Practical Orthopedics Biological Options and Simpler Techniques for Common Disorders

192 Pages·2015·27.075 MB·English

by  TULI SM

PRACTICAL ORTHOPEDICS
Biological Options and Simpler Techniques for
Common Disorders

PRACTICAL ORTHOPEDICS
Biological Options and Simpler Techniques for
Common Disorders
SM Tuli
MBBS MS PhD FAMS
Senior Consultant in Spinal Diseases and Orthopedics
Vidyasagar Institute of Mental Health and Neurosciences
New Delhi, India
Formerly
Chairman of the Department of Orthopedics
Banaras Hindu University
Varanasi, Uttar Pradesh, India
Professor and Head
Department of Orthopedics
University College of Medical Sciences
New Delhi, India
Foreword
Hardas Singh Sandhu
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Practical Orthopedics—Biological Options and Simpler Techniques for Common Disorders
First Edition: 2015
ISBN 978-93-5152-656-8
Printed at
Dedicated to
My teachers Prof KS Grewal, Prof PK Duraiswami and Prof Balu Sankaran,
the great orthopedic educators of their time
My enquiring students who induced me to continue as “student of orthopedics”
and
My ungrudging patients who could understand and accept a balance between their
expectations and constraints or limitations of clinical medicine.

Foreword
The author of Tuberculosis of the Skeletal System, Prof SM Tuli has come out with another
very useful book Practical Orthopedics—Biological Options and Simpler Techniques for
Common Disorders. Scientific papers on various aspects of orthopedics published in
national and international journals of repute have earned him global recognition and
popularity.
The strength of this book is that it is a reflection of his vast experience of nearly six
decades as a teacher, and of ethical practice in orthopedics.
This book appropriately covers the fundamental principles of orthopedics and
its practical applications. It would be a very useful book for new entrants and young
orthopedic surgeons before they get exposed to the market-driven orthopedics. It will serve
as a good guide to all medical practioners who are engaged in the care of musculoskeletal
disorders. One can appreciate the advantages of simple but effective available technology.
I congratulate Prof Tuli, for his effort to put his long experience in the shape of a book.
Hardas Singh Sandhu MBBS MS FRCS FAMS
Chairman
Department of Orthopedics
Government Medical College
Amritsar, Punjab, India

Preface
There are many books on orthopedics but most of these are written by authors working
in resource-rich countries. One must, however, realize that nearly 70 percent of people
worldwide are living in resource-compromised environment far away from the modern
facilities of metropolitan cities. The world is not made of New York, Paris, or Tokyo,
and similarly Indian subcontinent is not made of Delhi, Mumbai or Chennai. Seventy
percent of orthopedic problems are being managed in areas, which barely have moderate
infrastructure facilities available. One should appreciate the skill, and ingenuity of these
specialists, who show responsiveness to the needs of people who do not have access to
the metropolitan facilities. Despite intentions of upgradation of infrastructure facilities
worldwide, at all times there would be differences of economic inequalities and such
differences are not likely to disappear in future as well. Due to perpetual man-made
conflicts and natural disasters, there would always be pockets of deprivation, crowding,
malnutrition and inaccessibilities.
The experience and observations of orthopedic surgeons in resource-limited
environments, related published material in national and international literature, and
personal observations of over 60 years in the management of common orthopedic
disorders in moderate facilities form the basis of this book. The readers of this book are
requested and encouraged to communicate their thoughts for corrections, deletions and
additions. I seek their cooperation for help to continually improve orthopedic education
and related health care.
The guidelines suggested here are based upon the observations of the natural course
of common conditions and the observed efficacy of biological options and simpler
techniques. The suggestions made here are not limited to geographic boundries, but are
generally applicable to the patients who would prefer modalities in environments where
they reside, options, which do not require major changes in their lifestyle or entail frequent
medical or operative intervention, and are cost effective.
I hope this write-up would provide credibility to the efforts and techniques for
development of accessible, affordable and effective options for many orthopedic disorders.
Sound advice would be available for the family physicians, physical therapists, nursing
care personnel and concerned orthopedic specialists. Some problems, like complex spine
operations, repeat surgeries for joint replacement and the care of the malignant disease,
would, however, need to be referred to dedicated specialized hospitals.
SM Tuli