Slipped Capital Femoral Epiphysis: Causes, Symptoms And Treatment

by Administrator 19. February 2017 12:17

Slipped Capital Femoral Epiphysis or SCFE is a hip condition that mostly occurs in teenagers.  The hip is a ball and socket joint in which the head of the thigh bone fits into the socket of the large pelvic bone called acetabulum. The thigh bone grows along two growth plates (physis) that are found at each end of the femur. The growth head located at the upper end of the femur solidifies to become the femoral head and is also referred to as the epiphysis. In case of SCFE, this epiphysis gets displaced as the head of the thigh bone slips backwards. The condition may take some time to develop and is more prevalent in teenage boys. Timely diagnosis and appropriate treatment is necessary to prevent future complications like Hip Arthritis.

SCFE can be classified as follows:

  • Stable SCFE - The joint feels slightly unstable and the patient may be able to move around with some help
  • Unstable SCFE - The patient is unable to bear body weight even if walking aids such as a walker or crutches are used. This condition may also become a potential cause of Avascular Necrosis in the hip bone.


  • A sudden fall
  • Major trauma caused to the hip or pelvis joint
  • Hereditary factors
  • Being obese or over weight
  • Metabolic disorders such as hyperthyroidism
  • In some cases, a person may develop SCFE over a period of time even with no previous record of physical injury


  • Pain may be felt in the hip, groin, knee or thigh post injury
  • Stiffness
  • Unstable joint
  • Inability to bear body weight
  • In most cases, only one side of the hip joint is affected. However, in patients below the age of 10 years, the chances of both sides being affected are higher
  • The affected leg may appear shorter and turned outwards compared to the normal one
  • Change in gait
  • Physical activity may exaggerate the symptoms


  • Medical history, family traits and symptoms may be taken into account
  • Detailed clinical evaluation may be required to check range of motion in the affected leg
  • The patient’s gait may be observed
  • X-ray imaging may be conducted to analyze bone structure and locate the femoral head


The femoral head or epiphysis is stabilized through a surgical procedure in all cases. It may be carried out as follows:

  • In case of stable SCFE, in situ fixation is carried out by fixing the femoral head using a metal screw. As the growth plate grows and the screw gets fused within it
  • In case of unstable SCFE, a large incision is made in the hip joint and the displaced bone head is brought back to the correct anatomical position. It is held in place using two screws which eventually fuse within the joint
  • In cases where in the patient is likely to develop SCFE in the opposite hip as well, in situ fixation may be preformed to eliminate the risk
  • Physical therapy may be recommended post surgery
  • The patient may be advised to use crutches for a few weeks to allow the joint to heal
  • Regular follow ups and some repeat X-rays may be required to monitor the joint condition for 1-2 years after surgery

Visit the joint doctors at OrthoTexas for complete treatment of Slipped Capital Femoral Epiphysis and other disorders of the hip. To schedule an appointment with the orthopedic surgeons in Denton, TX, call at (940) 382-1577.

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Lumbar Herniated Disc: Orthopedic Denton

by Administrator 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.

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Acromioclavicular Joint Separation: Orthopedic Denton

by Administrator 24. September 2016 09:30

The acromioclavicular (AC) joint is the point where the clavicle (collar bone) meets the acromion (shoulder blade). Injury to the ligaments that support this joint and connect these two bones is referred to as Acromioclavicular Joint Separation. The two main ligaments that may be affected are the acromioclavicular (AC) ligament and the coracoclavicular (CC) ligament.

The injury can range from mild to severe depending on the extent of damage to the ligament and bones. Mild injuries involve slight stretching of the ligaments whereas severe injuries witness complete tearing of one or both ligaments besides the separation of the two bones.  Such injuries make the joint prone to Arthritis in the future.

Timely medical treatment can prevent chances of permanent shoulder deformity.


