Post-Tib Tendonitis: Orthopedic Treatment

by Administrator 30. June 2017 01:26

 A tendon is a soft tissue structure that connects the muscles to the bones. The posterior tibial tendon is found on the inner side of the foot near the ankle and it connects the calf muscle to the ankle. It is a an important tendon in the leg as it supports the foot while walking and hold up the foot arch. Stress caused to this particular tendon is known as the Post-Tib Tendonitis. Stress may be in the form of inflammation or tearing of this tendon. It may result in loss of foot stability and collapse of the foot arch.

Causes

  • Presence of over-pronation feet causes damage to the posterior tibial tendon
  • Overuse of the muscles in the feet leads to damage of the tendon resulting in this condition
  • A fall on the foot that may cause severe injury
  • Playing high impact sports such as basketball, tennis may tear or stretch the tendon

Symptoms

  • Development of over pronated feet as the tendon cannot support the foot arch
  • Pain
  • Growth or heel spurs
  • Pain is aggravated while walking, running, weight bearing
  • Pain and swelling may occur periodically in the initial stages but becomes permanent as the condition aggravates
  • The heel bone may shift  to a new position as the foot arch collapses and cause change in shape of the foot
  • The foot is visibly deformed with a tilted heel and inward bent foot
  • If the foot of the patient is observed from behind in a standing position, many toes are visible which indicates over pronation
  • The calf muscles may be tight

Diagnosis

  • The details of the patient’s medical history, symptoms and mode of injury may be taken into account
  • The foot may be moved, palpated and observed for visible signs of the condition, loss of flexibility and other symptoms
  • Single limb heel test - The patient may be asked to stand on one leg and raise the heel. Inability to do so indicates tendonitis
  • Range of motion of the foot
  • X-ray imaging may be required
  • MRI, CT scan and ultrasound tests may be needed

Treatment

  • Rest your feet adequately and avoid weight bearing as well as any physical activity that causes pain for a few days
  • Shoe inserts and orthotic devices  can be used to provide better protection, shock absorption and reduce the stress on the post tibial tendon or the plantar fascia
  • The exercise should be varied so that the same part and muscles of the foot is not strained every time
  • Ice packs can be applied 4-5 times a day to reduce swelling
  • Pain killers and anti-inflammatory medicines may be prescribed
  • The leg may be immobilized in a cast or a boot for 6-8 weeks
  • An ankle brace to correct the flat foot deformity
  • Steroids may be injected into the affected joint
  • Physical therapy may be helpful
  • Surgical lengthening of the calf muscles
  • Surgical removal of the damaged tendon
  • Surgical repair of the torn tendon
  • Arthrodesis or surgical fusion of the joints may be done to treat Flat Foot and Arthritis

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Joint Replacement

by Administrator 26. June 2017 09:46

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Shin Splints: Causes, Symptoms And Treatment

by Administrator 23. June 2017 09:29

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Easy Ways To Prevent Running Injuries

by Administrator 20. June 2017 09:18

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Proximal Humerus Fracture: Orthopedic Plano

by Administrator 16. June 2017 07:37

Proximal Humerus Fracture is a common type of injury of the shoulder joint that is prevalent in the elderly people. It is essentially a broken or cracked shoulder bone. This joint is made up of the shoulder blade (scapula), upper part of the humerus and the collar bone (clavicle). Tissues, ligaments, tendons keep the bones connected and help in movement of the arm. These bones together form 3 important joints- the sternoclavicular, the glenohumeral and the acromioclavicular joints. Proximal Humerus Fracture is a  type of fracture that damages the upper part of the humerus bone and is most commonly observed  in women and elderly people who suffer from poor bone health.

