Don’t Let Pain Slow You Down
Bones are rigid, but they do bend or “give” somewhat when an outside force is applied. However, if the force is too great, the bones will break—just as a plastic ruler breaks when it is bent too far.
The severity of a fracture usually depends on the force that caused the break. The vast majority of broken bones result from traumatic events, such as falls, sports injuries, and motor vehicle collisions. Conditions like osteoporosis or cancer can predispose individuals to a fracture or bone trauma, too.
Common types of fractures include:● Stable fracture. The broken ends of the bone line up and are barely out of place.● Open, compound fracture. The skin may be pierced by the bone or by a blow that breaks the skin at the time of the fracture. The bone may or may not be visible in the wound.● Transverse fracture. This type of fracture has a horizontal fracture line.● Oblique fracture. This type of fracture has an angled pattern.● Comminuted fracture. In this type of fracture, the bone shatters into three or more pieces.
Reduce your risk.
Proper diet and exercise may help in preventing some fractures. A diet rich in calcium and Vitamin D will promote bone strength, too. Weight-bearing exercises also help to keep bones strong.
Pinpoint your pain.
The symptoms of broken bones can vary depending on the type of fracture, but commonly include pain (can be extreme), numbness, swelling and bruising, weakness or stiffness, decreased sensation and movement, and possibly an open wound or deformity.
Get the answers you need.
Your doctor will do a careful examination to assess your overall condition, as well as the extent of the injury. He or she will talk with you about how the injury occurred, your symptoms, and medical history. Then, to evaluate a fracture, your physician will order X-rays, which provide clear images of the bone. X-rays can show whether a bone is intact or broken. They can also show the type of fracture and exactly where it is located within the bone.
Life’s too short to put up with pain.
Injuries can vary greatly from one to the next. The severity and location dictate the urgency of care and the type of treatments that are required. Treatment options include ice and elevation, use of medication to minimize pain and inflammation, setting the bone by splinting or casting, immobilization (such as by using a sling), surgery, joint replacement, and physical therapy. For more severe breaks, surgery could involve inserting rods or screws to maintain proper alignment of the bone during healing. Some breaks might have damaged an artery, blood vessels, or affected nerves, which would require further treatment.
Here to Help You Every Step of the Way
A broken ankle is also known as an ankle fracture. This means that one or more of the bones that make up the ankle joint are broken.
A fractured ankle can range from a simple break in one bone, which may not stop you from walking, to several fractures, which forces your ankle out of place and may require that you not put weight on it for a few months.
Simply put, the more bones that are broken, the more unstable the ankle becomes. When the fracture occurs, various ligaments that hold the joint in place may also be simultaneously damaged.
● Twisting or rotating your ankle● Rolling your ankle● Tripping or falling● Impact during an accident
Because a severe ankle sprain can feel the same as a broken ankle, a foot and ankle specialist should evaluate every ankle injury. Common symptoms for a broken ankle include:● Immediate & severe pain● Swelling● Bruising● Tender to touch● Inability to put weight on the affected foot● Deformity or feeling that the ankle is “out of place” particularly if the joint is dislocated
After discussing your symptoms and medical history, your doctor will do a careful examination of your foot and ankle. Then, he or she may order one or more tests, including:● X-rays: Helps to determine if and where the bone is broken or displaced● Stress test: Places pressure on the ankle to determine if the ankle fracture is unstable● Computed tomography (CT) scan: Used to further evaluate an ankle injury, particularly when the fracture extends into the ankle joint● Magnetic resonance imaging (MRI) scan: Captures high-res images of both bones and soft tissues, like ligaments
Whether the break involves a minor crack or multiple fractures, our surgeons deliver expert patient care to expedite rehabilitation. Treatment of broken ankles depends on which bone is broken and the severity of the injury, but typically includes:● Reduction involves physically manipulating the bone to its original position. Once the bone is set, the ankle is immobilized with a cast or brace.● Surgery may be required to stabilize the ankle. Pins, plates, and screws will help with proper alignment of the bone and may be removed after the ankle heals.● Physical therapy helps to improve strength and flexibility after a period of immobilization.
