1. JPNATC,AIIMS

2. Orthopedic Team
• Consultants : 4
• Senior Residents : 16
• Junior residents : 4+2
• Beds : 46
• Assisted by :
Entire Trauma Centre!

3. Emergency Department

4. ED-Ortho Consultations
0
10000
20000
30000
40000
50000
60000
70000
TOTAL
PATIENTS IN
E/D
ORTHO
CONSULT
RED AREA YELLOW
AREA
GREEN AREA
2011
2012
2013
24%
33%
16%
6%
4
TOTAL ATTENDENCE
ED
TOTAL ORTHO
CONSULTATIONS
RED AREA
CONSULTATIONS
YELLOW AREA
CONSULTATIONS
GREEN AREA
CONSULTATIONS
2011 42539 34738 2343 3171 29224
2012 55698 42974 2756 4507 35711
2013 58923 30164 1986 9001 19175

5. Emergency Department
0
10000
20000
30000
40000
50000
ORTHO
CONSULT
DISCHARGES TRANSFER OUT
2011
2012
2013
84% 95%
6% 3% 5%
2011 2012 2013
ORTHO CONSULT 34738 42974 30164
DISCHARGES 29152 35312 28714
TRANSFER-OUT 2124 1458 1450
83%

6. Admissions-2011/13
0
50
100
150
200
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
NOV
DEC
2011 (N=1301)
2012 (N=1580)
2013(N= 1546)
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
2011 88 65 71 73 61 65 97 118 112 121 111 94
2012 115 111 128 134 154 133 154 139 148 130 121 113
2013 140 145 147 129 117 105 111 139 127 138 113 135

7. Admissions-2011/13
0
200
400
600
800
1000
1200
1400
1600
2011(N=1301)
2012(N=1580)
2013(N= 1546)
1580
(29/WK)
1546
(28/WK)
7
1301
(25/wk)

8. Discharges-2011/13
0
100
200
JAN
FEB
MAR
APRL
MAY
JUNE
JULY
AUG
SEP
OCT
NOV
DEC
2011 (N=1052)
2012 (N=1566)
2013(N= 1564)
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
2011 63 62 73 76 61 71 101 117 116 114 109 89
2012 106 119 132 127 153 136 149 129 151 122 124 118
2013 144 148 145 139 118 107 118 126 131 133 122 133

9. Discharges-2011/13
0
200
400
600
800
1000
1200
1400
1600
2011 (N=1052)
2012 (N=1566)
2013(N=1564)
1052
(20/WK)
1566
(29/WK)
1564
(29/WK)

10. Admission/Discharges/Death
0
500
1000
1500
2000
2010
2011
2012
2013
972 1076
1580 1546
964 1052
1566 1564
ADMISSIONS
DISCHARGES
ADMISSIONS DISCHARGES
2010 972 964
2011 1076 1052
2012 1580 1566
2013 1546 1564

11. Bed Occupancy - 2013
 Total bed occupancy rate :97% (Days of Care/Beds*days X100)
 Open fractures: mean 22 days
 Spine: mean 12 days
 Pelvis & Acetabulum : mean 8 days
 Peri articular fractures: mean 5 days
 Diaphyseal fractures: mean 3 days
 Upper limb fractures: mean 3 days

12. Critical Care Admissions-2013

13. Critical Care Admissions-2013
10
19
4 4
11
26
19 18
21
4
14
17
0
5
10
15
20
25
30
2011 (N=37)
2012 (N=74)
2013 (N=56)
2011(N=37) 2012(N=74) 2013(N=56)
MULTIPLE LONG BONES 10 11 21
PELVIS/CHEST/ABD 19 26 4
SPINE 4 19 14
GERIATRIC 4 18 17

14. Critical Care Admissions-2013
DEATH =32%
SHIFTED TO WARD=68%
ORTHO ADMISSIONS=56

16. OPD Census-2013
TOTAL OPD REGISTRATIONS 2013(N=32130)
ORTHOPEDICS(N=18475)
SURGERY(N=7271)
NEURO SURGERY(N=6384)
23%
58%
19%

17. OPD Census 2012/13
0
5000
10000
15000
20000
ORTHO GEN SURG NEURO
2012
2013
DEPARTMENT 2012 2013
ORTHO 17912 18475
GEN SURG 7263 7271
NEURO 6131 6384
3%

