Sunday, 10 April 2011

Re: FW: Pt. Mazin Kasim / Columbia Asia

Dear Rashmi
This patient is walking with a hyperextension at the knee and equinus at the ankle.
There is sill minimal shortening of the tibia however video also shows that patient has possibly some problem in the hip joint as well.
Correction of the equnius deformity and compensating the resudual shortening with heel raise is likely to tackle the hyperextension/valgus at the knee (provided there is no muscle weakness). It appears that he will benifit from TA lenghthening as mentioned in my previous mail, but he may also need some procedure at the hip.
  I need to see an Xray of the hip and examine him thoroughly before any additional treatment can be finalised. This need to be comminunicated to the patient that providing a detailed treatment plan based only of few pictures of his leg taken from different angles without any previous medical record is not feasible.
Expected duration of stay after TA lenghthening will be 5 days  and that he will be in a plaster cast for 6-8 weeks postoperatively and walking with help of crutches.Wheather he needs any additional procedeue will only be decided after clinical examination.
He should also be informed that he has a long standing(possibly by birth) shortenning of the leg, therefore he should not expect any treatment will  miraclously give him a normal limb. At best he can expect an improvement as compared to the current clinical situation. 

Dr Jayant Arora

Fw: FW: Pt. Mazin Kasim / Columbia Asia


Please find attached some pictures & a video of the patient. The previous surgery was done in Turkey, so the discharge summary is in Turkish. I dont think it would be of much use.


Fw: Pt. Mazin Kasim / Columbia Asia



History provided for this patient is minimal and inadequate. My guess is that this patient has developed Equinus deformity post limb lenghthening procedure and is likely to benifit from Z-plasty and lenghthening of TA.
However this is only a tentative plan and I will need to examine the patient before surgical treatment is finalised.
We should also request the patient/HCA to send us more information /discharge summary from previous surgery/clinical pictures the patient.
Kind regards

Dr Jayant Arora
MS(Ortho), DNB(Ortho), MRCS(Edinburgh)
Fellowship in Joint Replacement and Arthroscopic Surgery, Newcastle, UK

Senior Consultant Orthopedics and Joint Replacement Surgeon
Columbia Asia Hospital




Web: http//

Fw: Pt. Mazin Kasim




32 years old male pt. complaining from shortening of the lt. leg since 30 years, he did a surgery in 2000 to lengthen the leg & put an apparatus for 6 month, but the surgery was failed & his leg split laterally during walking.

The pt. went to turkey 2 months ago, but the surgery was expensive & he is asking about the success rate & the duration of treatment.