29. April 2017 07:38
Ankle Instability is a condition that occurs when the outer ligaments that support the ankle joint are injured or damaged. The condition can be either mechanical or functional. In case of mechanical instability, the ligaments become loose resulting in laxity. However, in functional instability, the ankle joint is anatomically stable but the patient has a constant feeling of joint weakness. The ligaments that get affected in this condition are the anterior talofibular ligament and the calcaneofibular ligament.
- Ligament tear, stretch or rupture
- Repeated episodes of ankle sprain
- Arthritis of ankle joint
- Damage to nerves that surround the ankle
- Osteochondral lesions that develop in the talus and thus damage the joint cartilage
- Conditions like Flat Foot or Hindfoot Varus Alignment
- Presence of loose ligaments in the ankle
- Sports activities that involves a lot of jumping and high impact movement
- Bone spurs may impinge upon the ligament
- Bone fractures in leg or foot
- Inflammation of synovium lining within the joint
- Inability to bear body weight on the ankle and foot joint
- Constant pain on the outer part of inside the ankle
- A constant feeling of the ankle rolling outwards whenever moved
- Swelling and stiffness
- Change in gait and development of a limp
- Hypermobility of the joint
- Analysis of the symptoms and medical history
- Weight bearing X-ray imaging
- MRI and CT scans may be required
- The exact location of pain may be assessed through palpation
Conservative treatment methods include the following
- Wearing an ankle brace for joint support
- Painkillers and anti inflammatory medicines may be prescribed
- All physical movements that stress the joint need to be avoided for some time
- Physical therapy may help to improve joint function and strength
- Compression of the joint using a soft bandage is necessary
- Use proper foot wear and shoe inserts that help support the joint
- Ankle splinting and taping may be helpful
- Ankle Proprioception- Special therapy that improves brain and ankle coordination
Steroids may be injected directly into the joint
Surgical methods of treatment include the following
- Brostrom Procedure- Surgical tightening or shortening of the injured ligaments.
- Replacement of the damaged tissue using donor tissue which may have been extracted from a body part or artificially synthesized
- Calcaneal Osteotomy helps to realign the hindfoot by cutting the heel bone and fixing it in correct alignment using screws
25. April 2017 07:26
Tendons join the muscles to the bone and are responsible for the various hand movements. The tendons located on top of the fingers are known as extensor tendons and help to straighten the fingers. On the other hand, tendons located on the palm side are known as flexor tendons and assist in bending the fingers. Any injury in the hand can affect the flexor tendons and make thumb or finger movements difficult.
A flexor tendon injury can cause damage to the nerves in the fingers as well. In serious injuries, the blood vessels also get cut leaving the finger with no blood supply.
- Sports injuries while wrestling or playing football
- Rheumatoid Arthritis
- Deep cuts on the hands or arms
- ‘Jersey Finger’, where one player gets hold of other’s jersey and a finger gets pulled
- Inability to bend the finger
- A visible injury on the palm
- Discomfort and pain while bending the finger
- Numbing sensation in the fingertip
- Tenderness along the palm
- A thorough physical examination of the patient’s hand may be done by the orthopedic doctor
- The patient may be asked to make certain finger movements so that the extent of injury can be assessed
- The patient’s hand may also be tested for sensation
- The doctor may conduct examination to rule out injuries of the nerves and blood vessels
- Imaging tests such as X-Rays may provide a clear picture of the injury and damage
Generally, a tendon that has been cut will not heal without surgery. However, a partially torn tendon can be repaired with the use of splint or physical therapy.
- Application of ice packs immediately after a cut on the hand may be beneficial
- Keeping the hand in an elevated position to stop blood flow
- The doctor may give an injection and administer antibiotics to prevent infection
- The injured finger is placed in a splint to protect the hand from further damage before surgery
- Surgery for a flexor tendon injury may be performed within ten days of the injury
- A dressing and splint may be applied after the surgery
- The fingers and wrist may be positioned in a bent arrangement to keep tension off the repair
- Physical therapy may be recommended after surgery to regain normal hand motion
- Long-term stiffness after flexor tendon injuries is common
- In certain patients, another surgery may have to be performed to treat the scar tissue and help the patient use his hand normally
Get in touch with an hand and wrist doctors at OrthoTexas in case you suspect a Flexor Tendon Injury. For an appointment, call at (214) 618 – 5502.
18. April 2017 04:28
Little League Elbow, also called Medial Apophysitis, is a common injury in young children who play active sport. Repeated action of throwing a ball may stress the tendons and ligaments that support the elbow joint may get stressed beyond their limits resulting in this condition. The elbow is a type of a hinge and pivot joint comprising of the humerus, ulna and the radius. Many muscles, connective tissues and nerves cross each other at this joint. The condition can be serious if the ligaments or tendon gets torn and detached from the bone. It may result in permanent deformity or stunted growth in the child.
- Playing a high intensity sport at a young age
- Playing one sport for a prolonged period of time, specifically the ones that involve a lot of throwing action
- Use of faulty technique during and lack of conditioning after a sport
- Overuse of the joint by pitchers, fielders etc.