18. OPD Registrations-2010/13
0
2000
4000
6000
8000
10000
12000
OLD REGISTRATIONS NEW REGISTRATIONS
2010 (N=15933)
2011 (N=12982)
2012 (N=17912)
2013 (N=18475)
2%
18
2010 2011 2012 2013
OLD REG 9645 7235 7622 8419
NEW REG 6294 5747 10290 10056
MON/TUES AVERAGE 101 PATIENTS/OPD
WED/THUR AVERAGE 51 PATIENTS/OPD
6%

19. OPD - Minor Procedures

20. OPD Procedures(minor)
0
2000
4000
6000
8000
10000
2011 (N=7259)
2012 (N=12318)
2013 (N=14851)
63%
20
2011 (N=7259) 2012 (N=12318) 2013 (N=14851)
DRESSING 1609 2929 3245
SUTURE REMOVAL 1285 2147 1551
EX FIX REMOVAL 64 72 48
K WIRE REMOVAL 84 104 110
DEBRIDEMENT 46 7 172
OTHERS 282 342 442
POP PROCEDURES 3869 6717 9283
55%

21. Operation Theatre

22. Surgeries Monthly Calendar 2011/13
0
50
100
150
200
250
2012 (N=2197)
2011(N=1708)
2013(N=2126)

23. Operated Cases -2013
N=2126
ROUTINE
EMERGENCY
33%
67%

24. Routine/Emergency Cases-2011/13
0
200
400
600
800
1000
1200
1400
1600
2011(N=1708) 2012(N=2197) 2013(N=2126)
1221
1576
1421
487
621
705 ROUTINE CASES
EMERGENCY CASES
10%
13%

25. Demographic Profile

26. Demographic Profile-2013
15
106
1429
158
20
198
1770
209
31
214
1657
224
0
200
400
600
800
1000
1200
1400
1600
1800
2000
0-3 yrs 4-18 yrs 19-60 yrs > 60 yrs
2011 (N=1708)
2012 (N=2197)
2013 (N=2126)
26

27. Sex Distribution -2013
SEX DISTRIBUTION(N=2126)
MALES (N=1625)
FEMALE(N=326)
78%
22%

28. Surgeries-over all review
AXIAL SKELETON
APPENDICULAR SKELETON
2010 (N=163)
2011 (N=191)
2012 (N=219)
2010 (N=1093)
2011 (N=1517)
2012 (N=1978)
2013 (N=231)
2013 (N=1895)

29. Spine

30. Spine Surgeries-2013
15
29
4
29
37
4
12
64
6
34
54
22
0
10
20
30
40
50
60
70
ANTERIOR
APPROACH
POSTERIOR
APPROACH
DISCECTOMY
2010 (N=48)
2011 (N=70)
2012 (N=82)
2013 (N=110)
2010(N=48) 2011(N=70) 2012(N=82) 2013(N=110)
ANTERIOR
APPROACH
15 29 12 34
POSTERIOR
APPROACH
29 37 64 54
DISCECTOMY 4 4 6 22

31. Pelvi-acetabular Fractures

32. Pelvi-acetabular Fractures-2010/13
0
20
40
60
80
100
ANTERIOR
APPROACH POSTERIOR
APPROACH
48
67
83
38
65 72
46
75
2010 (N=115)
2011 (N=121)
2012 (N=137)
2013 (N=121)
2010(N=115) 2011(N=121) 2012(N=137) 2013(N=121)
ANTERIOR
APPROACH
48 83 65 46
POSTERIOR
APPROACH
67 38 72 75

33. Long Bone - Femur

34. Femur Surgeries-2010/13
81
130
87
10
163
118
84
14
322
169
80
33
312
224
93
16
0
50
100
150
200
250
300
350
PROX FEMUR IL NAILING DISTAL FEMUR HRA/THR
2010 (N=308)
2011 (N=379)
2012 (N=604)
2013 (N=645)
34
2010(N=308) 2011(N=379) 2012(N=604) 2013(N=645)
PROX FEMUR 81 163 322 312
IL NAILING 130 118 169 224
DISTAL FEMUR 87 84 80 93
HRA/THR 10 14 33 16

35. Leg Bones

36. Leg And Foot -2010/13
0
20
40
60
80
100
120
140
160
2010 (N=191)
2011 (N=253)
2012 (N=268)
2013 (N=395)
2010(N=191) 2011(N=253) 2012 (N=268) 2013(N=395)
PROX TIBIA(I/A) 54 78 76 88
NAILING 69 68 79 112
DISTAL TIBIA&ANKLE 43 82 82 142
TALUS 5 4 5 13
CALCANEUM 20 21 26 40

