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.
5. September 2016 10:04
Congenital Knee Dislocation (CDK) is a rare disorder that is present at the time of birth. It is a physical deformity which affects the alignment of the knee joint and may exist in isolation or could be a consequence of some musculoskeletal abnormality. It is characterized by a hyperextension of the knee, along with a possible misalignment or dislocation of the foot and hip joint as well. Congenital Knee Dislocation may promotes the chances of a breech birth and it is more common in girls.
- Family history or genetic factors
- Larsen Syndrome which refers to a faulty development of knee, hip or foot joints
- Neural Tube Defect- The spinal cord and meninges or the tissues covering it do not close and start protruding out of the baby’s back
- Abnormal fetal position in the womb
- Primary contracture of the quadriceps muscles
- Traumatic dislocation may also occur during parturition (vaginal birth)
- Underdevelopment or complete absence of the cruciate ligaments in the knee joint
- The child will be born with a clear knee recurvatum, i.e., backward bent knee
- Club Foot
- The child may also have an abnormal rib cage or chest cavity
- The hip joint may also be dislocated
- The knee cap is partially formed and may not be found during palpation
- A thorough clinical evaluation of the child’s limbs and adjacent parts may be done using palpation
- The flexibility and range of motion of the joint may be assessed
- An ultrasound test conducted during the gestation period may reveal the problem
- X-ray imaging to assess the severity of the deformity
- MRI scan may be recommended for children 3 years of age
In most cases, non-surgical treatment options are recommended for Congenital Knee Dislocation. Orthopedic doctors recommend that starting the treatment soon after birth enhances the chances of recovery. Treatment options may include:
- The hip and knee may be manipulated using external fixator to bring them back to their original position. These fixator devices may be used till the child attains the age of six months
- Use of splints on the affected part may be helpful
- Skin traction
- Percutaneous Quadriceps Recession- A minimally invasive surgical technique which aims at correcting the joint alignment
- Serial casting- Use of a fiberglass plaster to hold the deformed limb in correct position and stretch the tight muscle to control its flexion. A new cast may be fixed every week and the treatment is likely to continue for 3-6 weeks
- Surgical lengthening of the quadriceps or the tendons of the knee cap (patellar tendons) may be required at a later stage
- Leg brace may be worn to allow limited flexion of the knee
- Surgical repositioning of the displaced bones and reconstruction of supporting ligaments
- Strengthening the quadriceps muscles through physical therapy may be recommended
The knee doctors at OrthoTexas provide complete diagnosis and treatment for Congenital Knee Dislocation and other orthopedic conditions. Patients in Carrollton, TX can call at (972) 492 – 1334 to schedule an appointment.
23. April 2016 11:38
Knee Tendon Bursitis is a condition affecting the Pes anserinus (goose’s foot) bursa, a small fluid filled sac located between the tibia and tendons of the hamstring muscles, sartorius, gracilis and semitendinosus. The condition occurs as a result of inflammation of the bursa, causing it to produce too much fluid and swell which, in turn puts pressure on the adjacent structures within the knee joint. People who are obese, aged 50 to 80 years or involved in high impact sports activities are more likely to suffer from Knee Tendon Bursitis.
- Repetitive knee movements
- Improper sports training, such as lack of warm up exercises, excessive uphill running or sudden increase in running distances
- Direct blow to the knee
- Tight hamstring muscles
- Medical conditions, such as Osteoarthritis, Knee Cartilage Tear or Flat Feet
- Sudden twisting of the leg with the foot planted on the ground
- A forceful out turn of the knee or lower leg
Gradually developing pain on the inner side of the knee, a few inches below the joint
- Restricted range of motion
- Pain may increase with exercise, climbing stairs or other physical activity
- Difficulty bending or straightening the leg
- Tenderness to touch
The orthopedic doctor may physically examine the knee and assess the range of motion. He may gently press the inner side of the knee to determine the severity of pain. As the symptoms of Knee Tendon Bursitis are similar to those of a stress fracture, an X-ray may be conducted for a proper diagnosis and rule out damage to other parts of the knee joint.
