The great Indian growth story

Rare bone graft surgery enables Delhi boy with unique disorder gain more than a feet in height. Only a handful of exponents of the procedure are left in the world

Rare bone graft surgery enables Delhi boy with unique disorder gain more than a feet in height.u00a0 Only a handful of exponents of the procedure are left in the world

Mohit Singh, 14, had never dreamt of walking on his legs. By the time the class VI student of Kendriya Vidyalaya realised that he is suffering from a rare disease called Resistant Rickets his parents had lost all hope of ever seeing their son stand tall.


Mohit Singh with his family

But Mohit, who was once only four feet tall, now stands tall at five feet and three inches, thanks to a brave surgeon who performed a rare operation on the young Sikh lad to help him defeat the rare strain of rickets.
"It feels good and I am waiting for the rings to come out so that I can walk freely. Now no one will make fun of me in the school," an elated Mohit told MiD DAY.

Mohit was three-year-old when his parents realised that there is something wrong with their son. "He would fall regularly while walking. After a series of blood tests doctors told us about his rare complication called Resistant Rickets which leads to lack of calcium in the bones. We took him to several doctors but there was no improvement and we had lost all hope," said Mohit's father Jaspal Singh, who is employed with Airports Authority of India (AAI).

Things took a dramatic turn two years ago when Mohit's father met Dr Subhash Shalya, director and chief orthopaedic surgeon, Indraprastha Apollo Hospitals. Dr Shalya is one of the rare orthopaedic surgeons in the country who specialises in the complicated medical procedure called Ilizorov Technique.

The technique is non-evasive and considered one of the most complicated orthopaedic treatment procedures as an artificial gap is created between the bones to allow them to grow for the desired results. Mohit is one of the numerous successful cases handled by Dr Shalya and he has created a sort of world record by increasing his height by exactly a foot or 12 inches.

"It's a very difficult process where the bones are artificially broken to create a gap between them. Human bones have their own regeneration capability and once the surgery is over the body starts generating the new bones in the gap. After years of research we have found that the length of the human bone increases by one millimetre per day. Using this method we can cure a number of bone disorders and several other orthopaedic complications," said Dr Shalya.

Regeneration

Human bones once clinically broken and separated grow at the rate of 0.25 mm every six hours. Doctors while treating the patients with Ilizarov Technique keep increasing the distance between the bones which further increases the area to be covered by newly generated bones. "There is a sticky material between the bones called Callus which helps in curing any kind of fracture and injury in the bones. Once the bones are clinically separated the Callus starts the process of generating new bone," said Dr Shalya. He further said that Mohit's case was like climbing Mount Everest as his bones had twisted because of lack of calcium.

After creating the gap, rods and pins are inserted into the defective bones which are further controlled by two rings. The rings are used to increase the gap between the bones and also support the limb.

Initially the doctor had not planned to increase Mohit's height as his parent's only desire was to see their son stand straight on his legs. "Due to this disorder the bones could not retain calcium and as the patients gets older the bones gets brittle and tends to turn sideways or backwards. While the normal body structure gets distorted the patient is unable to grow in height," said the orthopaedic surgeon.u00a0u00a0

But within months of treatment which began in 2008 Mohit started showing encouraging results and then the doctors decided to move further. Within two years Mohit gained 12 inches in both of his legs and is now waiting for the metallic rings to come out.

"This is the first stage of his treatment and once his legs heal properly we will do the similar procedure on both of his thighs to increase his height by another six inches or half foot," he said. Patients undergoing such procedure have to get regular physiotherapy and rich diet to gain strength and promote faster recovery.
Doctor Shalya said Mohit will soon walk without any support.

The Ilizarov way

The technique was developed by Doctor GA Ilizarov from Russia. The doctor who is considered the father of modern orthopaedic surgery devised the idea to artificially increase the height of the human bone during World War II. While treating the soldiers who had lost their limbs in the war doctor Ilizarov discovered that human bones have tremendous regeneration capability and it can be used to cure a number of limb disorders. After years of research the doctor invented the circular rings, pins and rods to support the bone. With further researches and use of carbon fibres the rods and rings have become lighter in weight and stronger which helps the patients in walking and other exercises.