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    Bone Deformity

    LRS - Oblique Plane Deformity Femur

    This patient had a congenital short femur with dysplasia of the hip on right side. She had undergone the lengthening of the femur earlier. She presented again with a progressive deformity as shown in the picture on the left side.

    Now she had an apparent varus deformity with shortening of the right side.

    When the full length x-ray was done it showed an oblique plane deformity which would require correction at two levels.

    The planning for correcting this deformity was done by drawing the 90º line at the hip and the 87º line at the distal femur (at the knee). Another line intersecting these two lines was drawn along the femoral shaft. The points of intersection marked the two CORAs.

    The picture the on the left shows the profile from the right side. Besides the scars from the previous surgery it shows a flexion deformity at the proximal femur.

    The picture on the right shows tracing made from the x-ray. The tracing shows the proposed osteotomies and the corrected appearance.

    The tracings make an important part of the preoperative planning of deformity correction. They help in simulating the correction. One can plan the exact site of osteotomy, the placement of pins/screws/wires and the placement of hinges and also come to know of the relationship of the individual bone segments and the final outcome. Therefore, one can correct any mistakes made during he planning even before going to the operating room.

    Computer software are now available where the simulation of osteotomy and correction can be done directly on the digital x-ray image.

    The picture on the left shows the composite of intra-operative c-arm pictures.

    The schanz screws were placed perpendicular to the axis of the bony segment. Percutaneous osteotomies were then performed between the first and second set of schanz screws and the second and third set of schanz screws. Acute correction of varus and flexion deformities at the proximal osteotomy and correction of varus deformity at the distal osteotomy was done. The clamps and the rail were mounted and LRS (limb reconstruction system) fixator assembly was completed.

    The picture on the right shows the tracing of the proposed correction.

    These pictures were taken during surgery to correct the oblique plane multilevel deformity.

    The picture on the left shows the position of the schanz screws in the frontal plane. Three groups of schanz screws are visible. The proximal and distal group of schanz screws are divergent as compared to the middle group of screws (mimicking the double varus deformity of femur). The distal group of screws is parallel to the knee joint line (a reference wire was passed under c-arm guidance parallel to the knee joint). The arms of the goniometer have been placed parallel to the proximal and middle group of screws showing the divergence between the two. Once the osteotomy is completed the deformity gets corrected when the screws are made parallel to each other.

    The picture on right shows the position of the schanz screws in coronal plane.

    This picture was taken during surgery; shows the position of schanz screws in the sagittal plane. The proximal and middle group of screws are at an angle mimicking the flexion deformity of the proximal femur.

    The slope between the middle and distal group mimics the normal femoral bow in sagittal plane.

    Once the osteotomy is completed and the the proximal and middle group of screws are made straight the flexion deformity gets corrected.

    The appearance in the frontal plane once the varus angulations are corrected and the LRS (Limb Reconstruction System) assembly is completed.

    The picture on the right is the x-ray appearance with the corrected bony axis.

    The appearance in the sagittal plane once the flexion deformity is corrected and the LRS (Limb Reconstruction System) assembly is completed.

    Also seen are the small incisions (red arrows) through which the percutaneous osteotomies were performed.

    The bottom picture shows how the incisions are cleaned thoroughly using a high pressure sterile normal saline and betadine solution.

    For post-operative analgesia a long acting local anesthetic is infused at the pin sites and other incisions. We also like to use a pre-operative anti-inflammatory rectal suppository to cut down on the surgery induced inflammation and pain.

    The final x-ray pictures just before fixator removal (left) and just after fixator removal (right).

    The picture on the right is taken right after the fixator removal. The radiolucent shadow is the broken piece of threaded screw impacted in the bone. Also seen are the tracts left behind in the bone in the places where the schanz screws had been before removal. These tracts get filled up with new bone in about 3 weeks time. During this time we advise “careful weight bearing,” i.e. walk full weight-bearing with the aid of a crutch or a stick.

