Distal Femur Fracture Of The Knee

by Administrator 21. March 2017 10:34

Fracture refers to a break or a crack in one or more bones in any part of the body. The distal femur is the lower part of the thigh bone that connects to the knee joint. This bone has a shape like that of an inverted funnel and it joins the shin bone (lower leg) to support the body weight and allow movement. They are supported by the quadriceps muscle, hamstring muscles, a group of tendons and ligaments and a thick layer of articular cartilage which acts as shock absorber and prevents the bones from rubbing against each other.

A break in this part of the bone is referred to as the Distal Femur Fracture of the Knee and it is a rare type of injury that affects the elderly and young people who indulge in high impact sports. In some cases the patella or the knee cap also gets damaged along with the femur. The tendons and ligaments may also be damaged in the process. Sometimes the ligaments snap resulting in shortening of the muscle length. Distal Femur Fractures can be categorized as follows:

  • Transverse Fracture-  the break in the bone is observed to be straight across the bone
  • Comminuted Fracture- the bone tends to break into many pieces
  • Intra-articular Fracture- this type of fracture extends into the knee joint and damages the articular cartilage

Causes

  • Osteoporosis- people above the age of 50 years are likely to have weaker bones due to lack of calcium and general wear and tear with age. The weak bones are likely to crack easily
  • A fall from a height or a sudden fall
  • Vehicular accidents that impact the knee joint
  • Sports injuries
  • Direct hit to the knee joint or the thigh

Symptoms

  • Severe pain may set in immediately after the injury and it is generally persistent
  • Swelling, redness and tenderness around the joint and the thigh may be observed
  • Inability to bear body weight
  • Visible deformity may occur with a part of the bone sticking out of a wound in case of open fractures
  • Bruising and discoloration
  • Altered gait
  • Joint instability
  • Limited range of motion

Diagnosis

  • A detailed clinical evaluation by an orthopedic should be conducted immediately
  • The doctor will check for additional damage to other body parts
  • Details of the mode of injury and medical history of the patient are taken into consideration
  • Check for loss of blood supply or nerve sensation in the leg, feet and thigh
  • X-ray imaging helps diagnose the location and severity of fracture
  • The doctor will look for open wounds and infection that may have passed through it
  • MRI and CT scans may be required

Treatment

Distal Femur Fractures can be treated both surgically and non-surgically depending on the severity of the injury. The methods employed include:

  • Mechanical traction of the skeletal framework with weights and pulleys to bring the bone back in its original position. This is also referred to as manual reduction
  • Bones that are stable with a slight crack or break can be treated by placing the leg in a plaster for a few weeks
  • Immobilization- recommended use of a brace or a cast to keep the bone stable and promote healing
  • External fixation- metallic pins and screws may be used to hold the bone in place and these are attached to an external fixator to keep them stable
  • Internal fixation- a surgical method which involves insertion of a metal rod into the femur along with plates and screws to stabilize the broken bone
  • Severely damaged bone may require total replacement of the joint for best outcome
  • Bone graft by using a piece of bone extracted from other joints or artificial bone fillers may be induced to allow the bone to heal and solidify
  • Use of crutches or a walker is recommended post surgery
  • Activity modification and weight bearing needs to be avoided
  • Physical therapy is required to restore movement

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Orthopedic Treatment For Pulled Hamstring

by Administrator 24. February 2017 03:02

Hamstrings are a group of muscles running at the back of the upper thigh. They are responsible for proper bending of the knee and assist in moving the upper leg backwards. When these muscles get torn or excessively strained, the condition is termed as Pulled Hamstring. It is commonly seen in sportspersons like runners, skaters, football, soccer, and basketball players.

