General information about Dr Manish Dhawan of Sir Ganga Ram Hospital, located in New Delhi, India. Contact for specific information and latest updates.
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http://www.limblengtheningforum.com/index.php?topic=55.0Brief Profile (From Website):Dr. Manish Dhawan is working as a consultant orthopaedic surgeon at Sir Ganga Ram Hospital, New Delhi. His subject of interest, other than routine orthopedic work, is management of complex trauma, limb reconstruction, deformity correction and limb lengthening.
Dr. Manish Dhawan attended medical school at Kasturba Medical College, Manipal under Mangalore University for MBBS degree. Then he joined Sir Ganga Ram Hospital as Orthopaedic trainee for National Board of Examinations (DNB Student). After completing his DNB degree, he did senior residency at Bombay Hospital, Mumbai and Sir Ganga Ram Hospital. He cleared PLAB test and moved to UK for clinical attachment. He returned back to India and did his fellowship in advanced deformity correction offered by Indian Orthopaedic Association. Dr Manish did specialised training in Trauma as an AO Fellow at Homburg, Germany. Later he completed MCh Orthopaedics. Dr Manish is a member of National Academy of Medical Sciences, India (MNAMS). He is an active member of IOA (Indian Orthopaedic Association), ASAMI (Association for the Study and Application of the Method of Ilizarov), and IFAS (Indian Foot & Ankle Society). He is presently working at Sir Ganga Ram Hospital, New Delhi as Consultant Orthopaedic Surgeon with special interest in Limb Reconstruction, Deformity Correction and Limb Lengthening.
QualificationsMCh, MNAMS, DNB (Orthopedics), MBBS
TrainingComplex Trauma/Limb Reconstruction in adults, Limb Lengthening Deformity Correction and Paediatric Orthropaedics (Manipal)
InterestsTrauma, Ilizarov Fixation for Limb Reconstruction, Limb Lengthening and Deformity Correction and Limb Lengthening. Use of Computerised Robotic Hexapod for deformity correction.
Limb lengthening Methods: Cosmetic lengthening of the tibias is allowed up to 5 cm with LON and up to 7 cm with hexapod fixator. Femur lengthening will be done with monorail fixator.
Pricing: Estimate for bilateral tibial lengthening with LON is $9,000 USD. Estimate for bilateral tibial lengthening with hexapod fixation device is $10,000 USD. This covers surgery and initial stay at the hospital before discharge.
Accommodation Options:International patients will have to stay at a hotel after discharge. Information on hotels and guest houses in the hospital vicinity can be found at the bottom of the page here:
http://limblengtheningindia.com/my-hospital.htmlDiscounts at select hotels offered to Sir Ganga Ram Hospital referred guests, patients & attendants; Luxury & Service taxes extra as applicable. The above is only an information and not a recommendation.
FAQs:1) What is Ilizarov limb lengthening and corticotomy?Ilizarov procedure and apparatus was discovered by Prof Gavril Abramovich Ilizarov in 1950s. He was Orthopedic surgeon in Kurgan region of Siberia, then in the Soviet Union. This technique has revolutionised treatment of difficult Orthopaedic problems and is used to lengthen or reshape bones; to treat complex fractures with open wounds and bone loss; infected Non Unions and to correct deformities of joints. Bone lengthening and deformity correction works on principle of distraction osteogenesis. For lengthening, bone is surgically fractured by keeping its covering, periosteum intact (Corticotomy) and Ilizarov apparatus applied. Bone lengthening occurs if rings are made to move apart slowly 1 mm per day at the site of surgically created fracture. Lengthening (distraction is started approximately 7 to 10 days after surgery in adults.In childrens it is started at about 5 days.
2) Who will require limb lengthening or deformity correction by Ilizarov procedure? Anyone with: leg length discrepancy (short leg), congenital limb and joint anomalies, nonunions, malunions, bone loss, joint contractures, osteomyelitis or severely comminuted fractures with extensive soft tissue involvement [
Dr Dhawan also accepts cosmetic patients].
3) How long does 5 to 8 cm bone lengthening take?Lengthening of 5 to 8 cm will require 5.5 to 6.5 months. Intesive physiotherapy programme will be done during lengthening and after frame removal.
4) How long does 12 to 14 cm bone lengthening take? Lengthening of this magnitude is usually done in two stages. At first both tibias are lengthened for 5 to 8 cm and in next stage both femurs are lengthened. It can take up to 9 to 12 months.
5) After injury to my limb 3 to 6 inches of bone has fallen out and there is a gap. Can the bone made to grow to fill the gap? If there is a large bone loss due to trauma 3 to 6 inches of bone transport can be done by double corticotomy ie, from both ends of remaining bones.
6) After surgery when I am allowed to walk? Patients are allowed to walk with walker or crutches the next day after surgery. This helps in early rehabilitation of patients.
