25. March 2017 13:23
The knee joint is one of the largest in the body, comprising of three bones - femur, tibia and the kneecap (patella). The kneecap fits into a groove like cavity in front of the femur called the trochlea. All these bones have a protective tissue lining around their surface to reduce friction between them. The quadriceps tendon that lies near the patella connects the quadriceps muscle to the tibia. In normal joints, the patella is placed in the center of the trochlea but in some people it is pulled to one side of the groove and does not slide within the cavity as the leg moves. This is known as Patellar Subluxation or Kneecap Instability. The condition is caused due to the following reasons:
- The trochlea groove is inherently narrow or shallow and the kneecap bone is unable to fit into it
- The pelvis is broader than normal
- Abnormal gait stresses the knee joint and the patella tends to shift from its normal position
- A fall on the knee may damage the knee cap alignment
- A direct hit to the joint
- Vehicular accidents
- Discomfort while moving the joint
- Patellofemoral Pain Syndrome- pain on the sides of the knee during movement
- Inability to bear body weight
- The knee buckles when the patient tries to move or stand
- A feeling of locking or catching
- A popping or cracking sound is heard or felt when the knee moves
- Inflammation around the joint
- Thorough clinical examination of the affected joint to assess the severity of the condition
- X-ray imaging to check if the patella has been dislocated
- Analysis of the patient’s symptoms, medical history, gait etc.
- MRI or CT scan to check for tendon or cartilage damage
- The orthopedic doctor may suggest certain exercises to strengthen the quadriceps, hip abductors and hamstring muscles
- Bracing may be used to keep the joint stable and provide relief from the symptoms
- Taping may provide support to the joint while moving
- The patient may be recommended to wear special footwear that supports the legs and improve the gait
- Manual reduction of the patella may be done
- Recurrent incidences of dislocations need to be treated with arthroscopic surgery
- Physical therapy may be recommended to improve functionality and enable the person to return back to his/her normal activities
- Surgery may help to release the pressure from the tight tendons or ligaments that may be pulling the kneecap out of its place
For comprehensive treatment of Kneecap Instability, consult the doctors at OrthoTexas. The Frisco, TX based knee specialists specialize in treating a wide range of orthopedic conditions. To request an appointment, feel free to call at (214) 436 - 8997.
25. January 2017 04:04
Flexible Flatfoot, or Pes Planus, is a condition that causes the arch of the foot to temporarily collapse. The arch is not visible when the child stands and re-appears while sitting or when the foot is left hanging freely. The condition may be congenital and affects both the feet. In most cases, it gets resolved as the child attains the age of 5 years. It is considered serious if the child feels pain or does not develop an arch even after this age.
Flexible Flatfoot usually does not hinder the foot’s movement or ability of the child to participate in physical activities. With the growth of the bones and soft tissue structures, the child tends to develop a normal arch.
- Flexible Flatfoot may be an inherited problem
- A tight Achilles tendon may cause the arch to collapse
- Pain may be felt at the base of the foot or near the arch
- Visibly flattened foot while weight bearing
- Altered gait
- The child may complain of stiffness or tiredness after a physical activity. He may also feel pain in the legs and knees
- Shoes may be worn out on the inner side due to the inward tilt of the foot (overpronation)
- Detailed examination of the feet to check if the collapse of arch is rigid or flexible
- Details of the family history may be taken into consideration
- The doctor may ask the child to stand on toes, sit, walk or stand to check for the deformity
- X-ray examination may be required to check the bone structure and condition of the Achilles tendon besides other soft tissue structures
Treatment for Flexible Flatfoot generally includes conservative methods. Some of them are:
- Use of orthotic devices or shoe inserts can help in maintaining the arch and relieving the pain
- Specific stretching exercises may be practised for eliminating the symptoms and improving the functionality of the joint
- Physical therapy sessions may help to reduce the tightness in the Achilles’ tendon and improve the foot biomechanics
- Surgery may be recommended if the condition worsens or persists beyond adolescence. It may be done to relieve the tight Achilles tendon
- Surgical lengthening of the heel bone using a bone graft may be required in some cases
OrthoTexas provides comprehensive diagnosis and treatment for Flexible Flatfoot in children. To schedule an appointment with the foot doctors in Frisco, TX, you can call at (214) 618-5502.
