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Orthopedic Conditions

Orthopedic Conditions

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The term orthopedic (or orthopaedic) refers to the study, diagnosis, prevention, and treatment of conditions of the musculoskeletal system, which encompasses all bones, tendons, ligaments, joints, muscles, nerves, and associated anatomical parts and features. "Ortho" is Greek for "straight," as in setting bones straight. This discipline originated when doctors began to study, diagnose, and treat crippling and debilitating diseases in children, thus the "pedi" reference. "Pais" is Greek for children. While this medical discipline's name has remained intact, today orthopedics extends to treating patients of all ages.

General physicians who elect to study orthopedics must complete approximately 14 years of training prior to becoming a certified orthopedic surgeon. According to The American Board of Orthopaedic Surgeons, orthopedic surgery includes pediatric orthopedics, sports medicine, arthritis treatment including joint replacement and surgery, foot and ankle, hand, shoulder, elbows, spine, trauma and fractures, musculoskeletal oncology, musculoskeletal rehabilitation, arthroscopy, and arthroscopic surgery.

Arm Injuries

Whether caused by a specific traumatic event, a birth defect, or prolonged and continual stress, arm injuries can reduce quality of life and inhibit one's ability to be productive. The human arm includes the hands, wrists, forearms, elbows, upper arms, and shoulders. Often, athletes suffer from arm injuries first diagnosed by a sports medicine doctor. Repetitive motion, such as throwing a baseball or typing on a keyboard can cause stress that results in injury to various components of the shoulders, elbows, wrists, and arms. Children are prone to complications when damage occurs in or around the growth plates, either at the shoulder or elbow. The following list includes some of the most prevalent arm injuries seen by orthopedic specialists and surgeons.

  • Broken Arm (Forearm or Upper Arm)
  • Arthritis/Osteoarthritis of Shoulder or Elbow
  • Athletic Throwing Injuries
  • Biceps Tendon Tear - Shoulder, Elbow
  • Carpal Tunnel Syndrome
  • Clavicle (Collarbone) Fracture
  • Congenital Abnormalities
  • Dislocated Elbow
  • Dislocated Shoulder
  • Dislocated Shoulder Blade
  • Erb's Palsy
  • Forearm Fracture
  • Fractured Elbow (Olecranon)
  • Frozen Shoulder
  • Ganglion Cysts
  • Nursemaid's Elbow
  • Osteochondritis Dissecans of the Elbow
  • Radial Head Fractures of the Elbow
  • Recurrent, Chronic Elbow Instability
  • Rotator Cuff Tears
  • Rotator Cuff Tendonitis
  • Scapula (Shoulder Blade) Fracture
  • Separated Shoulder
  • Shoulder Joint (Glenoid Labrum) Tear/SLAP Tear
  • Sprains and Strains
  • Tennis Elbow (Lateral Epicondylitis)
  • Thoracic Outlet Syndrome
  • Ulnar Collateral Ligament (UCL) Injury of the Elbow
  • Ulnar Nerve Entrapment at Elbow (Cubital Tunnel Syndrome)

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Elbow Injuries

Often, elbow fractures of the distal humerus or olecranon result from a blow of significant force to the elbow. Commonly, this happens when a person falls on the elbow or is in an auto accident. Fractures of the elbow happen quickly and cause sudden pain that may be very sharp. The elbow joint may be separated during the injury, and the patient will experience swelling, pain, numbness in the fingers, and bruising or abrasion. Elbow fractures caused by trauma are often first diagnosed and treated in an emergency room. However, the patient may experience lingering effects of pain, tenderness, impeded range of motion in the effected elbow. Elbow fractures can also lead to arthritis and, in some cases, deformity.

Treatment for elbow pain, injuries, and conditions can range from limiting use and taking over-the-counter anti-inflammatory drugs to orthopedic surgery.

Repetitive movement may cause elbow pain and injury, as well as tears in ligaments and tendons. Overuse or injury of the elbow can trigger the bursa, a small fluid-filled sac in the joint, to become inflamed. This condition is known as bursitis, or tennis elbow when it occurs in the bursa of the elbow.

Sprains and strains are common in the muscles of the upper arms, forearms, wrists, and hands. When minor, these injuries may heal without professional medical care. However, a physician's exam is warranted with any elbow injury, for accurate diagnosis.

Treatment for elbow pain, injuries, and conditions can range from limiting use and taking over-the-counter anti-inflammatory drugs to orthopedic surgery. In some cases, wearing a supportive brace or wrap aids in healing and reduces the potential for re-injury.

