Trauma or accidents are the leading cause of death worldwide for individuals younger than 65 years. It continues to be responsible for more loss than cancer and heart disease together. Prehospital care remains a major lacuna in the trauma care system of India. It is almost nonexistent in most areas. The existing in-hospital trauma care system in India is still in its infancy. However, India is making major efforts to provide standard trauma care for all. While world-class facilities for trauma care exist, they are predominantly restricted to major cities.
With current understanding and evolution in orthopaedics science and technological advances, orthopaedic surgeons are able to give more predictable and excellent functional outcomes even in difficult situations. Advanced Trauma Life Support protocols should be applied in management of trauma victims. Many lives of Polytrauma or multiply injured patients can now be saved with treatment in golden hour and if they reach to tertiary care hospital in reasonable time. Level III trauma centres having all under one roof facilities and manpower and following international protocols in management dramatically changes the outcome in these victims. Morbidity associated with orthopaedic injuries can also be substantially reduced with early aggressive physiotherapy and rehabilitation protocols.
On the surgical front, main revolution is driven by minimal invasive approach aided by computer guided surgery, which means less morbidity and lesser hospital stay. Keyhole arthroscopic procedures has taken care of most ligament related injuries of major joints with excellent results, especially in younger population. Difficult, inaccessible, complicated, intra-articular and complex fractures can be operated with ease under imaging modalities, properly designed contoured implants which aid in anatomical reduction & rigid fixation. Bone infections, neglected injuries, malunion or non-union currently are tackled with newer techniques and modalities with improved knowledge and next generation antibiotics for better patient functional outcome. In Geriatrics, commonly occurring osteoporotic fractures are also nowadays treated aggressively even in advanced ages with improved anesthesia and critical care units availability. Limb lengthening and deformity correction orthopaedic surgeries can now be done with advanced Illizarov techniques.
The advancements in the field of orthopaedics in India are in tune with the global progress, as the latest techniques and equipments to handle this probable epidemic are available here and today. Matching world-standard surgeons are available with the latest surgery techniques in our hometown. Accordingly, India is expected to be the forerunner in terms of research, treatment options and improved outcomes in the orthopaedic segment, in the time to come. Finally print and visual media and Internet will increasingly play an important role in disseminating information and awareness to patients and their family members. There is a growing trend among patients and family members to seek alternate opinions and ask specific product-related queries of their surgeons prior to decision-making.
Improvement requires attention to three major issues: (1) Prevention through infrastructure, traffic laws, mandatory licensing; (2) Establishment of a prehospital care system; and (3) Establishment of regional trauma centers and a trauma registry. Ultimately goal of orthopaedic surgeon is to provide painfree, full range activity without limp or deformity and returning back to pre-injury status as early as possible. All these advances in orthopaedic science have certainly helped Orthopedic surgeons to improve quality of life to each patient.