- Sharp pain in the bony protrusion on the inner side of the elbow
- A feeling of catching or locking of the joint
- Limited range of motion
- Inability to perform basic tasks that involve use of the joint
- Tenderness and inflammation
- A pop may be felt when the joint is moved
- Development of bone spurs
- Arthritis may set in early childhood
- X-ray imaging of the affected joint to analyze bone damage, if any
- Palpation to check for visible symptoms
- Range of motion may be tested
- Resting the affected joint by keeping the arm at chest level
- All sport activities need to be avoided for some time
- The patient should learn to practise throwing in such a way that it does not stress the joint much
- Ice packs may be applied at regular intervals to get relief from pain and inflammation
- Surgery may be recommended when conservative methods do not give satisfactory results. This may be performed if the child is above 12 years of age. During the procedure, the loose pieces of tissue and bone fragments may be removed.
- Surgical grafting of the tendons or ligaments to repair the damage
- The connective tissues may be reattached or tightened surgically to improve the condition
- Regular physical therapy to strengthen the core, arms , shoulder and back that lend support to the joint
- Pain killers and anti-inflammatory medicines may be prescribed by the doctor
The surgeons at OrthoTexas offer complete treatment for Little League Elbow and other orthopedic conditions. For an appointment, call at (972) 985 – 1072.
15. April 2017 03:54
Plantar Fibromatosis is a rare medical disorder that marks the beginning of the growth of benign tumors under the foot. These tumor-like nodules are referred to as plantar fibromas. They develop on the underside of the foot or the plantar surface. The heel is connected to the bottom of the foot by a band of connective tissue, plantar fascia. The tumors grow slowly and are made up of excess collagen. The condition may affect both the feet (Ledderhorse’s diseae) and is not likely to get resolved on its own. It affects males more than females and is relatively widespread among the Caucasian race.
- Damage caused to the plantar fascia
- Age- people in the age group of 50 and above are at a greater risk. Highest incidence is observed in men above 70 years of age
- Prolonged use of anti-seizure medicines
- Congenital- this condition may affect a person at the time of birth
- Genetic disorder
- Diabetes Mellitus
- Alcohol consumption
- Liver dysfunction
- Thyroid dysfunction
- Standing for very long
- Excessive intake of vitamin C
- Pain and discomfort while walking
- As the tumors grow, bending the toes may become difficult
- A prominent and hard lump can be seen near the foot arch
- Multiple Fibromas - There may be more than one lump in the foot
- Discomfort while wearing shoes
- Barefoot movement may be painful
- Analysis of the patient’s medical and family history. The record of all the medications taken by the patient may be taken into consideration
- Detailed examination of the existing condition and the symptoms reported
- X-ray imaging may be required in most cases
- MRI and CT scan may reveal condition of soft tissues and the exact location, size and shape of the tumor
- If the tumor is small and does not interfere with the daily activities of the patient, the focus of treatment is on alleviating pressure on the foot. Orthotic devices like pads, night splints, shoe inserts that support the arch may be used. Reduction in pressure helps to shrink the tumor
- Medicated gel may be used to reduce the size of the fibromas
- Injecting cortisones may help in some cases
- Surgical removal of the fibromas
- Use of crutches for a few weeks post-surgery may be recommended
- Maintaining healthy body weight, use of comfortable shoes, plenty of fluid intake and regular stretching exercise may be recommended to prevent the condition from recurring or aggravating
- Activity modification- Standing for too long or walking on hard surfaces may pressurize the foot. Such activities should be avoided
To know more about treatment options available for Plantar Fibromatosis, call the foot and ankle specialists
at OrthoTexas. We can be contacted at (972) 899 - 4679.
11. April 2017 03:25
TFCC or the triangular fibrocartilage complex is placed in the little finger of the wrist. It not only supports the small sized carpal bones but also allows the flexion, pronation, supination, deviation, and rotation of the wrist joint. The radius and the ulna (two bones of the forearm) are stabilized by this cartilaginous tissue. An injury to the TFCC may lead to dysfunction and chronic wrist pain.
TFCC Tears can be classified into two types:
- Type 1 Tears- these are the traumatic tears caused by direct injury to the joint
- Type 2 Tears- these are the degenerative type of tears that occur over a period of time as the body ages
- Falling on an outstretched hand
- Process of ageing can cause wear and tear of the soft tissues. People above the age of 50 years are at a greater risk
- If the wrist or arm is rotated excessively or beyond comfort level
- Inflammatory diseases such as Rheumatoid Arthritis
- Injuries caused while playing tennis, basketball, squash, etc.