Types of pulled hamstrings-

  • Grade 1-   Stretched muscle fibers
  • Grade 2-   Partial tear of muscle of tendon fibers
  • Grade 3-   Complete tear of muscle fibers

Causes

  • Not warming up before exercise
  • Tight thigh muscles
  • Weak glutes (muscles which make up the buttock)
  • Wearing poor footwear

Symptoms

  • Sudden and extreme pain in the thighs during exercise that gives a snapping or popping feeling.
  • Pain in the back of the thighs radiating to lower buttocks while bending, walking or straightening the leg.
  • Bruising at the site of the injury
  • Muscle spasms
  • Tenderness

Diagnosis

  • The doctor may ask question about previous occurrence of an injury followed by a physical examination. In this the doctor palpates the affected area to assess swelling and tenderness.
  • In case the doctor suspects that the pain is due to a fracture or deformity in pelvis, femur, or knee he may suggest to take certain imaging tests such as x-ray or MRI Scans.

Treatment

  • Rest – To relieve the symptoms the doctor may ask the patient to avoid putting weight on the injured leg and take rest for some time.
  • Icing – To alleviate pain and swelling the patient can be asked to ice the injured area after every twenty to thirty minutes.
  • Compression – The doctor may ask the patient to wear an elastic bandage around the leg to reduce inflammation.
  • Elevation - The patient may be asked to keep his leg elevated by the help of a pillow while sitting or lying down. This may help to decrease pain.
  • Medication – Painkillers and anti-inflammatory drugs may be prescribed by the doctor to eliminate pain and other symptoms.
  • Exercises – The doctor may recommend muscle stretching and strengthening exercises to reduce muscle strain.
  • Crutches – If the condition is severe and there is extreme pain, the doctor may suggest the patients to take the support of crutches while walking.

Prevention tips:

  • Stop exercising if you feel that back of thigh is becoming stiffened
  • Do not play with injured leg, give it proper time to heal
  • Take proper nutrition

The knee doctors at OrthoTexas, Frisco, provide diagnosis and complete treatment for pulled hamstrings. To schedule an appointment with our orthopedic surgeons, you can call at (214) 618 – 5502 or visit 5757 Warren Pkwy, Suite 180, Frisco, TX 75034.

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Knee Fracture: Causes, Symptoms And Treatment

by Administrator 26. January 2017 11:08

Knee is the largest and most complex joint in the body comprising of three major bones femur, tibia and patella (knee cap). Other components include fibula, cartilages, ligaments and tendons. This joint is responsible for the flexible movement, bending and folding of the legs. It is highly prone to muscle tear and bone injuries. A fracture refers to a broken bone in the knee which in most cases is patella, but in severe conditions the other major bones are also affected. Based on the severity of injury they are classified into non-displaced, partial displaced and completely displaced fractures.

Risk factors

  • Knee joints  may degenerate with the age
  • Women going through postmenopausal period have decreased bone mass and are prone to fractures
  • People suffering from Osteoporosis have weaker bones
  • Obese people have a higher risk of knee fracture, because  excess weight puts a lot of pressure on the knees
  • Persons doing excessive exercises or playing high impact sports
  • Climbing a lot of stairs puts strain on the knees and damages the cartilage

Causes

  • A sudden jerk in the joint after falling from a moving vehicle
  • Lifting heavy weights
  • A tear in meniscus
  • Weak bones due to calcium and vitamin deficiency

Symptoms

  • Problem in walking
  • Incapability to straighten the knee
  • Swelling and stiffness around the knee
  • Pain
  • Cracking sounds when knee is bent or straightened
  • Change in knee’s shape.
  • Numbness in the leg below the knee

Diagnosis

  • The doctor  may diagnose the severity of injury by taking an X-Ray or a stress radiograph
  • CT scans may be necessary to completely understand the damage caused by the fracture
  • MRI scans may be required to visualize the soft tissue injuries
  • Arthrocentesis (collecting synovial fluid from a joint capsule) may also be done if the patient has Arthritis, to see blood and fat globules which are the indicators of knee fracture

Treatment

Non-surgical treatment

  • Cast: The doctor may advise the patient to put the fractured knee in a cast in order to restrict its movement and promote healing.
  • Medication: Anti-inflammatory medications and painkillers can be prescribed by the doctors to provide relief from pain.
  • Braces/Splint: The use of supportive devices like braces can be suggested by the doctors. After looking at the fracture’s healing speed the immovable braces can be replaced with the flexible ones.
  • Crutches or wheelchair: Doctors may recommend people with knee fractures to use crutches or wheelchair to avoid putting weight on the knee while walking.