- Rest: The patient may be advised to take rest and avoid putting stress on the affected knee. Refraining from strenuous physical activities may also be recommended.
- Ice Pack: Applying ice packs to the affected area after every few hours or as suggested by the orthopedic doctor may help to relieve pain.
- Medication: The doctor may prescribe non-steroidal anti-inflammatory medications to reduce inflammation.
- Physical Therapy: It may help to stretch and improve the flexibility of the hamstring muscles. The physical therapist may also suggest exercises to restore normal movement in the knee and leg.
- Surgery: The orthopedic doctor may perform aspiration (draining the fluid out of the bursa) or remove the bursa if there is severe infection.
We, at OrthoTexas, provide diagnosis and treatment for Knee Tendon Bursitis and other orthopedic conditions. To schedule an appointment with our knee specialists in Carrolton, TX, call at (972) 492 – 1334 or visit 4780 North Josey Lane, Carrollton, TX 75010.
16. January 2016 13:16
Hamstring refers to a group of muscles located at the back of the thighs that enable the bending of the leg at the knee joint. Pulled Hamstring or straining of the hamstring muscles is a common injury borne by athletes, runners, basketball players, footballers, dancers, gymnasts and skaters.
There are three main muscles that constitute the hamstring; the biceps femoris semitendinosus, and the semimembranosus. These begin at the lower end of the pelvis and move down to the shin bone. Stretching and overuse of these muscles leads to pain which can be severe and may lead to tearing of the muscles. Mild hamstring pulls can heal on their own while severe tearing of the muscles require timely medical assistance. Hamstring Pulls can be graded as follows on the basis of their severity;
- Grade I- Mild pain and discomfort may be experienced by the patient but the mobility will be intact. There could be some swelling and resistance while bending the knee of performing other activities
- Grade II- The injured person may limp and experience swelling and pain particularly when the hamstring muscles are touched or when the knee is bent
- Grade III- It is categorized as a severe injury involving partial or complete tearing of the hamstring accompanied by sharp pain, swelling, bruising and weakness in the limbs.
- Jumping or activities that involve sudden starts or stops
- Inadequate or refraining from warm up exercise before an activity/sport
- Tight quadriceps in front of the thighs may exert pull on the hamstring muscles
- Presence of weak glutes (skeletal muscles in the buttock) may lead to straining of hamstrings
- Medical conditions which arise in pelvis and lower back may become a cause for hamstring stress
- Mild to severe pain depending on the severity of stretching/straining of the hamstring
- Difficulty in standing or walking around
- A feeling as if something has snapped/popped at the back of the thigh
- Pain may radiate up to the buttocks when moved
- Bruising, soreness and tenderness
The doctor may conduct a physical examination of the affected area besides analyzing the cause of injury. MRI may help to assess the exact damage caused to the hamstrings.
- Resting the injured leg and refraining from any activity that stresses the thigh muscles
- Use crutches if required to avoid putting weight on the leg
- Apply ice packs at regular intervals
- Soft elastic bandage/thigh support may be used for compression
- Keep the injured leg elevated and provide support by placing a pillow under it
- Pain killers and anti-inflammatory drugs may help ease the pain
- Physical therapy under supervision helps strengthen the muscles and prevent repeated straining
- Surgery may be required in severe cases when the muscles are torn
For comprehensive treatment of Pulled Hamstring, visit OrthoTexas. To schedule an appointment with the orthopedic surgeons in Carrollton, TX, call at (972) 492 – 1334.
24. February 2015 09:10
A rehab program is aimed at restoring the normal joint functioning in patients suffering from different orthopedic conditions such as fractures, sprains, strains, Rheumatoid Arthritis, injuries etc. It also helps to recover from replacement as well as reconstructive surgeries of the knee, hip and shoulder. OrthoTexas offers comprehensive rehab services to meet the individual fitness goals and physical requirements of the patients.