Calcaneus (Heel Bone) Fractures
Get Back on Your Feet
A fracture of the calcaneus, or heel bone, can be a painful and disabling injury. This type of fracture commonly occurs during a high-energy event—such as a car crash or a fall from a ladder—when the heel is crushed under the weight of the body. When this occurs, the heel can widen, shorten and become deformed.
Since these fractures mostly result from falling or motor vehicle injuries, prevention is limited. Stress fractures—injuries that could be caused from twisting motion—can be prevented by strength training and stretching. Certain types of footwear, such as high heels or even running barefoot, can attribute to these fractures, too.
Patients with calcaneus fractures usually experience:● Pain● Bruising● Swelling● Heel deformity● Inability to put weight on heel or walk
With some minor calcaneus fractures, the pain may not be enough to prevent you from walking—but you may limp. This is because your Achilles tendon acts through the calcaneus to support your body weight. If, however, your calcaneus is deformed by the injury, your muscle and tendon cannot generate enough power to support your weight. Your foot and ankle will feel unstable, and you will walk differently.
After discussing your symptoms and medical history, your doctor will perform a careful examination. He or she will examine your foot and ankle to see if your skin was damaged or punctured from the injury, and then check your pulse at key points of the foot to be sure that there is a good blood supply to the foot and toes. Your doctor will also check to see if you can move your toes, and can feel things on the bottom of your foot. Our foot and ankle experts use advanced diagnostic testing during examinations to determine the extent of the injury.
Your doctor will consider several factors in planning your treatment, including the cause of your injury, your overall health, the severity of your injury and the extent of soft tissue damage. To restore function and the heel’s original dimensions, Dr. Rappaport may recommend:● Nonsurgical treatment. If the bones have not shifted out of place, temporary immobilization devices, such as a cast, may be used.● Surgical treatment. When the bones are displaced, patients may require:● Ankle Fusion. In traumatic fractures where the cartilage is severely damaged, the calcaneus bone will be fused to the joint to stabilize the foot for walking.● Reduction. Use small incisions to correct bone displacement, then insert screws and metal plates to keep the heel bone in place.
Distal Radius Fracture (Broken Wrist)
A Patient’s Guide to Distal Radius Fractures
Wrist fractures, or distal radius fractures, are very common. In fact, the radius is the most commonly broken bone in the arm.
The radius is the larger of the two bones of the forearm. The end toward the wrist is called the distal end. A fracture of the distal radius occurs when the area of the radius near the wrist breaks. A distal radius fracture almost always occurs about 1 inch from the end of the bone; however, the break can occur in many different ways, including:● Colles Fracture. One of the most common distal radius fractures, a Colles fracture occurs when the broken fragment of the radius tilts upward.● Intra-articular fracture. A fracture that extends into the wrist joint.● Extra-articular fracture. A fracture that does not extend into the joint.● Open fracture. When a fractured bone breaks the skin, it is called an open fracture. These types of fractures require immediate medical attention because of the risk for infection.● Comminuted fracture. When a bone is broken into more than two pieces, it is called a comminuted fracture.
It’s impossible to prevent the unpredictable events that often cause a broken wrist. However, there are some preventative measures that you can take, including:● Build bone strength. Eat a nutritious diet with adequate calcium and vitamin D, engage in weight-bearing exercises, and quit smoking.● Prevent falls. Most broken wrists occur when people fall forward onto an outstretched hand. So, be sure to wear sensible shoes, remove home hazards, avoid slippery surfaces, install handrails on your stairways, etc.● Use protective gear during sporting activities. Wear wrist guards for high-risk activities, such as in-line skating, snowboarding, rugby, and football.
The symptoms of broken wrists, and their severity, depending on the type of fracture experienced. General symptoms of broken wrists include:● Pain (moderate to extreme)● Swelling● Bruising● Decreased sensation and movement● Complete bone displacement and deformityIn the most extreme cases, a fractured wrist may affect nerves and blood flow, resulting in extreme pain, a numb wrist and hand, and pale fingers. A wrist injury causing these symptoms should be considered an emergency and immediate medical care should be sought.
To confirm the diagnosis, your doctor will order an X-ray of the wrist. X-rays can show if the bone is broken and whether there is displacement (e.g., a gap between broken bones). They can also show how many pieces of broken bone there are.
