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!

Spring Training is Injury Prevention Time for Young Pitchers

Spring Training is Injury Prevention Time for Young Pitchers

With the Cardinals back at spring training in Florida, youth baseball players in the St. Louis area are also returning to the cages to begin their preseason training regimens. For many young pitchers, that means restarting a throwing program after at least a few months off. Having grown and developed in the off season, they’re finding their balance and release points again, and maybe trying out a new pitch or two.

Though it’s fun to focus on those mechanics, players and parents should also remember that preseason is an exceptionally important time to do the work necessary to keep young arms healthy through the long season to come. Arm care isn’t just about counting pitches. The strength and flexibility training young pitchers do in the preseason can mean the difference between ending the season as an all-star and having season-ending surgery.

Benefits of a Preseason Throwing Injury Prevention Program

In 2016, research presented at the American Orthopaedic Society for Sports Medicine (“AOSSM”) Specialty Day reported that a preseason injury prevention program was shown to significantly diminish the risk of a throwing injury in youth pitchers. In the study, young pitchers participated in a program consisting of resistance training with dumbbells and elastic bands, focusing on flexibility exercises four times per week for at least fifteen minutes per session. The results found that they were four times less likely to suffer a throwing injury than a comparable group of pitchers who only followed a normal preseason throwing regimen. Quoted in the AOSSM press release reporting the findings, one of the study’s corresponding authors emphasized that encouraging “parents, coaches, and youth baseball organizations across the country to adopt similar programs [may give] athletes… a better chance for reducing time off the field because of injury.”

Resources for Developing Your Preseason Throwing Injury Prevention Program

You can find guidance from the National Strength and Conditioning Association on preseason training for youth baseball players here.

Parents, players, and coaches with questions about developing a preseason throwing injury prevention program should consult a certified athletic trainer, or contact our team at Missouri Orthopedics and Advanced Sports Medicine today.

When is a Meniscus Tear Repairable?

When is a Meniscus Tear Repairable?

According to the American Academy of Orthopaedic Surgeons, one of the most common knee injuries is a tear in the meniscus. These rubbery pieces of cartilage act as shock absorbers in the knee to cushion and stabilize the knee joint. There are two menisci in each of your knees: one on the inside of the knee and one on the outer side.

Treatment of a meniscus tear depends on a number of factors, including the type of tear, its size and where the tear is located on the meniscus. Most meniscus tears result either from trauma or are degenerative. Traumatic tears come about from a twisting of the knee, often while engaged in sports and physical activity. Degenerative tears can occur as the body ages and tissue gradually breaks down over time.

The outer one-third of the meniscus has a rich supply of blood flow, which is important for any part of the body to heal. The inner two-thirds, however, have little to no blood flow. Nutrients from blood are necessary for the body to heal naturally, so when there are tears in the inner part of the meniscus, surgical trimming and removal of the torn piece is generally the best option.

Tears in the meniscus that are located near the outer edge of the knee are typically the result of trauma and are longitudinal – basically following parallel to the long side of the meniscus. This makes these injuries the best candidates for surgical repair.

Arthroscopic surgery for such tears can be very successful at repairing the damage. This is a minimally invasive treatment, as only a few small incisions in the knee are needed. A miniature camera is inserted in one incision, and surgical instruments are inserted in the others, allowing the surgery to all take place within the knee. The tear is closed by stitching the torn pieces together.

Recovery time from a meniscus repair is longer than for surgery where part of the meniscus is removed because the tissue must heal together, requiring 3-4 months away from sports. However, you can expect to fully return to your previous level of activity once healing is complete.

If you have sustained a knee injury or are experiencing knee pain, contact us at Missouri Orthopedics and Advanced Sports Medicine. Dr. Irvine has extensive experience in treating knee pain and injuries, and is trained in the most advanced techniques in arthroscopic surgery.

General Orthopedic Care – Caring for Broken Bones

General Orthopedic Care – Caring for Broken Bones

There are many ways a bone can be injured or broken. Car accidents, contact sports, falls, and workplace accidents are some of the most common ways bones sustain injuries. Regardless of the cause, broken bones should be treated as soon as possible to avoid complications. The best way to treat an injury to a bone is to ensure proper alignment and stabilization.

Leaving a bone break or injury untreated can result in complications including bone deformity and permanent nerve damage. An untreated break may also cause damage to surrounding muscle and ligaments. These complications occur because bone is living tissue that attempts to heal itself in stages:

  • The trauma of the break damages blood vessels within the bone resulting in bleeding inside the tissue. Within hours this blood forms a clot. The blood clot associated with a broken bone contains specialized cells known as fibroblasts.
  • In a few days, these cells begin to manufacture granulation tissue. This tissue begins to form a web of cartilage and fibrocartilage and is known as the soft callus stage. This stage may last from about four days to as long as three weeks in most cases.
  • At this point cells known as osteoblasts begin to make new bone tissue. Usually, this process begins at about two to three weeks and ends at about six to eight weeks. This is known as the hard callus stage and depending on the location and severity of the break, may continue for months.
  • The final process is remodeling. Specialized cells called osteoclasts begin to break down excess bone in the fractured area, reducing the size of the callus and replacing it with hard, compact bone tissue. As this happens, the bone returns to its original size and shape. During this time, the bone functions as well as before the break; however, the process of complete remodeling can take years to complete.

Because bone begins to heal itself almost immediately after an injury, it is vital to see a doctor as soon as possible in order to assure correct healing and avoid complications.

When you visit our office for a broken bone, an X-ray of the affected area would be done to determine the type and severity of the break. For the majority of simple fractures, the bone is able to be gently manipulated back into place. If a more complex or severe break is found, the bone may require stabilization with pins, screws, or plates. Once the bone is back to the correct alignment, immobilization with a cast, splint, or in some cases, traction is essential in order to minimize pain and allow the bone to continue to repair itself in the correct position.

Once the bone is stabilized, recovery and rehabilitation can begin. Dr. Irvine and his team will devise a plan to suit your specific needs. A proper rehabilitation program promotes blood flow to assist in healing and maintaining muscle tone, while also reducing stiffness and helping prevent blood clots.

No matter what the cause, Missouri Orthopedics & Advanced Sports Medicine is here to help. Our clinic can diagnose and treat all types of breaks to get you back to your day-to-day activities. Contact us if you suspect you may have a broken bone or other orthopedic injury. We provide prompt, professional care to minimize further damage and get you back to a healthy, active lifestyle.