Goals Of A Rehabilitation Program
- Improves Mobility: Whether you are suffering from an orthopedic condition of the knee, hip, shoulder, spine or neck, rehabilitation programs can help improve the quality of your life. Some of these conditions also cause impairing of the normal functioning of the joint. Rehab services aim at improving the joint strength and stability to the patient.
- Shortens Recovery Period: Patients who have undergone a joint replacement or reconstruction surgery are also recommended to undergo rehab by the orthopedic doctors. It helps to shorten the recovery period and reduce post-operative pain. Injuries to a joint, ligament or tissue can also cause stiffness and immobility in the body. The exercises prescribed in the rehabilitation program help to regain flexibility of the affected area.
- Prevents Injuries: Rehab programs aims at improving body balance with the help of exercises that strengthen the ankle, hip and knee muscles. Also, strengthening of the core muscles and improvement in posture helps to prevent injuries to the joints.
A typical rehabilitation session includes stretching, strength building and range of motion exercises, endurance training, balance training and functional mobility training. It is a non-invasive form of treatment and is usually not painful. However, the patient might experience a little pain initially due to the stiffness in joints but it gradually decreases as the rehab program progresses. Rehabilitation not only helps in recovering from an orthopedic condition but also helps to improve overall fitness levels.
The rehabilitation professionals at OrthoTexas, Carrollton, specialize in:
- Sports Injury Prevention
- Custom Splinting
- Hand Therapy
- Work Conditioning
- Aquatic Therapy
- Functional Capacity Evaluations
- Alter G
- Sports Injury and General Orthopedic Rehabilitation
For more information on how rehab services can help improve your health and well-being, visit OrthoTexas, Carrollton, TX. The physical therapists use the most advanced techniques to provide focused and dedicated corrective services to the patients. To schedule an appointment with the rehab specialists, you can call at (972) 492 - 1334 or visit us at the clinic at 4780 North Josey Lane, Carrollton, Texas 75010.
4. March 2014 06:00
One of the most common issues that bring patients to wrist surgeon is Carpal Tunnel Syndrome. It is a condition that causes numbness, tingling, pain, and weakness in the fingers and thumb. It is basically caused due to compression of the median nerve, which is located in the wrist and is responsible for imparting sensation to the first three fingers and thumb.
The major cause of Carpal Tunnel Syndrome is pressure on the median nerve. This pressure is due to swelling or any condition that makes the carpal tunnel smaller. Some other causes that lead to the syndrome include:
- Diseases such as Rheumatoid arthritis, hypothyroidism, and diabetes
- Wrist injuries
- Certain wrist movements, which are made repeatedly
- Smoking also causes the syndrome by reducing blood flow to the median nerve
- Some of the common symptoms of Carpal Tunnel Syndrome are:
- Numbness, tingling, weakness, and pain in the thumb, index finger, middle finger, and ring finger except little finger
- Pain in arms between elbow and the hand
- These symptoms may be more noticeable at night and the problem often subsides by shaking hand.
- The doctors often diagnose this problem by physically examining hands, neck, shoulders, arms, and wrists. They may ask many questions to the patient related to their health and activities. They may also conduct some blood and nerve tests to confirm the problem.
Initially the symptoms can be treated at home by taking proper care for wrist and hands. It is important that the patient should start the treatment as soon as possible, as this will prevent long-term damages.
- A patient may feel better by giving rest or icing the wrist for a few minutes.
- A patient can also take anti-inflammatory drugs to relieve pain and reduce swelling.
- Patients are advised to wear wrist splint at night, which helps in keeping wrist in a neutral position.
Though mild cases may be treated with braces, injections, or self management techniques, moderate and severe cases need surgery. During surgery, a wrist surgeon makes an incision from the palm to the wrist, or a limited incision in the palm. The surgery is also done with an endoscopic carpal tunnel release that uses a fibro-optic instrument. Surgery for Carpal Tunnel Syndrome can have a recovery time of three to four months.
24. December 2013 06:25
Hallux rigidus is a common progressive arthritic condition associated with the big toe. The precise cause of hallux rigdus is still unknown but many orthopedic doctors in Carrollton, Texas believe that the increased motion within the big toe joints causes the cartilage between the joints to wear off which leads to hallux rigdus.