Surgical treatment

  • Internal Fixation Surgery: Depending upon the severity of fracture, the doctor may use metal pins and screws to put back the broken bone in place.
  • Knee replacement: In case of unrepairable damage surgeon may remove the patella and replace it with an artificial one.

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Knee Cartilage Tears: Orthopedic Treatment In Frisco, TX

by Administrator 16. January 2017 11:16

Knee Cartilage is a connective tissue that acts a cushion and protects the knee joint from sudden jerks or shocks.  There are two types of cartilage tissues present in the knee, the first one known as meniscus (presents between the bones) and the second as articular cartilage (covers end of the bones) respectively. Though cartilage is a tough tissue it is highly susceptible to injuries and the condition is majorly seen in elderly, obese and sportspersons.

Causes

  • A sudden jerk to the joint during a fall from an automobile accident or while playing contact sports like rugby, football etc.
  • Injury caused by sudden twisting of the knee
  • Over use of the joint
  • Lack of movement
  • Degeneration of tissues in elderly people

Symptoms

  • Persistent pain in the joint while walking or even resting
  • Swelling
  • Stiffness
  • Grinding sensation
  • Feeling that the joint will give away
  • Unusual lumps or bumps on the affected area
  • Pain in the knee joint
  • Difficulty in straightening the leg

Diagnosis

  • The doctor may recommend a McMurray’s Test or Thessaly’s Test in order to diagnose meniscal tears.
  • Certain imaging tests may also be suggested by the doctor to assess the condition. These include -
  • Magnetic Resonance Imaging (MRI) scans – This test may help the doctor to visualize the damaged tissue in the knee
  • Arthroscopy – To evaluate the extent of cartilage damage that has occurred the doctor may recommend arthroscopy. This involves inserting a camera into the affected area to visualize the damaged tissue.

Treatment

Conservative treatment

  • The doctor may suggest the patient to follow PRICE (protect, rest, ice, compress, elevate) technique to reduce inflammation and swelling.
  • Anti-inflammatory drugs and painkillers may also be prescribed in order to alleviate pain.
  • Exercises that enhance the rate of nutrient diffusion into the cartilage and reduce the formation of scar tissue in the joint, may also be recommend by the doctor.

Surgical treatment

Depending on factor like age and activity level of the patient, size of the lesion etc. The orthopedic surgeon may decide from one of the surgical methods –

  • Debridement-   This procedure may be conducted to remove the damaged tissues that irritates other body parts by continuously rubbing against them. The process is done arthroscopically with the use of a mechanical shaver.
  • Marrow stimulation - Orthopedic surgeon may drill holes under the damaged cartilage to expose the blood vessels that lay inside the bones. This allows a blood clot to be formed in the cartilage which further stimulates the formation of a new tissue.
  • Autologous chondrocyte implantation – In this technique the orthopedic surgeon may take a piece of cartilage from the patient and culture it in the laboratory to form new cells. Then, after 1-2 months implant the healthy cells in place of damaged tissue.

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Lateral Collateral Ligament Knee Injury: Orthopedic Frisco

by Administrator 24. December 2016 10:17

Ligaments are strong bands of tissue that joint the bones in the human body. The knee joint is stabilized by four major ligaments and the Lateral Collateral Ligament (LCL) is one of them. It lies on the outer side of the knee joint and connects the lower end of the femur (thigh bone) to the fibula (lower leg).

The LCL injury may vary from a mild stretch (sprain) to partial tears and complete ruptures. This injury can occur in any person irrespective of the age and gender. The outwards location of the LCL ligament makes it prone to injuries. Minor sprains tend to heal quickly with conservative methods but serious ruptures or tears make the joint unstable and it remains prone to such injuries in the future.

