29. October 2016 06:35
Boutonniere Deformity (BD) is a condition characterized by a deformity in the finger with the middle joint bent downwards and the distal end pointed backwards. The finger joints are connected by tendons and ligaments which allow motion. Due to tearing of the ligaments in this condition, finger bends downwards (flexed) at the proximal interphalangeal joint (PIP) and hyperextended (bent backwards) at the distal interphalangeal joint (DIP).
- Rheumatoid Arthritis- In this case, the inflammatory cells are released into the synovium (joint lining) which result in the formation of the abnormal pannus tissue. This in turn secretes substances which can damage tendons, bones and ligaments causing deformities.
- Trauma or injury- The tendon that is attached to the middle joint of the finger gets damaged if a bent finger is jammed or hit by an external force. This prevents the straightening of the joint
- Bruise or cut- A cut at the top of the finger can tear the underlying tendon causing deformity
- Dislocations and fractures: Dislocations and fractures in the bones of the hand may also lead to this condition.
- Swelling and tenderness
- Visibly deformed finger
- Limited ability to stretch the finger
- Imaging Tests: X-ray imaging helps to diagnose broken bones and soft tissue structures.
- Elson’s Test: The patient is asked to straighten the injured finger to check for loss of motion.
- Ice packs and heat therapy: Ice packs can be applied for 24-48 hours at regular intervals. They help to relieve pain and swelling. Heat therapy can also be beneficial in relieving the symptoms.
- Medications- Corticosteroids and anti-inflammatory medicines may be prescribed if the patient is suffering from Arthritis.
- Splinting- The middle part of the finger is secured using a splint for 4-6 weeks to allow the ends of the tendon to regrow and join each other. The patient may be asked to continue wearing the splint at night after 6 weeks
- Exercises- The doctor may recommend specific stretching and strengthening exercises to improve functionality. It may help to restore the normal range of motion.
- Taping: Taping is recommended if the patient is likely to participate in sports even after the treatment as a precautionary measure. It can help to provide stability to the fingers.
- Surgical treatment- This is required if the patient is suffering from Rheumatoid Arthritis, the tendon is completely torn or a piece of bone gets detached along with the tendon. The tendon and the bone are put back into their correct anatomical position.
For effective treatment of Boutonniere Deformity, visit OrthoTexas. To schedule an appointment with the orthopedic doctors in Flower Mound, TX you can call at (972) 899 – 4679.
25. October 2016 06:29
Functional Capacity Evaluations (FCE) refers to an assessment process which includes a combination of physical tests and observations. As the name suggests, these are conducted to evaluate the functional capability of an individual following an injury or surgery. In this process, a thorough evaluation is done to check for the employee’s physical condition and assess if he can return to his occupational routine. Also, it determines the the number of hours that the employee may be able to work besides any changes required at the workplace.
What It Includes?
FCE procedure includes a variety of tests and processes as enlisted below:
- The ability to bend
- Ability to hold or grasp things
- Duration for which the person can sit or stand comfortably
- The capacity to lift weight
- The power to push or pull objects
- Body balancing ability
- MET- Metabolic equivalents which measure the performance of the heart and the circulatory system
- Tests to check the coordination between the hands and eyes
- Cognitive testing
Depending on the nature of the patient’s job, he may be asked to walk, sit, stand, stoop, use the stairs, kneel, lift weights, reach out to objects etc. The physical therapist may ask the patient to stop as soon as there is any discomfort or when the required level of testing is reached. The patient may also be questioned about the mode, time and severity of injury besides the activities which aggravate pain or discomfort.
Benefits Of Functional Capacity Evaluation
- Employees who have been on a leave from work from a long time due to a medical problem can get their physical fitness levels assessed when they want to resume work. This helps the employer to evaluate the amount and type of work that can be performed efficiently.
- FCE can be conducted before a surgery to assess the patient’s endurance levels and decide if it is safe to proceed with the surgical procedure. This is particularly important for surgeries which may involve blood loss.
- FCE helps the physical therapists in designing a rehabilitation plan for the patient. It may also be helpful in examining the progress made by the patient post-rehabilitation
- It helps in assessing the loss of functional abilities of employees who have suffered an accident at the workplace. This is beneficial in settling medical claims and wage loss compensation for both the employee as well as the employer.
- People who wish to avail social security disability benefits can get their evaluation done
- Those applying for a job post illness or an accident can get their functional capacity evaluated and submit the reports to the prospective employer
- Insurance claims can be settled on the basis of FCE reports
The physical therapists at OrthoTexas perform functional capacity evaluations to help patients safely get back to work after an injury or surgery. To schedule an appointment with the therapists in Plano, TX, you can call at (972) 985 – 1072.