Our orthopaedic specialists have years of expertise in treating broken wrists. If Dr. Kayal and his team determine that a broken wrist is present, then they develop a treatment plan based on the patient’s age and condition, the location and severity of the fracture, and the potential for successful non-surgical treatment. Some non-surgical treatment options include closed reduction, casting the bone, physical therapy (following a necessary healing period), and anti-inflammatory and pain medications. If the wrist fracture is severe and requires surgical intervention, the surgeon will likely implant rods or screws to maintain the proper position of the bone during healing. Allowing the bones to remain out of alignment can cause issues such as early arthritis.
Find Facts, Symptoms & Treatments
A femur fracture is a break in the thighbone. The femur can be fractured in three areas: the head/neck of the bone (e.g., the upper end, near the pelvis), the main shaft of the bone, or the lower end near the knee.
The femur is the longest and strongest bone in the body; because it is so strong, it usually takes a lot of force to break it. That’s why the most common causes of femur fracture are high-speed trauma, such as a motor vehicle or motorcycle accidents; a fall from a high place; an injury during extreme or contact sports; or a preexisting bone disease that weakens the bone, such as a tumor, Paget disease, bone cysts or osteoporosis.
While most femur fractures are not preventable, some risk factors can be minimized with proper training techniques. Gradual increases in activity intensity and duration allows the body to respond to the increased load stresses. Maintaining proper footwear and not allowing footwear to break down, adequate rest periods in training, and good nutrition are also important aspects of prevention.
A femoral shaft fracture usually causes immediate, severe pain. You will not be able to put weight on the injured leg, and it may look deformed—shorter than the other leg and no longer straight.
A femur fracture is a serious injury that is diagnosed by a physician, usually in an emergency room. The doctor will check for all of the signs and symptoms of a fracture. After the visual inspection, your doctor will then feel along your thigh, leg, and foot looking for abnormalities and checking the tightness of the skin and muscles around your thigh. He or she will also feel for pulses. Your doctor will test for sensation and movement in your leg and foot. Then, your doctor will order an X-ray or CT scan to confirm the fracture and identify where it is located within the femur.
Most femoral shaft fractures require surgery to heal. However, very young children are sometimes treated with a cast. Treatment of a femur fracture usually involves extensive treatment in the hospital or a rehabilitative facility.
A Step in the Right Direction
A fibula fracture is a relatively common condition that’s characterized by a break in the smaller of the long bones of the lower leg, known as the fibula.
During certain activities, such as landing from a jump, a forceful impact to the outer lower leg or ankle, or when rolling an ankle, stress is placed on the fibula bone. When this stress is traumatic and beyond what the bone can withstand, a break in the fibula may occur.
A fibula fracture is common among the elderly, but can also occur in younger patients. Oftentimes, a fracture to the fibula occurs in combination with a sprained ankle or other fractures of the foot, ankle or lower leg.
A fibula fracture can occur when the joint is forced beyond its normal range of motion. A direct blow to the bone itself can also cause it.
Any form of trauma may cause injury, including:● Falls● Twists● Blows● Collisions
● Immediate pain—can be severe, but sometimes with fibula injuries, is surprisingly minor● Swelling● Bruising around the injured area● Tenderness when touching the injured bone● Inability to put weight on the injured foot without pain, although some people are able to walk with minor fractures
A thorough subjective and objective examination from an orthopaedist is essential to assist with the diagnosis of a fibula fracture. An X-ray is usually required to confirm the diagnosis and assess the severity of the fracture. Further testing, such as an MRI, CT scan, or bone scan, may be required, in some cases, to assist with diagnosis and assess the severity of the injury.
Treatment first involves ice and elevation of the leg, to reduce pain and inflammation. People with fibula fractures are advised to walk using crutches, too. A brace or walking boot may be given to restrain the injured leg and allow for healing. If it is a displaced fracture, surgery is needed to place a rod, plate, or screws in the bones in order to fix the fracture. After surgery, the leg is protected. Then, following bracing or casting, it is important to complete strengthening and stretching exercises to regain strength and a full range of motion.