Causes

  • A direct fall on the shoulder
  • Vehicular accidents
  • Sports injuries
  • Overuse injuries
  • Weakness of the joint and bones due to ageing
  • Physical combat or collision
  • Injury to the chest may cause fracture in the scapula
  • Forced twisting of the arm may cause displacements and soft tissue stress
  • Seizures or electric shocks can cause displacements of the joint
  • Lifting heavy objects or overhead
  • Osteoporosis

Symptoms

  • Pain
  • Swelling
  • A visible bony bump at the point of injury or fracture may develop
  • Limited range of motion remains intact
  • Bruising and discoloration around the shoulder
  • The hands and arm may turn cold if there is damage to blood vessels or nerves
  • The joint may look deformed
  • A grinding sensation when the shoulder is moved
  • Inability to move the shoulder or arm
  • The upper limb feels weak
  • In case of an open fracture, a part of the bone may be sticking out of the skin

Diagnosis

  • Details of the patient’s medical history, mode and time of injury as well as symptoms may be taken into account
  • Detailed physical examination of the injured joint and arm to check for visible symptoms and severity of injury
  • The peripheral pulses need to be checked to diagnose loss of blood supply to any part of the injured limb
  • X-ray imaging is required to analyze the changes or damage to bone structure. It helps diagnose fractures and displacements if any
  • CT scan or MRI scan may be required to assess the damage to soft tissue structures and blood vessels or nerves

Treatment

  • In case the bone is not badly broken and has not shifted from its position much, it can be treated by immobilizing the joint using a sling
  • Ice packs applied at regular intervals help reduce pain and swelling
  • Pain killers and anti-inflammatory medicines may be prescribed
  • Manual reduction of a displaced bone may be done as an initial step and it is then secured using a shoulder brace
  • Surgical fixation of the broken or displaced bone parts using metal screws, pins and plates
  • Surgical repair of tendons and ligaments that hold the joint may be required
  • Elderly people whose bones are weak and get damaged severely may require a shoulder replacement procedure
  • Physical therapy sessions may be required to restore function and strength of the joint post treatment

Consult the physicians at OrthoTexas to know more about the treatment options available for Proximal Humerus Fracture. To schedule an appointment, call at (972) 985 - 1072.

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Common Orthopedic Conditions In Kids

by Administrator 16. June 2017 06:22

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Orthopedic Treatment For Lateral Epicondylitis

by Administrator 12. June 2017 15:39

Lateral Epicondylitis or the Tennis Elbow, is a condition that affects the elbow joint. This joint is made up of 3 bones- humerus, ulna and radius. There are some bony bumps at the base of the humerus (upper arm bone) which are called epicondyles. The bony bump that is found on the outer side of the elbow is the lateral epicondyle. These bones are held together by the muscles, tendons and ligaments. In case of Lateral Epicondylitis, the tendons of the forearm get swollen due to overuse and thus cannot lend support to the hands, wrist, elbow and upper arm. It is a painful condition that tends to deteriorate over the time.

Causes

  • Overuse of the arm or the elbow joint may weaken the muscles that support the joint. This happens especially when the ECRB or the extensor carpi radialis brevis tendon that supports the forearm muscle gets damaged
  • Minor tears in the tendons that attach the muscles and the joint bones are also a potential cause
  • The ECRB muscle may undergo gradual wear and tear as it rubs against the bones over a period of time
  • Occupations such as painters, plumbers, carpenters, butchers, typists are at a greater risk as they overuse the elbow joint
  • Athletes use the forearm and the elbow joint vigorously causing long term damage
  • Improper techniques used in playing a sport and not warming up or cooling down is a potential cause
  • People in the age group of 35-50 years are at the highest risk
  • In some cases, the tennis elbow may develop without any past history of injury or repeated use. It is termed as an insidious occurrence
  • Repeated weight lifting

Symptoms

  • Pain is mild in the initial stages and becomes severe as the condition worsens
  • A burning sensation on the outer part of the elbow
  • The limb feels weak and there is a loss of strength in the grip of the hands
  • Throwing, raising the arm, shaking hands, playing a sport is difficult
  • Both the arms may be affected at the same time
  • Joint inflammation
  • Tenderness

