New treatment lets patients use broken bones immediately

Jewelry designer Eve Alfille, 72, sought medical attention for a wrist fracture just 10 days before she was to show a new collection of work at her gallery in Evanston.

She thought her show would be ruined because she would be unable to finish hand-crafting her jewelry with a clunky cast on her wrist.

She went to one doctor who told her he wouldn’t perform surgery – the wrist would just have to heal on its own. Without the surgery she faced permanent displacement, and might not have been able to twist her wrist ever again, she said.

“They weren’t really interested in my needs,” Alfille said. “I am a jewelry designer and there is a certain use of my hand that I just need – I wouldn’t be able to work.”

She was devastated and sought a second opinion. That’s when Dr. Mark Cohen, an orthopedic surgeon at Rush University Medical Center who specializes in hand, wrist and elbow surgery, told her that using the latest technology he could fix her wrist and have her back to work in just a few days.

“It was remarkable,” Alfille said. “There was no pain, before or after, and I was able to do work that same day.”

Alfille is but one of many patients who will find wrists fractures less of an inconvenience than in years past. New technology, which attaches small plates to the bone, has been tested over the past five years and has now had enough trials to be proved very effective at getting patients up and running months faster than before without risk of reinjuring the bone, Cohen said.

Wrist fractures are the most common type of broken bones, which means many people could potentially be incapacitated by the injury. Cohen said in the winter with slippery sidewalk and ice-crusted parking lots he treats three to four broken wrists a week. In addition to being of use on the wrist, the plates can also be used in ankle, leg, hip and other types of fractures.

“These small little locking plates have revolutionized the way we treat broken wrists,” Cohen said. “Patients experience less pain, fewer problems after surgery, recover quicker and rapidly recover their mobility and function.”

The small locking plates are secured internally with small screws placed directly into the bone. Once in place the plates are extremely secure and permanent. The patient can almost immediately enter rehabilitation therapy and start to return to normal activities, Cohen said. Using old technology, including casts, to set the wrist -- or external screws fixed into place with metal bars -- the patient would not enter therapy until about two months after the fracture occurred.

The process is much faster because the body is essentially tricked into thinking it is healed because it has been bolted back together internally, said Dr. John Fernandez, Cohen’s partner in orthopedics at Rush University Medical Center.

“We have a couple of students who were treated the old way versus the new way and the difference is dramatic,” Fernandez said. “Patients are able to use the hand immediately rather than waiting for the fracture to heal.”

This surgery will be most influential for seniors who are the most common victims of falls that result in broken or fractured bones, Cohen said.

“Many older people live alone and their independence is very important to them,” Cohen said. “To be able to make somebody independent within a few days is a huge difference than having someone rely on only one hand for all of their activities.”

Source: http://news.medill.northwestern.edu/chicago/news.aspx?id=76077

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Fractures (broken bones): First aid

A fracture is a broken bone. It requires medical attention. If the broken bone is the result of a major trauma or injury, call 911 or your local emergency number. Also call for emergency help if:

• The person is unresponsive, isn't breathing or isn't moving. Begin cardiopulmonary resuscitation (CPR) if there's no respiration or heartbeat.
• There is heavy bleeding.
• Even gentle pressure or movement causes pain.
• The limb or joint appears deformed.
• The bone has pierced the skin.
• The extremity of the injured arm or leg, such as a toe or finger, is numb or bluish at the tip.
• You suspect a bone is broken in the neck, head or back.
• You suspect a bone is broken in the hip, pelvis or upper leg (for example, the leg and foot turn outward abnormally, compared with the uninjured leg).
Take these actions immediately while waiting for medical help:

• Stop any bleeding. Apply pressure to the wound with a sterile bandage, a clean cloth or a clean piece of clothing.
• Immobilize the injured area. Don't try to realign the bone, but if you've been trained in how to splint and professional help isn't readily available, apply a splint to the area.
• Apply ice packs to limit swelling and help relieve pain until emergency personnel arrive. Don't apply ice directly to the skin — wrap the ice in a towel, piece of cloth or some other material.
• Treat for shock. If the person feels faint or is breathing in short, rapid breaths, lay the person down with the head slightly lower than the trunk and, if possible, elevate the legs.

---

MORE ON THIS TOPIC
• Shock: First aid
• Cardiopulmonary resuscitation (CPR): First aid
• Severe bleeding: First aid

Source: http://www.mayoclinic.com/health/first-aid-fractures/FA00058

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Five Foot Problems Men Should Never Ignore

Feet are the Rodney Dangerfield of body parts; they don't get no respect.

That's especially true for men's feet. Men often resist going to the doctor
when they're sick or in pain. But most foot conditions are treatable, and
easier to treat, when diagnosed early.

The American College of Foot and Ankle Surgeons (ACFAS) wants men to know about five foot problems they should never ignore:

• Heel pain is often caused by tissue inflammation, but can also result from a
broken bone, a tight Achilles tendon, a pinched nerve, or other problem. A qualified physician will know how to diagnose and treat the true cause of heel pain.

• Ankle sprains always, always, always require a prompt visit to the doctor. Men who skip out on medical care are more likely to suffer repeated ankle sprains and then develop chronic ankle instability.

