28. November 2016 11:25
The knee is the largest and most complex joint that regulates most of the body movement. It comprises of three major bones- femur, tibia and the patella. These bones are joined and held in their normal anatomical positions by the ligaments. These ligaments are categorized into two groups:
- Collateral Ligaments- These lay on either side of the knee joint and prevent any abnormal knee movements. These are the Medial Collateral Ligament (MCL) and Lateral Collateral Ligament (LCL)
- Cruciate Ligaments- There are two ligaments viz. Posterior and Anterior Cruciate Ligaments (PCL and ACL) that cross each other as well as control the back and forth movement of the joint
The stability of the knee joint depends on these ligaments and any stress or tear can affect the working of the joint. Tearing or stretching of the ligaments is medically termed as sprain. It may vary from a slight stretch or loosening of the ligament to a complete tear. When more than one ligament is affected, the condition is referred to as Combined Knee Ligament Injury.
- Sudden change in intensity of physical activity or workout
- Not following a proper warm up and cool down regime before as well as after a sport
- Direct injury or trauma to the joint
- Vehicular accident
- Fall from a height
- Debilitating pain may be felt immediately after the injury
- Difficulty in weight bearing and movement
- Swelling and inflammation of the joint
- Redness and tenderness
- The knee may feel cold when touched
- The joint is likely to get dislocated as multiple ligaments are damaged at the same time which results in loss of stability
- Detailed clinical evaluation of the injured joint to check for visible symptoms, whether there is an open wound, loss of sensation and motion as well as muscular strength
- Neurological or nerve tests may be conducted by an orthopedic doctor
- Blood flow to the lower extremities may be checked
- X-ray imaging may be required to diagnose changes in bone position or any other structural damage
- MRI and CT scan may give clear pictures of the ligaments and location as well as severity of the tear/strain. It may also help the doctor decide the mode of treatment that needs to be adopted
Combined Knee Ligament Injury is a serious medical condition that needs immediate medical attention. It may be treated both surgically and non-surgically depending on the severity of injury. Following methods may be recommended by the doctor:
- Bracing- This may be recommended to patients with low grade injuries, have a moderate level of physical activity or if he is not in a position to undergo surgery. It helps to promote healing of the soft tissues and restoring stability of the joint
- Antibiotics may be prescribed to prevent infection in case of open wounds
- Arthroscopy- A small camera guided instrument is used to reconstruct the damaged ligaments. The dislocated knee bones may be repositioned and held together by inserting screws and pins
- Surgical grafting to re- construct completely torn ligaments
- Surgical removal of debris and scar tissue
- In case of damage to the blood vessels or nerves, nerve reconstruction and grafting may be done to restore the sensory functions within the joint
- Physical therapy may be required to restore mobility, muscular strength and prevent joint stiffness
- Activity modification and avoidance of weight bearing may be recommended post-surgery
For treatment of Combined Knee Ligament Injury and other orthopedic conditions, visit OrthoTexas. To schedule an appointment with the knee surgeons in Flower Mound, TX, call at (972) 899 – 4679.
25. November 2016 17:51
Mallet Toe refers to a deformity of the distal interphalangeal (DIP) joint located near the tips of the toe. The condition causes the distal end of the toe to start pointing downwards and the middle portion of the toe to rise upwards. It can affect any of the small toes and hamper the normal functionality of the foot. Mallet Toe is most commonly observed in women.
- Wearing tight shoes may contract and shorten the tendons that hold the foot joints. It may also cause rigidness of the supporting muscles which do not allow the toe to straighten
- Use of high heels for prolonged period of time
- Rheumatoid Arthritis
- Previous foot injuries may damage the muscular balance of the joint or alter the shape of the bones
- Visibly deformed or clawed toe that begins to curl towards the floor
- Bunions may also be formed
- Pain in the toe, particularly while wearing closed shoes
- Calluses may develop as the middle of the toe rises like a bump and rubs against the shoe
- Redness and swelling may be seen
- Change in gait as the toe hurts while walking
- Physical examination of the affected toe
- Details of past injuries, type of shoes worn, duration spent standing or walking, medical conditions etc. may be taken into consideration
- X-ray scan of the joint can reveal changes in the bone and soft tissue structure
- The orthopedic doctor may attempt to straighten the toe manually to check if the deformity is rigid or flexible
- Doppler ultrasound test may be conducted to check the flow of blood to the joint
In case of flexible deformity, Mallet Toe can be treated by conservative methods. For rigid deformities and those caused due to other associated conditions, surgery may be required.
