Bedridden for over 2.5 years, 20-yr-old Yemeni boy walks after undergoing corrective surgery

The challenge at hand was that the patient’s bone quality was very poor, his leg had shortened and deformed and the muscles that stabilised the hip joint were missing

Bedridden, Taufiq, Yemen, Fortis Hospital, Kaushal Malhan, Orthopedic Surgery, Orthopaedic Surgery, Fortis Mulund, Director of Orthopedic Surgery, Yemeni boy

About three years ago, 20-year-old Taufiq from Yemen had met with an accident while riding his bike, during which he sustained fractures to his left hip and thigh. He was immediately rushed to a local hospital where he underwent multiple surgeries to correct the fractured hip joint and thigh. Post-surgery he used to limp while walking. Eventually discomfort and pain increased dramatically and he stopped walking completely. This impacted his personal, social and academic life as he was completely bedridden and had to drop out of school.

With sheer hope of seeing his child walk normally one day, Taufiq’s father sought treatment at Fortis Hospital, Mulund. Upon arrival at the hospital, his case was evaluated by Dr Kaushal Malhan, Director of Orthopedic Surgery, at the hospital. Detailed assessment revealed that his hip joint was disorganised and the leg that was operated upon had shortened by a few inches. The leg was stiffened and fixed at the hip joint in a very deformed position. It was turned inwards and rotated internally. The muscles around the hip were badly damaged as was evident from the prominent trochanter sitting under thin soft tissues. The hip joint was stuck to the socket, and was visibly protuberant in the hip area.

The challenge at hand for Dr Malhan & his team was that the boy’s bone quality was very poor, his leg had shortened and deformed significantly but most importantly the muscles that stabilised the hip joint were missing. One of the primary requirements for a successful total hip replacement is functioning musculature around the hip joint which gives it stability by holding the ball in the socket. Due to the soft tissue condition this patient was at high risk of dislocation after hip replacement. He was young and we were also looking for an option with more mobility and longevity. So we thought of using an uncemented hip with a dual mobility option here. Dual mobility is a design in which there is a dual planar movement in the artificial joint. Since movement is shared at two separate surfaces, there is theoretically less wear and greater range of movement. One offshoot of this is that the joint becomes more stable. Uncemented options are more challenging in cases with poor bone. Dr Malhan appraised Taufiq’s parents about his condition and its surgical challenges in detail. He went ahead with the operation and a dual mobility uncemented hip was satisfactorily implanted with correction of length and deformity. A buttock muscle the Gluteus Maximus was used to augment the function of the poor hip stabilisers. After week-long stay at the hospital, Taufiq was able to walk independently, and with a resolve to go back to school, he went home with his father.

Speaking about Taufiq’s medical condition, Dr Kaushal Malhan, Director of Orthopaedic Surgery, Fortis Hospital, Mulund, said, “When young Taufiq was brought to the hospital, he had completely stopped walking, due to which he hadn’t been able to complete schooling. Post-op, Taufiq was able to walk without support, showed good range of motion, and went back home with promise of a great future. The special dual mobility implant used on him, and the additional soft tissue procedure reduces the risk of dislocation”.

Taufiq’s grandfather who travelled with him to India did not leave a stone unturned for his grandson’s treatment said, “Taufiq was severely injured in the bike accident, he stopped going to school and retreated into a shell, it was excruciating to witness that. Here at Fortis Mulund, the doctors have given him a new life, a life that a 20yr old will highly cherish. I am thankful to the doctor, nurses and everyone involved in caring for my grandson”.