• Big toe stiffness and pain develops slowly over time, as cartilage in the big toe joint wears down. This eventually leads to arthritis. The sooner a man has this diagnosed, the easier it is to treat.

• Achilles tendonitis usually develops from a sudden increase in physical activity, such as when men play weekend sports. Chances of an Achilles tendon rupture can be reduced by treatment of the symptoms of Achilles tendonitis: pain and tenderness on the back of the foot or heel.

• Ingrown toenails can pierce the skin, open the door for bacteria to enter the body, and convince some men to perform dangerous "bathroom surgery." Few men know that a doctor can perform a quick procedure that will end the pain and permanently cure an ingrown toenail.

For a list of five additional foot problems men should never ignore, visit the
ACFAS Web site, http://www.footphysicians.com/ .

The American College of Foot and Ankle Surgeons (ACFAS) is a professional society of more than 6,000 foot and ankle surgeons. Founded in 1942, the College's mission is to promote research and provide continuing education for the foot and ankle surgical specialty, and to educate the general public on foot health and conditions of the foot and ankle through its consumer website, http://www.footphysicians.com/ .

SOURCE: American College of Foot and Ankle Surgeons
http://www.reuters.com/article/pressRelease/idUS108479+08-Jan-2008+PRN20080108

Mark Forstneger of the American College of Foot and Ankle Surgeons,
+1-773-693-9300, ext. 1306, forstneger@acfas.org

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Rib Fracture

WHAT YOU SHOULD KNOW
Broken ribs are more common in older adults than younger people. The ribs may be fractured in more than one place. They generally take from 3 to 8 weeks to heal.

Causes
Causes range from a fall or a blow to the chest to hard coughing or sneezing.

Signs/Symptoms
You'll suffer pain, especially when taking a breath. Other symptoms are tenderness and shallow breathing. You may feel as though you have to hold your chest to relieve the pain. There may be bruising at the place of injury.

Care
The break will need to heal naturally. To speed healing, follow the guidelines listed below.

WHAT YOU SHOULD DO
• Avoid strenuous activity. Be careful not to bump the injured rib.
• Eat a normal, well-balanced diet. Drink plenty of fluids to avoid constipation.
• Take deep breaths several times a day to keep the lungs free of infection.
• Do not wear a rib belt or binder.
• You may apply heat to the injury to help relieve pain. Use a warm heating pad, whirlpool bath, or warm, moist towels.
• You may use over-the-counter pain-killers such as aspirin, acetaminophen, or ibuprofen.

Call Your Doctor If...
• You develop a high temperature.
• You develop a cough.
• You cough up thick or bloody sputum.

Seek Care Immediately If...
• You have trouble breathing.
• You develop nausea, vomiting, or abdominal pain.
• Your pain gets worse.

Source: http://www.healthsquare.com/mc/fgmc2180.htm

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How to tell a broken bone from a hole in the snow

Winter is definitely here, with snow and ice in the morning, followed by sun and puddles in the afternoon. This can often cause a fall. Falling forward is a very common injury from many outside activities -- including skiing, snowboarding or running on icy trails -- and usually results in nothing more than a bruise or a bump.

Most commonly, falls mean a fracture of the wrist or hand, but sometimes the force of the blow can be transferred up the arm to the elbow. In this case, there could be a fracture or dislocation of the bones of the elbow, and the radial head is often where this occurs.

There are two bones in the forearm that connect to one in the upper arm. The humerus is the bone that goes from the shoulder to the elbow. At the elbow, it widens out so that it can connect to the bones of the forearm (the radius and the ulna). The construction of the forearm is complex in that it must allow rotation of the forearm so the wrist can go from facing down to facing up while still providing stability. This is achieved by having each bone swap functions at each end of the forearm. In the elbow, the radius is the bone that rotates. In the wrist, the ulna is the one that allows rotation. It is a pretty neat construct.

If there are excess loads to the forearm or wrist, these stresses can literally be sent up the arm to the elbow. This can result in so much force on the elbow and the forearm bones that something has to give. What gives depends upon many things, but one of the most important is that age of the person.

Young children tend to dislocate the elbow or fracture the end of the humerus or upper arm bone. Older people tend to fracture the wrist since they tend to have less calcium and weaker bones. Between the ages of 30 and 40, more commonly in women, the part of the radius bone that connects with the elbow is where the fracture occurs.

If you are unlucky enough to have an injury like this, here are some of the signs that you should look for:

Pain in and around the elbow, especially on the outside of the elbow.

Swelling around the elbow, especially on the outside.

Pain with bending or straightening the elbow.

Pain with trying to turn the forearm, such as with turning the palm up and down.

Pain in the elbow, especially on the outside, when gripping.

If any of these symptoms are present, you should get the arm in a sling or a splint to protect it and get it checked out. In most cases, the diagnosis is made from a routine X-ray, and we can classify the break as either a type I, II or III fracture depending on the severity.

If the initial X-rays are negative and the pain and especially loss of motion persist, you might need an MRI. This will allow proper treatment and hopefully a rapid return to full activity.

Paul Collins, M.D., is an orthopedic surgeon specializing in sports medicine at Orthopedic Health Care in Boise, Idaho. Collins is an avid participant in many outdoor activities.

Source: http://dailycamera.com/news/2007/dec/20/the-elbow-fractures-connected-to-the/