Hand & Finger Fractures
Symptoms & Treatment Options
Your hand consists of 27 bones: eight bones in your wrist (carpals), five bones in the palm of your hand (metacarpals), and 14 bones in your fingers (phalanges). The bones in a normal hand line up precisely, and they enable you to perform many specialized functions, such as grasping a pen or manipulating small objects in your palm.
Although the bones in the hand are small, a fractured hand or finger is not a minor injury. When you fracture a finger bone, it can cause your whole hand to be out of alignment. Without treatment, your broken finger might remain stiff and painful.
Generally, a fractured finger occurs as the result of an injury to the hand. You can fracture a finger when you slam your fingers in a door, when you put out your hand to break a fall, or when your finger jams while trying to catch a ball.
Conditions such as osteoporosis and malnutrition increase your chances of breaking your hand or a finger.
Signs and symptoms of a broken bone in the hand include:● Swelling● Tenderness● Bruising● Deformity● Inability to move the finger● Shortened finger● Finger crosses over the adjacent when trying to make a fist● Depressed knuckle
If you think that you fractured a bone in your hand, immediately tell your doctor what happened and when it happened. Your doctor must determine not only which bone you fractured, but also how the bone broke. Bones can break in several ways: straight across the bone, in a spiral, into several pieces, or shatter completely. Your doctor may want to see how your fingers line up when you extend your hand or make a fist. Does any finger overlap its neighbor? Does the injured finger angle in the wrong direction? Does the injured finger look too short? Your doctor may order an X-ray to identify the location and extent of the fracture.
Most of the time, the bones in your hand can be realigned by manipulating them without surgery. A cast, splint or fracture-brace is applied to immobilize the bones and hold them in place. The cast will most likely extend from the fingertips down past the wrist, almost to the elbow. This ensures that the bones remain fixed in place. Depending on the type and severity of the fracture, you may need surgery to put the bones into alignment. Small devices, such as pins, screws or wire, will be used to hold your fractured bones together.
Understanding Shoulder Trauma
The humerus is one of the long bones of the arm. The distal, or bottom, end contributes to the elbow joint. The proximal, or top, end contributes to the shoulder joint.
Fractures of the humerus typically occur as the result of a trauma, such as a fall where the individual lands directly on the shoulder, a forceful collision, or a more complicated event, such as a car accident. Typically, the position of the arm and body at the time of the trauma will determine how the bone fractures. Individuals of any age and gender may suffer this type of fracture. Individuals who suffer from osteoporosis, or the weakening of bone tissue, may have an increased risk of fracture during any traumatic event.
Humerus fractures may occur in a number of ways:● A direct blow. This can happen during a fall, when landing directly on the elbow, or by being struck by a hard object, like a baseball bat, car dashboard or door during a motor vehicle accident.● An indirect fracture. This can happen during a fall if a person lands on his or her outstretched arm with the elbow locked straight.
Humerus fractures can be very painful and may prevent you from moving your arm. Additional symptoms include:● Swelling● Bruising● Pain or tenderness to the touch● Stiffness● Feeling of instability, as if the elbow will “pop out”
During the examination, your physician will examine the skin to see if there are any lacerations, feel all around the arm to determine if there are any other areas of tenderness, and check the pulse at the wrist to ensure that good blood flow is getting past the elbow to the hand. In addition, your physician will check to see if you can move your fingers and wrist, and identify if you can feel things with your fingers. Lastly, an X-ray is often taken to confirm the fracture. If further information is needed, such as investigating if any soft tissues are also injured, an MRI or CT scan may be required.
Determining when surgery is required depends on a number of factors. Fractures close to the shoulder and elbow joints, especially fractures that extend into the joint, are more likely to require surgery. Conversely, fractures in the center of the shaft of the bone rarely require surgery. Eighty percent of humerus injuries are non-displaced or minimally displaced; therefore, they can be treated non-surgically. These patients can be treated with a sling or brace for immobilization, and with time, the fracture will heal. In severe cases, when the bone fragments are far out of position, surgery may be required. Surgery for a humerus fracture typically involves putting the pieces of the fractured bone back into place.
Keeping Up with the Jones Fracture
Metatarsal fractures are common injuries of the forefoot. The Jones fracture, more specifically, is a common fracture of the fifth metatarsal. Generally, it is injured during inversion-type injuries, such as ankle sprains. Fractures to the fifth metatarsal may also occur from direct or crushing types of injuries, as well as from stress fractures.