22. October 2016 06:22
Slipped Capital Femoral Epiphysis (SCFE) is a medical condition that affects the hip joint of people in their teen age. The hip is a ball and socket joint in which the head of the femur (thigh bone) rests in the socket referred to as the acetabulum. The femur has two plates at either end of the bone where the bone growth occurs. In some adolescents, the rounded head of the bone tends to slip out of the socket in the backwards direction causing pain and discomfort. A break or fracture in the growth plate causes instability of the femoral head (also known as capital) and it tends to slip out of its socket. This condition can be classified into two categories:
- Stable SCFE- This is a less severe condition in which the person is able to bear body weight without the use of orthotic devices
- Unstable SCFE- This condition creates a severe instability and the patient is unable to bear body weight
- Genetic traits- People with a family history of SCFE are more likely to be affected
- Metabolic disorders- Hyperthyroidism and Hypopituitarism are major risk factors for this condition
- Obesity- People suffering from SCFE have been found to be overweight in most cases
- Pain in the groin, thigh, hip and knee
- Physical deformity in the legs
- Inability to bear body weight
- Muscle spasms
- Detailed examination of the affected leg and the hip
- Analysis of the patient’s medical, genetic history, past injuries and existing symptoms
- Evaluation of the gait
- Physical tests may be performed to check for loss in range of motion
- X-ray imaging is done to study the position of the bone and it helps confirm the diagnosis
- The aim of the treatment is to realign the bones and enable the patient to move freely. The patient is generally required to undergo surgical treatment within 2-3 days of diagnosis.
- In-situ Fixation- A small incision is made in the hip. Screws and wires are used to fix the growth plates. This prevents the bone from slipping out and eventually the growth plates close once the patient attains maturity. This process is best suited in case of stable SCFE.
- Open Reduction- A large incision is made in the affected joint and the bone is placed back in its original position. It is then fixed using screws
- Post-operative care- The doctor may recommend using crutches to avoid bearing weight for a few weeks. Specific physical therapy sessions may be conducted to restore movement.
We at OrthoTexas, provide effective treatment for Slipped Capital Femoral Epiphysis. To schedule an appointment with the orthopedic doctors in Carrolton, TX, visit (972) 492 – 1334.
19. October 2016 04:26
Pigeon Toes (Intoeing) is a physical ailment which involves turning of the feet inwards. It may affect either one or both the feet. The condition may develop in the early phase of childhood or may become apparent in later stages when the child starts walking. In most cases, Intoeing can heal itself naturally over the time as the child grows. However, in severe cases, treatment from an orthopedic doctor is required. In most cases the patient responds to conservative methods of treatment. For the others, surgery is required.
- Gestational problems- The child may not get adequate space in the uterus which causes the legs to turn inwards
- Internal Tibial Torsion- The shinbone is turned inwards. This is generally the cause if Intoeing occurs in the first 2 years of life
- Medial Femoral Torsion or Anteversion- The thigh bone tends to turn inwards causing foot deformity which becomes apparent at the age of 4-5 years
- Other disorders: Neuromuscular disorders such as Cerebral Palsy may also be a cause of the condition
- Genetic factors: Intoeing can also be caused due to genetic factors
- Visible deformity
- Abnormal gait
- Difficulty in walking and running due to lack of balance
- The child is easily fatigued and may stumble very often
- Difficulty in wearing normal shoes
- Pain may be felt during activity
- A detailed examination of the symptoms, family history and the foot may be conducted
- X-ray imaging may be required to check the position of the bones and soft tissues
- The range of motion may be assessed through physical tests
- Bracing- The child may be asked to wear a night brace or a removable brace throughout the day to correct the position of the foot. It comprises of a special shoe made with connecting bars that is fixed on the leg. Bracing may be done even after birth if the baby is found to be deformed
- Orthotic devices- Special shoe inserts may be used to support the affected foot
- Plaster: Leg and the foot may be fixed in a plaster for a specific period of time.
- Surgery: The orthopedic doctors may recommend a surgery if the condition exists beyond 9-10 years of age. The procedure involves resetting of the tibia or the femur as well as the foot bones to improve the shape and create a proper gait.
Visit OrthoTexas for comprehensive diagnosis and treatment of Pigeon Toes. To schedule an appointment with the orthopedic doctor in Flower Mound, TX you can call at (972) 899 – 4679.
