Category Archives: blog

Managing and Restoring Mobility of a Broken Arm

By  aenriquez  published  July 5, 2018

A broken arm is a painful and unfortunate event in a patient’s life. But after that initial pain subsides, one can often be left wondering will I ever get back to normal? Will my movement be affected by the broken arm? Will I be able to work? Can I go back to playing sport? Of course, the answers to these questions is incredibly variable depending on what you have broken and how badly it has been broken.

What can you break in the arm?

A number of structures make up an “arm” and can this be broken. The arm is defined as everything between the wrist and the shoulder and includes a number of bony structures. These are:

  • The humerus bone is attached into your shoulder socket and goes all the way down to your elbow.
  • The forearm goes from the wrist to the elbow and has two bones, the radius, and the ulna. The radius is the bone you can feel on the side of your thumb, whilst the ulnar is underneath it and on the side of your little finger.

All of these structures can of course break, and break in different ways and at different points. Each individual fracture has its own specific management based on years of research.

All of these structures can of course break, and break in different ways and at different points

How do you manage a broken arm?

Whilst all break will be dealt with differently, there are some general principles that get people back to normal after a broken arm. Firstly, the break needs to heal. If the two ends of the broken bone line up perfectly and look like they will heal well then usually a sling will suffice to take the weight off the patient’s arm and ensure they are pain-free. However, in some breaks, the two bones are not properly lined up and need to be “reduced”. This can be done by pulling the bones back into position (don’t worry – anesthetic is provided) and putting a cast or splint on them to keep them in position. In some cases, surgery may be needed to fix the fracture into position.

Once this initial management has been completed the patient usually has a period of immobility where they cannot move the affected arm before rehabilitation starts. The rehab process will be specific to the break but usually involves devices to support the arm and physiotherapy to rehabilitate movement of the joints around the break. The specific exercises practiced in the physiotherapy will be determined by where the bone is broken.

If you or somebody you know has been affected by a broken arm, they may need specialist help to adequately rehabilitate mobility in their broken arm. To get specialist advice and treatment for this get in contact with a clinic providing orthopedic and physiotherapy services in the United States. It seems trivial but ensuring proper rehabilitation is often the most important part of the management of a broken arm and when done properly can allow the individual to return to work sooner with less pain and more mobility.

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Implications Of An Untreated Stress Fracture

By  aenriquez  published  June 26, 2018

If you have pain in a bone that is unrelenting and associated with exercise or work then you might have suffered a stress fracture. These injuries seem innocent enough but can have significant implications if left alone and not looked at by a professional.

What is a stress fracture?

A fracture (as many of us will know) is a broken bone. A complete fracture splits the bone into two or more pieces whilst a partial fracture doesn’t. However, a stress fracture is a broken bone caused by repetitive and repeated compressive stresses to it. It can occur from a small number of high load repeated stresses and a high number of low load stresses (ie a marine with a heavy backpack running for a few miles versus a distance runner pounding the pavement for over 100 miles a week).

What happens if you leave it untreated?

This all depends on where the fracture is and whether it is in a high or low-risk site. In the worst case scenario, the stress fracture can develop into a full fracture causing displacement of the bone, nonunion (where the bone doesn’t heal properly) or fracture propagation (where the fracture becomes bigger and bigger). These complications are likely to occur at high-risk sites. High-risk sites for a stress fracture include:

  • Any stress fractures in the spine but particular the region of the lumbar spine known as the pars interarticularis
  • Hip and thigh fractures in the femoral head
  • Knee and leg fractures of the patella or the tibia
  • Ankle and foot fractures in the:
    • Medial malleolus
    • Talus
    • Tarsal navicular
    • Base of second metatarsal

A fracture (as many of us will know) is a broken bone

Some sites have a low risk of complication and these include:

  • Second and fourth metatarsal shafts (bones in the feet)
  • Posteromedial tibial shaft (part of the lower leg bone)
  • Proximal Humerus
  • Humeral shaft (arm)
  • Ribs
  • Sacrum (bottom of the spine)

How should it be managed?

If you or somebody you know suspects you might be suffering from a stress fracture then get in contact with a specialist orthopedic clinic immediately for evaluation. They will assess what the best treatment is, but the general principle is that the sooner treatment is given the better the outcome. They will decide between conservative and surgical treatment for the fracture. Usually conservative is chosen in low-risk fractures in those whose livelihood does not depend on getting better immediately. However, if an individual has a fracture in a high-risk site or their livelihood depends upon being active (ie a highly competitive athlete or a laborer on their feet all day) then it may be decided that surgery is the best option.

