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!

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.

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.

Elbow Arthroscopy Recovery: How to Help Yourself Recover Stronger

A large majority of people who need to undergo surgery are curious about the recovery times, the level of pain they may experience, and what they will need to do to recover afterwards. The good news is, there are many things patients can do to recover stronger after a surgery such as Elbow Arthroscopy.

Elbow Arthroscopy can be performed to diagnose and fix many problems, such as releasing scar tissue or resurfacing the bone. It is often a very successful surgery, providing patients with less ongoing pain and a better range of motion. Immediately after the surgery, patients will notice the improved range of motion available in their elbow as there are very few limitations placed upon movement at this point. A sling is often given for comfort only.

As this is a surgical procedure, some pain and discomfort is to be expected, but the method of using only a small incision means this will generally only last the first week of recovery. If the surgery was more extensive, it will likely be several more weeks before the pain subsides. In either case, patients may be prescribed pain medication to help with any discomfort. Icing and raising the elbow for the first 48 hours after surgery as directed by the doctor will also help with the pain and recovery.

The doctor may ask the patient to leave on the post-surgery dressing for several days and to keep the area dry. After its removal, bathing can continue as normal, but always ensure that the wounds are covered with antibiotic ointment and bandages after bathing as directed by the doctor. Sutures are removed after one week.

Once the initial recovery time is complete, physical therapy will begin and lasts for approximately 4-6 weeks or until maximum range of motion is accomplished, allowing the patient to return to normal activities such as playing sports and moving regularly again!

To learn more about this simple recovery process or to schedule your Elbow Arthroscopy procedure, contact us.