7) What are possible complications of the procedure? Any surgical procedure has its complication. With due care and experience of surgeon these complications can be minimised to negligible. The most common one being pin/wire tract infection, loosening and breakage. Delayed maturation of regenerate or deformity or non-union at docking site are possible complications. Prolonged fixation and non adequate physiotherapy can lead to stiffness of joints. Smoking can delay maturation of regenerate and may require fixator to be kept for longer duration. Rarely damage to nerves and blood vessel can occur. Complications are temporary and do not influence the final outcome usually.
8 ) Is the method painful?There can minimal to moderate pain during lengthening. Pain usually occurs if there is pin/wire tract infection or loosening and breakage of wire. Pain can also occur if there is early consolidation of regenerate.
9) Can scars produced by pins of fixator be removed? Ilizarov treatment produces very little scars as it is non invasive. If patient wants scars can be easily removed by plastic surgery.
10) What are contraindications of this procedure?The contraindications are alcoholism (heavy), narcotic abuse, mental disease, venereal disease, HIV, skin and haematological problems. Smoking is a relative contraindication and smokers are seriously advised to leave it before lengthening procedure.
11) Can shape of legs (deformity) be corrected at the same time with lengthening?Lengthening and deformity correction can be done at same sitting. Now it can be done accurately by Hexapod fixator with use of computer software.
12) What is Hexapod fixator and how is computer software used for limb lengthening and deformity correction? Hexapod has 6 distractors which are applied to Ilizarov fixator and is used when complex deformities require lengthening, angulation, rotational and translational correction. It is a robotic application and works on principle of flight simulators for movement of ckpit. Taylor spatial frame also works similar but is expensive to apply. Deformity correction calculations are done on x- rays and it is fed in the software which generates prescription to the patient for correction. This procedure is very accurate.
13) Can I go to sports after this procedure?Function of muscle and joint return to normal after adequate physiotherapy and rehabilitation programme. The lengthened bone is able to withstand all stress. Patients are able to go for sports without restriction.
14) What kind of physiotherapy and rehabilitation programme is needed during and after surgery? Physiotherapy and rehabilitation programme is very important for proper functioning of joints, to prevent contractures and muscles to gain normal strength. Various modalities like active and passive stretching of muscles, static and dynamic splinting, electrical stimulation, hydrotherapy, progressive weight bearing, etc are employed.
15) Can I take bath with the fixator?You are allowed to take bath once stitches of corticotomy are removed usually after 14 days. Washing frame with water keeps it clean and prevents infection.
16)
How reliable is the method?The method is very reliable. Results are proportional to experience of surgeon and facilities at the centre where it is done.
17) After lengthening treatment is completed will my legs be as strong as they were prior to surgery? After lengthening your legs will be strong enough to withstand all dynamic and static stress like normal bone.
18) How long will be my hospital stay after surgery?Hospital stay is usually 5 to 10 days after surgery depending on procedure done.
19) During lengthening or deformity correction how often do I have to come for follow up visits? Usually every 10 days when distraction phase is going on. Once lengthening is complete and fixator is retained to improve strength of bone the visit could be at 3 to 4 weeks. Patients who stay in different city or country can send x-ray through email regularly.
20) What is mono-lateral fixator and how it is used for limb lengthening? Monolateral fixator like Orthofix and LRS (limb reconstruction system) work on same principle like Ilizarov but have added benefit like frame being less cumbersome. They work in single dimension and good for simple lengthening or bone transport but are less versatile than Ilizarov.
21) Can joint contractures be treated Ilizarov fixator?Joint contractures more than 90 degrees can be successfully treated by Ilizarov fixator by gradual distraction.
22) What is JESS fixator and how it is useful for hand and foot reconstruction after severe crush injury? JESS fixator is Joshi’s external stabilization system which is made of K-wires and distractors especially useful for problems in hand and feet.
23) Can fingers and thumb of hand can be lengthened? Yes, it can be successfully done by JESS fixator.
24) Why should patients prefer Sir Ganga Ram Hospital? Sir Ganga Ram hospital is one of the oldest, reputed and most modern hospital located in Delhi. It is a private trust hospital with all modern amenities for patient care. Large number of cases of lengthening, limb reconstruction and deformity correction are managed successfully. Cases are being done by computer software for accuracy of correction. Cost of treatment is less as compared to similar centres.
Contact Information:WebsitesHospital:
http://www.sgrh.com/departments/details/16/18Personal:
www.limblengtheningindia.comE-Maildrmanishdhawan@gmail.com
Sir Ganga Ram HospitalOld Rajendra Nagar, New Delhi, Delhi 110060
Tel:+91 11-25750000
Fax:+91 11-25861002
Private ClinicFlat No. 649, Sector-A, Pocket B & C, Vasant Kunj, New Delhi-110 070
+91 98-11128288