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!

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.

Hip Arthroscopy Recovery Tips

How to Boost Your Recovery after Hip Arthroscopy

Having hip arthroscopy is scary when you do not know what to expect afterwards. Science has found that psychological stress is detrimental to the body’s healing process and can prolong your recuperation. Learning how to prepare for the typical recovery period before your scheduled surgery will help ease your mind and give you time to make arrangements for the necessary post-procedural support. These are all great questions to explore with Dr. Irvine before you have hip arthroscopy:

  • How long will you experience pain during your recovery? Recovery from joint surgery is different for each person. It is not unusual to experience pain and soreness for 3-6 months after the procedure. Talk with Dr. Irvine about pain control methods that will work best for you. Keeping on top of your pain levels reduces your psychological stress and aids in your healing process.
  • Will you need to use a walker, crutches, or a cane? Crutches are used for the first 2 weeks (possibly up to 6 weeks) after the procedure so that you are not placing weight on the affected side.
  • Will you need to stay at an inpatient rehabilitation facility afterwards? Typically this is not the case, however, inpatient rehabilitation may be required in rare instances and Dr. Irvine can address this with you.
  • When should you expect to start physical therapy? A post-operative appointment is scheduled about a week after the surgery to remove any stitches and check on your progress. During this visit Dr. Irvine will assess if you are ready to begin physical therapy, which often begins the following week.
  • How long does physical therapy usually last? The usual course of physical therapy is 2-6 weeks, though this varies from patient to patient.
  • Who will help you at home and transport you to your appointments? Enlist a friend or family member to stay with you for at least the first few days after the procedure. You will need assistance with activities of daily living, such as preparing food, toileting, and bathing. If you anticipate needing additional help, you may wish to arrange for visits from a home healthcare service.
  • When will you be able to start driving again? You may be able to drive as soon as a week after the surgery if Dr. Irvine clears you to drive at your initial post-operative appointment. Talk with Dr. Irvine to find out what criteria is used to determine when you will be ready to drive again.

At Missouri Orthopedics, we strive to help you achieve your mobility goals so you can get back to the activities you enjoy. Please contact us to find out how we can serve your physical rehabilitation and orthopedic needs in the Greater St. Louis area.

Understanding Elbow Arthroscopy

The elbow joint consists of three bones: the humerus bone of the upper arm, and the ulna and radius bones of the forearm. The ulna and the humerus meet at the elbow and form a hinge, allowing the arm to straighten and bend. Life without this ability would be difficult, indeed.

Thanks to elbow arthroscopy, conditions inhibiting the normal use of the elbow can be treated, relieving pain and enabling one to freely use their elbow again.

What is elbow arthroscopy?

Missouri Orthopedic Care St. Louis, Advanced Sports Medicine

Arthroscopy is a procedure that allows surgeons to inspect, diagnose, and repair problems such as releasing scar tissue to improve range of motion, removing loose cartilage and bone fragments, repair lesions, among others.

Common procedures include:

  • Removing loose fragments in the joint
  • Repairing fractures
  • Treatment of tennis elbow (lateral epicondylitis)
  • Treatment of osteoarthritis (arthritis that causes wear and tear)
  • Treatment of rheumatoid arthritis (inflammatory arthritis)
  • Treatment of elbow stiffness often caused by fractures and other injuries

How is elbow arthroscopy performed?

Under general or regional anesthesia, a fiber-optic camera is inserted through a cut the width of a pencil in the elbow, magnifying and projecting the structures of the elbow on a television screen. This allows the surgeon to diagnose the condition. Several other small cuts allow insertion of additional instruments into the joint for treatment.

Recovery and rehabilitation.

Arthroscopy is usually an outpatient procedure; expect to return home with a bandage over your incisions, your arm possibly placed in a splint to keep it still and instructions to put ice on it and elevate it regularly for the next couple of days. You more than likely will be given instructions for certain exercises to perform to build strength and increase movement and may even need physical therapy to complete the rehabilitation process. While recovery from elbow arthroscopy is often faster than that of open surgery, expect it to take several weeks for your joint to completely recover.

For more information on elbow arthroscopy and how we can help, contact Missouri Orthopedics & Advanced Sports Medicine.