Causes

  • Direct hit or injury to the inner part of the knee joint which in turn pressurizes he outer LCL ligament
  • Sport activities that involve a lot of running and sudden directional changes such as soccer
  • Not warming up adequately before exercising or lack of muscle conditioning
  • Improper alignment of the muscles and bones may lead to ligament injuries during simple activities such as walking or climbing stairs
  • Falling on the knee
  • Collisions in sports or vehicular accidents

Symptoms

  • Mild knee ligament sprains are generally not accompanied by any symptoms in most cases. However, the partial tears and complete ruptures may have the following symptoms.
  • Stiffness of the joint
  • Swelling in the knee joint
  • Limited range of motion is intact
  • Weakness and instability is felt in the joint
  • The feeling of joint locking or catching may occur
  • Pain which varies from mild persistent ache to sharp severe ache

Diagnosis

  • Detailed clinical evaluation of the injured knee through visual observation and palpation
  • The patient is asked to move the leg and knee in different directions to check for movements that aggravate the symptoms and assess the range of motion intact
  • X-ray imaging may be required in most cases
  • MRI scan reveals the severity of damage to the ligaments and other soft tissues in the knee

Treatment

  • Splinting or use of a knee brace
  • Application of ice packs at regular intervals within first 72 hours of injury
  • Prescription of pain killers and anti inflammatory medicines
  • Resting the injured knee or leg in an elevated position is recommended. Any activity that involves weight bearing or knee movement should be avoided until the swelling subsides
  • Physical therapy sessions aimed at strengthening the supporting muscles and improving joint flexibility
  • Complete tears of the LCL ligaments require surgical intervention. The ligament may either be stitched back or removed and replaced by a ligament graft
  • The patient may be asked to use taping or bandage techniques while exercising or playing a sport to give the joint support post surgery

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Knock Knees: Orthopedic Treatment In Frisco, TX

by Administrator 15. December 2016 10:37

Knock Knees, also known as Genu Valgum, is a deformity in which the knees turn inwards and touch each other. The condition occurs during the development stage when the child is 2 to 3 years old.  It is caused due to week ligaments that fail to provide adequate support to the knee. If the condition does not get corrected itself until the age of 6 years, it can lead to a bone disorder.

Causes

  • Obesity
  • Congenital factors
  • Rickets
  • Injury to the shinbone
  • Scurvy
  • Blount’s Disease
  • Irregular bone growth
  • Osteomyelitis
  • Osteoarthritis

Symptoms

  • Pain in the anterior part of the knee 
  • Abnormal gait
  • Gap between ankles
  • Diagnosis
  • Physical examination
  • X- rays
  • Blood tests

Treatment

  • Braces
  • Exercises
  • Shoes
  • Surgery

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Meniscal Injuries: Causes, Symptoms And Treatment

by Administrator 27. November 2016 10:15

The meniscus is a wedge shaped piece of cartilage located on top of the shin bone. Each knee consist of two menisci, one on the outer edge of the joint and the other one on the inner edge. It helps to distribute weight evenly across the knee to provide cushioning to the bones and maintain the stability of the joint.  Meniscal injuries are quite common, particularly among athletes who are involved in contact sports. It may cause the meniscus to tear, either partially or completely. The injury is often accompanied by a ligament tear.

Causes     

  • Quickly turning or twisting with the foot planted on the ground
  • Getting up suddenly from a squatting position
  • Sports injury
  • Lifting heavy weights
  • Age related wear and tear of the cartilage
  • Knee ligament injury
  • Sudden trauma to the knee
  • Obesity
  • Osteoarthritis may increase the risk of a meniscal injury

Symptoms

  • Severe pain in the knee
  • Swelling and stiffness around the affected area
  • Limited range of motion
  • Catching or locking sensation
  • Feeling that the knee may give out
  • The knee may feel tender to touch
  • Difficulty bending or extending the leg
  • Popping sound
  • Inability to walk or bear weight

Diagnosis

After evaluating the symptoms and noting down the patient’s medical history, the orthopedic surgeon may physically examine the knee joint. He may look for pain, swelling, tenderness and other visible symptoms.
McMurray test may be conducted to confirm diagnosis for a meniscus injury. In this, the doctor may bend, straighten and rotate the knee. If a clicking sound is heard, it indicates a tear in the meniscus. X-ray may be conducted to rule out other possible causes of pain, such as Osteoarthritis. MRI scans reveal the severity of the cartilage tear and damage to adjacent structures within the joint.