27. December 2016 10:30
Quadriceps tendon refers to the band of tissues that allow the four quadriceps femoris muscles (vastus medialis, vastus lateralis, rectus femoris and vastus intermedius) to converge above the patella. This tendon, in association with the quadriceps muscles, enables the extension of the knee joint. Excessive stretching and tearing of this tendon is referred to as the Quadriceps Tendon Rupture. The condition most commonly affects people above the age of 40 years. The rupture is generally preceded by the degeneration of the structure due to other factors. This injury may result in physical disabilities and in some cases a part of the patella also breaks along with the tendon attached to it.
- The predisposing factors that may cause Quadriceps Tendon Rupture are as follows
- Medical conditions like Obesity, Diabetes, Gout, Renal failure, Hyperparathyroidism etc.
- Prolonged immobilization of the lower extremities
- Falling on a flexed knee
- Direct trauma to the kneecap during sports or vehicular accident
- Overuse injuries due to excessive jumping or running
- Inflammation of the quadriceps tendon
- Severe Pain
- Swelling and tenderness
- The joint becomes unstable and the patient may fall or stumble while walking
- A popping sensation at the time of injury
- The pain increases with physical activity
- Change in color of the skin around the knee
- the orthopedic doctor may peform thorough clinical evaluation of the injured leg
- The patient’s medical history, mode of injury and lifestyle details may be taken into consideration
- X-ray imaging may help to reveal the bone structure and fractures if any
- MRI and CT scan may help to evaluate the extent of damage to the soft tissue structures
- The range of motion may be analyzed
Partial tears can be treated through conservative methods while the complete tears require surgical treatment. These may include the following procedures.
- The knee may be immobilized for a period of 3-5 weeks
- Physical therapy may be recommended to improve range of motion
- Exercises focused on strengthening the hamstring muscles must be performed
- Lifestyle modifications may be recommended
- Rest the injured leg by keeping it elevated at chest level
- Compression may be done using soft bandage
- Use of ice packs during the first 24-72 hours of injury may be helpful
- Plasma injections that have a rich platelet count may promote healing of the tendon
- Wires, screws and pins may be used to secure the tendon in place
To know more about the treatment options available for Quadriceps Tendon Rupture, consult the surgeons at OrthoTexas. For an appointment, visit 5757 Warren Pkwy, Suite 180, Frisco, TX 75034 or call at (214) 618-5502.
9. December 2016 13:46
Dupuytren’s Contracture can be defined as a deformity that results in thickening of the fascia, a thin elastic tissue under the skin of the palm. The fibrous cords in this tissue develop knots, causing the fingers to bend downwards. In most cases, it is the little and ring finger that gets bent towards the palm. Dupuytren’s Contracture is a progressive disorder that may affect one or both the hands and the symptoms tend to aggravate over the time.
- Dupuytren’s Contracture is categorized as an idiopathic disorder as the exact cause has not been not clearly identified. However, the following factors may increase an individual’s susceptibility to the condition:
- It could be a genetic trait that
- affects members of the same family
- Men above the age of 50 years are more likely to develop the condition
- Alcohol consumption and smoking are believed to cause changes in the blood vessels that may lead to skin contractures
- Diabetic people are at a greater risk
- Routine activities such as wearing gloves, shaking hands may become difficult
- Visibly deformed fingers as they tend to bend towards the palm
- The lumps of tissues may be visible in the hand and are sensitive when touched
- Pain may or may not be experienced
- Reduced flexibility of the hands and fingers
- The deformity begins with the thickening of the skin of the palm and as it progresses, the palm may appear puckered due to thick knots
- Inability to straighten the hand or grasp objects
- Some patients may develop knots on their knuckles as well as soles of the feet
- Details of the patient’s family history, medical history and lifestyle may be noted
- The orthopedic doctor may perform a physical evaluation of the hand which includes comparison of both the hands to identify the symptoms and palpation to detect knots or lumps under the skin
- Table top test- The patient may be asked to place his hand flat on the table. Inability to do so confirms the presence of Dupuytren’s Contracture
Treatment is aimed at ceasing the progression of the condition and enabling the patient to cope up with the symptoms. These may include:
- Needling technique may be used to puncture the thick tissue cords in the palm. It can be used to pierce more than one finger at the same time as no incision is made
- Splinting may be helpful in straightening the fingers in case of mild contractures
- Surgical release or cutting of the affected tissue that causes bending of the fingers
- Enzymes may be injected into the affected part of the palm to weaken the hard lumps and cords. The fingers are then manipulated to bring them back into their normal position and improve flexibility
- In severe cases, all the tissues from the hand may be surgically removed followed by a skin graft to allow reconstruction of the palm.
