Getting to Know Dr Hitendra Doshi K

My mother was a nurse trained in Singapore and from a very young age, I was exposed to medical care through various medical camps. Over the years, I naturally developed an interest in becoming a doctor. In my 3^rd year of medical school, I decided to specialise in Orthopaedics as it was a practice involving mechanics and biology, which I truly enjoy.

Besides traumatic sports-related injuries, I am also specialised in treating complex fractures (young and the elderly) and managing conditions that require joint replacement.

My philosophy of managing patients is based on 3 arms – Early Diagnosis, Holistic Management and Preventive Measures. Prevention is always better than cure. I invest time in generating awareness on preservation of musculoskeletal function and mobility. At the same time, I also help patients understand the need to seek an early consultation to ensure timely investigations and diagnosis before their condition progresses. Not all conditions require surgical intervention. Hence, I will explore all possible aspects of treatment and management options with the patient.

I oversee my patients from diagnosis to post-operative care. A typical day starts with reviewing patients in the ward by 8am, and a second review in the late afternoon. I usually schedule surgeries during the day and often take on emergency surgeries after office hours. When I am not in the operating theatre or the ward, I will be seeing patients in my clinic for diagnosis, outpatient treatments and post-surgery follow-up.

To see a patient regain painless mobility and function with a smile of satisfaction!

There was once an elderly in her 80’s living all alone and she sustained a severe elbow fracture after a fall. With her pre-existing condition of osteoporosis, her elbow bone was shattered into multiple pieces. Her condition was therefore not suitable for the common fracture fixation method of stabilising the bone area with plates and screws to allow the bones to heal and fuse back. She had to undergo a total elbow replacement, where her elbow bone and joint were replaced with artificial implants. She tolerated the procedure well and had good early functional recovery and independence. I still remember her words of gratitude during the follow-up 2 weeks later. She told me with a smile, “My mobility is my happiness! Thank you, Doctor!”

Conservative treatments with medications and injections and surgical treatments ranging from ligament reconstructions and fracture fixations to joint replacement.

While ligament reconstruction from traumatic sports injuries are performed mainly in the young, the elderly may require intervention for arthritic joints ranging from intra-articular injections to knee replacement surgery.

Fragility fractures are on the rise in the elderly. Many will benefit from early surgery either through a joint replacement if it involves a joint (for eg. hip fractures) or open reduction and internal fixation if it involves the long bone (for eg. distal femur fracture). The surgeries are typically performed within 24 hours and done with minimally invasive techniques. This is to ensure earlier restoration of function and mobility while minimising risk of complications in the elderly.

Early diagnosis and treatment is the key to restoring function and mobility. Particularly when managing the elderly, there are many other compounding ailments that can make the elderly vulnerable to complications after a fall due to immobility. These include chest infection, urine infection, bed sores, deep vein thrombosis and many more. 

Hence, orthogeriatric management is a multidisciplinary approach to surgically treat the fracture early and restore the premorbid function of the patient while instituting rehabilitation very early in the recovery phase. The goal of this holistic approach is to improve lives of the elderly after a fall and to restore their independence, mobility and function. Above all, I aim to restore quality of life after a fall and to prevent secondary fractures!