When Does a Fracture Require Surgery?

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Article featured on BCOS

A bone fracture is a broken bone. Bone fractures are one of the most common injuries orthopaedic doctors see. About 6.8 million people fracture a bone every year, with the most common being hip, ankle and leg bone fractures.

Bones are strong so it takes a big impact to break or fracture one. Bone fractures are most commonly caused by a car accident, a fall, or a sports-related injury. Osteoporosis, a condition where bones become brittle and weak, is related to numerous fractures as well.

While many bone fractures can heal with a cast, others require surgery to treat. The experienced orthopaedic surgeons at Burlington County Orthopaedic Specialists share important information on different types of fractures and when a fracture might require surgery to heal properly.

TYPE OF FRACTURE

Some bone fractures are minor with just a hairline fissure on the bone, while others result in a bone being broken into two or more pieces. The type of fracture will dictate your treatment options.

A hairline or stress fracture is a minor fracture, although one that may be difficult to detect in an x-ray, where there’s a small chink or simple line in the bone. A complete fracture is when the break goes through the bone, breaking it into two pieces. With an open fracture, the bone has broken through the skin, and a comminuted fracture means the fracture has shattered.

BONE FRACTURE SYMPTOMS

If the bone is sticking through your skin, it’s simple to figure out that you’ve broken it. In other cases, it’s no so evident that your injury caused a fracture.

Bone fracture symptoms include:

  • Severe pain
  • Swelling
  • Bruising
  • Difficulty using or bearing weight on the limb

In some cases, the limb looks deformed or is sitting at a strange angle.

FRACTURES THAT REQUIRE SURGERY

The goal of fracture treatment is to allow the bone to heal and fuse back together. Often, this can be accomplished by immobilizing the bone for several months with the help of a cast and splint. The more severe the fracture is, the more likely it is that surgery will be recommended.

For example, an open or comminuted fracture will require surgery to ensure that the bone full grows back together and safely supports your weight. Surgical repair entrails using metal rods, screws, or plates to set the bone in place or align it while it heals.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

When Back Pain Is a Spine Compression Fracture

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 Article featured on Spine-Health
The type of fracture in the spine that is typically caused by osteoporosis is generally referred to as a compression fracture.

A compression fracture is usually defined as a vertebral bone in the spine that has decreased at least 15 to 20% in height due to fracture.

These compression fractures can occur in vertebrae anywhere in the spine, but they tend to occur most commonly in the upper back (thoracic spine), particularly in the lower vertebrae of that section of the spine (e.g. T10, T11, T12). They rarely occur above the T7 level of the spine. They often occur in the upper lumbar segments as well, such as L1.

Types of Fracture

A spinal fracture due to osteoporosis (weak bones) is commonly referred to as a compression fracture, but can also be called a vertebral fracture, osteoporotic fracture, or wedge fracture.

The term “wedge fracture” is used because the fracture usually occurs in the front of the vertebra, collapsing the bone in the front of the spine and leaving the back of the same bone unchanged. This process results in a wedge-shaped vertebra. A wedge compression fracture is generally a mechanically stable fracture pattern.

While wedge fractures are the most common type of compression fracture, there are other types as well, such as:

  • Crush fracture. If the entire bone breaks, rather than just the front of the vertebra, it may be called a crush fracture.
  • Burst fracture. This type of fracture involves some loss of the height in both the front and back walls of the vertebral body (rather than just the front of the vertebra). Making this distinction is important because burst fractures can be unstable and result in progressive deformity or neurologic compromise.

Compression Fracture Symptoms

Vertebral fractures are usually followed by acute back pain, and may lead to chronic pain, deformity (thoracic kyphosis, commonly referred to as a dowager’s hump), loss of height, crowding of internal organs, and loss of muscle and aerobic conditioning due to lack of activity and exercise.

A combination of the above problems from vertebral fractures can also lead to changes in the individual’s self-image, which in turn can adversely affect self-esteem and ability to carry on the activities of daily living.