  • A direct fall on an outstretched arm or hand
  • Sudden trauma to the arm, elbow, shoulder or hand
  • Sports injuries


  • Pain in the upper part of the shoulder/collar bone which may get worse when the joint is moved
  • Swelling and tenderness
  • Loss of function and difficulty in raising the arm overhead
  • Redness
  • A lump may form above the shoulder
  • Some cases may have visible shoulder deformity


  • Clinical evaluation of the injured shoulder through palpation and range of motion tests
  • Evaluation of the mode of injury, symptoms reported by the patient and the medical history
  • X-ray may be done and in some cases, the patient may be asked to hold a weight in the injured hand during the scan for better view of the injury


The treatment for AC joint separation may include:

  • Resting the injured arm and avoiding any stress to it
  • Applying ice packs at regular intervals may curb swelling and pain
  • Keep the arm elevated above chest level
  • Immobilization using a removable sling to provide support to the shoulder
  • Soft compression may be used for relief
  • Use of a shoulder brace
  • Prescription of anti-inflammatory medications to relieve pain and discomfort
  • Taping of the joint may be done for 2-3 weeks to improve stability
  • Specific exercises may be done to improve strength, mobility and flexibility
  • Surgical trimming of the collar bone to avoid it from getting in contact with the shoulder blade
  • Surgical reconstruction of the damaged ligaments

The shoulder specialists at OrthoTexas provide effective treatment for Acromioclavicular Joint Separation and other orthopedic conditions. Patients in Denton, TX can call at (940) 382 – 1577 to schedule an appointment with the shoulder surgeons.

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Plantar Fasciitis: Orthopedic Treatment In Denton, TX

by Administrator 29. August 2016 01:39

Plantar Fascia refers to the band of ligaments that connect the heel bone (calcaneus) to the toes. It is the largest ligament in the foot and spreads out in the shape of a web. It absorbs external shocks and also lends support to the foot arch. This ligament undergoes a lot of stress in the day to day life while walking and due to excessive body weight, leading to Plantar Fasciitis. The condition may result in inflammation and micro tearing of the ligament. It may affect one or both feet and is more commonly observed in women.


  • Being overweight may stress the ligament
  • Increase in weight during latter stages of pregnancy
  • Running long distances
  • Occupations that require standing for long hours
  • Structural problems in foot structure, i.e. Flat Feet or high arches
  • Tightness of the Achilles Tendon may pull the Plantar Fascia
  • Wearing shoes that do not offer cushioning for the soles
  • Injury caused by jumping or landing on hard surface
  • Reactive Arthritis
  • Ankylosing Spondylitis
  • Tightening of ligaments with age


  • Pain at the base of the foot which may vary from a dull ache to a burning pain
  • Stiffness
  • Pain may increase after long periods of rest or physical activity
  • Redness and swelling
  • Change in gait
  • The foot may feel warm and tender
  • Walking barefoot may be painful


  • The orthopedic doctor may perform detailed physical examination of the foot
  • Symptoms may be analyzed by moving the foot or palpation
  • Evaluation of the muscle strength and nerve coordination
  • X-ray imaging to check for fractures and rule out structural problems
  • MRI and CT scan may be done to analyze soft tissue damage


  • Reduce the amount of physical activity and takerest
  • Apply ice packs for 15-20 minutes to reduce pain and swelling
  • Use foot supports and arches in the shoes
  • Pain killers and non-steroidal anti-inflammatory medicines are prescribed
  • Injecting corticosteroids into the foot for immediate relief
  • Physical therapy is required especially in case the Achilles Tendon is causing the problem
  • Surgical detachment of the plantar fascia ligament
  • Special splints that stretch the foot to lengthen the Achilles Tendon and the ligaments can be worn overnight for a specified period of time
  • Removable boot to immobilize the foot and reduce stress on it

For treatment of Plantar Fasciitis and other orthopedic conditions, visit OrthoTexas. To schedule an appointment with the foot and ankle specialists in Denton, TX, you can call at (940) 382 – 1577 or visit 2535 W. Oak Street, Denton, TX 76201.

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Bennett's Fracture: Orthopedic Treatment In Denton

by Administrator 27. July 2016 12:24

Bennet’s fracture can be defined as a crack or break in the first carpometacarpal joint at the base of the thumb. This is the point where the metacarpal bone of the thumb meets one of the eight carpal bones, trapezium, that forms the wrist. The cartilage that covers it helps in the extensive movement of the thumb and maintains joint stability. In most cases, Bennet’s fracture causes this ligament to get detached from the bones, leading to a dislocation of the carpometacarpal joint. If not treated properly, the injury may result in loss of functionality, thumb weakness and the development of Osteoarthritis at the base of the thumb.


