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FEBRUARY 14, 2008 — When a plate glass shelf
fell across the top of Kalpesh Parikh’s left foot in early
September 2007, he had no idea that the injury might permanently
shatter his ability to walk.
“I went to my doctor right away, and because I’m a
diabetic and my sugar levels were high and my blood pressure was
elevated, the severe swelling from the injury was attributed to
those conditions,” says Parikh, 51, a resident of Sayreville,
NJ.
An MRI and CT scan performed at a local hospital didn’t reveal
any significant injury and Parikh was placed on antibiotic therapy.
His doctor told him that because of his diabetes, it could take
a long while for his swollen foot to heal. Parikh knew that being
a diabetic can drastically slow the healing process and so, initially,
he was not concerned. It was only after several months, seeing no
improvement in the swelling and now experiencing pain if he tried
to stand on his feet for any length of time that Parikh realized
something was terribly wrong with his foot.
A friend recommended he see Dr. Ankur Dharia, a podiatrist on staff
at Kimball Medical Center in Lakewood who specializes in foot and
ankle trauma. Parikh decided that the trip would be well worth it.
“By the time I saw Mr. Parikh in my office,” says Dr.
Dharia, founding partner of Garden State Foot & Ankle Group
in Lakewood, “the damage to his foot was much worse than the
initial injury. His foot was swollen and deformed-looking. Just
by looking at his foot I had an idea that something was out of place.
We immediately took an x-ray and that’s exactly what we found,”
he adds.
In fact, the images taken of Kalpesh Parikh’s foot revealed
he had fractured and dislocated four bones in his foot – and
because it went undiagnosed, he had been hobbling around on that
injured foot, compounding the injury for months.
Normally, the related pain would have sent most people back to
their doctor or emergency room. However, Dr. Dharia explains that
Kalpesh Parikh suffers from diabetic neuropathy, a complication
of diabetes that damages the nerves in the feet, causing numbness
and a loss of feeling. As a result Parikh’s injured foot wasn’t
painful.
“I told him that he would need surgery to fix the injury,”
says Dr. Dharia, who immediately put Parikh in a temporary cast
to prevent further damage until the surgery could be scheduled.
“Initially I knew I was going to have to open Mr. Parikh’s
foot up, fix the injury, secure it with small plates and screws,
and then fix it in position,” explains Dr. Dharia. “Because
of his diabetes, and this patient’s tendency to walk on the
injured foot, I knew that securely immobilizing the foot would be
paramount to his recovery,” he adds. The solution that Dr.
Dharia turned to is a new trend in foot and ankle surgery known
as Ilizarov external ring fixation.
Dr. Dharia completed his podiatric surgical residency program at
Saint Vincent Catholic Medical Center in New York City and earned
his doctoral degree at the New York College of Podiatric Medicine
in New York City – which is where he learned about the Ilizarov
method.
Developed in Russia, the cylinder-shaped Ilizarov apparatus is
comprised of a set of rings that surround the limb in treatment.
Doctors use wires, which are surgically positioned through a patient’s
bones in a minimally invasive procedure and then adhered to the
rings with special bolts. The rings in turn are connected to one
another by a series of threaded rods.
Because of its cylindrical shape, and the ability to make adjustments
in the bolts and rods to produce tension or compression, the fixture
allows doctors to precisely correct deformities, fix fractures and
even lengthen limbs simultaneously in all three dimensions.
“I can’t say enough good things about Dr. Dharia,”
says Parikh. “He took the time to explain the procedure to
me, to show me what the apparatus looked like. He explained everything
that he was going to do during the surgery, and told me honestly
what my chances for recovery were,” he adds. “He was
wonderful.”
Kapesh Parikh’s nearly four-hour surgery took place in the
state-of-the-art operating room suite at Kimball Medical Center.
Just as planned, Dr. Dharia painstakingly repaired the damage to
Parikh’s foot, secured it into position, and then immobilized
the foot using the Ilizarov external ring fixation method.
“The Ilizarov external ring fixation, although a little more
labor intensive to put on, provided the extra support this patient
needed to enhance the healing process,” explains Dr. Dharia.
“In a traditional cast, you can wiggle your toes and move
your muscles, which in turn can move bones out of place. We opened
up the foot and realigned the bones, putting everything back into
place, and used the Ilizarov apparatus for extra stabilization.
This particular external casting was non-weight bearing, which also
encouraged Mr. Parikh to stay off his feet to further speed his
recuperation,” he adds.
“The Ilizarov external ring fixation was the perfect solution
for Mr. Parikh,” says Dr. Dharia. “It is particularly
beneficial for patients with diabetes, because it minimizes their
risk of infection and can help salvage limbs.”
The external fixation apparatus was on Parikh’s foot for
about five weeks – enough time to put him well on his way
toward healing. Now in a traditional cast, he’ll have the
plates and screws removed from his foot in another month or so,
and then it’s back in a plaster cast for several more weeks.
Dr. Dharia is pleased with his patient’s overall progress,
although because of his diabetes, the healing process has been slower.
“Mr. Parikh is doing well, showing evidence of good bone
healing. He’s not in any pain and his progress is particularly
promising, especially given that he is a diabetic.”
Because the initial injury was so severe, Dr. Dharia says, “Mr.
Parikh will never run a marathon, but he will have full use of his
foot.”
“He may well need some physical therapy, but eventually he’ll
be able to walk normally, and he will be able to go back to work
and get back to living his life.”
“The doctors and nurses at Kimball Medical Center took very
good care of me,” says Parikh, “and I can’t thank
them enough. I’m very pleased with how far I’ve come
and I’m looking forward to getting back on my feet.”
If you’d like to contact Ankur Dharia, D.P.M., or for a referral
to another podiatrist affiliated with Kimball Medical Center, please
call 1-888-SBHS-123.
Kimball Medical Center is an affiliate of the Saint Barnabas Health
Care System, the largest integrated health care delivery system
in New Jersey. Located in Lakewood, Kimball Medical Center is a
fully accredited, 350-bed facility offering the most advanced, ultra-modern
diagnostic and treatment services. Kimball offers comprehensive
rehabilitative services featuring The Balance Center and an advanced
sports medicine program. Kimball is also the recipient of the Magnet
Award for nursing excellence. The Center for Healthy Living at Kimball
offers a wide variety of programs and services for area families,
children and seniors, including community education programs, support
groups and school based initiatives.
CONTACT: Kristine A. Brown
Director of Public Relations
(732) 557-3902
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