Thursday December 13, 2018

Bone lengthening not recommended by doctors

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New Delhi: Gavriil Abramovich Ilizarov, who used external devices on patients to fix infected non-unions of bones in the 1950s, might not be a well-known orthopedic surgeon but his technique gained some popularity among Indians.

Indians, in recent past, preferred Ilizarov technique to increase their heights.

Ilizarov surgery has been accepted globally for lengthening the bones up to four to six inches but doctors advise not to go through this extremely slow and painful procedure for cosmetic purpose.

Femur (thigh bone) and tibia (lower leg bone) are the two bones that are involved in the elongation purposes.

It takes, at least, four to six months before this painful process is complete.

In layman terms, the surgery involves strategically breaking the bone and then slowly separating the ends of the broken bone over a long period of time to gain extra height. This is done under the supervision of highly trained surgeons only, experts advise.

“It works on the principle of distraction osteogenesis, whereby slow and controlled distraction of bone at 1 mm per day generates new bone at the lengthening site of a bone. This is done using an external ring fixator or frame,” said Dr (prof) Raju Vaishya, senior joint replacement surgeon at Indraprastha Apollo Hospitals and president of the Arthritis Care Foundation.

“Ilizarov surgery is a boon for patients with severe compound fractures, for the lengthening of bones and for deformity correction of bones and joints,” said Dr Vaishya.

Dr Dhananjay Gupta, senior consultant (orthopaedics) at Fortis Flt Lt Rajan Dhall Hospital in the capital did not recommend the use of this technique for cosmetic purpose.

“As the body tries to heal the break by creating new bone, the fracture is extended yet again and the body creates even more, bone in the gap during the process,” added Subhash Shalya who is associated with Delhi-based Orthopedic Surgeon Bone Joint Care Foundation of India.

During this agonizing process, the fracture is extended by a tiny amount several times a day, up to a millimeter each day, until the desired length is reached.

“The trick is to do it slow enough so that new bone continues to grow, but fast enough that it does not heal entirely,” Shalya added.

Doctors, nowadays, use fixators, which have rings, rods, and wires to gradually distract the bone parts and keep them fixed at desired length.

“The entire procedure is minimally invasive as it uses wires to fix the bones to the rings. It involves less tissue damage and ensures a quick recovery. After the procedure, the Ilizarov fixator is removed,” said Shalya.

The procedure is followed by a lengthy rehabilitation period and extensive physiotherapy to allow the body to get accustomed to the new bone development.

“Wires which are passing through soft tissue and bone may get infected and painful. Regular distraction should be done with clock-like precision as too fast or slow rate may jeopardise the outcome,” advised Dr Gupta.

“Blood vessels or nerve may not stretch at the same rate and may result in loss of their function. Muscles may cause stiff joints; so this procedure must be done under the guidance of a very trained surgeon,” he said.

According to Dr Sanjay Agarwala, head (orthopedics and traumatology) at Mumbai-based P.D. Hinduja National Hospital & Medical Research Centre, as in any operation, there are concurrent risks which are manageable.

“As it is a slow process, it needs perseverance and persistence both on the patient and doctors’ part. The procedure has been in place for 30 years and fills a required niche in orthopedics,” said Dr Agarwala. (IANS)

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How sexual violence in neighbourhood affects your health

Researchers conducted interviews with nearly 350 adults in nine neighbourhoods in a major American city with high rates of poverty, unemployment and crime

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Sexual violence in neighborhood can affect the mental health of women. Pexels
Sexual violence in neighborhood can affect the mental health of women. Pexels
  • Sexual violence in the neighbourhood can harm your health.
  • Neighbourhood plays a vital role in human behaviour.
  • Men can be more aware of what makes women feel insecure.

A study finds sexual violence in the neighbourhood can harm the physical and mental health of women. Neighbourhoods play a key role in the behaviour and development of people, previous studies show and some conditions — such as crime, segregation, poverty and disorder — can have harmful effects on health.

Researchers conducted interviews with nearly 350 adults in nine neighbourhoods in a major American city with high rates of poverty, unemployment and crime.

“Feeling unsafe, especially in and around your home, can erode physical and mental health,” said Dana M. Prince, co-author of the study and assistant professor at the Jack, Joseph and Morton Mandel School of Applied Social Sciences at Case Western Reserve University.

Researchers say men can be more aware of what makes women feel insecure. Pexels
Researchers say men can be more aware of what makes women feel insecure. Pexels

According to the researchers, feelings about the frequency of rape or other forms of sexual assault in a neighbourhood are significantly tied to women’s perceptions of its safety.

“Our results could mean men are less aware of sexual violence, or perhaps they do not feel comfortable reporting that it makes them feel less safe — perhaps both — while women tend to be socialised early on to be aware of the possibility of sexual attack,” Prince added.

Participants were asked how often particular crimes occurred in their neighbourhood in the past six months.

“Our results indicate that men can become more aware of how women feel about what contributes to and threaten their safety,” the researcher said.

The study was published in the Journal of Community Psychology. (IANS)