A Jones fracture is usually caused by stress that’s placed across the bone when the heel is off the ground and the forefoot is planted. This type of fracture may also represent an old stress fracture, which has progressed to a complete fracture. A Jones fracture is significant because it occurs in an area where the blood supply to the bone is less than adequate, often resulting in healing problems.
To reduce your risk of a Jones fracture, practice the following:● Use proper footwear● Avoid excessive running or jumping on hard surfaces● Avoid uneven surfaces
The most common symptoms of a Jones fracture include:● Pain● Swelling● Bruising● Severe pain when walking● Immobility
Anyone who has symptoms of a fifth metatarsal fracture should see a foot and ankle specialist as soon as possible for proper diagnosis and treatment. To arrive at a diagnosis, your surgeon will ask how the injury occurred or when the pain started. The foot will then be examined, with the doctor gently pressing on different areas of the foot to determine where there is pain.
Next, your doctor will order an X-ray to determine the extent of the fracture, to confirm the diagnosis, and to ensure that there is no further damage.
Minor Jones fractures are typically treated with a cast, splint or walking boot for six to eight weeks. You may be non-weight bearing in the foot. Over-the-counter or prescribed anti-inflammatory medications may also be used to alleviate discomfort and swelling during the healing process.
For athletes, or for those who incur an acute Jones fracture that has shifted and is no longer in-line, our orthopaedic surgeons conduct cutting-edge surgical procedures. Your foot and ankle surgeon will determine the type of procedure that is best suited for your unique case.
Lisfranc (Midfoot) Injury
Everything You Need to Know
Located in the middle of the foot, the Lisfranc joint is the point at which the metatarsal bones, which are the long bones that lead to the toes, attach to the tarsal bones (e.g., arch bones). Lisfranc injuries result if bones in the midfoot are broken or if ligaments that support the midfoot are torn. The severity of the injury can vary from simple to complex, involving many joints and bones in the midfoot.
A Lisfranc injury is often mistaken for a simple sprain, especially if the injury is a result of a straightforward twist and fall. However, injury to the Lisfranc joint is not something that should be simply “walked off.” It is a severe injury that may take many months to heal and may require surgery to treat.
Lisfranc injuries can happen with a simple twist and fall. This is a low-energy injury. In fact, it is often seen when someone stumbles over the top of a foot that’s flexed downward.
More severe injuries occur from direct trauma, such as a high-impact fall. These high-energy injuries can result in multiple fractures and dislocations of the joints.
The most common symptoms of a Lisfranc injury include:● The top of foot may be swollen and painful● There may be bruising on both the top and bottom of the foot; bruising on the bottom of the foot is highly suggestive of a Lisfranc injury● Pain that worsens with standing or walking
The diagnosis of a Lisfranc injury is made using several things: your symptoms, a foot exam, X-rays and other imaging tests. Your orthopaedic foot and ankle specialist will examine the middle part of your foot to identify the location of pain, and then perform tests to check the stability of this area. X-rays may show broken and/or shifted bones in the middle of the foot. An MRI scan may be helpful, too, to determine if the ligaments in the foot are damaged. A CT scan can help determine the extent of the bone injury, and is particularly useful when planning surgery.
If there are no fractures or dislocations in the joint, and the ligaments are not completely torn, nonsurgical treatment may be all that is necessary for healing. In these instances, a Lisfranc injury may be treated with casting, followed by custom-molded orthotics. However, a majority of Lisfranc fractures are unstable and displaced, so they require surgery. Your doctor will carefully assess your injury to determine the precise type and severity of fracture. If you require surgery, your foot and ankle surgeon will reposition the joints and realign fractured bone fragments. Once bones are in their proper place, screws and metal plates are used to stabilize the joint and allow injured tissues to heal. In cases of severely ruptured ligaments and irreparable bone damage, your surgeon may even recommend fusion to “weld” together the joints as a single piece.
Comprehensive Care for Broken Kneecaps
The patella, or your kneecap, is a small bone located in front of your knee joint—where the thighbone (e.g., femur) and shinbone (e.g., tibia) meet. It protects your knee and connects the muscles in the front of your thigh to your tibia to allow to extend your knee.