Conservative treatment usually consists of:

  • Pain control with medications
  • A splint that stops weight bearing on the fractured site
  • A reduction in activity until the fracture has healed
  • A slow and gradual increased in activities once the patient is pain-free
  • Exercises to help with rehab

 

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Important Signs You Need to See an Orthopedic Doctor

By  admin6  published  June 19, 2018

Are you suffering from stubborn joint pain that just doesn’t go away? Has your back been hurting for some time? Millions of people in the United States suffer from musculoskeletal problems every year, and they come from a wide variety of sources: overuse, strains, sprains, and simple back, knee, and shoulder pain.

Many people resort to painkilling medication to relieve pain but that is only a temporary solution. It also carries the risk of tolerance and dependence. It is always better to see an orthopedic doctor or surgeon to overcome your pain and discomfort entirely.

Orthopedic surgeons treat the problems arising from the musculoskeletal system. Here are some common signs that you need orthopedic treatment –

  • Stubborn or chronic pain in the muscles, joints or tendons, that persists for more than a few days
  • Deformity in joints
  • Any signs of infection in the joints, such as inflammation, swelling, redness, heat
  • Difficulty in carrying out activities of daily living
  • Joint pain persists even while resting
  • Swelling or bruising around a joint or injury
  • Restricted range of motion

There is a common myth involved with orthopedic treatment. Many people think that orthopedic doctors or surgeons only use surgery to treat orthopedic problems. This is not true. Surgery is always the last resort if medication, physical therapy and minimally invasive procedures fail to provide relief and restore motion and function in the affected part of the body.

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5 Common Knee Injuries and Treatments

By  admin6  published  May 14, 2018

The knee joint may suffer damage during almost any activity, even sitting down. Here’s what you need to know about the five most common knee injuries, and their treatment.

Meniscal Tears

The meniscus is a thin cartilage rim that cushions the knee joint. The meniscus may become torn or ruptured in an athletic or other injury, causing pain, swelling, tenderness, and a limited range of motion.

Meniscus tears do not often heal by themselves but respond quite well to physical therapy and other conservative treatments. Arthroscopic surgery may be necessary in the most severe tears.

ACL Injuries

The ACL (Anterior Cruciate Ligament) is one of the four important ligaments that stabilize the knee. The ACL may get torn due to a sudden shift of force or direction, as in sports injuries. A partial or complete tear causes pain, swelling, instability in the knee, and, a popping sound in the knee.

While partial tears in less active patients can be treated conservatively, active patients who suffer from partial or complete tears need arthroscopic surgery to regain knee joint function.

Fractures

Three bones – the thigh bone, the shin bone and the kneecap – together make up the knee. Any of these bones can break during a fall, a car accident, or indirect trauma. A fractured bone can cause heavy pain, severe swelling, and difficulty walking.

Stable fractures can heal by themselves within several weeks or months once set in a cast. But displaced fractures require surgery to reset the bones. In both cases, recovery requires an extensive physical therapy program to strengthen the joint and regain the full range of motion.

Dislocations

The kneecap or patella may become dislodged from the groove at the bottom of the femur. This is referred to as dislocation and can be caused as a result of an acute or chronic injury. It causes severe pain and swelling and restricted motion.

Many patellar dislocations can be stabilized with rest and bracing but a repeatedly dislocated kneecap may require surgery.

Tendon Tears

The patellar tendon is the tissue responsible for connecting the thigh muscles to the patella. It allows you to flex and straighten your knee. It may become ruptured due to a sudden, strong force, and tear upon a fall or an awkward landing.

Partial tears can be treated conservatively with a brace and physical therapy. But a full tear will require surgery.

Both athletes and non-athletes can suffer from a knee injury. If you’re suffering from acute or chronic knee pain, it’s time to consult an experienced orthopedic surgeon to help you recover completely.

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How Can Knee Arthroscopy Help?

By  admin6  published  April 23, 2018

Minimally invasive knee arthroscopic surgery has proven beneficial for patients with knee problems where surgery is recommended. Since arthroscopy requires smaller incisions, it doesn’t cause much damage to the surrounding soft tissues, reduces blood loss, decreases hospital stay and risk of complications. All these factors make recovery quicker and complete.