  • Thumb injury due to punching something hard
  • Falling on the hand with the thumb partially flexed
  • Work related injuries
  • Motor vehicle accidents
  • Contact sports injuries, such as in boxing, rugby and soccer


  • Pain
  • Swelling and tenderness at the base of the thumb
  • Difficulty grasping objects
  • Visible deformity in the thumb and wrist
  • Joint instability
  • Bruising


To diagnose a Bennett’s fracture, the orthopedic doctor may physically examine the site of injury to look for visible deformity and signs of dislocation. He may conduct certain imaging tests, such as X-ray, CT scan or MRI, to confirm the exact location of injury and extent of dislocation of the carpometacarpal joint.


Conservative treatment is not usually recommended as the fracture involves displaced joint surfaces that need to be aligned back to their normal position. However, in case of a hairline fracture without any significant displacement, the orthopedic doctor may perform closed reduction procedure. In this, the thumb may be manually manipulate the joint to restore the original position of the bone. The patient may be advised to wear a splint or cast to immobilize the thumb and promote a faster healing.

Surgical intervention may be required for a major Bennett’s fracture. It may also be required to treat a shortened or abnormally rotated thumb as a result of the injury. Metal screws, wires and plates may be inserted to hold the broken bone fragments in place. Physical therapy may be recommended post-surgery to reinstate complete functionality of the thumb.

We, at OrthoTexas, specialize in the diagnosis and treatment for Bennett’s fracture as well as other hand injuries. To schedule an appointment with our hand and wrist surgeons in Denton, TX, you can call at (940) 382 – 1577 or visit 2535 W. Oak Street, Denton, TX 76201.

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Ankle Dislocation: Causes, Symptoms and Treatment

by Administrator 24. June 2016 13:23

The ankle is a hinge joint which connects the foot bones to the leg. It bears the maximum body weight which makes it prone to injuries. The two leg bones, fibula and tibia, are connected to the talus (ankle bone) and supported by many tendons, ligaments, connective tissues as well as muscles. These enable the joint to function and remain stable. A strong force may damage the connective tissues and lead to the displacement of the constituent bones. This condition is termed as Ankle Dislocation.

In most cases, the injury occurs in association with other foot injuries such as fractures and sprains.


  • Sports injury
  • Sudden change in direction while running or exercising
  • Inward or outward rolling of the ankle
  • Sprain
  • A direct fall on the foot
  • Vehicular accident


  • Pain which can be severe at the time of injury
  • Inability to walk, stand or bear body weight
  • Swelling which may get aggravated with time
  • Limping
  • Visible deformity
  • Numbness
  • Pins and needles sensation
  • Redness of skin or warmth around the ankle
  • Ecchymosis and bruising
  • The foot may turn cold after injury, if blood supply is obstructed


  • Clinical examination by the doctor
  • The symptoms, mode of injury and patient’s medical history may be analyzed
  • MRI and CT scan may be recommended to assess soft tissue damage

Non-surgical options include the following:

  • Rest the injured foot with the leg elevated at chest level
  • Weight bearing should be avoided for 4-6 weeks. Crutches or a walking stick may be used for support while walking
  • Anti-inflammatory medicines may be prescribed to relieve pain
  • Wearing a specifically designed boot for a few days to restrict the movement of the ankle
  • Cryotherapy- ice packs may help curb pain and swelling
  • Anatomical reduction or manual re-alignment of the displaced (ankle) bone. The doctor may administer local anesthesia before the procedure
  • Use of a splint or cast to keep the foot stable post-reduction
  • Physical therapy may help to restore motion and strengthen the supporting muscles

Surgery may be required in case of torn or damaged ligaments and tendons. The following procedures may be recommended:

  • Surgical fixation using screws and plates may be required in case dislocation is accompanied with a bone fracture
  • Ankle replacement surgery may be performed in case of severe damage to the joint

OrthoTexas provides effective treatment for Ankle Dislocation and other various orthopedic conditions. To schedule an appointment with our ankle surgeons in Denton, TX, you can call at you can call at (940) 382 – 1577 or visit 2535 W. Oak Street, Denton, TX 76201.