37. Upper Limb Trauma

38. Upper Limb Trauma -2010/13
40
30
41
97
18
42 51
92 90
58
42 38
69 67
47
72
55
73
64 62
0
20
40
60
80
100
120
PROX
HUMERUS
SHAFT DISTAL
HUMERUS
FOREARM DISTAL
RADIUS
2010 (N=226)
2011 (N=333)
2012 (N=263)
2013 (N=314)
38
2010 (N=226) 2011 (N=333) 2012 (N=263) 2013(N=314)
PROX HUMERUS 40 42 42 72
SHAFT 30 51 38 55
DISTAL HUMERUS 41 92 69 73
FOREARM 97 90 67 64
DISTAL RADIUS 18 58 47 62

39. Compound Fractures

40. Compound Fracture Procedures-2010/13
316
75
6
291
71
12
241
77
9
102
49
7
0
50
100
150
200
250
300
350
DEBRIDEMENT &
EX. FIX
AMPUTATION DEBRIDEMENT &
DEFINITIVE
FIXATION
2010 (N=397)
2011 (N=374)
2012 (N=327)
2013 (N=178)
40
2010(N=397) 2011(N=374) 2012(N=327) 2013(N=178)
DEB+EX FIXATER 316 291 241 102
AMPUTATION 75 71 77 49
DEB+DEFINITIVE
FIXATION
6 12 9 7

41. Arthroscopy

42. Arthroscopy -2010/13
0
20
40
60
KNEE
SHOULDER
46
8
34
8
35
10
37
4
2010 (N=54)
2011 (N=42)
2012 (N=45)
2013 (N=41)
KNEE SHOULDER
2010 46 8
2011 34 8
2012 35 10
2013 37 4

43. Complex Intra-articular Fractures
(Excluding Pelvis & Acetabulum)

44. Complex Intraarticular Fractures
(Excluding Pelvis & Acetabulum)-2010/13
0
20
40
60
80
100
120
140
160
2010 (N=327)
2011 (N=466)
2012 (N=429)
2013 (N=505)
44
2010(N=327) 2011(N=466) 2012(N=429) 2013(N=505)
DISTAL FEMUR 87 84 80 78
PROX TIBIA 69 78 76 88
PROX HUMERUS 40 42 42 72
DISTAL HUMERUS 41 92 69 77
DISTAL RADIUS 18 58 47 72
SCAPULA 4 5 6 --
CALCANEUM AND TALUS 25 25 31 53
DISTAL TIBIA AND ANKLE 43 82 82 142
27%

45. Other Fractures-2010/13
52
37
25
5
44
29 28
4
35
18
48
5
21
13
29
0
0
10
20
30
40
50
60
HAND FOOT PATELLA CLAVICLE
2010 (N=119)
2011 (N=105)
2012 (N=106)
2013 (N=63)
2010(N=119) 2011(N=105) 2012(N=106) 2013(N=63)
HAND 52 44 35 21
FOOT 37 29 18 13
PATELLA 25 28 48 29
CLAVICLE 5 4 5 0

46. Other Procedures -2010/13
0
20
40
60
80
100
120
140
160
2010 (N=137)
2011 (N=114)
2012 (N=224)
2013 (N=254)
2010(N=137) 2011(N=114) 2012(N=224) 2013(N=254)
IMPLANT REMOVAL 103 65 135 132
BONE GRAFTING 15 18 29 33
ILLIZAROV 12 11 15 18
TENDON REPAIR 5 13 9 7
BM INJECTON 2 7 11 13
PRPP INJECTION 0 0 15 17
VAC APPLICATION 0 0 10 34

47. Achievements….
 ONE OF THE HIGHEST NUMBER OF PELVI-ACETABULAR SURGERIES IN
INDIA (121 in 2013).
 TOTAL OF SURGERIES:
 COMPLEX INTRA-ARTICULAR FRACTURES: 43% OF SURGERIES
 LATEST PRINCIPLES OF FRACTURE MANAGEMENT.
 VARIOUS RESEARCH WORK IN DIFFERENT TOPICS STARTED IN 2013
 VARIOUS PRESENTATIONS IN ALL INDIA AND REGIONAL CONFERENCES
 13 INDEXED PUBLICATIONS INVOLVING ORTHOPAEDICS TEAM IN 2013
47