  • Arthritis/Osteoarthritis of Elbow
  • Athletic Throwing Injuries
  • Biceps Tendon Tear Elbow
  • Congenital Abnormalities
  • Dislocated Elbow
  • Fractured Elbow (Olecranon)
  • Ganglion Cysts
  • Nursemaid's Elbow
  • Osteochondritis Dissecans of the Elbow
  • Radial Head Fractures of the Elbow
  • Recurrent, Chronic Elbow Instability
  • Sprains and Strains
  • Tennis Elbow (Lateral Epicondylitis) or Bursitis
  • Ulnar Collateral Ligament (UCL) Injury of the Elbow
  • Ulnar Nerve Entrapment at Elbow (Cubital Tunnel Syndrome)

Arthritis

An illustration of the different types of arthritis

Arthritis causes pain in joints and is usually aggravated by use of the joint. The extent of pain depends upon the severity of the condition, which can be seen in x-rays. Advanced arthritis can result in limited range of motion or loss of motion, swelling in the joint, and weakness. Joint deformity may also occur, particularly with rheumatoid arthritis. Resting the joints tends to alleviate pain, if only temporarily.

There are two forms of arthritis. Osteoarthritis, commonly called degenerative arthritis, is the most prevalent. Over half the population over 60 years old and 85 to 90 percent of people over 75 years old suffer from this condition, which can present in any joint. Aging, injury, instability, infection, and overuse can cause osteoarthritis. Rheumatoid arthritis is much more rare, affecting only one percent of adults. It results from inflammation of the synovium, the lining of joints and tendons that provides their nutrients and lubrication. This condition typically begins in the hands before affecting other joints, particularly the elbows.

Over half the population over 60 years old and 85 to 90 percent of people over 75 years old suffer from this condition, which can present in any joint.

An orthopedic doctor or general physician may treat arthritis by advising that a patient rest the affected joints, eliminate activities that stimulate pain, use a splint on the joint for support, apply ice and heat, and/or take over-the-counter acetaminophen and/or anti-inflammatory medications, such as ibuprofen. Moderate daily exercise of the joints helps, in some cases, and orthopedists can prescribe prescription drugs designed for osteoarthritis and rheumatoid arthritis. When a joint is immovable or deformed, or pain is not manageable, surgery may be indicated. An orthopedic surgeon has many options for treating arthritis, ranging from joint stabilization to joint replacement.

Bone Cancer

Cancer is a disease that occurs when tumors form in the body. These tumors are made of rapidly dividing cells that create a mass of tissue. Cancer cells can replace healthy, normal cells, thereby weakening bones and increasing the risk of fracture. There are two types of cancer: benign (not life-threatening) and malignant (rapidly spreading via blood or lymph nodes). While benign bone tumors should be closely monitored, they may not require removal. Malignant tumors should be promptly treated.

A bone tumor weakens the bone, making it more apt to fracture.

Patients with bone cancer may experience aching pain, from mild to severe, where the tumor exists. Other symptoms include high temperature, waking from sleep in pain, or sweating while asleep. A bone tumor weakens the bone, making it more apt to fracture. If your general physician suspects a tumor, he may order urine and/or blood tests, x-rays, an MRI, or a CT of the affected area. Should a tumor be found, a biopsy will be taken and examined under a microscope.

Bone cancer that starts in the hard tissue of bone usually occurs only in children, either with osteosarcoma or Ewing tumors. We call the original location of a tumor a primary cancer. For instance, if a tumor first occurs in the lungs, lung cancer is the patient's primary cancer. Those cancer cells can spread to the hard tissue of bones, as well as other parts of the body. Adults generally experience secondary cancer of the bone when the disease spreads from another part of the body, such as the lungs or breast. Cancer is called "metastatic" when it spreads.

While adults rarely experience primary cancer in the hard tissue of bones, tumors can develop in an adult's soft bone marrow. Examples of cancers that originate in the bone marrow include multiple myeloma, lymphomas, and Leukemia. The four main types of malignant bone cancers include: multiple myeloma, chondosarcoma, osteosarcome, and Ewig's sarcoma. Benign bone cancers include: fibrous dysplasia, giant cell tumor, non-ossifying fibromaunicameral bone cyst, osteochondroma, and enchondroma.

While adults rarely experience primary cancer in the hard tissue of bones, tumors can develop in an adult's soft bone marrow.

Orthopedic oncologists may treat malignant bone cancer with: radiation to shrink tumors and eradicate cancer cells; chemotherapy to eradicate cancer cells in the blood; or surgical removal. Cancer may be prone to return, so orthopedic oncologists should monitor bone cancer patients even after treatment.

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Foot Injuries

About a quarter of all the bones in your entire body are located in your feet. Each human foot has 26 bones, 33 joints, and over a hundred muscles, ligaments, and tendons. Pain in any part of the feet may interfere with activities or, in severe cases, prohibit a person's ability to walk. A foot specialist, called a podiatrist, can examine and diagnose maladies of the feet. In many cases, however, an orthopedic doctor is called upon when a patient's issue involves bones, joints, muscles, ligaments, or tendons.

