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‘Rehab centres need of the hour’

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With spinal injuries, rehabilitation often forms major part of treatment

Two months after he was hit by a train and paralysed from the neck down, Allen Jes Roger is walking again.

Though he hasn’t completely recovered, his doctors at Global Hospitals are delighted at his progress and highlight the importance of rehabilitation in such cases.

The sixteen-year-old, who is planning to resume his studies as soon as possible, had a spinal cord injury in the neck, with a fracture at three vertebral levels and a dislocation in one place, says S.S. Kumar, senior consultant orthopaedic spine surgeon at the hospital.

“We operated on him quite quickly and decompressed his spinal cord and fixed the three levels. After this, he was able to sit comfortably. But a large part of his recovery was thanks to rehabilitation at the Spinal Rehabilitation Centre,” says Dr. Kumar.

The need for rehabilitation centres that offer a gamut of services is urgent, says Nalli Uvaraj, professor of spine surgery at Rajiv Gandhi Government General Hospital. “In cases of spinal injuries, often surgical management forms just 10 per cent of the treatment. The rest is rehabilitation,” he says.

Pointing to the lack of full-fledged rehabilitation centres in both the government and private sector, Dr. Uvaraj said rehabilitation centres helped in a number of ways. “It’s not just physiotherapy. The patient’s ambulation or mobility is enhanced by strengthening muscles. Training is given to control bladder and bowel movement and patients are taught what to eat, such as food high in fibre. Vocational rehabilitation is given to those who cannot go back to their old jobs to ensure they have a livelihood,” he says.

For patients who have suffered severe injuries, such centres would help immensely in getting their lives back on track.

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At a time when the State is surging ahead in kidney and liver transplants, efforts by surgeons to launch hand transplant continue to be unfruitful.

In 2011, Government Stanley Medical College Hospital became the first in the country to obtain the nod for performing hand transplants under the State government’s cadaver transplant programme. But since then, there has been no headway.

The launch of the cadaver transplant programme in 2008 sparked off interest in hand transplants. The presence of a sizeable population of people who had lost one or both hands in accidents backed the initiative.

Experts say that more than 50 hand transplants have been performed abroad.

“Hand transplants will help in improving a person’s quality of life. We obtained the government’s approval then and also started a registry with 100 persons,” says R. Krishnamoorthy, former head of the Institute for Research and Rehabilitation of Hand and Department of Plastic Surgery, Stanley Hospital.

Doctors cite a number of reasons for the failure of hand transplants to take off. Unlike kidney and liver transplants, it is not a life-saving procedure. Motivating families of brain-dead persons to donate hands is a task, say doctors. Moreover, the procedure is not an easy one. Several aspects like blood group and tissue typing, age, gender, size, shape and colour of hands of donors and recipients need to match. The skin colour, particularly, is a challenge in the Indian scenario, doctors add.

The government has not responded to requests for funds for infrastructure and personnel. “We need separate operation theatres, more microsurgeons to harvest and transplant hands, besides anaesthetists, immunologists, intensivists and physiotherapists,” says a senior surgeon.

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Printable version | Jan 20, 2020 11:51:04 PM | https://www.thehindu.com/news/cities/chennai/chen-columns/rehab-centres-need-of-the-hour/article6226176.ece

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