Comprehensive Orthopedic Care: Fracture of the Calcaneal

Comprehensive Orthopedic Care: Fracture of the Calcaneal

A broken foot is serious, but perhaps the most serious is a fracture of the calcaneal: the large bone that forms the foundation of the rear part of the foot, more commonly known as the heel bone. This bone has a thin, hard, outer shell covering softer spongy bone on the inside.  A break here causes the bone to collapse and become fragmented, lending to the seriousness of this kind of injury.

How do they occur?

A calcaneal fracture is usually the result of a traumatic event such as:

  • Falls: Common in falls with sudden impact, like from a ladder or a slip on some black ice.
  • Auto-accidents: Typically in a head on collision, especially if the person braces their foot on the floorboard before impact.
  • Sports injury: Heel fractures are more common in long-distance runners and can become worse with the stress of the foot hitting the ground over time.
  • Osteoporosis: Individuals with osteoporosis are more easily prone to breaks as their bones are fragile.

Calcaneal fractures can also occur in conjunction with other types of injuries, such as an ankle sprain.

How are they Diagnosed?

Signs and symptoms of heel fracture include:

  • Severe pain
  • Bruising
  • Unable to bear weight
  • Swelling
  • Heel deformity

Diagnosis of a calcaneus fracture involves a thorough examination which usually requires an X-ray to confirm the diagnosis and determine the severity of the fracture. In some cases, an MRI or CT scan may be required.

Receiving proper treatment requires a correct diagnosis on the type of fracture. There are several different types of calcaneal fractures that may occur, including:

  • Intra-articular fractures involve damage to the cartilage between the joints. These are considered the most serious type of heel fracture.
  • Avulsion fractures are when a sliver of bone is split off from the calcaneus due to pulling from the Achilles tendon or another ligament.
  • Multiple fracture fragments, also known as a crushed heel injury.
  • Stress fractures, resulting from overuse.

How are they Treated?

Some fractures can be treated without surgery by simply utilizing the following:

  • RICE: Rest, ice, compression and elevation.
  • Immobilization: placing the foot in a cast to keep the bone from moving.

Traumatic fractures often involve surgery which may include:

  • Percutaneous screw fixation: This surgery involves reducing, realigning, and attaching fractured pieces of bone with metal plates and screws.
  • Open reduction and internal fixation: Metal screws are used to attach larger fractured bones.

Recovery time can be lengthy, involving physical therapy to help regain strength and restore function.

If you have recently suffered a foot or heel injury or calcaneal fracture, contact us today. We will diagnose and properly treat your injury to get you onto the road to recovery.

Common Sports Injuries for Teen Athletes

Common Sports Injuries for Teen Athletes

High school sports have become a popular extracurricular for many teens. They are a great way to stay in shape and help teach teamwork, leadership, and even time management when balanced with other responsibilities. Unfortunately, for many young athletes, injuries are common, ranging from acute to catastrophic. Each type of injury requires specific treatment that may cause them to miss a game, or even the entire season, but healing time is essential for a proper return to the field or court.

If you watch professional sports, you have undoubtedly witnessed any number of injuries throughout the season. Teens are injured at about the same rate as professionals, but the injuries can be much worse if not treated correctly as these young athletes are still growing. According to the American Academy of Orthopaedic Surgeons, “Growth is generally uneven: Bones grow first, which pulls at tight muscles and tendons.” This tension is a major contributing factor of injuries to muscles, tendons and growth plates that are common among young athletes.

There are a few different levels of injury that can occur in athletes. Understanding each can help the healing process and provide a realistic expectation for healing.

  • Acute Injuries: These are classified as bruises, sprains, strains and fractures. Typically, they are caused by a sudden trauma, such as a collision between players or with an obstacle. Another common acute injury is a twisted ankle, resulting in fracture or sprain.
  • Overuse Injuries: As the skill level of a sport increases, so do the practices, training and games. This can result in gradual damage over time as there is not enough recovery time in between to heal. Common overuse injuries have been seen in elbows of baseball pitchers, shoulders of swimmers, and wrist and elbow injuries in cheerleaders and gymnasts. Stress fractures also become very common, as old bone breaks down quickly with overuse and new bone does not have enough time to grow in, causing weakness.
  • Catastrophic Injuries: These types of injuries are more common with contact sports, such as hockey and football, but have been reported in many others. Catastrophic injuries include damage to the brain, spinal cord, or growth plates. Concussions, or mild traumatic brain injuries, have become a hot topic of conversation with their rise in professional football. If a concussion is suspected, the American Academy of Pediatrics and American Academy of Neurology recommend the athlete be evaluated and cleared by a doctor before they can return to normal play to avoid any permanent damage. Growth plate injuries occur to the developing cartilage at the end of long bones. These are the final portion of the bone to harden, which is why they are more susceptible to fracture. An injury to the growth plate can cause the bone growth to stop or cause a deformity of the bone.

Any injury that occurs due to sports, particularly if any symptoms or discomfort persist, should be seen by a doctor. Athletes who are pushed to work through pain, or are downplaying the severity in order to continue competing may be causing further damage that could become permanent or even result in a disability. This is where the importance of observation by both coaches and parents comes into play as pain or discomfort can be seen if their technique seems off or they have a decreased interest in practice.