Because your patella acts as a shield for your knee joint, it can easily be broken. Falling directly onto your knee, for example, is a common cause of patellar fractures.
Patellar fractures account for roughly 1% of all fractures. They are most common in people who are 20 to 50 years old, and men are twice as likely as women to fracture the kneecap. These fractures are serious injuries and often require surgery to heal.
To help reduce your chance of a patella fracture:● Do not put yourself at risk for trauma to the bone● Do weight-bearing exercises to build strong bones● Build strong muscles to support the knee, prevent falls, and to stay active and agile● Wear proper padding and safety equipment when participating in sports or activities
The major symptoms of a patellar fracture include pain and swelling in the front of the knee. Additional symptoms include:● Bruising● Inability to straighten the knee● Inability to walk
After discussing your symptoms and medical history, your doctor will examine your knee. The edges of the fracture can often be felt through the skin, particularly if the fracture is displaced. Your doctor will also check for hemarthrosis, which is swelling deep inside of the joint that is usually a result of bleeding caused by the fracture. Your doctor may order an X-ray. X-rays create images of dense structures, like bone, so they are particularly useful in showing fractures. Although rare, a person may be born with extra bones in the patella that have not grown together. This is called bipartite patella and may be mistaken for a fracture. X-rays help to identify bipartite patella. Many people have bipartite patella in both knees, so your doctor may take an X-ray of your other knee, as well, to confirm diagnosis. This is an incidental finding and often does not cause people any issues.
If the force of the injury has not displaced the pieces of a broken bone, you may not need surgery. Instead, casts or splints may be used to keep your knee straight. This will keep the broken ends in the proper position while they heal. On the other hand, if the patella has been pulled apart (displaced), you will most likely need surgery with wires or pins. Fractured patellar bones that are not close together often have difficulty healing or may not heal. The thigh muscles that attach to the top of the patella are very strong and can pull the broken pieces out of place during healing.
Symptoms, Diagnosis & Treatment
The talus is located in the middle of the ankle joint and connects the shinbone to the heel bone and foot. Acting as a hinge, the talus enables the foot to flex up and down, and side to side. Therefore, injuries to the talus have a profound effect on the movement and function of the foot & ankle. When a fracture to the talus occurs, patients will feel acute pain, difficulty with bearing weight, and swelling or tenderness around the ankle joint.
Even more, a talus fracture can cause complications later in life, including arthritis or osteonecrosis (avascular necrosis). A fractured talus can interrupt blood flow to the bone. If the proper nutrients can’t reach the talus, the bone is unable to heal.
Most talus fractures are the result of high-energy trauma, such as a car collision or a high-impact fall. Injuries from sports, particularly from snowboarding, are another, less common, cause of talus injuries.
Patients with talus fractures usually experience:● Acute pain● Inability to walk or bear weight on the foot● Considerable swelling, bruising, and tenderness
After discussing your symptoms and medical history, your doctor will do a careful examination. To minimize future complications, our New Jersey foot and ankle specialists will promptly pinpoint the site of the fracture, check to see if there is an adequate blood supply to the foot, and look for damaged nerves. Then, your doctor will order imaging tests to determine whether surgery is required.
Our podiatric specialists treat talus fractures with the latest technology, including innovative surgical procedures, to restore motion, function and strength. Treatment options vary based on the magnitude of the talus fracture. If bones are in their proper positions, your doctor may suggest wearing a cast. After the cast is removed, prescribed exercises can restore strength and range of motion. Unfortunately, though, most fractures require surgery to reset the talus. During surgery, your surgeon will remove small bone fragments and insert screws or pins to hold the bone in place while it heals. Patients should avoid placing weight on the injured foot and ankle during the recovery period.
Recapture Your Quality of Life
Tur with these types of fractures.
