Three Key Factors of Top-Notch Comprehensive Orthopedic Care

Three Key Factors of Top-Notch Comprehensive Orthopedic Care

Joints: We all have them, and as long as they are doing their job of keeping us mobile, most people don’t think too much about them. What happens, though, when you suffer an injury, or when a joint develops problems over time, limiting your mobility? Obtaining an evaluation and treatment from a qualified specialist is imperative to getting your body moving again so you can continue doing the activities you love. Searching for an orthopedic care provider can feel overwhelming, however, and when you are experiencing joint pain, the process can seem even more frustrating.

How do you know what to look for in a provider? What type of services are offered and how long will you need to be followed by the specialist? There are numerous factors to consider when choosing an orthopedic clinic, including what qualifications the provider has, what services are available, and which local hospital the doctor collaborates with should an emergency arise.

Here are three key factors to consider when choosing top-notch comprehensive orthopedic care for yourself or your loved one:

  • Board certified surgeon:Your health is your most valuable asset so you want to know that the provider you are entrusting to help your body heal is one of the best. When researching the orthopedic doctors in your area, inquire if they are board certified, indicating they have had extensive training in their specialty area of medicine and have passed a standardized national exam. Dr. Irvine is board certified in both Orthopedic Surgery and Sports Medicine.
  • Targeted services and procedures offered: Whether it’s bursitis preventing you from taking your daily walks, carpal tunnel syndrome impeding your efficiency at work, or a knee injury from last week’s football game, you want to receive comprehensive orthopedic care. Missouri Orthopedics provides care for both acute and chronic conditions, including those that originate in the shoulders, elbows, wrists, hands, hips, knees, feet, and ankles.
  • Hospital privileges and collaboration with other medical centers: If hospitalization or a rehabilitation facility is required as part of your treatment, you want to ensure that your orthopedic specialist is able to provide care in these facilities, either directly or through collaboration with their staff physicians. Dr. Irvine has a working relationship with five medical facilities in the St. Louis area, including the nationally-ranked Barnes-Jewish Hospital in St. Louis.

If you are currently searching for orthopedic care, look no further than Dr. Irvine and staff at Missouri Orthopedics & Advanced Sports Medicine. We strive to help you achieve your mobility goals so you can get back to the activities you enjoy. Please contact us to discover how we can serve your physical rehabilitation and orthopedic needs.

St. Louis Cardinals’ Alex Reyes Returns To DL with a Lat Strain

St. Louis Cardinals’ Alex Reyes Returns To DL with a Lat Strain

St. Louis Cardinals’ starting pitcher Alex Reyes is unfortunately back on the disabled list (DL) with a lat strain. He pitched only four innings against the Milwaukee Brewers on May 30, 2018.

Although Reyes initially told reporters after the game that he was not worried about the injury at the time, Cardinals’ general manager Michael Girsch told the St. Louis Post-Dispatch that the strain is “significant.” Girsch said the pitcher will miss at least a few games.

This is only the latest injury to plague Reyes. The May 30th game was Reyes’ return to baseball after being on the DL since September 2016 for a torn ulnar collateral ligament (UCL), which required Tommy John Surgery.

What Is A Lat Strain?

A lat strain occurs when the latissimus dorsi is overstretched or torn. The latissimus dorsi is the broadest muscle of the back, and runs all the way from the top of the hip to the front of the upper arm near the shoulder’s ball-and-socket joint.

Some activities can increase the risk of a lat strain, including:

  • sports that require throwing motions, like baseball and softball
  • rowing
  • swimming
  • swinging a baseball bat or tennis racket
  • chopping wood
  • chin-ups and push-ups
  • activities that require constant, repeated lifting of the shoulders

Symptoms of a lat strain include:

  • pain below the shoulder blade
  • pain at the front of the shoulder
  • pain in the mid-back and down the side
  • numbness, tingling, and/or aching that extends down the arm to the third and fourth fingers
  • steady, constant pain (even when muscle is at rest)
  • Pain when reaching forward or lifting arms over your head

Lat strains are graded by severity. The three grades of strains are:

  • Grade 1: mild strain in which the muscle is overstretched but not torn.
  • Grade 2: moderate strain in which the muscle is partially torn.
  • Grade 3: severe strain in which the muscle is completely torn, or ruptured

Treatment and Recovery

Initial treatment for a lat strain involves a combination of treatments known as the RICE method. The acronym RICE stands for:

  • Rest: rest the injured muscle
  • Ice: apply ice for 20 minutes every hour when awake
  • Compression: wrap affected area with an Ace bandage to reduce inflammation
  • Elevation: elevate your back by sitting in a recliner, sofa, or upright chair to enhance the healing process

Treatment primarily consists of rest to allow time for proper healing. Ultrasound, light therapy, and electric stimulation can also be used to promote the healing of tissue. Physical therapy and exercise can restore the muscle’s strength and flexibility.

In cases where the muscle is completely torn, surgery may be required. Surgery can, in some cases, involve repairing the torn muscle with sutures. More severe cases may warrant a full latissimus dorsi reconstruction, in which case the torn muscle is removed and a donor tendon (either from the patient’s own body or a cadaver) is used to replace it.