- Physical therapy may be recommended post-surgery
- Wearing padded gloves while lifting weights or grasping objects may be helpful
The hand and wrist specialists at OrthoTexas provide comprehensive treatment for Dupuytren’s Contracture. Patients in Frisco, TX can call at (214) 618 - 5502 to schedule an appointment.
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.
17. September 2016 06:33
Kienböcks Disease, also known as Avascular Necrosis Of The Lunate, is a medical condition in which the blood supply to the lunate bone in the wrist joint is disrupted. The condition may also lead to the death of the bone. Lunate is an important bone that provides support and assists in the movement of the joint. Damage to this bone can cause pain, stiffness and if left untreated, may lead to the development of Arthritis.
- A fall on the wrist/outstretched hand can cause trauma to the joint and cease the blood flow
- The lunate is supplied blood by two arteries but in some people one of them may be missing. This may reduce the amount of blood that reaches the bone and thus damages it
- Disparity in length of the forearm bones- ulna and radius- may exert excessive pressure on the lunate bone
- Pain in the wrist
- Stiffness in the joint
- Inability to form a firm grip with the hand
- Loss of range of motion
- The middle portion of the wrist is tender when touched
- The hand cannot be moved upwards
- Analysis of the patient’s medical history, symptoms and injuries to the wrist
- The orthopedic doctor may examine the wrist and the movements that cause discomfort
- X-ray imaging may be done
- MRI scan may help to diagnose the severity of damage to the bone
- The disease may be managed through conservative methods of treatment in its initial stages.
- Anti-inflammatory medicines may be prescribed to relieve pain
- Immobilization of the joint using a cast or a splint for 2-3 weeks may relieve pressure from the wrist
- Surgical Revascularization- A piece of bone along with an attached blood vessel is removed from the other hand and attached to the damaged lunate bone. External fixator devices may be used to facilitate fusion and re-growth of the lunate
- Joint Leveling - If the wrist bones have difference in length, the doctor may use a bone graft to lengthen one of them or shorten the other by removing a part of it. Leveling may help to reduce pressure on the lunate bone and stop the progression of the disease
- Proximal Row Carpectomy - A surgical procedure in which the lunate is removed along with two adjoining bones. This may be recommended in case the lunate has broken or is severely damaged
- Bone Fusion - The lunate may be fused with one or more bones in the wrist joint for better support
For treatment of Kienböcks Disease, visit OrthoTexas. To schedule an appointment with the hand and wrist surgeons in Frisco, TX, you can call at (214) 618 – 5502.
20. July 2016 09:14
Congenital Scoliosis can be defined as a sideways curvature of the spine due to a deformity present at birth. This means that the child’s spinal cord did not develop properly doing the initial four to five months of fetal growth. The condition is characterized by a twisted or rotated spine, which usually resembles the letter ‘C’ or ‘S’. Though the deformity is innate, the symptoms may not become apparent until the child attains adolescence.
- One or more of the spinal vertebrae may form partially or completely fail to develop
- Bones may not get separated as they should be
- Absence of one or more bones in the spine
- Formation of compensatory curves in the spine to balance the Scoliotic curves
- Tilted or uneven shoulders
- One shoulder blade may protrude more than the other
- The head or upper body may tilt to either side
- One hip may be higher than another
- Uneven waistline
- Tilted pelvis
- Prominence of ribs on one side
To diagnose Congenital Scoliosis, the spine surgeon may evaluate the child’s medical and family history. He may conduct a physical examination to look for the apparent symptoms. He may also check the reflexes in the abdomen and legs to rule out any nerve problem. Imaging tests such as X-ray, CT scan, MRI and ultrasound may be performed to detect the exact abnormality that has led to the development of Scoliosis.
