Dr Vaibhav Bagaria is Director, Department of Orthopaedics at Sir H N Reliance Foundation Hospital and Research Centre, Mumbai.
After completing his MBBS, Dr Bagaria completed MS (Orthopaedics) at KEM Hospital, Mumbai. Then, he pursued an Orthopaedic fellowship at Medical College of Wisconsin, Milwaukee, USA for a year. During that fellowship, he received two international awards and also a diploma from SICOT, Belgium. Then, he underwent fellowship in advanced joint replacement and adult reconstruction in Germany and later at Perth, Adelaide, and Melbourne in Australia. He is the first Indian to top the international diploma SICOT exam.
Dr Bagaria has an experience of 12 years in the field of Orthopaedics. Prior to his association with our hospital, he worked as a full-time Consultant at Apollo Hospital in New Delhi, Care Hospital and Origyn Clinic in Nagpur. Dr. Bagaria gained experience in all the latest technologies in Orthopaedics at different centres of excellence around the world. He is proficient in performing most orthopedic surgeries with special interest in hip and knee replacement procedures. He is specialized in hip and knee revision procedures, hip resurfacing and unicondylar knee replacements. He is well-versed with the latest technology like Minimally Invasive Surgery (MIS), Computer Navigated Surgery (CAS) and patient specific instrumentation.
Dr Bagaria is a member of the editorial board of many journals. He has published several peer-reviewed publications in national and international journals and has written several books and book chapters. He has received many national and international awards. He was selected to represent the medical community in the Beijing Olympic torch relay held in 2008. He is also the recipient of the prestigious Korean award and Lester Lowe award at World Orthopedic Congress held at Istanbul in 2005.
As we age, our bones become fragile- because at a certain age, around 30 years, we have what is called Peak Bone Mass. This Peak Bone Mass is like a fixed deposit and with every passing year, unless we take appropriate care, a certain amount keeps debiting from the deposit.
When the force is more than the strength, it gives a way and when it gives way, it results in a fracture.
Hip fracture
The most common out of all the fractures during this age is a fracture of the hip bone. This can be:
- Intertrochanteric fracture
- Fracture neck of femur
These are the most vulnerable areas for fracture in our body.
Not all hip fractures are the same. Broadly, fractures can be divided into 2 types:
- Intertrochanteric fracture: outside the capsule
- Fracture neck of femur: this is within the capsule
The management of both the fractures differ with respect to the strategy the surgeon uses for management and surgery of both. Which is:
Intertrochanteric fracture:
The fracture happens outside the joint, hence it needs to be operated. And the surgery performed can include nailing and/ or plating. Here the intent is to fix the bone.
Fracture neck of femur:
The ball is broken within the joint, hence the ball needs to be replaced.
Wrist fracture
The second most common type of fracture is a fracture of the wrist. Wherein there is a fracture of the radius bone which is seen.
This often is due to fall on an outstretched hand and the entire weight of the body falls on the hand, leading to fracture of the radius bone.
Depending on the site if fracture type and configuration of the fracture, age, activity, and expectation of the patient from the management, the surgeon can manage by:
- Securing the fracture site by placing a plaster after putting the bones in place
- Wiring
- Plating is required when the fracture is much more complex
Vertebral fracture
Another category of fractures which are commonly seen are fractures of the spinal body which are called vertebral fractures.
When you fall, the vertebra gets compressed forming a wedge.
The good thing about vertebral fractures is that they tend to heal on their own. With most patients you only need to provide the patient with supportive measures and pain relief medication.
But they are also the most dramatic fractures. Because when you fall, the pain can be severe leading to greater panic.
These fractures do not require surgery mostly and heal on their own.
Fracture of the humerus
This can be a fracture of the proximal part of the humerus or the shoulder joint.
Common cause for this type of fracture is all fall on an outstretched hand because the impact of the fall is taken by the shoulder joint.
Most of these fractures can also be managed conservatively with a closed reduction and immobilisation of the limb with a sling.
However, if the fracture is too displaced or the ball has moved out of the socket, a surgery is required in such cases.
Miscellaneous fractures
- Rib fractures
- Small bone fractures
- Fractures around the knee
- Meniscal fractures due to trivial injuries are common as one ages
Osteoporosis is a silent disease which can lead to easy fractures after fall.
Measures to keep your bones strong
- Taking calcium supplements- take it for a year, then skip for the next and then take your calcium supplements in the next year, is what Dr Vaibhav advices
- Good and nutritious diet should also be taken and it should include natural sources of calcium
- Adequate amount of Vitamin D should be taken
- Physical exercise/ activity: this definitely includes 20 mins of daily walk and if possible, compliment it with 15-20 mins of weight training.
- BMD (Bone Mass Density) / Dexa scan can be done in case further intervention by a medical specialist needs to be consulted.
Bone replacement surgeries can be done due to a lot of reasons, some of which include:
- Fracture of the hip, causing the need for replacing the ball in the ball- socket hip joint
- Hip arthritis
- AVN (Arteriovenous Necrosis) of the femur
- Congenital defects
- Knee replacement surgery: since we use our knee and that leads to wearing of the knee joint/ cartilage of the knee, giving rise to the need for surgery
Knee replacement surgery helps by changing the cartilage of the knee joint and replacing the knee joint.
Knee surgery nowadays can also be performed robotically. Robotic surgery is an interplay between man and machine which helps us achieve the desired results.
There is no specific age indication for the surgery. Rather it depends on the patients complaints and his profile