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Turf Toe: Causes, Symptoms And Treatment

by Administrator 28. April 2016 12:57

Turf Toe is a condition in which the joint of the big toe gets sprained. The injury affects the “plantar complex’ a group of various ligaments, small bones and soft tissues that enclose as well as support the big toe. The condition is mainly seen in footballers, high jumpers, gymnasts, basketballers and ballet dancers.

Depending on the severity of the injury, the condition can be categorized as following:

  • Grade 1: mild swelling at the big toe joint with minimal tenderness occurring due to stretching of the plantar complex.
  • Grade 2: Tender joint with limited movement, moderate swelling and bruising may be seen. It occurs due to tear in the plantar complex.
  • Grade 3: Complete tearing of the plantar complex, painful movement of the joint, severe swelling and tenderness. Patient may be unable to perform routine activities.


  • Stretching of the joint
  • Hyperextension of the joint
  • Repetitive trauma or stress injury
  • Wearing shoes that do not provide proper support to the feet


  • Mild to moderate pain
  • Swelling at the joint
  • Bruising
  • Difficulty moving the big toe
  • Limited range of motion


  • First Aid treatment: The doctor may advise the patient to follow the RICE protocol, which is as follows:

Rest:Taking rest to allow the muscles to heal.
Ice: Applying ice packs to compress swelling
Compression: Compression bandages may be worn to prevent further damage.
Elevation: The leg should be kept elevated above the heart level to reduce swelling.

  • Keeping the joint immobile for a few days may be recommended for patients with Grade 2 Turf Toe.
  • Wearing a walking boot or braces may be recommended to restrict the movement of the joint
  • Anti-inflammatory drugs may be prescribed to provide relief from pain and inflammation.
  • Surgical treatment may require if there is a severe tear in the plantar complex. Following complications may also call for a surgical intervention:
Fracture of the sesamoid bones
Unstable big toe
Damaged cartilage of the joint
Severe symptoms

We, at OrthoTexas, provide treatment for Turf Toe and various other foot conditions. To schedule an appointment with our orthopedic surgeons in Denton, TX, you can call at (940) 382 – 1577.

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Wrist Fracture: Orthopedic Denton

by Administrator 13. April 2016 12:54

Wrist fracture or Distal Radius Fracture is a medical term used to denote a broken wrist. The human wrist comprises of 8 small bones which are together joined with the two bones of the forearm, ulna and the radius. Breakage or crack in any of these ten bones is referred to as a wrist fracture. Most of the wrist fractures involve the breaking of the radius bone and are termed as the Distal Radius Fracture. Fractures increase the risk of Osteoarthritis in the affected joint if not treated properly. 


  • A direct fall on an outstretched hand
  • Physical combat
  • Automobile accident
  • Sports related injuries
  • Weak bone structure due to calcium deficit diet
  • Osteoporosis


  • Severe pain
  • Visible deformity
  • Bruising and redness 
  • Swelling and tenderness in the arm and wrist
  • Inability to move the hand or loss of function
  • A piece of bone may protrude out of skin
  • The hand and fingers may go numb or turn white
  • Stiffness


  • The orthopedic doctor may ask questions about the cause of injury
  • Evaluation of the patient’s medical history and previous injuries, if any
  • Thorough physical examination of the injured hand
  • X-ray imaging may be done to assess bone damage
  • MRI scan may help to detect minute fractures and ligament tears
  • CT scans show damage to nerves, blood vessels and soft tissues


  • The doctor may recommend to support the injured wrist with a splint
  • Applying ice packs for a few days following the injury 
  • Anti-inflammatory medications may be prescribed by the doctor
  • Taking rest and avoiding strenuous activities that may aggravate pain 
  • Fracture reduction- The doctor may manually put the displaced and broken pieces of bones together. The patient is generally given local anesthetic before the treatment
  • The patient may be advised to undergo physical therapy for a couple of months after removing the cast to restore joint function
  • Surgical fixation in case of compound fracture may be done by implanting screws, rods and plates
  • External fixation- The surgeon may immobilize the broken joint by holding it between two metal plates and passing a rod across the bone

We, at OrthoTexas, provide comprehensive treatment for wrist fracture and other injuries. To schedule an appointment with our orthopedic surgeons in Denton, TX, you can call at (940) 382 – 1577.