The following factors may contribute to the prevalence of hallux rigidus:
- This condition may also develop due to overuse of big toe joint.
- People with osteoarthritis are more prone to developing this disorder.
- Imbalance in foot structure may also trigger the development of hallux rigidous.
- It is believed that people with inflammatory diseases like rheumatoid arthritis, gout etc. may cause hallux rigidus.
- Participating in activities that involve continuous stress on the big toe joint may lead to hallux rigidus.
- Some researchers believe that hallux rigidus may also be inherited.
Some early and late symptoms of hallux rigidus include:
- Intense pain in the big toe joint
- Stiffness and tenderness around the joint
- Crushing feeling when the foot is moved
- Difficulty in bending big toe up and down
- Inability to bear weight
- Pain in lower back
- Pain in other lower extremity joints
- Difficulty in wearing shoes
- Gait problems like walking with a limp
- Development of bunion and bone spurs
It is advisable to consult an orthopedic doctor if the aforementioned symptoms are noticed. The doctors may perform physical examination and imaging tests like X-ray and MRI to rule out other problems. He may also conduct biomechanical and gait exam to determine the severity of condition.
The treatment of hallux rigidus depends on the diagnostic report. Some of the common treatments, however, include:
- Non-surgical treatment: Non-steroidal anti-inflammatory medications may be prescribed by the orthopedic doctors to relieve pain and inflammation. You may also be suggested to wear proper-fitting footwear. In order to regain the flexibility of big toe joint, daily stretching exercises such as toe extensor stretch and bunion stretch may also be recommended by the doctor. The orthopedic doctors may also refer you to a physical therapist to help you with abduction/adduction, dorsiflexion and flexibility exercises.
- Surgical treatment: Surgery may be considered by the doctors in severe cases of hallux rigidus. The most common surgical treatments include joint fusion, artificial joint replacement and cheilectomy.
Following steps must be taken in order to prevent this condition:
- Practicing joint mobility exercises
- Wearing proper shoes
- Regular podiatric care
18. July 2013 09:19
Olecranon is the tip of the elbow in human body that is highly susceptible to injuries and fractures. This can be attributed to its location, which is directly under the skin; there is no protective layer of tissues or muscles. So any direct impact or falling over the elbow can result in a fracture.
An Olecranon fracture can occur due to a number of reasons. A direct blow or being hit by a hard object could be one of them. At times, it might so happen that the person falls on the weight of the outstretched arm and the elbow can get directly exposed to a fracture. In most of the cases, Olecranon fractures are a consequence of impact hitting by objects like a bat or a stick.
Olecranon fractures are characterized by the following symptoms:
- The person experiences sudden intense pain in the elbow.
- It becomes difficult to straighten the elbow because of the pain.
- The fracture could also be accompanied by swelling in the area.
- Bruises and cuts also become prominent.
- A fracture in the elbow can also impact hands. The fingers tend to get numb and it becomes difficult to hold objects.
- Pain in joints plays a major part; it can considerably reduce the mobility.
Diagnosis and Treatment
Olecranon fractures are synonymous with intense pain and swelling. Hence required medical help must be sought immediately to avoid worsening the situation. An orthopedic doctor will look for any bruises in the injured area as they make the skin prone to infections.
The doctor will also examine areas in and around the elbow to check for any tenderness that might be there. Tenderness can be indicative of other broken bones or injuries that the patient may have sustained.
Body parts such as arms, hands, and shoulders are also thoroughly examined in order to check the mobility of joints.
Treatment involves both surgical and non-surgical procedures. Any of them could be employed depending upon the extent of injury.
- Pain killers can be given to alleviate the extent of pain and swelling in the elbow.
- In certain cases, a sling will suffice to hold the elbow in its position during the healing process. This form of treatment calls for regular X-rays to check the progress, and also to determine any additional measures that may be required.
- In cases where the fracture is severe, a surgery has to be carried out by the orthopedic doctor to bring the elbow back to its place.
- Antibiotics can also be administered so as to eliminate the chances of infection.