With 26 bones in each foot, there is high potential for foot bone fractures.

With 26 bones in each foot, there is high potential for foot bone fractures. A doctor will order an x-ray to determine whether a person's foot pain is caused by a fracture or other injury. Often, a "broken foot" is dressed with a compression bandage to secure the bones in proper place for healing. Patients are advised to rest, elevate the affected limb, and apply ice periodically. Crutches are generally advised to keep weight off of the foot as it heals. If a bone is irreparable, surgery may be recommended. Any foot injury that involves a joint may contribute to the development of arthritis.

Another common foot injury is stressed or sprained ligaments and strained tendons or muscles. Sprains occur when a ligament is torn or over-stretched, and strains happen when a tendon or muscle is torn or over-stretched. Both injuries can result from one wrong motion or a repeated motion that weakens the tissues over time. In some cases, an x-ray, MRI, or CT scan is ordered to help a doctor diagnose a foot sprain or strain. Treatments often involve rest, ice, elevation, anti-inflammatory medication, and compression, though in some cases surgery and/or physical therapy is warranted.

Other foot injuries include, but are not limited to:

  • Achilles Tendon Pain
  • Arthritis of Foot or Ankle
  • Bunions, Hammer Toes, Claw Toes
  • Flat Feet Deformities
  • Ligament Sprains & Tendonitis
  • Plantar Fasciitis (Heel Pain)

Hand Injuries

An illustration of the hand

Another quarter of your body's bones is found in your hands and wrists - each of which has 27 bones. The wrist has 8 bones, the palm has 5, and the fingers, including the thumb, have 14 small bones. The connection between each bone forms a joint, allowing the hands to move freely and comfortably. Hand injuries, especially to the dominant hand, can impair motion and daily activity.

Any of the 27 bones in either hand can suffer a fracture.

Any of the 27 bones in either hand can suffer a fracture. People often place their hands in front of them to brace for a fall or blow, and the hands suffer injury. As with a foot bone fracture, a hand bone fracture is diagnosed by x-ray. A hand specialist will usually suggest a brace or cast be placed on a broken hand to immobilize it for healing. Any injury to the hands increases the potential for developing arthritis.

When muscles, ligaments, or tendons are over-stretched or over-used, painful sprains and strains may occur. Most mild sprains and strains heal naturally, and the patient is advised to rest the affected hand or wrist, limit its use, apply ice, and take over-the-counter pain reliever or anti-inflammatories as needed. In severe cases, a sprain or strain may require surgical repair to restore full, fluid function.

Other hand injuries include, but are not limited to:

  • Arthritis of Hand or Wrist
  • Birth Defects/Congenital Anomalies
  • Carpal Tunnel Syndrome
  • Dupuytren's Contracture
  • Ganglion Cysts
  • Nerve and Tendon Injuries, Lacerations
  • Tendonitis
  • Thumb Injuries

Hemophilia

Occurring more in women than men, but still affecting only 1 in 25,000, hemophilia is an inherited disease in which blood does not clot properly. The condition is caused by a lack of sufficient proteins of particular types, in the blood. The condition is normally diagnosed at birth, and it causes prolonged bleeding, unexplained bruising, and in some cases, internal bleeding of the organs, muscles, and joints. Eventually, hemophilia episodes in the ankles, knees, hips shoulders, or elbows can impair mobility or cause permanent deformity. Severe hemophilia may be treated with replacement therapy, in which clotting factors are administered to the patient's blood.

Hip Injuries

The hip is a "ball-and-socket" joint composed of just two bones. The bottom of the pelvis, called the acetabulum, cups the rounded edge of the femur, called the femoral head, allowing for a wide range of motion.

Hip fractures, cracks in the femur, typically occur as a result of blunt force from a fall. Aging patients and those with cancer or osteoporosis have weakened bones, making them more prone to hip fractures from injury. Orthopedists diagnose hip fractures using radiography to locate the fissure in the bone. Milder fractures may be treated non-surgically with physical therapy and careful monitoring, but most orthopedists recommend surgical intervention for hip fractures because they can worsen over time. Procedures for hip fracture involve repairing cartilage and repositioning the bones with biocompatible metal as needed.

Aging patients and those with cancer or osteoporosis have weakened bones, making them more prone to hip fractures from injury.

Hip sprains and strains typically occur when patients do not warm up before or overexert themselves during exercise. Most of these injuries can be managed with ice, anti-inflammatory medication, compression to hold the muscles in place, elevation of the affected leg, and rest. If your ligaments or muscles tear, you may need surgery to reconnect them.