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Femoral Fracture: Denton Orthopedic

by Administrator 19. March 2016 10:52

The femur or thigh bone is the longest bone in the human body which begins near the hip and extends straight to the knee. A break/crack or displacement along the straight part of the femur (known as femoral shaft) is termed as Femoral Fracture.
The injury can be classified into:

  • Displaced Fracture- It involves change in alignment of a part of the bone
  • Open Fracture- A bone may break and protrude out of the skin. Such fractures may cause damage to the surrounding muscles, ligaments, tendons etc. and can also lead to infections
  • Closed Fracture- It involves breaking of the femur into one or more pieces but the skin is not damaged


  • Direct hit/trauma or fall on the extended leg
  • Automobile accident
  • Bullet wound from a gunshot
  • Loss of bone density with age or due to malnutrition
  • Underlying bone condition such as Osteoporosis may render the femur prone to fractures


  • Severe pain
  • Inability to stand or bear body weight
  • Visible deformity in the inured leg which may lead to apparent change in limb length
  • Redness, bleeding, swelling and tenderness at the point of injury
  • Bone pieces may be seen protruding out of the skin in case of severe injuries


  • Physical examination of the injured leg may be done by the orthopedic doctor to check for bruises, redness, swelling, or loss of motion
  • Analysis of the patient’s medical history and cause of injury
  • X-ray imaging may be required to view the damaged bone and assess the type of fracture that has occurred
  • CT scan helps in obtaining a cross sectional view of the leg and may also be required in case the fracture occurs as a thin line across the femur


  • Most of the femoral fractures need surgical intervention. Only young children may be treated by using a leg cast
  • In case of open fractures, the wound or cut on the skin is cleansed and allowed to heal before surgery
  • Skeletal traction- It is a kind of pulley system with weights that holds the leg straight and keep the broken pieces of bones in place. It also provides relief from pain.
  • External fixation- the bone is attached to pins and screws to keep it stable. However, this is a temporary treatment and is used if the patient is not in a situation to undergo surgery immediately.
  • Surgical induction of a metal rod in the narrow cavity within the femur to keep it stable. It is inserted either by making a small incision through the hip or the knee joint
  • Metal plates and screws are used to position the femur in case the fracture extends to the hip/knee joint and metal rods cannot be inserted
  • Physical therapy is important during the recovery period to restore strength and mobility
  • The doctor may administer antibiotics in case bone infection develops

We, at OrthoTexas, provide effective treatment for femoral fractures and other hip injuries.  To schedule an appointment with our orthopedic surgeons in Denton, TX, call at (940) 382 – 1577.

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Orthopedic Treatment For Torn ACL

by Administrator 20. May 2014 08:50

ACL is a part of a complex group of four ligaments present inside the knee. It is the musculoskeletal part of the knee and is known as the Anterior Cruciate Ligament. The ACL is one of the most sensitive parts of the body and is prone to injury.  It is most commonly observed in athletes who play heavy impact sports such as American football, Pro wrestling, Gymnastics and combat sports. Women and younger athletes are more prone to a torn ACL. Older people are also seen to be effected by a torn ACL due to wear and tear of ligaments. Any heavy impact or a slip can cause the ACL to tear.

Some of the most common causes of a torn ACL are as follows.

  • Tears and ruptures that happen without contact
  • Overstretching of the ligament
  • Extending the knee beyond its maximal position
  • Forcing the lower leg forward in context with the position of the upper leg
  • Twisting of the knee in disharmony with the alignment of the rest of the body

The following symptoms might indicate a torn ACL.

  • If the impact is followed by a popping sound
  • If the knee tends to buckle during movement
  • If he knee locks completely during movement
  • If the injured area swells up after an hour or two of the impact
  • If the subject feels severe pain while bending the knee

Professional orthopedic treatment is the best bet for a torn ACL. Orthopedic surgeons deal with injuries related to the knee and can give professional medical treatment to the patient. They have a series of tests to confirm whether you are suffering from a torn ACL or not. There are movement tests which help the doctor analyze and arrive upon a conclusion. He might also suggest some other tests like an X-ray or an MRI before deciding on any treatment method. If the injury is severe you might have to undergo a surgery to fully treat it.

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