Treatment options may include:
- The patient may be advised to wear open footwear, low heels, soft soled shoes that allow the toes to stretch and do not rub against them
- Customized shoes with increased foot arches or shoe inserts may be recommended
- Pain killers and anti-inflammatory medicines may be prescribed to reduce swelling and tenderness
- Buddy taping- The deformed toe can be taped with the adjoining one to provide support and allow it to straighten
- Certain orthotic devices like toe splints or caps can protect and keep the toe straight
- The patient may gently pull the deformed toe in a straight position and hold it for some time. This exercise can be done repeatedly to alter the shape of the toe.
- Towel curls- Place a towel on the floor and try to crumple it with the toes. This is a an effective exercise that can strengthen the tendons and restore joint flexibility
- Surgical release of the tendons that cause the toe to bend
- Arthroplasty- A part of bone may be removed from the toe joint to correct the deformity
- Arthrodesis- Surgical fusion of the joint which allows new bone mass to grow
- Physical therapy may be recommended after both surgical and conservative treatment to help restore joint functionality.
The foot specialists at OrthoTexas provide complete treatment for Mallet Toe and other medical conditions. Patients in McKinney, TX can call at (972) 727 – 9995 to schedule an appointment.
21. November 2016 12:36
Ulnar Nerve Entrapment, also known as the Cubital Tunnel Syndrome, refers to a medical condition in which the ulnar nerve gets irritated or trapped. It is one of the three main nerves in the human arm that originates near the neck and runs down the entire length of the arm to the hand. The nerve provides sensation to the ring and the little finger besides enabling the arm muscles to form a grip. It may get compressed along this path, most commonly it happens at the collar bone, elbow joint or the wrist. The condition should be addressed with timely medical care as it may lead to muscle atrophy and physical disabilities.
- Formation of bone spurs along the path of the ulnar nerve
- Arthritis of the elbow joint
- Past instances of bone fractures or dislocations in the arm, hand, wrist or collar bone
- Repeated and excessive bending or flexing of the elbow joint may put the ulnar nerve out of place
- A direct hit or injury to the elbow joint
- Accumulation of joint fluid in the elbow may compress the nerve
- Bending the elbow or leaning on it for long can result in nerve entrapment. This happens because the ulnar nerve passes over the small bony ridge called medial epicondyle when the elbow is bent. Repeated activity may irritate it
- Some people have inherent structural problems which may make the ulnar nerve slide out of the cubital tunnel every time the elbow is bent.
- Prolonged resting of the elbow on the armrest of the chair
- Numbness in the hand, little finger and ring finger
- A tingling sensation may occur sporadically in the fingers and hand
- Flexing the fingers may become difficult
- Loss of grip or ability to hold objects
- The fingers may go numb or ‘fall sleep’ when the elbow is bent for a short stretch of time
- Details of the patient’s symptoms, past injuries, lifestyle, occupational requirements, may be noted
- Physical tests may be conducted to check the level of strength and flexibility in the hand or wrist
- The elbow may be bent to check if the nerve moves out of its place
- X-ray imaging of the elbow, hand and wrist joint to assess the bone structure
- Nerve conduction tests may be carried out by stimulating the ulnar nerve at a particular point and recording its response. This helps to determine damage to nerve and muscles
- Prescription of anti-inflammatory medicines to eliminate swelling in soft tissues around the nerve
- A soft padded elbow brace or splint can be worn at night to keep the arm straight while sleeping
- Specific exercises may be performed to guide the ulnar nerve to slide through the cubital tunnel when the elbow is bent
- Surgical treatment may be required if the patient does not show improvement with conservative methods. These may include the following:
- Cubital Tunnel Release- Surgical cutting of the ligament within the cubital canal to make more space for the ulnar nerve
- Ulnar Nerve Anterior Transposition- In this, the ulnar nerve is relocated from its original position to the front side of the forearm. This prevents it from sliding out of its position when the joint is moved
- Physical therapy may be recommended post-surgery to prevent stiffness in the arm
For treatment of Ulnar Nerve Entrapment and other wrist conditions, visit OrthoTexas. To schedule an appointment with the orthopedic doctors in in Frisco, TX, call at (214) 436-8997.
