About Limb Reconstruction
  • EFFECT ON PATIENTS

    Any deformity, whether congenital or acquired, creates not only an unacceptable physical disfigurement but also a deep emotional & mental scar. This can only be understood by a person who has been actually affected or from their near & dear ones.

  • SOCIAL IMPACT

    Cases are found where he or she may be the sole earning member of the family who could return to their normal life, if we can correct their problem. Most such patients gradually learn to live with it, resigning to their fate with a sigh of resentful defeat. It's so ironical & unfortunate that they are unaware of a possible end to all their miseries, both physical & emotional. They are very far from the hope of getting corrected their deformity and getting in to their routine works

  • NEW HOPE

    Now there are various methods available in treating deformity of limbs. Ilizarov method is one such treatment method. Various other implants are also used in deformity correction surgeries. These are orthofix, LRS, Nails and plates etc. Recently newer instruments have come up in India with which we can treat such patients with lesser time, and it will be a great thing that we can offer to these communities. Computer assisted instruments like SUV is an instrument of this kind, which can offer wide scope in such patients. Now it is available in India. We are the first Government medical centre in Kerala to venture into this kind of novel treatment methodology.

  • PEOPLE AFFECTED ARE

    Mainly from low socioeconomic status. The main causes are Road Traffic Accidents, Work place injuries, Various industrial accidents, Farming and mining.

  • CURRENTLY I AM DOING...

    In our orthopaedic OPD we are seeing deformity patients regularly. We have a separate deformity clinic for treating these patients . I have corrected nearly thousand patients who was suffering from all of the above such deformities between the year 2010-2020. This is a great achievement in my career as well as of our department and our institution.

What I do in deformity correction

Deformity is defined as any deviation from normal anatomy. Limb lengthening and reconstruction techniques are used to replace missing bone and to lengthen and/or straighten deformed bone segments. Below you can see video link which explains how I corrected the deformities using the ilizarov principle.
  • Description

The Ilizarov fixator or the ring fixator is an assembly of rings usually 3-4 rings applied to the bone using wires and pins. The rings are connected to each other by connecting rods. The apparatus is applied externally so that the bone ends can be moved and adjusted from outside as and when required. The flexibility of the Ilizarov technique is its biggest advantage and ensures a desired result.

  • Advantages

No osteotomy or soft tissue dissection at the deformed site is required. So there is no chance of neurovascular injury to the foot which is main disadvantage in case of open surgeries. In case of long standing deformity where all the structures will be contracted, can be corrected by gradual distraction at the deformity site so there won’t be any neurovascular injury.

  • Presentation

Patient is a 41 year old lady presented with deformity at the foot and ankle since childhood. She was walking with foot completely supinated of so many years duration. It was a case of neglected type of CTEV.





  • Disadvantages

Since it is external fixator it will be cumbersome for some patients. And there is a chance of pin tract infection if it is not cared properly..

  • Description

LRS is an unilateral external device used for the deformity correction, lengthening and treating of non-union etc



  • Advantages

It is less cumbersome than ilizarov. Pin tract care will be easier than ilizarov. But it can’t be used in all case where stability is more important.

  • Presentation

41 year old man presented with rotational deformity of his one limb following surgery after sustaining fracture of shaft of femur. He was treated with LRS .The deformity was corrected acutely after osteotomy and lengthening also was done.

  • Disadvantages

It is less stable than ilizarov. And it Can’t be used in complex deformity corrections and joint contractures etc

  • Description

Genu varum is an angular deformity of the knee, often treated surgically by osteotomy or by growth modulation (using tension band, staples, transphyseal screws and eight-plate which require removal after correction).In skeletally immature patients with at least 2 year growth remaining period is present can consider growth modulation or eight plate surgery. Here we are applying a small plate on the convex side of the deformity and is fixed with screws on either side of the physis. So that it temporarily stops the growth on the more growing side and the deformity will be corrected during the growth. Once the deformity is corrected which is confirmed by taking a full length x ray the plate can be removed.

  • Presentation

3 year old girl presented with bilateral genu varus deformity. Treated by growth modulation. The plate was removed once the deformity was corrected.

  • Advantages

No need of any bony osteotomy and it is a very simple surgery.

  • Disadvantages

Need to remove the plate in correct time once the adequate correction attained.

