Coimbatore: Writhing in pain, S Vijay, 26, a resident of Salem, didn’t think he could walk again properly when he was brought to the Coimbatore Medical College and Hospital (CMCH) with a fractured lower right limb on Jan 2. His family also thought that Vijay would lose the leg to the fractures he sustained in the accident a day ago, especially since the govt medical college hospitals in Salem and Erode couldn’t do much to save the same. However, doctors at the Institute of Orthopaedics and Traumatology at CMCH did what they thought was impossible – saved Vijay’s leg that too free of cost.Vijay’s mother S Selvi, 46, says, “We almost lost hope because his lower right limb condition was worse and thought it would be amputated. We were given a choice to shift Vijay either to Chennai or Coimbatore, and we opted for CMCH. Here, they secured his limb, and we haven’t paid a single penny for the treatment so far.” Dr D R Hariharan, assistant professor, Institute of Orthopaedics and Traumatology, CMCH, says Vijay’s was one of the complex surgeries that they handled. “Part of his limb bone was lost in the accident spot, and it made the surgical process complex. We have stabilised his bone with external fixators, and once the soft tissue health improves, we shall go ahead with bone reconstruction. There are options like bone grafting, expanding the bone through the Ilizarov method and artificial bone grafts.” Vijay is just one of the 4,500 patients who successfully underwent orthopaedic surgeries at the Institute of Orthopaedics and Traumatology at CMCH since its inception in 2018. A source at CMCH says the surgeries are done free of cost under the Tamil Nadu Emergency Intensive Care initiative to ensure timely fracture management, improving outcomes through rapid assessment, stabilisation and definitive treatment. According to the source, there are two ways to fix the fractures – closed fixation and open reduction. “Closed fixation typically involves minimal invasive stabilisation methods such as casting, traction, or percutaneous fixation. We have done 1,500 such procedures. Open reduction involves surgically exposing the fracture site to realign bones and securing them with internal fixation devices like plates, screws, or rods. We have done 3,000 open reduction surgeries.” This speaks volumes for the higher volume of complex fracture cases, requiring operative exposure and internal fixation, handled at CMCH. Tamilselvi, 46, a native of Trichy, who was injured in a road accident along with three other members of her family near Palakkad, says, “While all four of us had sustained fractures, my condition was critical and had to go for internal fixation. Our treatments were done free of cost.” Dr Hariharan says there are cases in which they have to prioritize saving lives over fixing fractures. The case of Raghumoorthy, 43, of Salem was one such, he says. “A lorry driver, Raghumoorthy met with an accident in Jharkhand last month. He was brought to Salem from there in an ambulance after almost five days. He was brought to us on the sixth day. Since his injury was major and arrived very late, his lower limbs were non-salvageable. In such conditions, our priority is to save the patient’s life and then save the limbs. We did save his life, but had to amputate both his legs.” Dr S Vetrivel Chezian, director, Institute of Orthopaedics and Traumatology, says most of the patients undergoing vascular orthopaedic surgery at CMCH are from the western districts of Tamil Nadu. “Trauma cases from Palakkad and Sathyamangalam border towards Mysuru also come here. The main reason is that such super speciality treatments, especially in patients with comorbidities, could not be handled in the govt hospitals in the Nilgiris, Tirupur or Salem. If a trauma patient needs a vascular ortho surgery along with a muscle flap, it could only be done at CMCH in Western TN.”
