21-year old walks after 11 years, post a crippling accident in childhood

It was an unfateful foggy day on January 27, 2005, when Gaurav Sharma, his parents and a few relatives were travelling to their hometown in UP for a family function when their car met with an accident.

The 11-year old saw his uncle and cousin dying in front of him and later, he also lost his mother while he himself was in the ICU.

Mentally and physically traumatized, Gaurav went through eight surgeries in the initial years which left him with a crutch, a fused hip and short left leg.

Gaurav was living a dependent life till the age of 21 when through a relative, he met Dr Dhananjay Gupta, Director of Orthopaedics, Spine, Joint Reconstruction and Replacement Surgeon, Fortis Flt. Lt. Rajan Dhall Hospital, Vasant Kunj, Delhi (FHVK).

After consultations, Gaurav and his family decided to go for a series of surgeries again in an effort to make him fully movable.

Key challenges in the surgery:

-There was already a nail in his thigh bone preventing the placement of a hip prosthesis in the thigh bone. This had to be taken out first through the knee joint from where it was put earlier.

-Extensively scarred tissues following the accident and multiple surgeries presented the possibility of a sound breeding ground for infection.

-Muscles around his hip joint were also scarred and atrophied due to multiple surgeries and disuse. This made his prosthetic hip unstable and more prone to dislocation.

-In young patients, joint replacements don't last for life as the wear out rate is quite high due to high level of activities. This means costly implants for longer life and more surgeries to revise the worn out implants in their lifetime.

-As per nature's law, bones which are not loaded normally, becomes weak and undeveloped making them prone to fractures during surgery.

On May 5, 2016, Gaurav underwent his first surgery at FHVK to walk again and his final surgery was on 9th September, 2016 when he was completely able to walk without support. Now Gaurav is undergoing physiotherapy to increase his muscle strength.

Dr Dhananjay Gupta shared on the case, "In the first stage, the plan was to take out the nail from the thigh bone and then open the hip joint. Implant removal is always more challenging and preferably should be done by the surgeon who had conducted it. Gaurav's case was also complicated as he already had multiple surgeries and exposure to strong antibiotics. After a month of successful Hip Replacement surgery, he started complaining of fever and a small limp."

"An ultrasound suggested a localized abscess in the muscular plane. Gaurav again underwent removal of all the implants as his infection level was high and units of blood were transfused along with specific antibiotics by CCM team to help body fight infections. Once the infection settled, patient was again taken for hip arthroplasty surgery. This time the surgery was much smoother and swifter as his hip joint was already open and there was time to plan the implants and their placement," he added.

The post-op procedure went as planned and Gaurav was allowed full weight bearing from day one. All investigations are normal now post six months after the surgery in May 2016. He is walking unaided with a slight limp. This is because of the still weak muscles around the hip but he is hopeful of overcoming that little hindrance in fulfilling his dream of a normal life.

We salute to the faith and spirit of the boy and the family to continue with the fight against all odds.

Abrar Ali Dalal, Facility Director, Fortis Flt. Lt. Rajan Dhall Hospital, Vasant Kunj, Delhi said, "This is an example of a case that was very complex and extremely moving. In the absence of a normal environment, growing bones assume an abnormal shape and size."

"The normal stress of running and jumping make the bones stronger which didn't happen in Gaurav's case. Hence there was a strong possibility of bone fracture during surgery. We had to do two rounds of surgeries, but after all post-op procedures and checks, Gaurav has resumed college and passed the exam with flying colors," he added.

The patient, Gaurav said, "I was dwelling in uncertainty before I met Dr Dhananjay Gupta. Although not comfortable with the idea of surgeries; God knows what made me trust Dr Gupta. It was a temporary shock when I had to redo my surgery after the first one last year, because of the various challenges in my case. However, when I saw myself walking without support in the mirror, I had no words to comment.