Surgical Procedures

Surgical Procedures

At HRDC we offer a range of surgical procedures. Below are listed our most common procedures. 

Clubfoot is a condition where the foot is turned inwards and downwards so that the sole cannot be placed flat on the ground, in other words the child will not be able to walk properly, in addition to hav-ing a hard time finding footwear. If left untreated, the deformity worsens and the foot stiffens up making treatment more difficult and invasive, in addition to providing a more suboptimal result.

At HRDC, we use the Ponseti method which is a (non-invasive) method that uses serial plaster casts to correct the deformity.This is followed by a minor surgical procedure to loosen the tight heel cord. For those children that present late for treatment, surgical correction is also offered at HRDC.

HRDC treats one of the highest numbers of clubfeet in the world. The poor socio-economic situation in Nepal, also makes preventable physical disability like clubfoot the most common condition that we treat in the field and at our hospital.

A trauma patient is someone who has suffered a serious or life threatening injury as a result of an event such as a car accident, gunshot wound or fall. Traumatic injuries may affect many parts of the body, including the brain, the extremities, and internal organs. The severity of injuries can range from minor to life-threatening. At HRDC, the majority of trauma and injuries we see have either not been treated at all or not been treated properly. The lack of prompt and professional help often leads to unnecessary disability. At HRDC, a lot of these cases are due to injuries secondary to fall. Neglected trauma forms a considerable burden of the case load at HRDC.

Cerebral Palsy is an impairment of muscular function and weakness of the limbs, caused by lack of oxygen to the brain immediately after birth, brain injury during birth, or an infection. Often accompanied by poor motor skills, it sometimes involves speech and learning difficulties.

The HRDC cerebral palsy program approaches this difficult lifelong problem in a holistic manner, incorporating physiotherapy for the muscles, judicious surgical procedures in selected cases, and a rehabilitation program to help achieve the best function possible for the child. We also involve the caregiver in treatment so that the gains made at the hospital are sustained in the household as the child grows up.

Burn scar contracture refers to the tightening of the skin after a second or third degree burn. When skin is burned, the surrounding skin begins to pull together, resulting in a contracture. It needs to be treated as soon as possible because the scar can result in restriction of movement around the injured area.

In Nepal, a lot of families, particularly in rural areas, have open fires at home. Many young children get burns while the parents are out working in the fields. Many of the cases we see are incidents where children have had an accident by the fire, and gotten burned. A dedicated plastic surgical team takes care of these difficult cases at HRDC.

Osteomyelitis is infection in the bone. Osteomyelitis can occur in infants, children, and adults. Different types of bacteria typically affect different age groups. In children, osteomyelitis most commonly occurs at the ends of the long bones of the arms and legs, affecting the hips, knees, shoulders, and wrists. Left untreated, this can cause significant disability, as amputation might be the only option.

Septic arthritis is a serious and painful infection in a joint. Bacteria can get into the joint and cause rapid cartilage deterioration and bone damage. This can lead to significant pain, swelling, redness, and loss of movement for the child.

One can usually make a full recovery with early medical intervention. However, any delay of treatment could lead to permanent joint disability and even septic shock.

Metabolic bone diseases are disorders of bone strength, usually caused by abnormalities of minerals (such as calcium or phosphorus), vitamin D, bone mass or bone structure. The most common metabolic bone disorder is osteoporosis. At HRDC, we see a lot of bone deformities secondary to Rickets (vitamin D deficiency), primarily due to nutritional deficiency. Such problems are treated with a combination of vitamin D supplements and surgical measures to correct the deformity. In order to prevent this kind of unnecessary physical disability, HRDC provides educational information to parents and communities on how to avoid preventable disabilities such as osteoporosis.
Spinal tuberculosis is still not uncommon in Nepal and many children at HRDC undergo medical and surgical treatment for this. If left untreated, Spinal tuberculosis can cause paralysis of the legs. Spinal deformity (Scoliosis) is also commonly seen at HRDC and many of these children require complex surgical procedures to correct their deformity..
Hip disorders commonly encountered at HRDC include hip dislocations (where the hip joint is out of its socket, and may be genetic or secondary to injury), hip infections and injuries around the hip. At HRDC, most of these children undergo complex surgical interventions to restore function. 
Conditions such as bone tumors, hand deformities, webbing of the fingers (syndactyly), genetic conditions affecting normal bone growth (skeletal dysplasias) etc. are also seen at HRDC on a regular basis, and dealt with by a specialized team of surgeons.