- Fractures in the wrist
- If the length of the ulna is longer, it may cause more stress on the TFCC. This is called the Ulnar Impaction Syndrome
- A clicking sound in the wrist when it is moved
- Pain may felt at the base of the little finger and when the wrist is rotated
- Inability to grip objects
- Weakness in the hand and wrist
- The wrist may be manipulated manually by an orthopedic doctor to check for the exact location of the pain
- The patient’s medical history and lifestyle activities may be analyzed
- X-ray imaging may be required to check for bone damage and fractures
- MRI testing may show the condition of the tissue and cartilage
- Wrist arthroscopy
- An injectible dye may be used to highlight lesions if any in the joint
The following methods of treatment may be applied to treat the condition:
- Use of a splint or a cast to stabilize the wrist for about 6 weeks
- Straps that support the wrist may be used if the condition has not deteriorated much
- Prescription of anti inflammatory medicines and pain killers
- Injecting corticosteroids directly into the joint for immediate relief
- Surgery may be suggested only when the condition does not improve through conservative therapy. Arthroscopic surgery may be preformed to remove the damaged tissue and cartilage structures
- The torn tissues may be fixed using sutures
- Surgical shortening of the ulnar bone
- Ultrasound therapy may be helpful in some cases
- Physical therapy and activity modification may be required post-surgery to restore complete joint function
For treatment of TFCC Tear and other wrist conditions, visit the doctors at OrthoTexas. To request an appointment, call at (214) 618 - 5502,
6. April 2017 15:30
Irritable Hip Syndrome, also known as the Toxic or Transient Synovitis, is a condition that affects the hip joint in children. It may affect any child between the age of 4-10 years and boys are more prone than girls. The condition is attributed to the inflammation of the synovial membrane that lines and protects the joint. It generally does not cause any further complication.
- Viral infection that may occur in chest or digestive system
- Injury to the hip joint
- Bone fractures in the joint
- Infection in the upper respiratory tract
- Stiffness in the joint
- Severe pain in hip, knee, groin or leg
- The child may not want to put weight on the affected leg
- Limping and change in gait of the child
- Very young children may keep crying when the pain sets in
- Movement may be restricted
- Slight rise in body temperature
- The child may tend to hold the hip outwards, slightly bent away from the body
- The condition may develop slowly with only one side of the joint being affected at first
- Muscle spasm
- Redness in the affected part of the leg
- Analysis of the patient’s medical history and lifestyle besides the symptoms reported
- X-ray imaging
- Bone tests to check for bone growth and infections
- Blood tests
- MRI or CT scan
- Ultrasound test may help reveal fluid accumulation in the joint
- Aspiration in case fluid is present in the joint to check for infections
- Palpation to check for joint tenderness and locate the exact location of pain
- Log roll test- the whole joint is rotated outwards to see if there is any involuntary resistance by the supporting muscles (muscle guarding)
- Neurological tests may be conducted to rule out other causes such as developmental dysplasia of the hip joint
- The patient is advised to rest and abstain from any strenuous activity for a couple of weeks
- Medication may be prescribed to relieve pain and swelling
- Application of heat pads relieves muscular stress
- Certain physical therapy exercises may improve blood flow and provide relief
- Traction (manual) may be applied to the affected leg to release stress from the joint. This is done by attaching weight bearing pulley to the leg and then stretching it.
To know more about the treatment options for Irritable Hip Syndrome, contact OrthoTexas at (972) 492 - 1334.
28. March 2017 13:20
Participating in sports activities is a good way to stay active and physically strong. However, the time spent in the field also increases the risk of getting injured. Sportspersons are prone to injure the knees, shoulders, ligaments, muscles, suffer from concussions, fatigue or other soft tissue damages.
Listed below are some methods and tips to prevent such injuries:
- It is important for the athlete to report any sense of discomfort, pain or persistent problem to a medical practitioner or the coach. Pushing through the pain and discomfort can lead to permanent damage to the body.
- Athletes should develop a habit of warming up or stretching before every game. This prevents fatigue and injuries besides improving the performance of the player.
- A proper cool down session (at least 10 minutes) after a game or physical activity is important in conditioning the body. It helps to soothe the stressed muscles and remove the toxins that accumulate due to intense use.
- Athletes should play different types of games so that they do not stress one particular joint or part of the body.
- It should be mandatory for the player to undergo a thorough physical examination before he or she is inducted in a sport. Any health related issues need to be addressed at the earliest to avoid further complications.
- Athletes should take breaks in between the sport activity and sleep well to destress the body. This helps to prevent overuse injuries.
- Drink lots of fluids and water to keep the body hydrated. This prevents muscle fatigue, nausea, fainting or heat strokes. A balanced diet with lots of nutrition is equally important in building muscles and stamina.
- They should maintain ideal body weight as it does not allow the joints to be pressurized
- Proper technique for any sport played should be mastered and followed to prevent injuries. All the technical guidelines need to be followed by the players and taught by the trainers.
- Use of proper shoes, protective gear (helmets, knee and shoulder ads, face guard) is important.
- Regular stretching should be incorporated in daily routine to prevent muscle tightness and keep the joints flexible.
- Food and beverages rich in sugar, caffeine and carbonated drinks need to be avoided. Smoking and alcohol also affect the performance and physical capability.
- The duration and intensity of the play or physical exercise should be increased slowly keeping in mind the body’s capacity.
- Maintain a good posture at all times.
The sports medicine specialists at OrthoTexas provide treatment for various injuries and conditions. For an appointment, call at (972) 985 - 1072.