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      Our Doctors

      Dr. Mangal Parihar

      MS Orthopaedics, MBBS
      Speciality Orthopedist, Joint Replacement Surgeon
      Consulting Room 202
      Consultation
      Timing
      Monday, Wednesday and Friday
      3 pm - 8 pm

      Dr. Anand Parihar

      MD - Radiodiagnosis, DMRD, MBBS
      Speciality Radiologist
      Consulting Room 201
      Consultation
      Timing
      On Appointment

      Dr. Maya Parihar Malhotra

      MD - Pathology
      Speciality Pathologist
      Consulting Room 201
      Consultation
      Timing
      On Appointment

      Dr. Divya Ahuja

      DNB Orthopedics
      Speciality Orthopaedics
      Consulting Room 203
      Consultation
      Timing
      Tuesday and Thursday,Saturday
      4pm - 7pm ,1pm - 4pm

      Dr. Chetan Anchan

      MS-Orthopedics, Trained in Orthopedic Oncology from Tata Memorial Hospital
      Speciality Orthopaedics
      Consulting Room 201
      Consultation
      Timing
      On Appointment

      Dr. Sunil Arora

      MS - Orthopaedics, MBBS
      Speciality Orthopaedics
      Consulting Room 205
      Consultation
      Timing
      Monday to Saturday
      11am - 1 pm

      Dr. Prasad Chaudhari

      MS - Orthopaedics, DNB - Orthopedics
      Speciality Orthopaedics
      Consulting Room 204
      Consultation
      Timing
      On Appointment

      Dr. Kaustubh Durve

      MS -Orthopedics, MRCS (UK)
      Speciality Orthopaedics
      Consulting Room 004
      Consultation
      Timing
      On Appointment

      Dr. Hitesh Kubadia

      DNB - Orthopedics
      Speciality Orthopaedics
      Consulting Room 002
      Consultation
      Timing
      On Appointment

      Dr. Abhishek Kini

      DNB Orthopedics/Orthopedic Surgery, MBBS
      Speciality Foot & Ankle Surgeon
      Consulting Room 202
      Consultation
      Timing
      Wednesday
      7pm - 8pm

      Dr. Parag Lad

      Diploma Orthopedics, FCPS - Orthopedics
      Speciality Hand Surgeon
      Consulting Room 003
      Consultation
      Timing
      Wednesday
      3.30pm to 5pm

      Dr. Kunal Makhija

      MS - Orthopedics
      Speciality Joint Replacement
      Consulting Room 005
      Consultation
      Timing
      Tuesday, Thursday and Saturday
      3pm - 4pm

      Dr. Sheetal Mohite

      MS - Orthopedics, Fellowship in spine
      Speciality Spine
      Consulting Room 205
      Consultation
      Timing
      Wednesday, Saturday
      5:30pm - 7pm, 10am - 11am

      Dr. Pradip Nemade

      MS - Orthopedics, DNB - Orthopedics
      Speciality Arthroscopy & Trauma
      Consulting Room Ground floor, Room no.3
      Consultation
      Timing
      Monday, Wednesday and Friday
      6pm - 7 pm

      Dr. Chasanal Rathod

      MS - Orthopedics, Fellowship in Pediatric Orthopedics
      Speciality Pediatric Orthopedics
      Consulting Room Ground floor, room no. 1
      Consultation
      Timing
      Mondays
      3pm - 5pm

      Dr. Dipit Sahu

      MS - Orthopedics, Fellowship in Shoulder Surgery
      Speciality Orthopedics
      Consulting Room 005
      Consultation
      Timing
      On Appointment

      Dr. Milind Sawant

      MS - Orthopedics, FRCS Trauma & Orth
      Speciality Joint Replacement
      Consulting Room 203
      Consultation
      Timing
      Saturday
      2pm - 3pm

      Dr. Amandeep Singh Gujral

      DNB - Orthopedics, Fellowship in Spine Surgery
      Speciality Spine
      Consulting Room 204
      Consultation
      Timing
      Tuesday and Thursday
      7pm - 8pm

      Dr. Raghuprasad Verma

      MS - Orthopedics, Fellowship in Spine Surgery
      Speciality Spine
      Consulting Room 201
      Consultation
      Timing
      On Appointment

      Dr. Swaroop Hegde

      MD - General Medicine and Endocrinology
      Speciality General Medicine
      Consulting Room 204
      Consultation
      Timing
      On Appointment

      Dr. Antima Jain

      BPT - Bachelor of Physiotherapy
      Speciality Physiotherapist
      Consulting Room 004
      Consultation
      Timing
      Monday to Saturday
      8am to 1pm

      Dr. Kusumlata

      BPT - Bachelor of Physiotherapy, MPT
      Speciality Physiotherapist
      Consulting Room 004
      Consultation
      Timing
      Monday to Saturday
      5pm - 9pm

      Dr. Kanchan Suvasia

      BPT - Bachelor of Physiotherapy
      Speciality Physiotherapist
      Consulting Room 004
      Consultation
      Timing
      Monday to Saturday
      4pm - 7pm

      Dr. Sauramibika Tiwari

      BPT - Bachelor of Physiotherapy
      Speciality Physiotherapist
      Consulting Room 004
      Consultation
      Timing
      Monday to Saturday
      9am - 2pm