Clinical scenarios, in which arthroscopic surgery may be suitable, include –

  • known or suspected septic arthritis
  • Symptomatic meniscal tears that have been treated with non-operative treatment, without relief
  • Symptomatic loose bodies
  • Locked or locking knees
  • Meniscal tears that require repair
  • Inflammatory arthropathy requiring synovectomy
  • Synovial pathology requiring biopsy or resection
  • Unstable chondral pathology causing mechanical symptoms
  • As an adjunct to, and in combination with, other surgical procedures as appropriate for osteoarthritis: for example, high tibial osteotomy and patellofemoral realignment
  • As a diagnostic tool when the condition of the knee or the problem is unclear on MRI or MRI is not possible, and the symptoms are not of osteoarthritis

When osteoarthritis is present, the decision for arthroscopic surgery is made by the treating orthopedic surgeon –

  • after a thorough review and assessment of the arthroscopically treatable pathology, contribution of the osteoarthritis, and the patient’s symptoms
  • only after all conservative and minimally invasive treatment options have been utilized but failed to provide relief and restoration of function
  • after a thorough discussion with the patient about the advantages of the arthroscopic procedure as opposed to continuing non-invasive treatment
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3 Common Sports Injuries

By  admin6  published  March 30, 2018

Athletic activity is a great way to maintain fitness and is terrific for our overall health. However, any activity that causes stress on joints and soft tissues, can cause injuries. There are 3 common knee and shoulder injuries that athletes encounter.

Meniscus Injuries

The meniscus is a wedge-shaped cartilage in the knee joint. There are two menisci in each joint that act as “shock absorbers” between your thigh and shin bone. Meniscus tears are the most common knee injuries among those who play contact sports. When you hear your doctor talk about torn knee cartilage in the knee, s/he is usually referring to a torn meniscus.

ACL Injury

The Anterior Cruciate Ligament, or ACL, runs diagonally in the middle of your knee. The ACL prevents the tibia from sliding out and provides rotational stability in the knee. Skiers, soccer, basketball and football players are at high risk for ACL injuries due to the stress on the knees.

Rotator Cuff Injuries

The rotator cuff is a group of four muscles that cover the head of the upper arm or humerus. The rotator cuff helps you lift and rotate your arm. Injured or torn rotator cuff tendons can become inflamed and painful. You should get immediate medical evaluation if you are experiencing persistent shoulder pain and difficulty in reaching or overhead movements.

For any joint injury, it is recommended that you seek urgent medical attention to prevent the injury from worsening and to restore motion and function in the affected joint.

 

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4 Signs your Shoulder Pain requires Urgent Medical Attention

By  admin6  published  February 21, 2018

Shoulder pain can happen for so many different reasons, it is important to know the difference between something that would go away by itself or something serious that requires medical attention.

Let us understand when your shoulder pain requires an urgent trip to the doctor.

1. If your shoulder seems popped or out of place, especially after an injury or accident, this requires immediate medical attention. Out of place shoulder could indicate ligament tears that would threaten shoulder stability.

2. A popping or clicking sensation may be a sign of a labral tear, which may require surgery to fix.

3. If you are not able to lift your arm pain free, it is time to see a doctor. It could indicate a rotator cuff injury which often requires surgery.

4. If your shoulder pain is not due to a trauma but due to overuse or aging, it is important to note any changes in the severity of pain and range of motion. Increasingly worsening pain could be an indication of arthritis. Getting timely medical help for early diagnosis and treatment of arthritis can delay its progression.

If you simply not sure, seek professional medical advice anyway. Seemingly harmless discomfort and pain may worsen and turn chronic, if left untreated. So, it is best to see an experienced orthopedic surgeon right away.

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Platelet Rich Plasma Therapy Can Delay Knee Replacement Surgery

By  admin6  published  January 25, 2018

Osteoarthritis is a degenerative condition that gradually wears away the protective joint cartilage. It is the most common form of arthritis and has no cure till date. However, several conservative and interventional pain management methods can help to reduce pain and delay progression.

Treatment options include physical therapy, prescription pain medications, steroid injections, or joint replacement surgery. But regenerative medicine has given us a new treatment called platelet-rich plasma (PRP) therapy which may help to delay the need for surgery in moderate arthritis cases.

PRP therapy uses the patient’s own blood for its healing properties. The patient blood sample is drawn and filtered. Platelets are then concentrated. Platelets produce a high concentration of essential growth factors which initiate a natural healing response. The extraction and injection, both, are relatively painless. The growth factors can repair the degenerative cartilage, reduce inflammation and relieve pain.

Patients need to undergo treatments for about 4 to 6 weeks. The basic aim of PRP is to assist repair and build up damaged and worn out tissues.

Since the platelets are extracted from the patient’s own blood, there are virtually no risks of infection and rejection.

If you are experiencing knee pain due to osteoarthritis and don’t want it to prevent you from living a healthy, active life, ask your orthopedic doctor about PRP therapy.

