Common_Orthopedic_Conditions.pdf

1. Clayton E Turner, MD Casper Orthopaedic Associates Casper, Wyoming Frontiers in Wyoming Medicine 2014 Common Orthopedic Conditions

2. 2 Common Orthopedic Conditions 1. Ankle Sprain 2. Plantar Fasciitis 3. Tennis Elbow 4. ACL Tear 6. Meniscus Tear 7. Rotator Cuff Tear 8. Carpal Tunnel Syndrome 9. Distal Radius Fracture

3. 3 Ankle Sprain Ligament injury Ankle pain, tenderness, swelling One or more of these ligaments can be torn or stretched. Twisting force Illustration reproduced with permission from The Body Almanac, Rosemont, IL American Academy of Orthopaedic Surgeons, 2003

4. 4 Ankle Sprain

5. 5 Ankle Sprain R.I.C.E. Rehabilitation Anti-inflammatory Brace Recurring problem Adequate healing time Rehabilitation surgery Illustration reproduced with permission from The Body Almanac, Rosemont, IL American Academy of Orthopaedic Surgeons, 2003

6. 6 Plantar Fasciitis Microtears of plantar fascia Painful heel Unrelated to “heel” spur on xray

7. 7 Plantar Fasciitis Tape heel, arch Customized orthotics Stretching Massage Exercises

8. 8 Plantar Fasciitis - Treatment Warm up well before sports or activities Ice heel, 20-30 minutes after sports or stretching (freeze Styrofoam cups) Anti-inflammatories Night splint Massage

9. 9 Plantar Fasciitis Prepare before running Wear good, supportive shoes Arch support Keep feet strong Avoid activities that cause heel pain If pain persists Corticosteroid injection Surgical referral

10. 10 Tennis Elbow Lateral epicondyle

11. 11 Tennis Elbow Pain just distal to bony ridge Extensor muscle origin Avoid with: warm up Avoid with: stretch before play Correct, well maintained equipment Condition beforehand Evaluate cause

12. 12 ACL Injury Direct blow to knee Non-contact injury, with foot planted and an attempted change in direction – pivot or cut Landing on straight leg Making abrupt stops

13. 13 ACL Tear Normal anatomy Hyperextension Femur Anterior cruciate ligament Anterior cruciate ligament tears Patella Tibia Fibula Femur slips Illustration reproduced with permission from The Body Almanac, Rosemont, IL American Academy of Orthopaedic Surgeons, 2003

14. 14 ACL Tear Treatment – aggressive rehab and potential surgical reconstruction Incidence of ACL much higher among female athletes Combination of causal factors

15. 15 ACL Tear- Prevention Land safely from jumps Practice cutting maneuvers Use little steps to stop Strengthening exercises

16. 16 Meniscus Tear Helps knee joint carry weight, glide, and turn Twisting injury Football and other contact sports Subset of Degenerative Tears occurring in MA

17. 17 Meniscus Tear Pain Giving way Locking Clicking Swelling

18. 18 Meniscus Tear Normal meniscus Torn meniscus

19. 19 Rotator Cuff Tear

20. 20 Rotator Cuff Tear Shoulder pain Worse at night Weakness Catching Limited motion

21. 21 Rotator Cuff Tear Treatment Rest Cold heat Sling Physical Therapy NSAIDS Injection Surgery

22. 22 Rotator Cuff Tear Prevention Avoid repetitive activities with the arm at shoulder level or higher

23. 23 Carpal Tunnel Syndrome Median nerve Transverse carpal ligament Flexor tendons Compressive neuropathy of the median nerve Common in: Pregnancy Diabetes Thyroid dysfunction

24. 24 Numbness Tingling Pain Clumsiness Carpal Tunnel Syndrome

25. 25 Carpal Tunnel Syndrome Splint or brace at night (neutral position) Ergonomic/work evaluation Cortisone injections Anti-inflammatories Surgery to release ligament if unresponsive

26. 26 Distal Radius Fracture Wrist fracture Fall onto outstretched hand (FOOSH) Snowboarders, skaters, elderly Nondisplaced - cast Displaced – reduction possible surgery, ? Intra- or extra- articular

27. 27 Normal Wrist Normal wrist: 15’ radial deviation 11’ volar or palmar tilt Radial deviation Volar Tilt

28. 28 Distal Radius Fracture

29. 29 Wrist Fracture – Cast Care Keep it dry Don’t pull out the padding Don’t stick objects inside Keep dirt, sand powder out Don’t break off or trim edges

30. 30 Overuse Injuries Change Intensity Duration Frequency Common issue in the aging population

31. 31 Training errors Less-than-optimal environment Improper technique Overuse Injuries Boomeritis®

32. 32 Acute vs. Overuse Injuries Acute - sudden trauma such as sprains, strains, bruises, and fractures Overuse - series of repeated small injuries

33. 33 Boomeritis® Exercise - key, but . . . Bike accidents prevail Mortality children 50% wear helmets

34. 34 tendinitis bursitis sprains strains Boomeritis®

35. 35 Treatment R.I.C.E. Modify or stop sports activities 90% of these issues can be addressed with conservative/nonsurgical measures Physical therapy medication Surgery may be warranted in rare situations

36. 36 Preventing Sports Injuries Know and abide by rules Wear appropriate protective gear Know how to use equipment Never “play through pain”

37. 37 Preventing Sports Injuries Warm up stretching are two separate steps! Dynamic stretch Combine the 2 into One activity

38. 38 10% Rule Don’t Increase Activity by More Than 10% Per Week Overuse Injuries

Common_Orthopedic_Conditions.pdf

Common_Orthopedic_Conditions.pdf

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Common_Orthopedic_Conditions.pdf