15. October 2016 04:18
Commonly known as Hunching Back or Dowager’s Hump, Kyphosis refers to the development of an abnormal outward curvature of the spine. A normal human spine has a slightly rounded structure but in some cases, the rounding may get exaggerated causing disfigurement and other spine related problems. Kyphosis may occur at any age irrespective of the gender. However, it mostly affects women in their post-menopausal stages as they lose bone mass rapidly. Break or compression of any part of the vertebrae alters the spinal curvature. This creates a visibly exaggerated curve or a hunch back.
- Congenital defects
- Spinal degeneration
- Neuromuscular disorders such as cerebral palsy
- Diet lacking in Vitamin D and calcium leads to loss of bone mass
- Poor postural habits can cause Kyphosis
- Past injuries
- Scheuermann’s Disease that particularly affects adolescents may be a cause
- Decompressive spinal surgeries may lead to Iatrogenic Kyphosis
- An abnormally curved back is the most prominent symptom
- Stiffness and pain may be felt while performing daily routine tasks
- The patient is generally fatigued as the spine does not provide adequate support
- There may be visible loss of height
- The patient is unable to stand straight
- Some people develop breathing problem as the lungs may be constricted
- Altered gait
- There may be a loss of appetite as the abdominal cavity is affected and the organs are compressed
- X-ray imaging may be recommended to identify the exact location of damaged vertebrae
- Thorough clinical examination of the existing symptoms, past medical records and injuries if any
- MRI and CT scan may reveal soft tissue damage and the degenerated discs
- Pain killers, muscle relaxants and anti-inflammatory medicines may be prescribed
- A back brace may be recommended for additional support to the spine
- Physical therapy to strengthen the supporting muscles and improve posture as well as flexibility
- Spinal infections may require antibiotics
- Rest is highly recommended and the patient is advised to abstain from stressful activities
Surgical procedures may include the following:
- Osteotomy- Removal of degenerated vertebrae and discs
- Surgical decompression: This procedure is done to relieve the pressure on the nerves between the vertebrae that may have been pinched
- Spinal Fusion: Some vertebrae may be fused together to increase spinal stability. This may require fixation using metal screws and wires
- Balloon Kyphoplasty- A special balloon kind of instrument is used to inflate the collapsed vertebrae in case of compression fractures. This may help to regain the height of the spinal column
We at OrthoTexas provide complete diagnosis and treatment for Kyphosis. To schedule an appointment with the spine surgeons in Allen, call at (972) 727-9995.
10. October 2016 10:42
Osteoarthritis refers to the wear and tear of the protective cartilage layer in the elbow joint that covers the bones as well as prevents them from rubbing against each other. It is more commonly seen in men and the symptoms are mostly seen after 50 years of age. Being a degenerative disorder, Osteoarthritis progresses with time and may result in permanent disability.
- Previous injuries such as fractures or dislocations of the joint
- Wear and tear of the joint parts due to aging
- Sports, such as baseball, which involve excessive use of the elbow may wear out the ligament structure
- Family history of Osteoarthritis may increase the chances of its development
- Pain in the joint and arm
- Significant loss of range of motion
- The patient may feel a grating or cracking sensation when the joint is moved
- A feeling of the joint ‘locking’ due to displaced bones
- Tingling and numbness
- Tenderness and swelling
- Development of bone spurs
- The joint feels unstable
- Lifting and carrying heavy objects becomes difficult
- Weakened grasping ability
- Analysis of the patient’s symptoms, medical history and previous elbow surgeries, if any
- Palpation and range of motion tests may be done to check for the extent of degeneration
- X-ray imaging to determine the changes in bone structure and rule out fracture or dislocation
- MRI and CT scan to assess the damage to soft tissue structures
- Prescription of anti-inflammatory drugs by an orthopedic doctor
- Rest the affected arm and avoid any strenuous activities
- Injecting corticosteroids may be an option to provide relief from severe pain
- Viscosupplementation - Certain fluids may be injected into the joint to improve mobility and prevent rubbing of bones
- Physical therapy may help to restore strength, flexibility and range of motion
- Arthroscopy, which is a minimally invasive process, may be performed to remove damaged parts, bone spurs and debris from the joint
- Arthroplasty - Surgical joint replacement in case the elbow has been severely damaged
- Cartilage or bone grafting may be required to restore functionality of the joint
OrthoTexas provides treatment for Osteoarthritis of the Elbow and other medical conditions. To schedule an appointment with the elbow doctors in Plano, TX, you can call at (972) 985 – 1072 or visit 4031 West Plano Parkway, Suite 100, Plano, TX 75093.
