1. Department of
Orthopaedics
Census: 2011-2012
JPNATC, AIIMS
1

2. INTRODUCTION
 JPN Apex Trauma Centre
started functioning in Dec.
2006.
 Dept. of Orthopaedics started
working to its full capacity
from Jan. 2007.
2

3. Emergency Department
40000
35000 2010-11
30000 2011-12
25000
20000 33076 34738
(90/day) (95/day) 28800
15000 29152
(79/day) (80/day)
10000
5000
0
TOTAL ORTHO CONSULTATIONS TOTAL DISCHARGES FROM
CASUALTY
3

4. EMERGENCY DEPARTMENT
2011-12
45000
40000
35000 73%
30000
25000 100%
20000
15000
10000 6% 21%
5000 82%
0 2011-12
4

5. Minor procedures in emergency
department
12000
10000
8000
6000 2010-11
9882 9382 2011-12
4000 (190/wk) (180/wk)
7300
5840 (140/wk)
2000 (112/wk)
0
POP APPLICATION SUTURING(Combined)
5

6. ADMISSIONS
1400
1200
1000
800
2010-11
600 1301 2011-12
400 (25/wk)
972
200
(19/wk)
0
ADMISSIONS
6

7. REGRET, NO BED AVAILABLE
1200
48
% 53
1000 %
800 1 34 %
1 2 1
1 35
600 1 1 % 5 2
6 2 2 5
400 6
200 4 5
11 7 2010-11(2304)
% %
0 % % 1.5% 2011-12(2124)
7

8. Operation theatre
surgeries
 (Total-1708)
284
(17%)
1424 General/Regional
(83%) anaesthesia
Local anasthesia
8

9. SURGERIES
2010-11 2011-12
AXIAL SKELETON AXIAL SKELETON
N=198(14.2%) N=187(13%)
APPENDICULAR
APPENDICULAR SKELETON N=1237(87%)
SKELETON N=1202(85.8%)
9

10. SPINE
60 48
50
37
76%
40 29
56%
30 2010-11(N=63)
2011-12(N=66)
15
20
44%
10
24%
0
ANTERIOR APPROACH POSTERIOR APPROACH
10

11. PELVI-ACETABULAR
TRAUMA
90 83
80
67
70
60 48 2010-11(N=115)
50
68 38 2011-12(N=121)
40 %
30
58%
20 42%
32
10 %
0
ANTERIOR APPROACH POSTERIOR APPROACH
11

12. FEMUR
180
160
140
120
100 43
80 %
60 31
42
40 26 4 4 2010-11(N=308)
% % 28 22
20 % % %
% % 2011-12(N=379)
0
12

13. LEG AND FOOT
90
80
70
60
50
40
30 10 8
20 31 27 % %
28
36 23 32 3 2 2010-11(N=191)
10 % % %
% % % % % 2011-12(N=253)
0 2
13

14. UPPER LIMB TRAUMA
120
100
80
60
40 28
15 %
20 18 13 13 % 18 43 27 8 17
2010-11(N=226)
0 % % % % % % % % 2011-12(N=333)
14

15. COMPOUND FRACTURES
200
180
160
140
120
100
80 46
44
60 %
%
40 34 34
19 2010-11(N=397)
20 % % 18.5 1.5 3
% % % % 2011-12(N=374)
0
15

16. ARTHROSCOPY
50
45
40 87%
35
30
25 2010-11(N=54)
81% 2011-12(N=42)
20
15
13% 19%
10
5
0
KNEE SHOULDER
16

17. OTHER FRACTURES
60
50
40
30 2010-11(N=119)
44 2011-12(N=105)
20 42
%
%
10 28
31 21 27
%
% % % 4 3
0 % %
HAND FOOT PATELLA CLAVICLE
17

18. COMPLEX INTRAARTICULAR FRACTURES
(EXCLUDING PELVIS & ACETABULUM)
1 20
8 %
100
90 %
80
70 17%
60 27
50 %
40
30 21 12 2010-11(N=327)
9
20 % % % 13
10 17 12 12 1 8 5 2011-12(N=466)
5 %
%
0 % % %
% %
%
18

19. OTHER PROCEDURES
120
100
80
60
40
20
2010-11(N=137)
0
2011-12(N=114)
19

20. AGEWISE DISTRIBUTION
OF SURGERIES
2011-12(N=1708)
1600
1400
1200
1000
800
2011-12(N=1708)
600
400
200
0
0-3 yrs 4-18 yrs 19-60 yrs > 60 yrs
20

21. MONTHLY DISTRIBUTION
OF SURGERIES
21

22. CRITICAL CARE ADMISSIONS
2011-12(N=37)
18
16
14
12
10
8
6 27 41
4 % 46 4 11
2 % % % %
0 2011-12(N=37)
22

23. CRITICAL CARE ADMISSIONS
ADMISSIONS=37
DEATH =11 SHIFTED TO WARD=26
23

24. ICU DEATHS
DATA-2011-12
S.NO AGE SEX DIAGNOSIS
1 51 M MULTIPLE LONG BONE #
2 75 F INTERTROCHANTRIC FRACTURE
3 65 M PELVIC # WITH HEAD INJURY(frontal contusion)
4 47 M MULTIPLE LONG BONE# WITH CHEST TRAUMA
5 79 M INTERTROCHANTRIC FRACTURE
6 25 M MULTIPLE LONG BONE# WITH CHEST TRAUMA
& HEAD INJURY
7 3 F PELVIC # WITH VASCULAR & ABD INJURY
8 63 M MULTIPLE LONG BONE# WITH CARDIOMYOPATHY
9 55 M PELVIS WITH SHAFT FEMUR #
10 26 M PELVIC #
11 27 M L3 # WITH ELBOW DISLOCATION
24

25. OPD REGISTRATIONS
12000
10000
8000
6000 2010-11
57/
opd 2011-12(N=12982)
4000 93/ 45/
opd 61/ opd
opd
2000
0
OLD REGISTRATIONS NEW REGISTRATIONS
25

26. OPD PROCEDURES(MINOR)
2011-12(N=4843)
2000
1800
1600
1400
1200
1000
800
600
400
200 2011-12(N=4843)
0
26

27. Procedures : opd
dressing Suture Ex fix removal K wire debridement others total
removal removal
Jan 102 87 8 9 2 3 211
Feb 80 103 1 3 1 5
193
March 96 96 7 6 2 4
211
April 80 84 9 4 1 2
180
May 86 112 6 8 0 9
221
June 99 71 2 5 2 8
187
July 88 88 1 0 1 8
186
August 111 113 6 5 4 7
246
Sep 180 106 4 7 3 7
307
Oct 217 140 6 16 2 11
392
Nov 183 98 5 10 4 12
312
Dec 187 110 9 12 4 6
328
Total 1509 1208 64 64 26 82
2974 27

28. ACHIEVEMENTS
 Highest number of pelvi-acetabular surgeries in India
(121 in 2011).
 Total of 1708 surgeries:
 Complex Intra-articular Fractures: 33% of surgeries
 Compound Fractures: 26%
 Latest principles of fracture management.
 10 indexed publications involving Orthopaedics team in
2011.
28

29. Challenges ahead …..
Geriatric patients : silent epidemic on the rise!
 Establishment of geriatric trauma ward.
 Managing medical co-morbidities.
Need to increase bed capacity in wards
 Regretted patients (2124)
Dedicated 24 hour Ortho OT
29

30. Team (Orthopaedics)
• Senior Residents : 16
• Consultants : 4
• Assisted by :
Entire Trauma Centre!
30

31. Census: 2011-201
31