18. November 2016 09:19
De Quervain's Tendinitis is a medical condition that affects the tendons located at the base of the thumb. There are two main tendons in the thumb which pass through a tunnel kind of an enclosure referred to as the sheath. A thin layer of slippery tissue, called synovium, covers the tendons and facilitates their passage through the sheath. Irritation or constriction may cause these tendons to swell and rub against the outer sheath. The condition mainly affects women between the age of 35 and 50 years.
- Prolonged repetitive movement of the hand and wrist joint while playing golf, gardening, playing badminton or tennis etc.
- Overuse injuries to the thumb or wrist joint
- Pregnancy may cause certain internal changes resulting in inflammation of the tendons
- Rheumatoid Arthritis in the hand or wrist joint
- Lifting a baby may stress the hand over a period of time
- Past injuries may result in the formation of a scar tissue which may hamper the movement of the tendons at the base of the thumb
- Difficulty or pain while grasping, clenching a fist, holding or lifting weights, pinching or wringing clothes
- Pain may be sudden or set in gradually. It may be initially felt in the thumb or wrist and radiate upwards to the forearm
- The base of the thumb may be swollen and tender to touch
- The patient may feel a snapping kind of sensation when the thumb is moved or used
- Finkelstein Test- This is a physical test in which the patient is asked to make a fist and then bend the wrist in the direction of the little finger. If pain is felt while performing this test, it confirms the presence of De Quervain's Tendinitis
- The doctor may palpate and apply pressure at the base of the thumb to check if it causes pain
- X-ray imaging may be required to assess the bone structure and detect a fracture or dislocation
- The patient may be inquired about his daily activities, sports played and previous wrist injuries, if any
- De Quervain's Tendinitis can be treated both surgically as well as non-surgically depending on the underlying cause and the severity of the condition. The methods adopted may include the following:
- A soft removable splint or a brace may be worn to hold the thumb and wrist in place as well as give them rest for a few weeks
- Anti-inflammatory medicines may be prescribed to provide relief from the symptoms
- Activities that involve excessive use of the hand need to be avoided. This can be helpful in easing the pain and swelling
- Corticosteroid injections may be administered directly at the point of inflammation to provide immediate relief
- Application of ice packs at regular intervals can be effective
- Surgery can be performed to expand the thumb compartment in order to create space for the swollen tendons
- Physical therapy may be recommended to reinstate the stability and functionality of the thumb. Specific exercises may be designed to strengthen the supporting muscles and reduce pain
- Occupational therapists may advise the patient on proper usage of the hand without irritating the tendons
Visit OrthoTexas for complete treatment of De Quervain’s Tendinitis. To schedule an appointment with the wrist specialists in McKinney, TX, you can call at (972) 727 – 9995.
14. November 2016 09:09
Charcot Foot refers to a progressive foot deformity that occurs as a result of nerve dysfunction or damage. This causes the bones in the foot joint to become so weak and brittle that they may be easily dislocated or fractured. Weight bearing and walking further pressurizes the foot, causing it to change its shape. This may lead to permanent disability.
Charcot Foot is mainly observed in people suffering from Diabetes. However, it may also affect people suffering from Leprosy or Syphilis. The condition has a high probability of reoccurring even after treatment and is therefore considered to be a lifelong impairment.
- Neuropathy- Damage to the nerve endings causes inability to sense pain, change in temperature or external injury, making the condition worse
- Inherent structural problems- People who have a tight Achilles tendon are at a greater risk of developing Charcot Foot
- Continuing to walk or put weight on the foot after an injury may be a reason as it adversely affects the joint stability
- Repeated micro trauma or injuries which may go unnoticed can result in this syndrome over a period of time
- Past fractures or dislocations which have not been healed properly may cause Charcot Foot
- The affected foot may feel slightly warm to touch
- Pain and soreness
- Swelling and redness may occur
- The mid foot arch may collapse completely as the condition progresses
- Change in gait
- Some people may develop ulcers as the bone and the skin covering it are constantly stressed
- Bone infection, in severe cases
- The orthopedic doctor may conduct a setailed clinical examination of the affected foot and ankle
- Analysis of the patient’s medical history, past injuries, family history etc. to identify the cause
- X-ray imaging may be recommended to get a detailed view of the changes in the bone structure
- CT scan and MRI may help in diagnosing damage and condition of the soft tissue structures that support the foot joint
- Blood tests may be conducted to monitor the sugar levels and check for any infections
Charcot Foot can be treated both surgically and through conservative methods. These may include one or more of the following:
- Wearing a protective removable brace or splint on the affected foot
- Specific orthotic devices or shoe inserts may be used to support the foot and prevent further damage
- Weight bearing should be reduced or completely avoided in severe cases. Lifestyle and activity modification may be required to prevent further damage
- Surgery to remove the bony outgrowth that may result in ulcers and skin injuries. This procedure is called ostectomy
- Foot amputation may be done in severe cases of Charcot foot
- Surgical alteration of the tight Achilles tendon to reduce pressure on the foot
- Surgical removal of the damaged parts of tissues and bones to relieve pressure within the joint
- Bone graft or fusion may be done to correct structural deformities
- Physical therapy may be recommended post treatment to help the patient regain mobility
- Crutches or walker may be used to avoid weight bearing on the foot
For diagnosis and treatment of Charcot Foot and other orthopedic conditions, visit OrthoTexas. To schedule an appointment with the foot and ankle specialists in Carrolton, TX, call at (972) 492 – 1334.