7. October 2016 04:07
Sudden stretching or tearing of the supporting ligaments within the knee joint is referred to as a Knee Sprain. It is a common type of injury that affects people irrespective of age or gender. The knee joint is supported and protected by four ligaments. The center of the joint has the two cruciate ligaments- Anterior Cruciate Ligament (ACL) and the Posterior Cruciate Ligament (PCL). The sides of the joint are bound by the collateral ligaments- Medial Collateral Ligament (MCL) and the Lateral Collateral Ligament (LCL). Any of these ligaments may get stretched beyond their normal capacity causing a tear or sprain.
- Sudden twist of the knee while walking, running, playing or exercising
- Over straightening or hyperextension of the knee
- Stopping suddenly while moving or playing
- A direct blow to the knee may cause ligament damage
- Vehicular accidents (when the knee is smashed against the dashboard)
- Falling while the knee is bent
- Overpronation may increase the risk of a knee sprain
- Not warming up before a game or exercise
- Past knee injuries may cause weakening of the ligaments and result in a sprain
- Sudden enhancement in the intensity of workout
- Instability- the knee seems to give away while standing or moving
- Pain- it may vary from a dull throb to being severe depending on the extent of ligament damage. The pain starts immediately or within a few hours of injury
- Inability to bear body weight
- Discoloration, swelling and tenderness may be observed
- A popping sound is heard or felt inside the joint at the time of injury
- Limited range of motion remains
- The time and mode of injury besides the existing symptoms may be investigated
- The injured as well as non-injured knees may be examined for comparison
- Range of motion may be tested
- X-ray imaging may be suggested to check for fractures, grade of ligament tear and detachment of bone pieces along with ligament
- MRI scan may be required
- RICE therapy- this involves resting the knee, applying ice packs at regular intervals, using soft compression and keeping it elevated at chest level
- Medication- pain killers and anti inflammatory drugs may be prescribed
- Use of knee brace may be helpful in supporting the injured joint
- Exercises- specific rehabilitation exercise plan may be prescribed to strengthen the injured knee and to prevent any more injuries
- Arthroscopic surgery may be done to reconstruct damaged ligament using own tissue or form a donor
- Any activity that aggravates the symptoms should be avoided
4. October 2016 10:29
Lisfranc fracture refers to a break in the bones that connect the mid foot to the forefoot. This part comprises of a group of bones and connective tissues called ligaments that form the arch on top of the foot. Five long bones called metatarsals extend out from the mid foot to the toes. The arch not only supports the foot while walking, but also helps to transfer the pressure exerted by the leg muscles to the forefoot. The lisfranc complex is important to maintain a proper gait and ensure even distribution of body weight through the lower extremities.
Lisfranc fracture may affect one or more joints in the foot and can be accompanied by a ruptured ligament. It is a serious injury that should be treated immediately as it may take months before the patient can regain complete functionality of the limb. Severe injuries may result in a permanent loss of arch (Flat Foot) or cartilage and Arthritis.
- Sudden twisting of the foot
- Sports injuries which may occur due to falling while the foot is flexed downwards
- A fall from a height can severely fracture or dislocate the bones
- Vehicular accident
- If a heavy or large object falls directly on the foot
- Diabetes and neurological defects may increase the chances of such injuries
- Swelling may occur on the top of the foot
- Pain may increase with movement
- Bruising, accompanied with discoloration above and below the foot
- Difficulty in bearing weight
- The foot may appear abnormally wide
- Thorough clinical examination of the injured foot and ankle
- Analysis of the patient’s symptoms, injuries and medical history
- Palpation may be done by the orthopedic doctor to check for tenderness and dislocations
- Piano Key Test- the toes are moved up and down to see if it causes pain
- Single limb heel rise test to check if the patient can stand on tip toes without pain
- X-ray imaging to evaluate changes in alignment of the Lisfranc joint
- MRI and CT scan may be done to obtain cross-section images of the foot and identify damage to soft tissues
- The foot may be immobilized for a few weeks using a cast. The patient may not be allowed to put weight on the foot. After the immobilization period, the cast may be replaced with a removable one and slight weigh bearing may be permitted
- Ice packs may be applied during the initial period to reduce pain and swelling
- The injured foot should be kept elevated to compress swelling
- Internal fixation of the broken or dislocated bones may be done. In this, the bones are put back in place and held together using metal screws and plates
- Surgical fusion of the damaged bones so that they are allowed to grow back into one single bone mass. This is done in case of severe injuries when internal fixation is not possible
- Surgical repair of torn or stretched ligaments may also be recommended in some cases
We, at OrthoTexas, offer complete diagnosis and treatment for lisfranc (midfoot) fracture. To schedule an appointment with the foot and ankle specialists in Flower Mound, TX, you can call us at (972) 899 – 4679 or visit 4951 Long Prairie Rd, Suite 100, Flower Mound, TX 75028.