To help reduce your chance of a shinbone fracture:● Do weight-bearing and strengthening exercises regularly to build strong bones● Wear proper padding and safety equipment when participating in sports or activities● Do not put yourself at risk for trauma to the bone
The most common symptoms of a tibial shaft fracture are:● Pain that ranges from mild to severe, but worsens with activity● Swelling, inflammation, and tenderness● Bruising in the injured area● Decreased range of motion of the knee or ankle● Limping● Inability to bear weight on the fractured leg
It is important that your doctor knows the circumstances of your injury. It is just as important for your doctor to know if you sustained any other injuries. After discussing your symptoms and medical history, your doctor will do a careful examination of your shinbone. He or she will assess your overall condition and then focus on your leg. After the visual inspection, your doctor will feel along your leg to see if there are abnormalities of the tibia. Your doctor will test your sensation and muscle strength by asking you to move your toes and see if you can feel different areas over your foot and ankle. Then, your doctor may order X-rays or a CT scan to examine your lower leg more closely and to confirm the diagnosis.
In planning your treatment, your doctor will consider several things, including the cause of your injury, your overall health, the severity of your injury, and the extent of soft tissue damage. Initially, most injuries cause some swelling for the first few weeks. Therefore, your doctor may apply a splint to provide comfort and support. Unlike a full cast, a splint can be tightened or loosened and allows swelling to occur safely. Once the swelling goes down, your doctor will consider a range of treatment options. One proven nonsurgical treatment method is to immobilize the fracture in a cast for initial healing. After weeks in the cast, it can be replaced with a functional brace made of plastic and fasteners. The brace will provide protection and support until healing is complete.
Tibial Plateau Fracture
Overview, Treatment & Management
The tibial plateau is the top joint surface of the shinbone and is one of the most critical load-bearing areas in the human body. So, fractures of the plateau affect knee alignment, stability and motion.
A tibial plateau fracture involves the cartilage surface of the knee joint. Because these fractures occur around the knee joint, they must be treated differently than the tibial shaft fractures.
When a fracture occurs into or around a joint surface, that joint is at high risk of developing arthritis due to the injury. Unfortunately, even if the bone and cartilage surfaces are lined up perfectly, there is still a risk of developing knee arthritis due to injury to the cartilage cells.
● Warm up and stretch properly before activity● Maintain physical fitness● Strength, flexibility, and endurance● Cardiovascular fitness● Wear properly fitted and padded protective equipment (i.e., shin guards for soccer)
● Severe pain at the fracture site, at the time of injury, which may continue over a period of time● Tenderness, inflammation, and/or bruising over the fracture site● Decreased knee function● Inability to stand or walk on the injured leg● Visible deformity, if the bone fragments are not properly aligned● Signs of vascular damage: numbness and coldness below the injury site
It is important that your doctor knows the circumstances of your injury, including how and when it occurred. After discussing your symptoms and medical history, your doctor will do a careful examination of your lower leg. After the visual inspection, your doctor will feel along your leg to see if there are abnormalities of the tibia. Your doctor will test your sensation and muscle strength by asking you to move your toes and see if you can feel different areas over your foot and ankle. Then, your doctor may order X-rays or a CT scan to examine your lower leg more closely and to confirm that it is indeed a tibial plateau fracture.
Treatment first involves the use of ice and medicine to reduce pain and inflammation. If the bone fragments are out of alignment (e.g., a displaced fracture), immediate realignment of the bone by a Kayal surgeon is required. Fractures that cannot be realigned by hand, or are open, may require surgery to hold the fracture in place with screws, pins, and plates. Once the bone is aligned, the knee should be restrained to allow for healing. You may be non-weight bearing during this period of healing. After restraint, it is important to perform strengthening and stretching exercises to help regain strength and a full range of motion.
Detection and Diagnosis
Your hand consists of 27 bones: eight bones in your wrist (carpals), five bones in the palm of your hand (metacarpals), and 14 bones in your fingers (phalanges). The bones in a normal hand line up precisely, and they enable you to perform many specialized functions, such as grasping a pen or manipulating small objects in your palm.
Although the bones in the hand are small, a fractured hand or finger is not a minor injury. When you fracture a finger bone, it can cause yoThe scaphoid bone is one of the carpal bones on the thumb side of the wrist. This bone is important for both motion and stability in the wrist joint, and it can most easily be identified when your thumb is held in a “hitch-hiking” position.