Treatment

  • RICE Therapy: This implies rest, ice, compression and elevation. The therapy is usually recommended for patients who have a minor tear in the meniscus.
  • Medications: Non-steroidal anti-inflammatory medicines may be prescribed to relieve pain and compress swelling.
  • Physical Therapy: The doctor may suggest doing certain exercises to strengthen the muscles which in turn help to increase stability and mobility of the knee.
  • Surgery: If the symptoms are not relieved by non-surgical treatment options, surgery may be recommended. The procedure involves either repairing or removing the torn cartilage pieces from the joint spaces.

We, at OrthoTexas, Frisco, provide diagnosis and treatment for meniscal injuries. To schedule an appointment with the orthopedic surgeons, you can call at (214) 618 – 5502 or visit 5757 Warren Pkwy, Suite 180, Frisco, TX 75034.

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Knee Bursitis: Orthopedic Frisco

by Administrator 25. October 2016 07:44

Knee Bursitis refers to the condition when the bursa, a fluid filled, closed sac becomes inflamed. This bursa acts as cushion that helps reduce friction between the knee tissues. The bursae, the plural for bursa, are located near tendons of primary joints such as elbows, hips, knees and shoulders.

Knee Bursitis occurs mostly due to a direct injury to the front of the knee, while in some cases, it is the result of a bacterial infection, referred to as septic bursitis. Another common cause includes prolonged kneeling.

Causes

  • Also referred to as ‘Housemaid’s Knee’, ‘Roofer’s Knee’ or ‘Carpet Layer’s Knee’, based on the most common patients’ occupation, Knee-Bursitis has the following causes:
  • Due to overuse or an injury, the bursa of the knee fills with flood
  • It is also common in patients of Rheumatoid arthritis, gouty arthritis and pseudo-gout
  • It can also occur due to a bacterial infection
  • Previous injury can damage the bursa and leave it inflame, causing knee bursitis

Symptoms

  • A localized swelling and/or tenderness of the knee is observed
  • A dull pain accompanied by warm sensation and redness
  • Pain and stiffness while walking or kneeling, restricting the motion of the knee
  • In severe cases of Knee Bursitis, difficulty in straightening the knee may be observed
  • Septic bursitis is also accompanied with symptoms like fever and tiredness

Diagnosis

An inflamed bursa along with symptoms like pain, stiffness, tenderness, visibly red knee and warm sensation are all signs of Knee Bursitis. Next step involves distinguishing between a septic or aseptic bursitis. It is necessary for the doctor to first rule out other knee problems like arthritis or gout, fracture etc, before making a ‘Knee Bursitis’ diagnosis.

Treatment

  • Before starting the treatment for Knee Bursitis, the doctor needs to confirm that it is not a septic bursitis.
  • The doctor can treat an aseptic bursitis using anti-inflammatory or pain medications. Along with medications, ice compresses and rest are also recommended.
  • Another way to treat aseptic bursitis is through ‘Aspiration’. This procedure can be carried out at the doctor’s clinic and involves removal of the bursa fluid collected in the knee using a syringe and a sterile needle.
  • Treating the septic bursitis requires careful and thorough examination in order to identify the infection causing bacteria. Accordingly, a course of antibiotics can be resumed.
  • Certain topical medicines like creams, gels and sprays can also be prescribed as a pain-reliever. These can be applied directly on the skin and are good for relaxing the knee muscles temporarily.
  • Upon ending the treatment, the doctor may suggest certain physical exercises to help strengthen the knee. For effective and immediate treatment of Knee Bursitis, contact your orthopedic doctor.


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Orthopedic Treatment For Plica Syndrome

by Administrator 19. October 2016 07:47

The Plica Syndrome refers to irritation and inflammation of the synovial membrane in the knee joint. This membrane contains fluid which lubricates the knee joint allowing its smooth movement. Folding and straightening the knee can cause hindrance in day to day activities by restricting movement of the knee joint.