Non-steroidal anti-inflammatory drugs (NSAIDs) and over-the-counter pain medications can help manage the pain. If the pain is too uncomfortable, your doctor may prescribe pain medication or muscle relaxants to provide you with some relief.

Recovery time for lat strains can range from a month to a year, depending on the severity of the injury and whether surgery is required.

Hope for Reyes

Girsch told the Post-Dispatch that they are still gathering information about the injury and don’t have an estimate yet for Reyes’ return.

There is still hope for Reyes’ pitching career, however. Other baseball pitchers have recovered from lat strains and returned from the DL to enjoy successful pitching careers. Jake Peavy of the Chicago White Sox suffered a lat strain in 2010 and required surgery. Peavy was on the DL for over a year, but was able to return to the sport and became an All-Star in 2012.

We Can Help

Missouri Orthopedics & Advanced Sports Medicine is dedicated to providing exceptional care to people of all ages. Our goal is to relieve pain and restore mobility and function so that you can return to your normal activities as quickly as possible. Contact us for more information or to schedule an appointment today.

The 4 Most Common Wrist Fractures

The 4 Most Common Wrist Fractures

The human wrist is one of the most complex body structures, consisting of a collection of ligaments, tendons, joints and bones. Unfortunately, its intricacy makes the wrist very prone to injuries, and it doesn’t require performing extreme sports to be at risk of a break. Even something as minor as a tiny wet spot on the floor, when unnoticed, may cause a slip and fall, breaking one of the wrist bones.

While there are many injuries that can occur with the wrist, certain wrist fractures are more common than others. The following are a few of those that are experienced most frequently:

1. Colles’ Fracture

Colles’ fracture is also known as a distal radius fracture. It occurs when the radius, which is the longer forearm bone on the thumb side, breaks at the end toward the wrist. The radius is one of the most common broken bones in the United States. The fracture commonly occurs due to falling on an outstretched hand or a direct trauma to the wrist, but there are several other causes of this fracture, including: age, osteoporosis, lack of calcium or vitamin D.

2. Smith’s Fracture

Smith’s fracture is sometimes termed a reversed Colles’ fracture. It also involves the distal radius, but there are some crucial differences between these two. The Colles’ fracture results from falling onto an extended hand, causing the broken bone fragment to be displaced dorsally, or toward the back. The Smith’s fracture, however, involves falling onto a flexed hand, contributing to displacing the broken fragment of the bone ventrally, or toward the front.

3. Barton’s Fracture

Barton’s fracture also involves the radius. We distinguish two types of it: dorsal and volar. It occurs when the base of the thumb breaks and either the dorsal or volar fragment of the carpal gets dislocated. This condition is often called a fracture-dislocation of the radiocarpal joint.

4. Scaphoid Fracture

Apart from radius and ulna, the shorter bone of the forearm, there are also eight carpal bones that form the wrist, arranged in two rows. One of them is the scaphoid bone which sits at the base of the thumb right above the radius. This small, bean-shaped bone is prone to fractures, yet it’s often hard to detect them; they are sometimes mistaken with wrist sprains. Untreated scaphoid fracture may lead to non-unions, avascular necrosis, and early arthritis.

Throughout our lives, slipping, tripping, and falling at some point are inevitable. All of them may result in a couple of bruises, but some may require immediate medical attention to ensure proper treatment and healing. To make an appointment or learn more about wrist fractures, contact us.

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.

Arthroscopy – Not Just to Get a Better Look!

Arthroscopy – Not Just to Get a Better Look!

Most have probably heard the term arthroscopy, even if we aren’t exactly sure what it means. Arthroscopy, like much of medical terminology, comes from the Greek language; Arthro- means joint and -scopy is the act of viewing with a camera or lens.

During arthroscopy, one or more small incisions are made around the joint and a camera is inserted, as well as a variety of tiny surgical instruments. This allows Dr. Irvine to not only diagnose problems by looking around inside the joint with a camera, but he can also treat problems, using burrs, drills, rasps and other surgical instruments to remove and reshape bone, release caught tendons and clean out broken pieces of cartilage.

Why arthroscopy instead of open surgical procedures? Since arthroscopic procedures utilize much smaller surgical incisions, there is much less soft tissue to heal, meaning less pain and a quicker recovery time.

What joints can be treated arthroscopically? While most joints can be viewed arthroscopically, some of the most common candidates for arthroscopic examination and treatment include the knees, hips, shoulders and wrists. Many spinal procedures are now performed arthroscopically, as well as temporomandibular joint (TMJ) conditions.

What conditions can be treated arthroscopically? Here at Missouri Orthopedics and Advanced Sports Medicine, we are using state-of-the-art arthroscopic treatment for many conditions. Evaluation and some treatments can be done arthroscopically for shoulder disease, hip conditions, knee pain and injuries and more.

Procedures like total knee replacements and other more involved surgeries requiring large hardware or prostheses cannot be performed arthroscopically.

To find out more about arthroscopy and all of the orthopedic services we have to offer, please contact us. There’s no need to put up with the pain and limitations any longer!