  • Description

HTO is a surgical procedure used to correct the Tibial varus deformity. It is done in genu varus or bowleg. Bowleg is a condition in which the legs have a gradual or sudden bent due to various reasons. The term varus means bent inwards and the term valgus means bent outward.

  • Advantages

Perfect alignment can be achieved as the correction done after external fixation on the limb. No separate surgery for implant removal

  • Presentation

Case of 21 year old man presented with bilateral genu varum treated with Orthofix assisted varus deformity correction.



  • Disadvantages

Since it is an external fixator it can cause little inconvenience to some patients. Requires pin tract care also.

  • Description

HTO is a surgical procedure used to correct the Tibial varus deformity. It is done in genu varus or bowleg. Bowleg is a condition in which the legs have a gradual or sudden bent due to various reasons. The term varus means bent inwards and the term valgus means bent outward. Here instead of orthofix, uses a plate to correct the deformity.

  • Advantages

Here the implant is completely inside the body. No external fixation is required.so it won’t cause cumbersome to the patient

  • Presentation

Presented a 17 year old boy with genu varus deformity for correction. He was not symptomatic, but wants to correct the deformity. The deformity was corrected acutely with Plate.


  • Disadvantages

Perfect alignment is not possible in every cases as it is done acutely .No Separate surgery is needed for implant removal


Ortho-SUV Frame is an advanced extension of traditional Ring Fixator developed in Russia as a single step solution for treating complex deformities and fractures. Ortho SUV is an advancement from the principles of the ilizarov Method, that allows for deformity correction and fracture reduction through the utilisation of computer assisted technology

  • Description

Here the deformity is corrected by using SUV. The SUV is connected over the ilizarov ring after application on the bone.

  • Advantages

By using SUV for deformity correction the correction time duration is less than the traditional ilizrov method. And the accuracy also far better than the traditional ilizarov method.

  • Presentation

Presented a 14 year old girl with genu valgus deformity on one side for correction. She had metabolic bone disease. She was diagnosed as renal rickets which was treated before correction of the deformity.

  • Disadvantages

No particular disadvantage except it is costly

  • Description

Here the deformity is corrected by using SUV and Hexapod . The SUV and Hexapod is connected over the ilizarov ring after application on the bone at different stages.

  • Advantages

By using SUV or Hexapod for deformity correction the correction time duration is less than the traditional ilizrov method. And the accuracy also far better than the traditional ilizarov method.

  • Presentation

Presented a 40 year old man with genu varus deformity on one side for correction. He has PPRP on other side and was severely symptomatic. The deformity was corrected using Hexapod and SUV at two stages.


  • Disadvantages

No particular disadvantage except it is costly

Testimonials

My name is vishnumaya 21 years residing at Thanoor, Malappuram, Kerala. Since childhood I had bend in both leg. I was treated from various doctors with different modalities of treatment. I was on belt for so many years. Despite all these measures the bend was increasing. Finally, we reached at medical college Kozhikode and I was introduced to Dr Jeejesh Kumar who is a specialist in deformity correction by Dr Jacob Mathew. He evaluated me and suggested me to undergo deformity correction by a surgical technique called ilizarov in a staged manner. I underwent surgery and finally the deformity was corrected. Just because of the doctor I can lead a normal life in the society and I am very thankful to him.

Vishnumaya

I am from Moozhikkal, Kozhikode district. Kerala I am very thankful to Dr jeejesh because he saved my leg from amputation stage following an accident. It was 10 years back I met with a major accident while I was riding a bike. I suffered multiple open fractures. It was infected during the course of treatment. Finally, the doctors suggested amputation of my leg. It was my luck to meet dr jeejesh kumar at that time in the medical college. He saved my leg by doing ilizarov surgery. I am a barber by job. Now I can stand many hours without any difficulty.

Subineesh

I am 52-year-old man from vadakara. I had a crush injury of my right leg following an accidental fall of crackers on my leg and was a very severe injury with comminuted fracture. It was treated by many orthopaedic doctors and plastic surgeons. Then the wound was infected. After that I had undergone multiple surgeries to eradicate infection. When all the measures failed finally I could meet Dr Jeejesh kumar who did ilizarov surgery and he succeeded in eradicating the infection as well as saving my leg. I am very grateful to him for saving my leg. Thanks to him, now I am leading a normal life.

Babu

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