brahmanand clinic

  34 year old male suffers a fall and fractures his wrist ,X ray reveals that he has undisplaced scaphoid bone fracture . A  cast was applied , but fracture refused to heal and went into nonunion. So that gentlemen was referred to us .   X ray showing non union Scahoid vascularised bone graft in bone gap with head less screw in place A P view Lateral view Artery marked in blue and bone graft being elevated bone graft with pedicle fully elevated dissection of  Scaphoid bone non union site Scaphoid non union is troublesome condition it results in pain and weakness. Though some patients live well with it but majority seek treatment . I usually do vascularized bone grafting in Scaphoid non union . We usually take outer table of radius based on 1,2 intercompartmental supraretinacular branch of radial artery it gives adequate chunk of bone ,just good enough to fit inside non union site. Scaphoid is dissected and non union ...

V Y INCISION MARKED Lateral view one finger done  Lateral view of pre and post op results Burns are common problem especially pediatric burns . In pediatric burns hand burns are special because flexor tone is more in kids . They usually healed with resulting flexion contracture of fingers. There are neumerous ways of treating post burn contractures Release and skin graft Distraction   Z plasty Release and flap cover  V-Y plasty V- Y plasty is very good way doing flexion contracture release . It gives good results as can be seen from above pictures. It is applicable in wide variety of contracture.  Distraction lengthening is use full for very tight long standing contracture, as it lengthen nerve and other soft tissue along with lengthening scar. Multiple surgery and need for resurfacing scar is major drawback.  Release and flap cover is usually reserved for contracture with extensive tissue Loss and need for tendon...

 Nasal reconstruction in India has been done for times immmorial Suhsrut was first surgeon in world to do nasal reconstruction heaped up flap before first debaulking original wound front view forehead flap in place       Second debaulking Dr Adhishwar Sharma 8860650846 adhishwar7@gmail.com

I have a special interest in AV malformations , when this 25 year old young lady come into my OPD with a hand swelling . She has painful swelling in palm for last 5 years which was static in size for past few years . She had a slight painful swelling which was compressible and no bruit was heard or felt. She showed angiogram which showed that involved carpal arch . She was operated 0n 17 /9/2016 ,after opening up we found that it was a involving lumbrical muscles . So we excised involved muscle Tourniquet was released and hemostasis was achieved dressing was done and light compression applied . Next day physiotherapy was started. Sutures were removed after 15 days patient had uneventful recovery afterwards. Excision of AVM , sclerotherapy , embolization are the treatment options for vascular malformation. Morbidity of excision should not be worse than disease itself . Even subtotal excision is better than total excision if safer. Asthetic outcome of scar and function should be ...

anterior tibial artery to flap artery anastomosis Flap insetted Flap insetting lateral view lateral skin graft and scar of previous surgery Exposed bone Sequestrum popping out Well settled flap good contour and color match Post op day 2 7 year old Iraqi boy had a fracture tibia following a fall, being undisplaced fracture a cast was applied in 2016 . Poorly applied cast resulted in skin break down and bone was exposed . This was discovered once cast was removed. Plastic surgeon was consulted and local rotation flap was done . Flap surgery was not very successful with total break down of flap . Loss of flaps are very difficult to fathom and morale hits new low. Family decided to seek treatment aboard once the the situation of wound stabilized , In november 2017 father and son travelled to India and I saw the patient in Metro hospital Faridabad . Orthopedic surgeon ( Dr Sujoy Bhattacharjee )opinion was taken in view of intact posterior co...