11. November 2016 05:52
The lumbar spine refers to the lower back which is made up of 5 small bones called vertebrae. A fibrous pad called the intervertebral disc is stacked between each vertebra to absorb all the external shocks on the spine.
The disc is divided into two main parts- the outer ring and inner ring. The outer called the annulus fibrosus holds a gel like substance called the nucleus pulposus. A break or a crack in this outer ring causes the inner gel (nucleus pulposus) to flow out of the disc space. This condition is termed as Lumbar Herniated Disc. It can compress the small nerve roots that emerge out of the intervertebral joints. It may causes many other problems and can be physically limiting.
- Lack of physical activity or sitting for longer durations may weaken the vertebrae
- Poor posture is responsible for over stressing the lumbar spine and can lead to uneven distribution of weight on the lower extremities
- As a person ages, the body undergoes natural wear and tear which affects the vertebral bones as well as the discs that support them. The discs tend to dry out or become thin with time
- A diet deficient in calcium and minerals leads to loss of bone mass in the spine
- Being overweight can increase the risk of Lumber Herniated Disc
- Driving for long hours at a stretch can also lead to the condition
- Men are genetically pre disposed to develop the condition
- Activities that involve a lot of bending, twisting and lifting weights can be a causative factor
- Some people may not experience any symptoms and yet have a Herniated Disc. In others, the following symptoms may be observed.
- Muscle spasms and cramps
- Pain in the lower back and legs is a characteristic symptom of Lumbar Herniated Disc. The pain may vary from a dull ache to severe sharp pain which tends to intensify when the patient coughs, bends or sneezes
- In extreme cases, loss of bowel and bladder control may be experienced
- In case of nerve pinching, the patient may experience a sharp shooting pain that radiates from the lower back to one side of the leg
- Weakness or instability may be felt in the legs and thighs
- Some patients may feel a tingling or pricking sensation in the legs or feet. Numbness may also occur
- A detailed physical examination is conducted to check for the symptoms
- X-ray may be done to diagnose changes in the structure of the spine and disc spaces
- Neurological tests may be required to assess the loss of sensory capabilities
- The medical and family history of the patient may be analyzed
- CT scan and MRI can help to reveal the condition and position of the vertebrae as well as damage to the soft tissue structures
- Myelogram, a dye-induced CT scan, may be required for a detailed view of the spine
Lumbar Herniated Disc can be treated by non-surgical as well as surgical methods depending on the level of the damage, patient’s age and existing health condition. Treatment may include:
- Cryotherapy: Application of ice packs at regular intervals for a couple of days can help to relieve pain.
- Medications: Anti-inflammatory medicines and muscle relaxants may be prescribed by the doctor to relieve the symptoms. Corticosteroids may be injected directly into the affected lumbar region in case of severe pain or muscle spasms.
- Heat therapy: It may be a good option to relax the muscles and improve the flow of blood to the affected part of the spine
- Surgery: If the patient does not respond to conservative methods, surgery may be required. Discectomy may be performed to remove the affected spinal vertebrae or the damaged part of the disc
- Physical therapy: A physical therapy program may be recommended post-surgery to help the patient regain flexibility and strength.
We, at OrthoTexas, provide effective treatment for Lumbar Herniated Disc. To schedule an appointment with the orthopedic surgeons in Plano, TX, you can call at (972) 985-1072.