      Dr. Suman Bijlani

      MBBS, MD - Obstetrics & Gynaecology, DGO, FCPS - Mid. & Gynae
      Speciality Gynecologist
      Consulting Room 203
      Consultation
      Timing
      On Appointment

      Dr. Preeti Jobalia

      DGO - Obstetrics & Gynecology
      Speciality Gynecologist
      Consulting Room 003
      Consultation
      Timing
      On Appointment

      Dr. Shilpa Shah

      DNB - Obstetrics & Gynecology
      Speciality Gynecologist
      Consulting Room 001
      Consultation
      Timing
      On Appointment

      Dr. Vidula Daundkar

      MS - Obstetrics & Gynecology
      Speciality Gynecologist
      Consulting Room 201
      Consultation
      Timing
      On Appointment

      Dr. Ashutosh Kharche

      MD - Radiodiagnosis, Fellowship in Vasclular & Interventional Radiology
      Speciality Vascular Surgeon
      Consulting Room 203
      Consultation
      Timing
      Tuesday and Friday
      8pm - 9pm

      Dr. Amit Sahu

      MD - Radiodiagnosis, Fellowship in Vasclular & Interventional Radiology
      Speciality Interventional Radiology
      Consulting Room 205
      Consultation
      Timing
      On Appointment

      Dr. Satish Chougale

      MD - Anesthesiology
      Speciality Anesthesiology
      Consulting Room 002
      Consultation
      Timing
      On Appointment

      Dr. Sayali

      Diploma in Anesthesiology
      Speciality Anesthesiology
      Consulting Room 003
      Consultation
      Timing
      On Appointment

      Dr. Sheetal

      Speciality Anesthesiology
      Consulting Room 005
      Consultation
      Timing
      On Appointment

      Dr. Suratkal

      MBBS, DNB Nephrology
      Speciality Nephrologist
      Consulting Room 201
      Consultation
      Timing
      Monday, Wednesday and Friday
      11am - 1pm

      Dr. Ashish Agrahari

      MD Pathology
      Speciality Pathologist
      Consulting Room 203
      Consultation
      Timing
      On Appointment

      Dr. Akshay Deshpande

      MCH - Plastic & Reconstructive Surgery
      Speciality Plastic & Reconstructive
      Consulting Room 204
      Consultation
      Timing
      On Appointment

      Dr. Amit Patil

      MBBS, MCh - Plastic Surgery, MS - General Surgery
      Speciality Plastic & Reconstructive Surgery
      Consulting Room 004
      Consultation
      Timing
      On Appointment

      Dr. Tushar Jadhav

      DNB - Surgical Oncology
      Speciality Surgical Oncology
      Consulting Room 005
      Consultation
      Timing
      On Appointment

      Dr. Devashri Patil

      MS - ENT, Fellowship in Head and Neck Surgical Oncology
      Speciality Surgical Oncology
      Consulting Room 001
      Consultation
      Timing
      On Appointment

      Dr. Ankit Shah

      MDS & Fellowship in Head & Neck Surgical Oncology
      Speciality Surgical Oncology
      Consulting Room 201
      Consultation
      Timing
      On Appointment

      Dr. Dimple Chudgar

      DNB (Obstetrics & Gynecology), Fellowship in Reproductive Medicine and Endoscopic Surgery
      Speciality Obstetrics & Gynecology
      Consulting Room 204
      Consultation
      Timing
      On Appointment

      Dr. Sanjay Singh

      DNB (Orthopedics), Fellowship in Shoulder & Elbow
      Speciality Shoulder & Elbow Surgery
      Consulting Room 203
      Consultation
      Timing
      On Appointment

      Our Doctors

      Dr. Mangal Parihar

      MS Orthopaedics, MBBS
      Speciality Orthopedist, Joint Replacement Surgeon
      Consulting Room 202
      Consultation
      Timing
      Monday, Wednesday and Friday
      3 pm - 8 pm

      Dr. Anand Parihar

      MD - Radiodiagnosis, DMRD, MBBS
      Speciality Radiologist
      Consulting Room 201
      Consultation
      Timing
      On Appointment

      Dr. Maya Parihar Malhotra

      MD - Pathology
      Speciality Pathologist
      Consulting Room 201
      Consultation
      Timing
      On Appointment

      Dr. Divya Ahuja

      DNB Orthopedics
      Speciality Orthopaedics
      Consulting Room 203
      Consultation
      Timing
      Tuesday and Thursday,Saturday
      4pm - 7pm ,1pm - 4pm