Causes

  • Friction in the synovial membrane due to repeated knee movement
  • a fall or direct blow to the knee
  • Overuse of the knee
  • Tightness in the thigh muscles
  • Abnormality in the knee or hip structure and functioning
  • It can also be associated with other factors like Kneecap Dislocation or instability, injury in the foot , abnormal gait, etc

Symptoms

  • Swelling and pain in the knee
  • Snapping or popping sensation in the knee while moving
  • Tenderness in the knee
  • Weakness can be felt while moving the knee

Diagnosis

  • The orthopedic doctor may conduct a physical examination and ask the patient about the medical history. He may check the patient’s gait, standing and sitting posture to identify the cause of the condition.
  • Additional tests such as X-Ray are usually not required. However, in case the pain persists, an MRI scan may be scheduled in order to identify the source of the pain.

Treatment

Non-surgical treatment

  • Icepacks: Application of ice packs at frequent intervals may help to reduce inflammation and swelling.
  • Medications: Anti-inflammatory medications prescribed by the doctor may be beneficial in reducing pain and discomfort.
  • Rest: Patients are advised to take complete rest to promote healing.
  • Physical therapy: stretching and strengthening exercises may be recommended by the doctor to boost recovery

Surgical treatment

Surgery may be recommended when all the non-surgical treatment fail to reduce the symptoms.

Arthroscopy: In this procedure, the surgeon makes small incisions to remove irritated and inflamed tissues. The surgery should be followed by physical therapy to regain strength and mobility in the knee.

The knee surgeons at OrthoTexas, Frisco provide comprehensive treatment for Plica Syndrome. To schedule an appointment with the surgeons, you call at (214) 618-5502.

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Knee Pain: Symptoms When To See An Orthopedic Doctor

by Administrator 24. September 2016 08:55

Knee pain refers is a commonly reported condition in the elderly people although the younger age group may also be affected. The condition occurs if any of the constituent bones (patella, femur, tibia or the fibula) are affected or the soft tissue structures surrounding these bones (ligaments, tendons, muscles, cartilage) are strained. The knee is one of the largest and most used joints in the body which makes it susceptible to injuries as well as strain. The condition can be treated successfully with conservative options in most cases.

Knee pain can be caused due to various intrinsic, congenital and extrinsic reasons. These may include direct injury to the joint, infection, wear and tear due to age, obesity, Arthritis, overuse, lack of exercise, muscular imbalance, fracture, dislocation, damage to the soft tissue structures etc.

Symptoms

  • Loss of flexibility and range of motion can make it difficult for the patient to perform day to day tasks
  • Pain can be felt at a particular point or can be spread across the entire knee
  • Redness and swelling around the knee may be observed particularly if there is fluid accumulation in the joint. Warmth may also spread across the joint in some cases
  • The knee may feel unstable and tend to give away
  • Change in gait or limp is a common development which occurs as the patient’s ability to bear weight and move the joint is decreased
  • The pain and discomfort may be felt the most after getting up in the morning or periods of prolonged rest
  • Climbing stairs, bending, kneeling or sitting cross legged are particularly painful
  • Locking or catching sensation when the joint is moved
  • The knee cannot be flexed
  • Weight bearing is painful
  • A cracking or grinding sensation may be felt

When To See An Orthopedic Doctor?

The patient should consult an orthopedic doctor in the following cases:

  • The knee pain and discomfort occurs regularly and has been a prolonged disorder
  • Conservative methods of treatment fail to cure the problem within 4-6 weeks
  • Knee pain is accompanied by fever, nausea and joint instability
  • Visible deformity is present in the joint
  • The patient is unable to stand or walk
  • The pain does not increase by pressing it, the source of the problem could be some other body part and this needs to be investigated
  • Severe and sudden onset of the above mentioned symptoms
  • Family history of Arthritis/Gout/Osteoarthritis/Tumor needs also warrants medical investigation

For complete treatment of acute or chronic knee pain, visit OrthoTexas, Frisco. To schedule an appointment with the knee surgeons, you can call at (214) 618 – 5502 or visit 5757 Warren Pkwy, Suite 180, Frisco, TX 75034.

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