7. November 2016 05:28
Transient Synovitis, Toxic Synovitis or Irritable Hip is a medical condition observed in children between 3-8 years that causes pain in the hip joint followed by limping. The underlying cause is the inflammation in the lining of the synovial joint. Although the condition is usually transitory, it may lead to Osteoarthritis in the later stages of life or may recur in case the child acquires infection.
- The hip lining may be affected following a viral infection, usually of the upper respiratory system
- A fall or an injury to the hip joint
- Reaction or after effects of certain medicines or vaccines may cause inflammation
- Pain in the hip, legs, thigh, groin and knee
- Change in gait as the child tends to develop a limp
- Infants may find it difficult to crawl
- The condition mostly affects one side of the hip
- The pain may develop as a mild ache and progress slowly to be severe. In other cases, there may be a sudden onset of severe hip pain
- Resting in a certain position may become particularly painful
- A catching or locking sensation may be experienced while walking
- Weight bearing may become difficult for some patients
- Some children may also have low grade fever
- Detailed physical examination of the joint to check for movements that cause pain
- Palpation may be done to check if the hip is tender
- A complete detailed examination of the muscuo-skeletal system of the body to check if there is inflammation in other joints
- Log Roll- This test is done by making the patient lie in a supine position and then roll from one side to the other
- Urine analysis
- Blood tests to check for white blood cell count
- X-ray examination of the hip joint
- Ultrasound or MRI may be conducted to check the condition of the soft tissue structures
- A sample of the synovial fluid may be drawn through aspiration and tested in a laboratory
- Bone scan may be required in some cases
- Pain killers and anti inflammatory medicines may be prescribed to relieve the symptoms
- Heat therapy may be used to provide relief
- Bed rest for 7 to 10 days or till complete recovery may be recommended
- Physical activities like sports that pressurize the hip joint should be avoided to allow complete recovery.
For complete diagnosis and treatment of Transient Synovitis, visit OrthoTexas. To schedule an appointment with the orthopedic doctors in Allen, TX, call at (972) 727 – 9995.
3. November 2016 07:26
A foot with an unusually high arch is referred to as the Cavus Foot. The condition may lead to excessive weight bearing on the heel and ball of the foot causing a host of physical inadequacies. Cavus Foot may affect one or both feet and may occur at any age irrespective of gender. This defect has the chances of progressing, specifically if it is accompanied by any neurological problems.
- It may be a result of a genetic abnormality in the foot structure
- Neurological diseases such as Cerebral Palsy, Spina Bifida, stroke or Muscular Dystrophy could eventually cause the development of a Cavus Foot
- Past injuries to the foot
- The abnormally high foot arch is noticeable when the person is standing
- Pain and instability while moving
- Frequent ankle and foot sprains
- Due to the lack of stability, the patient may tend to clench the toes while walking. This can result in the growth of Hammer Toes
- Muscular weakness may cause Foot Drop
- Change in gait as the person may start dragging the foot/feet while moving
- The patient’s genetic history and medical conditions in the past may be reviewed by the doctor
- X-ray examination may be required to assess the changes in the bone structure
- A neurological test may be required for accurate diagnosis
- The doctor may test the foot and limbs for loss of muscular strength and check for the range of motion
- Analysis of the gait
- The visible symptoms may be taken into consideration
- Customized orthotic devices such as shoe inserts may be used to provide support to the foot while walking or standing
- Bracing may be recommended in case of foot drop as well as to hold the ankle in the right position
- The shoes may be chosen as per the doctor’s recommendation to provide better support to the heel and ball of the foot
- Surgical intervention may be required if conservative methods of treatment do not provide relief. The procedure may be done to alter the bone structure permanently.
- Surgery may also be recommended in case of neurological defects that may be the cause of Cavus Foot
- Hammer or Claw Toes that develop as a result of Cavus Foot may require surgical treatment
- Exercises that aim at strengthening the leg and thigh muscles as well as improve the flexibility of the foot may be incorporated
- Activity modification and avoidance of weight bearing may be recommended post-surgery to allow the soft tissue and altered bone structures to heal
For complete diagnosis and treatment of Cavus Foot, visit OrthoTexas. To schedule an appointment with the orthopedic foot doctors in Flower Mound, TX, call at (972) 899 – 4679 or visit 4951 Long Prairie Rd, Suite 100, Flower Mound, TX 75028.