common causes of ankle injuries include:

  1. Sprains, strains, and fractures.
  2. Sudden and accidental Tripping or falling
  3. Instable or uncomfortable landing after a jump
  4. Walking or running on uneven surfaces
  5. A sudden impact such as an accident
  6. Twisting or rotating of the ankle on the uneven surface

The symptoms of ankle injuries include pain swelling, bruising in the affected area. If the pain is getting worse even after the immediate care RICE then you should consult an ankle and foot specialist.

Common Ankle Injuries:

  1. Ankle sprains
  2. Achilles Bursitis
  3. Ankle Instability
  4. Stress Fracture.
  5. Broken Ankle
  6. Bunions
  7. Cavus Foot
  8. Flat Foot

Treatments:

The initial treatments of ankle injuries include RICE (rest, ice, compression, elevation).

  • Ankle replacement
  • Ankle surgery
  • Physiotherapy and exercises

General

Orthopedics is the field of medicine that is centered on surgery or manipulation of the musculoskeletal system to address all the conditions and diseases affecting the musculoskeletal system in individuals of all ages.

Orthopedic conditions can be treated operatively and nonoperatively through physical therapy, medications, exercise, alternate therapies, or an array of surgical procedures. There are a few procedures that require very minimal invasiveness and are less traumatic to the body than traditional open surgery.

Common Types of Fractures

A fracture is a common injury that can affect any bone in the body. When a bone receives a blow that is difficult to tolerate, it can break or get fractured. Fractures typically result from a fall, any high-intensity physical activity, a motor vehicle accident, or any kind of sports injury. However, some fractures can be caused by the condition called osteoporosis, in which the bones get weakened bu overuse or the repetitive motion.

From minor to severe there are multiple types of fractures including the following:

  1. Greenstick: It occurs when there’s a crack on one side of a bone that doesn’t affect the bone through it.
  2. Complete: It occurs when a bone is completely broken.
  3. Stress: Hairline crack caused by overuse or repetitive motion.
  4. Open or compound fracture: It occurs when the bone breaks through the skin or the force cause an open wound at the time of the fracture.
  5. Transverse: Also called the horizontal line fracture.
  6. Comminuted: It occurs when the bone breaks into three or more pieces.

Symptoms:

As numerous types of fractures also vary in degrees and severity, however, they all have the same symptoms. If you have a fracture then you might experience these symptoms:

  • Swelling and tenderness around the affected area.
  • Bruising and pain in or around the area.
  • Loss of function and limited range of motion
  • Inability to bear weight on the affected area.

Diagnosis:

As soon as you experience these symptoms, you must consult the orthopedic for the physical examination. Based on your explanation and their observation you might have to undergo an x-ray to find out the cause and severity of the condition.

Treatment:

Once the severity of the condition and location is determined we decide what treatment method will work best to heal your fractured bones. The methods of treatment will depend on the severity and type of fracture. The most commonly used method to treat fractured bones is cast immobilization. A plaster or fiberglass cast is applied to the fracture that keeps the ends of the bones in the proper position as they heal. Surgery is required in cases of an open fracture or when the bone breaks through the skin.

Hip Replacement Surgery of 102 Yr Old Woman

God is great to give life, but it’s You Who Can Create a Healthy Living.

A 102-year-old woman faced successful hip joint replacement surgery by Dr. Prateek Goyal.

It’s always a bit difficult to treat old patients but Dr. Prateek says, the patient was coordinating accordingly with positivity and that made him more comfortable to treat.

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Reconstruction of Left Hip Joint

We are quite Proud to share a complicated case with a fractured hip that survived through a simple and reproducible fixation technique by Dr. Prateek Goyal, Senior Consultant and Orthopedic Surgeon @ SDMH, Jaipur

35 years old male, A banker in AU bank sustained road traffic accident and there were Severe injury to his left hip joint, face, chest along with head injury. He stayed in ICU for 15 days due to Polytrauma. On radiological ( Xray and CT) evaluation he was diagnosed to have communicated fracture of the neck of the left femur with fracture of superolateral part of the neck as well as avulsion or trochanter of the left hip. Hardly any neck was left for fixation.

After 15 days of the traumatic event and Considering his young age it was planned to reconstruct his left hip joint. we explained the prognosis to the patient and when he agreed we moved further with the plan of reconstruction.

We close reduced and maintained the fracture fragments in Alignment under CCTV. Normal head neck and shaft angle of the femur achieved and we fixed the main head and neck segment with the help of a simple DHS implant.

The superior end superolateral part of the neck was also avulsed and fractured .we planned not to touch it or open reduce the hip joint and avoid further damage to vascularity rather, we decided to reconstruct it with the help of fibula. we took ipsilateral fibula and reconstructed the deficient superior cortex of the neck by guiding over a previously placed guidewire (all closed).

After 4-5 months of follow up now, we allowed full wt bearing with a stick, the patient has an almost full range of motion without pain and is able to manage his daily living.