If the scoliotic curve is much not significant, the spine specialist may monitor its progression by conducting X-rays after every few months during the growing years. Braces or cast may be used to treat a curve between 25 and 40 degrees. It may help to reduce the pressure on the spine and keep it in a more aligned position.
Surgical intervention may be required for children who:
- Have significantly abnormal curves
- Have curves that are worsening with growth
- Have developed an abnormality of the spine
- Are experiencing neurological problems, weakness, numbness or a loss of coordination due to the deformity
The spine surgeon may recommend spinal fusion to join the underdeveloped vertebrae so that they heal into a single bone. If the child is young, a ‘growing’ rod may be attached to the spine above and below the curve. After every few months, the surgeon may lengthen the rod to allow continued growth of the spine. Once the child has completely grown, a spinal fusion may be performed.
The spine surgeons at OrthoTexas specialize in the treatment of Congenital Scoliosis and other orthopedic conditions. Patients in Frisco, TX can call at (214) 618 – 5502 to schedule an appointment or visit 5757 Warren Pkwy, Frisco, TX 75034.
10. May 2016 12:43
Scaphoid or Navicular fracture is a medical condition that occurs with the breakage of one or more of the small bones present in the wrist and the base of the thumb. The wrist joint is formed where the two bones of the forearm namely ulna and radius meet the eight small sized carpal bones. The carpals are placed in two rows at the base of the hand. The scaphoid is one of these carpal bones which is located at the base of the thumb. Most scaphoid fractures occur in the middle portion of the bone.
The Scaphoid Fracture can be classified into:
- Displaced- When the bone pieces dislocate from their normal position
- Non-Displaced- The bone pieces are properly aligned in spite of breakage
- Fall on an outstretched hand
- Vehicular accidents
- Sports injuries
- Twisting and turning of the wrist
- Direct blow to the wrist
- Pain in the thumb
- Bruising, discoloration and redness
- Pain may aggravate while trying to grasp an object
- Deformation of the wrist joint
- Loss of sensation
- Restricted range of motion
- A feeling of warmth in the hand and forearm
- Physical examination of the injured wrist
- Evaluation of the cause of the injury and symptoms experienced by the patient
- Analysis of the patient’s medical history
- X-ray imaging may be required to assess the extent of damage to the joint and displacement of bone fragments
- CT scan or MRI may be conducted to diagnose soft tissue injuries
- The wrist doctor may use a splint or cast to restrict the movement of the forearm and hand
- Prescription of pain killers and anti-inflammatory medicines to provide relief from the symptoms
- Resting the injured wrist, application of ice packs, compression with a bandage and elevation of the arm may also help to ease pain
- Lifting weights, participating in sports and doing activities that may stress the joint should be avoided
- Bone stimulator may be used to deliver electromagnetic waves to aid healing
- Surgery may be recommended in case of a displaced fracture. Arthroscopic surgery may be performed to put the bone fragments back in place. Artificial implants such as screws, wires and pins may be used to hold the bone.
- A specific set of exercises suggested by a physical therapist may help restore motion and prevent stiffness in the wrist.
The hand and wrist surgeons at OrthoTexas provide comprehensive treatment for Scaphoid Wrist Fracture. To schedule an appointment with the orthopedic specialists in Frisco, TX, call at (214) 618 – 5502.
9. April 2016 06:13
The nerve roots that branch out towards the base of the spine together form the sciatic nerve which begins near the lower back and extends into the legs, feet and toes. Sciatica is a medical condition which causes pain, numbness and tingling sensation radiating from one side of the buttock downwards into the legs and feet. It generally affects only one side of the body
- Spinal Stenosis- narrowing of the spinal canal
- Development of bone spurs in the spine
- Herniated Disc
- Compression of the nerve root
- Injuries to the spine
- Degenerative disc disease
- Spinal cancer
- Tingling sensation
- Pain after sitting or standing for long duration
Sciatica symptoms and pain generally improve over a period of time. Some of the treatment options are mentioned below:
- Heat therapy/Cryotherapy- In the initial stages of Sciatica, application of heat or ice packs may be recommended to alleviate pain. The patient can wrap ice cubes in a clean towel for application to prevent ice burns. The patient may be advised to apply the pack every 2-3 hours for not more than 10 minutes each. Some patients may find relief by alternating between hot and cold therapy.