Other hip injuries include, but are not limited to:

  • Arthritis of Hip
  • Bursitis
  • Hip Tumor
  • Labrum Tears (Joint Socket Lining)

Knee Injuries

An illustration of the knees

The knee is a compound or modified hinge joint. It is composed of three bones: the femur, or thighbone, the tibia, which runs through the shin, and the patella, also called the kneecap. These three components create a hinge, allowing the lower leg to move backward and forward on one plane. It can also move in a limited range from side to side and toward the rest of the body.

Fractures can occur in any of the three knee bones.

Fractures can occur in any of the three knee bones. Patellar fractures usually result from severe, direct trauma to the area, as in a car accident, while the tibia is most often broken in jumping injuries. The large, strong femur can be fractured with tremendous force or in patients with weakened bone tissue. If they disrupt the surrounding nerves, knee fractures can also cause difficulty lifting the front section of your foot, preventing you from walking properly. Depending on the severity of your fracture, your orthopedist may simply reposition it and instruct you to wear a cast and use crutches for several months. Severe fractures may require surgical intervention, using biocompatible metal screws, wires, and nails to repair your knee joint.

Strenuous exercise or direct trauma can cause knee sprains or strains, which can create a popping sound, cause discomfort, make your knee give out as you try to walk, or limit your mobility. These types of injuries are typically treated with rest, anti-inflammatory medications, physical therapy, and elevation. Your orthopedist may require you to wear a brace or use crutches for several weeks as you recover. If your ligament, muscle, tendon, or cartilage is torn, you may need to undergo surgery.

Other knee injuries include, but are not limited to:

  • Anterior Knee Pain
  • Arthritis
  • Bursitis
  • Ligament Injuries
  • Meniscal Injuries
  • Knee Tumor
  • Strains and Sprains
  • Tendon Injuries

Scleroderma

This autoimmune disease causes the skin to harden, creating waxy, thick patches in lines or blotches on its surface. Superficial scleroderma may require no intervention, but if scleroderma extends below the skin, it can interfere with joints and motion, cause muscles to function poorly, or contribute to issues such as Raynaud's phenomenon (sensitivity to cold on the feet and hands) or esophageal dysfunction. Scleroderma affects mostly women between 20 and 50 years of age. A biopsy of a skin patch, as well as blood tests, chest x-ray, MRI, and CT scan may be ordered to diagnose scleroderma. Depending on the type of scleroderma a patient has, treatment ranges from using topical moisturizers and exercising joints regularly to taking prescription medications and undergoing surgery.

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Shoulder Injuries

The shoulder is made up of several different joints. The collarbone, or clavicle, and the shoulder blade, or scapula, form a ball-and-socket configuration. The clavicle also connects to the chest bone, the scapula sits against the ribs, and the top of the scapula meets the clavicle at the acromioclavicular joint, or "AC." The clavicle is more prone to fracture than the scapula and can be broken from trauma or a blow to the shoulder. Most shoulder fractures can be managed with physical therapy and rest rather than surgery. Shoulder sprains and strains can limit movement and are typically treated with anti-inflammatories, rest, and slings.

Other shoulder injuries include, but are not limited to:

  • Arthritis
  • Bursitis
  • Tendonitis Arthritis/Osteoarthritis of Shoulder
  • Athletic Throwing Injuries
  • Biceps Tendon Tear - Shoulder
  • Clavicle (Collarbone) Fracture
  • Congenital Abnormalities
  • Dislocated Shoulder
  • Dislocated Shoulder Blade
  • Erb's Palsy
  • Frozen Shoulder
  • Ganglion Cysts
  • Rotator Cuff Tears
  • Rotator Cuff Tendonitis
  • Scapula (Shoulder Blade) Fracture
  • Separated Shoulder
  • Shoulder Joint (Glenoid Labrum) Tear/SLAP Tear
  • Thoracic Outlet Syndrome

Spinal Injuries

The spine is a column of 33 bones, called vertebrae, which allow the back to flex and twist. Where the vertebrae meet, they form what are called facet joints. Spinal fractures can result from injuries, but they most often occur in older patients who suffer from osteoporosis. As the bones weaken, pressure accumulates and they ultimately crack, requiring physical therapy or surgery. Stretching, twisting, or overly demanding exercise can create sprains or strains, which often cause uncomfortable spasms. Rest, ice, and medications can alleviate these symptoms until the ligaments and muscles heal.

Other spinal injuries include, but are not limited to:

  • Bone Spur
  • Cauda Equina
  • Chordoma
  • Deformities: Scoliosis, Kyphosis
  • Degenerated or Herniated Disc
  • Muscular Torticollis
  • Osteoporosis
  • Sciatica
  • Spinal Deformity
  • Spinal Tumor
  • Spondylosis
  • Stenosis

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