Diagnosis

  • Details of the patient’s lifestyle, physical activities and medical history
  • X-ray imaging
  • MRI and CT scans
  • The orthopedic doctor may flex, rotate and bend the patient’s arm, wrist and hand to check for movements that reproduce the symptoms

Treatment

  • Rest the inured arm by keeping it elevated at chest level
  • Pain killers and anti inflammatory medicines may be prescribed
  • Activity modification to prevent stressing of the muscles and tendons is suggested
  • Ice packs can be applied
  • Elbow brace or splint may be used
  • Injecting corticosteroids may be an option
  • Some specific stretching exercises can help relieve pain and improve joint function
  • Surgical repair of damaged tendons may be required when conservative methods do not work

For treatment of Lateral Epicondyliti, visit the physicians at OrthoTexas. To schedule an appointment with the doctors in North Texas, call at (972) 727 - 999.

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Tibial Plateau Fractures: Causes, Symptoms And Treatment

by Administrator 6. June 2017 15:35

Tibial Plateau Fracture is a serious type of injury that is commonly observed in athletes. It refers to a crack or break in the upper portion of the tibia or the shin bone. This is also known as the proximal tibial fracture. Tibial plateau is the uppermost part of the bone that attaches to the knee joint. It has a honeycomb kind of shape and is relatively softer than the remaining shin bone.

Such fractures may be accompanied by damage to the ligaments, muscles, blood vessels and nerves. These fractures can be categorized as follows:

  • Displaced Fractures- The bone pieces are separated from each other or the main joint
  • Non- displaced Fractures- The bone may break or crack but remains attached to te main joint in its correct anatomical position
  • Transverse- The bone breaks along a straight line
  • Comminuted- The bones are shattered into many pieces

Tibial Plateau Fracture can be a serious injury which can be limb threatening. It may cause defects in joint alignment, loss of motion/flexibility and Arthritis.

Causes

  • A fall from a height
  • Vehicular accident
  • Sports injuries
  • A direct hit or trauma to the outer part of the knee joint
  • Slight stress to a weak bone that may be a result of mineral deficiency, cancer, bone infection, osteoporosis etc
  • Stress caused by increased physical activities
  • Age related weakness of the bones make them susceptible to such breaks
  • An impact that pushed the edge of the femur into the knee joint and the tibial plateau sinks downwards

Symptoms

  • Visibly deformed knee or leg
  • Pain which can be severe at the time of weight bearing or activity
  • A feeling of pins and needles pricking the limb or foot
  • Swelling and tenderness
  • The foot below the affected knee may turn cold and pale as the blood supply is hindered
  • Numbness in the leg and foot
  • Difficulty in bending and moving the joint

Diagnosis

  • Details of the patient such as symptoms, medical history, mode of injury and lifestyle
  • Examination of the injury through visual observation, palpation and manual manipulation. The doctor will check for open wounds and deformity if any
  • X-ray imaging will be carried out to check bone damage and position. It also helps to diagnose the exact location of the fracture
  • Flow of blood to the limb and the joint may also be checked
  • MRI and CT scans may be required to assess the severity of fracture and additional damage to the soft tissue, if any
  • Arteriogram may be used to check for damaged blood vessels

Treatment

  • Rest the injured leg and avoid weight bearing
  • Apply ice packs at regular intervals
  • Keep the leg elevated at chest level
  • Soft bandage may be used for compression
  • Prescription of pain killers, anti inflammatory drugs and antibiotics
  • Knee may be immobilized for a short while using a knee brace
  • External fixation- a non-surgical procedure in which the displaced bone is fixed back (manually reduced)and held together using screws and pins that are fixed externally for a specified time period
  • Internal fixation- surgical procedure that involves anatomic reduction of the displaced bone or bone pieces and these are then fixed using metal plates or screws which are left inside the body
  • Fasciotomy- an incision is made to cut open the skin and muscles that cover the joint. The incision is left open for a few days until the blood flow is restored and swelling subsides. This is done only in case of a compartment syndrome

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