Treatment will all depend on the type of injury and its severity. It could range from simple rest to therapy and even surgery. The injury should be healed completely before the athlete can return to physical activities. While it may not be easy to have to take the time off to heal, it will result in a much better outcome than what could happen if left untreated. Athletes can work to prevent these types of injuries by making sure they are properly conditioned, trained, and using proper equipment. Limiting the number of teams the athlete participates on during a given season can help prevent overuse injuries, and making sure to take breaks between seasons, as well as playing other sports throughout the year, can not only help to prevent injury, but help develop an array of athletic skills.

If you have a teen athlete who has a sports-related injury, contact us today. We will help them with the necessary treatment plan to recover and safely get back on the field.

Total Joint Replacement

Having Total Joint Replacement

Total joint replacement is not a step that is ever taken lightly, but should you need this advanced surgical option, Missouri Orthopedics and Advanced Sports Medicine is committed to making this a winning experience from evaluation to recovery: Missouri Sports Medicine. Before deciding your joint’s condition warrants replacement, several less drastic forms of care may be tried. These can include physical therapy, injections, and arthroscopic surgery. If these ameliorative treatments don’t restore the joint’s normal function, an x-ray, and possibly an MRI, may be ordered to determine any joint and tissue damage.

The Decision for Surgery

Assuming that you are healthy enough for surgery, joint instability, pain that won’t allow you to sleep at night, the inability to perform the normal daily functions of life, and being prevented from doing the things you enjoy are all factors that may lead you to decide that total joint replacement is the best option. After you and your doctor decide that you will go ahead with the surgery, you will be thoroughly briefed on what to expect, and you will also be informed about the preparation that should take place in the home, so your recovery phase will run smoothly. In most cases you will be administered general anesthesia before the procedure begins. Using knee-joint replacement as an example, damaged parts of the joint will be removed in preparation for your new knee, and after the surfaces of the joint have been prepared, the new components of the knee will be anchored in place.

Post-Total Joint Surgery

After coming out of surgery, a great number of post-surgical tasks will be taking place. You will, of course, be having pain medication administered, but steps will also be undertaken to monitor the surgery site for infection. You may also receive blood thinners to prevent blood clots from forming, and as soon as possible, steps will be taken to maximize the joint’s flexibility. Your hospital stay may last from 3-5 days, and, in addition to post-operative care, light physical therapy will begin.

Recovery From Total Joint Surgery

By far, the greatest part of your recovery will take place during the 4 to 6 weeks following surgery. The physical therapy and follow-up doctor visits you keep will have you well on the way to a much-improved quality of life. If you need a consultation about possibly needing this procedure, please contact us.

Hip Arthroscopy: A Minimally Invasive Option


The hip-joint is one of the most amazing and important joints of the body. A ball and socket joint, it is one of the most flexible, providing a level of mobility that allows the femur to rotate freely through a 360-degree circle and is capable of supporting half of the body’s weight along with any other forces acting upon the body.

Estimable as it may be, like any other part of the body, the hip-joint is capable of suffering several painful conditions due to falls or repetitive use that is common in athletes. The normal wear and tear that comes with age plays its part as well and can lead to arthritis or tears of tendons and ligaments.

Non-surgical treatments that include rest, physical therapy and injections to reduce inflammation can help but some injuries and even diseases demand a more aggressive approach. Bone spurs around the socket; dysplasia and snapping hip syndrome are a few of the conditions that may fall into this category.

In cases like these, your doctor may recommend hip arthroscopy, a procedure where your surgeon inserts a small camera, called an arthroscope, into your hip-joint. The camera then displays pictures on a screen, allowing the doctor to use these images to guide miniature surgical instruments to the affected area.

Hip arthroscopy is generally performed under general anesthesia and on an outpatient basis.

Recovery will likely include crutches for a specified amount of time, as well as physical therapy to help restore strength and mobility.

For more information on how we can help, contact us

Most Common Youth Sport Injuries

Youth injuries are frightening to everyone for a variety of reasons. From a parent’s perspective, knowing that your child hurt is reason enough to pull them out of any sport for the rest of their lives. Your kids – and possibly their coach – worry that they may never be able to play again.

Thankfully, our body has strong muscles and bones that make us able to re-cooperate with a little rest; or with more extreme cases, some physical therapy. While allowing your child to play a sport has its potential risks, here are some very common injuries that can arise from intramural and team sports.


Sprains & Strains

Many people can get the two of these injuries confused, but they are actually quite different. Sprains are ligament injuries that prevent excessive movement of the joints. Ankle sprains are quite common in sports like soccer, while wrist sprains can occur in football, basketball, and tennis

Strains can injure muscles or tendons. Due to the fact that we are dealing with bundles of cells that produce movement – muscles – and tissue that cushions the bones – tendons – most parts of the body are susceptible to injury.

Growth Plate Injury

The growth plate is an area in children and adolescents that holds developing tissue. When growth is complete, the tissue replaces solid bone. Long bones can include the hands and fingers, the forearms the legs, and the feet. These bone injuries are serious and should be consulted with an orthopedic surgeon.

Repetitive Motion Injuries

Hairline fractures and tendinitis are painful injuries related to stress. It’s important to know that these injuries may not always show up on hospital scans while they are still discomforting. Thankfully, a pack of ice and compression will relieve this pain quicker. In the most extreme cases, athletes need crutches, immobilization, and physical therapy.

Keeping kids active is extremely important to us. One thing to remember is that injuries should be reported as soon as they happen. Let us help you get back on the field as soon as possible. Contact us for more information on sports injuries and treatments today.