- Rest- The patient may be recommended to take rest to allow the body to heal. Avoiding bending or lifting heavy objects may also ease pain.
- Injections- For patients with severe pain, the orthopedic doctor may recommend Injecting epidural medications to relieve the discomfort.
- Medication- Prescription of anti-inflammatory medications may help to relieve pain, inflammation and muscle spasms.
- Exercising- Long walks, stretching the piriformis muscle (runs parallel to the sciatic nerve in the leg), water aerobics, lower abdominal crunches and strengthening muscles of the abdomen and back help may provide additional support to the sciatic nerve
- Orthotics: Use of external support devices such as back brace, crutches and a walking cane can help relieve pressure on the nerve
- Physical Therapy: Consulting a physical therapist may enables the patient to deal with his/her daily activities and shorten recovery period.
- Surgery- It may be recommended only when the conservative methods of treatment fail to provide relief. Depending upon the cause of the condition, surgical treatment may involve removal of bone spurs, reduction of pressure on the nerve, repairing a damaged disc as well as enlarging the space within the spinal cavity
We, at OrthoTexas, provide complete treatment for Sciatica and other spine conditions. To schedule an appointment with our orthopedic surgeons in Frisco, TX, call at (214) 618-5502.
7. March 2016 07:56
The spinal cord is an assembly of small bones (vertebrae), nerves and soft tissues which together work to transmit messages to the brain and vice versa. It runs from the base of the head down to the lower back. The nerves project out of the intervertebral spaces and connect with the muscles to send signals to the whole body. Pressure in any part of the spine is referred to as Spinal Cord Compression.
- Osteoarthritis- wear and tear of the spinal vertebrae due to the process of ageing
- Tumor in the spine
- Rheumatoid Arthritis
- Inherent defect in the alignment of the spinal cord
- Direct trauma to the spine
- Bone disease or infection in the spinal cavity
- Bone spurs may exert undue pressure on the spine
- Fractures in the spinal cord
- Damage or dislocation of the intervertebral discs
- Accumulation of abscess (pus) around the spinal cord
- Hardening of the connective tissues
- Hematoma- accumulation of blood near or within the spine
- Pain which can be severe and incapacitating
- Weakness or numbness
- Loss of sensation in the limbs
- Stiffness in the arms, legs, back or neck
- Sexual disorders
- Inability to maintain body balance or movement
- Sciatica- burning pain radiating into the arms, legs and hips
- Disruption of bowel movements or urinary incontinence
- Muscle cramps
- Feeling of pricks and needles in the body
- The spine specialist may analyze the apparent symptoms, reflexes and weakness of limbs may be conducted
- X-ray imaging may be required to assess the change in spine alignment or growth of bone spurs
- MRI scans and CT scans may help to review the damage to soft tissues as well as other structures within the spinal cavity
- Bone scans may also be performed
- Electromyography- testing the muscle activities using electric currents
- Myelogram- injecting a dye into the spine before conducting a scan
- Prescription of anti-inflammatory drugs and pain killers
- Administering steroid injections into the spinal cavity
- Use of a cervical collar or removable brace to support the spine
- Physical therapy to strengthen the muscles and restore mobility
- Surgical removal of bone spurs or tumors
- Surgical fusion of vertebrae to enhance the stability of the spinal cord
- Cold or heat therapy may help to reduce pain and swelling
- Radiation or chemotherapy may be required to destroy the tumor if it compresses the spine
- Drainage of accumulated pus or blood
- Antibiotics may be prescribed in case of an infection
- Surgical insertion of metal screws, wires and rods to stabilize as well as rectify the spinal alignment
For diagnosis and treatment of Spinal Cord Compression, visit OrthoTexas. To schedule an appointment with the spine specialists in Frisco, TX, call at (214) 618 – 5502 or visit 5757 Warren Pkwy, Suite 180, Frisco, TX 75034.