      Dr. Chetan Anchan

      MS-Orthopedics, Trained in Orthopedic Oncology from Tata Memorial Hospital
      Speciality Orthopaedics
      Consulting Room 201
      Consultation
      Timing
      On Appointment

      Dr. Sunil Arora

      MS - Orthopaedics, MBBS
      Speciality Orthopaedics
      Consulting Room 205
      Consultation
      Timing
      Monday to Saturday
      11am - 1 pm

      Dr. Prasad Chaudhari

      MS - Orthopaedics, DNB - Orthopedics
      Speciality Orthopaedics
      Consulting Room 204
      Consultation
      Timing
      On Appointment

      Dr. Kaustubh Durve

      MS -Orthopedics, MRCS (UK)
      Speciality Orthopaedics
      Consulting Room 004
      Consultation
      Timing
      On Appointment

      Dr. Hitesh Kubadia

      DNB - Orthopedics
      Speciality Orthopaedics
      Consulting Room 002
      Consultation
      Timing
      On Appointment

      Dr. Abhishek Kini

      DNB - Orthopedics, Dip. Sports Medicine from IOC
      Speciality Foot & Ankle Surgeon
      Consulting Room 202
      Consultation
      Timing
      Wednesday
      7pm - 8pm

      Dr. Parag Lad

      Diploma Orthopedics, FCPS - Orthopedics
      Speciality Hand Surgeon
      Consulting Room 003
      Consultation
      Timing
      Wednesday
      3.30pm to 5pm

      Dr. Kunal Makhija

      MS - Orthopedics
      Speciality Joint Replacement
      Consulting Room 005
      Consultation
      Timing
      Tuesday, Thursday and Saturday
      3pm - 4pm

      Dr. Sheetal Mohite

      MS - Orthopedics, Fellowship in spine
      Speciality Spine
      Consulting Room 205
      Consultation
      Timing
      Wednesday, Saturday
      5:30pm - 7pm, 10am - 11am

      Dr. Pradip Nemade

      MS - Orthopedics, DNB - Orthopedics
      Speciality Arthroscopy & Trauma
      Consulting Room Ground floor, Room no.3
      Consultation
      Timing
      Monday, Wednesday and Friday
      6pm - 7 pm

      Dr. Chasanal Rathod

      MS - Orthopedics, Fellowship in Pediatric Orthopedics
      Speciality Pediatric Orthopedics
      Consulting Room Ground floor, room no. 1
      Consultation
      Timing
      Mondays
      3pm - 5pm

      Dr. Dipit Sahu

      MS - Orthopedics, Fellowship in Shoulder Surgery
      Speciality Orthopedics
      Consulting Room 005
      Consultation
      Timing
      On Appointment

      Dr. Milind Sawant

      MS - Orthopedics, FRCS Trauma & Orth
      Speciality Joint Replacement
      Consulting Room 203
      Consultation
      Timing
      Saturday
      2pm - 3pm

      Dr. Amandeep Singh Gujral

      DNB - Orthopedics, Fellowship in Spine Surgery
      Speciality Spine
      Consulting Room 204
      Consultation
      Timing
      Tuesday and Thursday
      7pm - 8pm

      Dr. Raghuprasad Verma

      MS - Orthopedics, Fellowship in Spine Surgery
      Speciality Spine
      Consulting Room 201
      Consultation
      Timing
      On Appointment

      Dr. Swaroop Hegde

      MD - General Medicine and Endocrinology
      Speciality General Medicine
      Consulting Room 204
      Consultation
      Timing
      On Appointment

      Dr. Antima Jain

      BPT - Bachelor of Physiotherapy
      Speciality Physiotherapist
      Consulting Room 004
      Consultation
      Timing
      Monday to Saturday
      8am to 1pm

      Dr. Kusumlata

      BPT - Bachelor of Physiotherapy, MPT
      Speciality Physiotherapist
      Consulting Room 004
      Consultation
      Timing
      Monday to Saturday
      5pm - 9pm

      Dr. Kanchan Suvasia

      BPT - Bachelor of Physiotherapy
      Speciality Physiotherapist
      Consulting Room 004
      Consultation
      Timing
      Monday to Saturday
      4pm - 7pm

      Dr. Sauramibika Tiwari

      BPT - Bachelor of Physiotherapy
      Speciality Physiotherapist
      Consulting Room 004
      Consultation
      Timing
      Monday to Saturday
      9am - 2pm

