Thanks to modern medicine, even chopped off limbs can now be restored --and minus bone grafting! In an example of medical breakthroughs in orthopaedics,

Dr Ajay Jain, a noted orthopaedic surgeon, presently working at the Maharaja Agarsain Hospital, New Delhi, describes a case where the patient was sure to lose one of his arms.

A 21-year old young man got his elbow caught in a heavy pressing machine -- a case of severe trauma. The elbow joint and the lower part of the patient's arm was completely crushed by the pressing machine and the nerves connected to it was also badly damaged.

The only hope was that the blood vessels were intact. The only alternative was that the arms were to be amputated. However, in this case, Dr Jain opted for surgery whrein the segment of the limb that had got crushed and was dead was removed from the body and the nerves attached to the affected part were repaired. To give a support, an external fixtar was applied in the injured part.

After two weeks, the limbs survived and after another two weeks, skin grafting was done in which a small portion of the skin of the thigh was removed and stitched on the affected part in a variation of plastic surgery.

After three weeks, manipulation was done and the limb was put at 30 degree at flexion (to the degree to which the limb can be flexed). The limb was also shortened. Luckily, the damaged bone united, but the elbow joint was not there. There was no need of bone grafting, says Dr Jain, adding that it was one of the most unusual cases of industrial injury or multiple fractures which got cured without a bone grafting.

Types of bone disorders are broadly two types

Trauma based-- due to an injury, a fracture, dislocation, slip disc, etc.

Congenital anomalies -- defects from the birth or sometimes hereditary disorders. There are also small injuries such as sprains which are usually in the ligaments, and not in the bones; in medical, this is called a soft tissue injury. Ligaments are tissues that bind the joints.

Fractures again can also be broadly of two types -- Open wound fracture: Where there is a bleeding from the wounds and a fracture within the bone Closed wound fracture: Where there is no blood from the injured part --but there is a fracture in the bone or bones as the case may be.

Actually a fracture can be explained as a break in the continuity of the bones. There is another type of anomaly commonly seen in bones called as dislocation which can be called as congruity of the joints.

Congenital anomalies of the bones are usually seen in children and they are the ones, who are deformed by birth ie their limbs are shortened or absent or deformed by birth.

The break in the continuity of bones or a fracture can be treated broadly by two ways -- depending upon the severity of the fracture

Conservatively

Conservatively In this case depending upon the bone, plaster can be given or used or the bone could be reduced. The materials that are usually used for plaster are light resin cast, imported material, or Plaster of Paris.

Surgically -- A fractured bone can be treated surgically through many ways such as (1) Nailing (2) Plating
(3) Cruise, etc. In Nailing, a long rod is put intermedially inside the body at the site of fracture In plating, says
Dr Jain, a plate is put on the surface of the bone where the fracture has occurred and it is fixed with the help of screws.

By Sharbani Bose