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Top 6 Signs you may need a Knee Replacement Surgery

By  admin6  published  December 28, 2017

The number of total knee replacements continues to rise. Despite the long recovery process, an increasing number of people believe that a knee replacement surgery can help them live a better life.

But how do you know you need a knee replacement surgery? Read on for answers.

Patients, and doctors, prefer conservative and minimally invasive treatment options for any health problems and knees are no exception. Many times, the best treatment option is to undergo total or partial knee replacement.

Telltale Signs you need Knee Replacement Surgery

  • Severe knee pain that interferes with or even prevents everyday activities
  • The pain persists even during rest; you feel moderate to severe pain at all times
  • Knee swelling and inflammation that have become stubborn
  • Knee stiffness
  • Bowing of the leg
  • Non-steroidal Anti-inflammatory drugs fail to provide pain relief.

These signs are serious. Do not allow them to become worse. If you experience one or more of these warning signs, consult an orthopedic surgeon immediately.

Left untreated, these symptoms may give way to even more serious problems, such as –

  • Weakened knee muscles and ligaments
  • Knee deformities
  • Loss of motion and function in the knee
  • Knee joint degeneration
  • Delayed knee surgery may not prove as effective as it can when performed early
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Reduce the Ongoing Risk of Arthritis – The Importance of Healing Damaged Knee Ligaments

By  aenriquez  published  December 6, 2017

Ongoing Risk of ArthritisAs the largest and perhaps most important joint in the body, the knee joint is an easy one to injury. Through twisting or moving awkwardly, there can be a strain on the joint and even if overusing, this can create knee pain. The knee joint takes a great deal of pressure and weight-bearing and this, along with natural aging are all likely causes of joint problems. Mild strains are likely where the tissues of the knee are stretched but minor aches and pains are unlikely to need medical assistance. Protecting, resting and using ice to relieve any inflammation is wise but ensuring flexibility is maintained and good muscular strength is present around the knee joint will help in a preventative manner. During recovery from any sprains, it’s useful to keep the leg elevated as much as is possible.

It is wise to take preventive measures to knee joint health because a severe injury could lead to a greater risk of ligament issues or, even arthritis in the long term:

  • Take a measured approach to increasing activity levels
  • Wear good fitting sports shoes
  • Warm up prior to exercising and stretch as part of the cool down process
  • Try low-impact exercises which will not injure the knee joints

Any injury to the knee joint could be costly. Damage to the joint will certainly affect movement, flexibility and, once weakened, it is likely that the individual will suffer from future pain or a reduction of mobility. According to Dr. Mininder Kocher, an orthopedics professor at Harvard Medical School, the potential to develop arthritis in the knee joint following a tear to a tendon or ligament is more than 50 percent. Therefore, treatment and due consideration to the health of the joint is paramount. Arthritis is very common and pain, swelling, and stiffness in the joint are typical.

The knee is a modified hinge joint which enables extension and flexion. It also enables external and internal rotation to a certain degree. There are three compartments; the patella (kneecap) the patellar groove on the front of the femur and the medial and lateral tibiofemoral articulations which connect the femur to the tibia. The joint capsule contains synovial membrane and fluid.

Knee joint pain can be considerable and where the severe injury occurs to the lateral collateral ligament (LCL) perhaps a severe sprain or if torn, the individual will experience stiffness, swelling, pain on the outside of the knee and a weakness in the joint. Partial LCL injuries may not demonstrate many symptoms. The LCL is one of four ligaments to help stabilize the joint but, this is the most common of LCL injuries.

It is easy to injure the LCL:

  • Over-stretching or over-use
  • Hyperextension of the knee
  • Twisting movements or a sudden change of direction

Injuries are graded accordingly. A grade 1 LCL sprain means that the ligament did not tear although there is the risk of further injury. A grade 11 LCL sprain means that there is partial tearing to the ligament and some symptoms will be experienced. When a grade 111 LCL sprain occurs, the ligament will have torn completely and there may be bleeding beneath the skin. If all the pain fibers are torn at the same time, there will be little to no pain.

Recovery – depending on the grade of injury may take up to four months. Minor injuries take much less healing time. Certainly, physiotherapy treatments will accelerate the healing process via massage, joint exercises, and electrical modalities. They will also guide the way that the knee ligament fibers heal. This can also help to reduce the potential to tear this ligament again. An MRI may be used for diagnostic purposes to be sure that there are no other combination injuries. Knee surgery may be required especially where there is a combination of injuries. Rehabilitation thereafter will focus on being able to increase strength to the joint and to restore the full motion of the knee. This will also help to reduce the risk of arthritis.

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