      Dr. Suman Bijlani

      MBBS, MD - Obstetrics & Gynaecology, DGO, FCPS - Mid. & Gynae
      Speciality Gynecologist
      Consulting Room 203
      Consultation
      Timing
      On Appointment

      Dr. Preeti Jobalia

      DGO - Obstetrics & Gynecology
      Speciality Gynecologist
      Consulting Room 003
      Consultation
      Timing
      On Appointment

      Dr. Shilpa Shah

      DNB - Obstetrics & Gynecology
      Speciality Gynecologist
      Consulting Room 001
      Consultation
      Timing
      On Appointment

      Dr. Vidula Daundkar

      MS - Obstetrics & Gynecology
      Speciality Gynecologist
      Consulting Room 201
      Consultation
      Timing
      On Appointment

      Dr. Ashutosh Kharche

      MD - Radiodiagnosis, Fellowship in Vasclular & Interventional Radiology
      Speciality Vascular Surgeon
      Consulting Room 203
      Consultation
      Timing
      Tuesday and Friday
      8pm - 9pm

      Dr. Amit Sahu

      MD - Radiodiagnosis, Fellowship in Vasclular & Interventional Radiology
      Speciality Interventional Radiology
      Consulting Room 205
      Consultation
      Timing
      On Appointment

      Dr. Satish Chougale

      MD - Anesthesiology
      Speciality Anesthesiology
      Consulting Room 002
      Consultation
      Timing
      On Appointment

      Dr. Sayali

      Diploma in Anesthesiology
      Speciality Anesthesiology
      Consulting Room 003
      Consultation
      Timing
      On Appointment

      Dr. Sheetal

      Speciality Anesthesiology
      Consulting Room 005
      Consultation
      Timing
      On Appointment

      Dr. Suratkal

      MBBS, DNB Nephrology
      Speciality Nephrologist
      Consulting Room 201
      Consultation
      Timing
      Monday, Wednesday and Friday
      11am - 1pm

      Dr. Ashish Agrahari

      MD Pathology
      Speciality Pathologist
      Consulting Room 203
      Consultation
      Timing
      On Appointment

      Dr. Akshay Deshpande

      MCH - Plastic & Reconstructive Surgery
      Speciality Plastic & Reconstructive
      Consulting Room 204
      Consultation
      Timing
      On Appointment

      Dr. Amit Patil

      MCH - Plastic & Reconstructive Surgery
      Speciality Plastic & Reconstructive Surgery
      Consulting Room 004
      Consultation
      Timing
      On Appointment

      Dr. Tushar Jadhav

      DNB - Surgical Oncology
      Speciality Surgical Oncology
      Consulting Room 005
      Consultation
      Timing
      On Appointment

      Dr. Devashri Patil

      MS - ENT, Fellowship in Head and Neck Surgical Oncology
      Speciality Surgical Oncology
      Consulting Room 001
      Consultation
      Timing
      On Appointment

      Dr. Ankit Shah

      MDS & Fellowship in Head & Neck Surgical Oncology
      Speciality Surgical Oncology
      Consulting Room 201
      Consultation
      Timing
      On Appointment

      Dr. Dimple Chudgar

      DNB (Obstetrics & Gynecology), Fellowship in Reproductive Medicine and Endoscopic Surgery
      Speciality Obstetrics & Gynecology
      Consulting Room 204
      Consultation
      Timing
      On Appointment

      Dr. Sanjay Singh

      DNB (Orthopedics), Fellowship in Shoulder & Elbow
      Speciality Shoulder & Elbow Surgery
      Consulting Room 203
      Consultation
      Timing
      On Appointment

      Our Vision & Mission

      Our Vision दृष्टिकोन:
      To improve the quality of life; free of deformities for our patients, at an affordable price while always treating them like a family.
      आमच्या रुग्णांच्या जीवनाचा दर्जा सुधारण्यासाठी त्यांस परवडणाऱ्या किंमतीत आरोग्य सेवा देणे. तसेच त्यांच्या सोबत नेहमी कुटुंबाप्रमाणे वागणे.

      Our Mission मोहीम:
      To provide the best, empathetic medical care to our patients. To help our patients make an informed choice in their treatment. To pass on the knowledge we have received to our collegues and to the next generation.
      आमच्या रुग्णांना सर्वोत्तम, सहानुभूतीपूर्ण वैद्यकीय सेवा प्रदान करणे. आमच्या रुग्णांना त्यांच्या उपचारांमध्ये माहितीपूर्ण निवड करण्यास मदत करणे. आम्हाला मिळालेले ज्ञान आमच्या सहकाऱ्यांना आणि पुढच्या पिढीपर्यंत पोहोचवणे.