A scaphoid fracture usually occurs when you fall onto an outstretched hand, with your weight landing on your palm. The end of the larger forearm bone (e.g., the radius) may also break in this type of fall, depending on the position of the hand on landing. The injury can also happen during sports activities or motor vehicle collisions.
Fractures of the scaphoid occur in people of all ages, including children. There are no specific risk factors or diseases that make you more likely to experience a scaphoid fracture.
It’s impossible to prevent the sudden events that often cause a scaphoid fracture of the wrist. However, some studies have shown that using wrist guards during high-energy activities, like inline skating and snowboarding, can help to lower your chance of breaking a bone around the wrist.
Scaphoid fractures usually cause pain and swelling at the base of the thumb. The pain may be severe when you move your thumb or wrist, or when you try to pinch or grasp something.Unless your wrist is deformed, it might not be obvious that your scaphoid bone is broken. With some scaphoid fractures, the pain is not severe and may be mistaken for a wrist sprain. Pain in your wrist that does not go away within one day of injury may be a sign of a fracture—so, it is important to see a doctor if your pain persists. Prompt treatment of a scaphoid fracture will help you to avoid potential complications.
During the physical examination, your doctor will want to know how your injury occurred. With most fractures, there will be tenderness at the base of your thumb. Your doctor will also look for swelling, bruising, and loss of motion. An X-ray of the wrist usually diagnoses scaphoid fractures; however, X-rays do not always show scaphoid fractures. If you are tender directly over the scaphoid bone, which is located in the hollow at the thumb side of the wrist, your health care provider might recommend wearing a splint to be safe. If pain persists, a follow-up exam and X-ray in a week or two can be used to diagnose. Even more, your doctor may order an MRI to confirm diagnosis, and to learn more about the bones and soft tissues in your wrist. An MRI can often show a fracture of the scaphoid before it can be seen on an X-ray.
The treatment that your doctor recommends will depend on a number of factors, including the location of the break in the bone, whether the bone fragments are displaced, and how long ago your injury occurred. Scaphoid fractures that are closer to the thumb usually heal with proper protection and restricted activity. For these types of fractures, your doctor will place your forearm and hand in a cast or a splint for a few weeks. If your scaphoid is broken at the waist or the area closer to the wrist joint, or if pieces of bone are displaced, your doctor may recommend surgery. The goal of surgery is to realign and stabilize the fracture, giving it a better chance to heal since the blood supply to the proximal end of the scaphoid bone is poor and has difficulty healing.
Vertebral Compression Fracture
Get Your Back Back
Vertebral compression fractures (VCFs) occur when the bony block or vertebral body in the spine collapses, which can lead to severe pain, deformity, and loss of height.
VCFs are the most common fracture in patients with osteoporosis, affecting roughly 750,000 people each year. Even more, VCFs affect an estimated 25 percent of all postmenopausal women in the United States. The prevalence of this condition steadily increases as people age, with an estimated 40 percent of women aged 80 and older affected. Although far more common in women, VCFs are also a major health concern for older men.
While osteoporosis is the most common cause, VCFs may also be caused by trauma or metastatic tumors.
In people with severe osteoporosis, a VCF may be caused by simple daily activities, such as stepping out of the shower, sneezing vigorously or lifting a light object. In people with moderate osteoporosis, it usually takes increased force or trauma, such as falling down or attempting to lift a heavy object, to cause a VCF. People with healthy spines most commonly suffer a VCF through severe trauma, such as a car accident, sports injury or a hard fall.
The main symptoms of VCFs may include the following:● Sudden, severe back pain● An increase in pain intensity while standing, walking or bending over● A decrease in pain intensity while lying on the back● Limited spinal mobility● Eventual height loss● Eventual deformity and disability
Physicians diagnose VCFs by conducting physical examinations and utilizing imaging tests, such as X-rays, CT scans and MRIs. If these diagnostic tools indicate the presence of a spinal fracture, Dr. Kayal and his team determine the best treatment plan for the patient.
Our physicians provide expert treatment for spinal fractures. This is dependent upon the type and severity of the fracture, the spinal level(s) involved, and the condition of the patient. The first line of treatment for non-emergency cases involves conservative steps, such as activity limitations, physical therapy, anti-inflammatory medications and customized bracing. With more severe fractures, however, surgery may be required to address the condition.