Because the majority of damage is limited to the front of the vertebral column, the fracture is usually stable and rarely associated with any nerve or spinal cord damage.

Spinal Fractures are Common

Spinal compression fractures that occur as a result of osteoporosis are actually quite common, occurring in approximately 700,000 people in the U.S. each year.

Osteoporosis is especially common in postmenopausal women. In fact, it is estimated that approximately 25% of all postmenopausal women in the United States have had a vertebral compression fracture.

While osteoporosis is far more prevalent in women – approximately four times as many women have low bone mass or osteoporosis as men – it still occurs in men. As many as 25% of men over age 50 will suffer a bone fracture (e.g. hip or spine) due to osteoporosis.

The problem is that the fracture is not always recognized or accurately diagnosed – instead, the patient’s pain is often just thought of as general back pain, such as from a muscle strain or other soft tissue injury, or as a common part of aging. As a result, approximately two thirds of the vertebral fractures that occur each year are not diagnosed and therefore not treated.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Broken vs. Sprained Wrists: How to Tell the Difference

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Article featured on HealthPartners

Wrist injuries are incredibly common. They can happen after a fall, or a forceful hit or sudden twisting of the wrist. For example, you might slip on some ice in your driveway and fracture a bone when falling on an outstretched hand. Or your little hockey player might block a goal and, unfortunately, score a sprained wrist.

But when a wrist injury happens, it may be hard to tell how serious it is. So, how can you tell the difference between a break and a sprain?

Both sprains and breaks need immediate care, but the treatments they need aren’t always the same. Your wrist may need more or less attention depending on the seriousness of the injury. Below, we share key differences between broken and sprained wrists, and when to see a doctor.

What’s the difference between a broken wrist and a sprained wrist?

The difference between a break and a sprain is related to your anatomy. If you have a sprain, it means you have damaged one or more ligaments – the tough bands of fibrous tissue that connect your bones to each other.

If you have a broken wrist, it means that one or more bones in your wrist have fractured or shattered. Your wrist joint is made up of eight small bones around your wrist (the carpal bones) and the end of your forearm bones (the radius and ulna).

So, what is a fractured wrist? A fracture is the medical term for a broken bone –   which means a fractured wrist is the same as a broken wrist.

How can I tell if I broke or sprained my wrist?

For starters, broken wrists tend to hurt more than sprained wrists. If your wrist is broken, you’ll likely feel severe pain. Sprains can cause some tenderness and pain, but sometimes they may not cause much discomfort at all.

Another difference is how much you can move your hand. With a sprain, you should be able to move your wrist in a normal range of motion (but it will be painful). If you have a broken bone, you probably won’t be able to move your wrist very much.

Still, it can be hard to tell the difference between the injuries since both come with bruising, swelling and hand weakness. It’s also possible to have both a fracture and a sprain – and the resulting symptoms – at the same time. The only sure way to tell the difference between a fracture and a sprain is to talk to a doctor or hand specialist.

Fractured wrist symptoms vs. sprained wrist symptoms

 

Fracture Sprain
The sound your wrist makes at the time of injury Grinding, crunching or cracking Often silent, sometimes there’s a popping sound
Hand strength after injury Hand will feel weak Hand will feel weak
Range of motion after injury Only able to move your wrist a little or not at all. Finger movement may also be affected. Can move wrist (but it will be uncomfortable to do so)
Swelling Gradual and mild Quick and significant
Wrist deformity after injury Wrist may look deformed or have an unnatural bend (but it’s also possible to have a fracture without noticeable deformity) None

 

What should I do if I’ve injured my wrist?

One of the first things is to decide if you need to see a doctor or if you can treat your injury at home.

If your hand is numb or your wrist is bent in an unnatural way, head to orthopedic urgent care. If you think your wrist is sprained, it’s okay to wait to see a doctor and treat it at home. But if your wrist doesn’t feel better in a day, make an appointment with a hand specialist or walk in to one of our convenient orthopedic urgent care locations.

Not sure? Schedule an appointment with a hand specialist – they’ll be able to tell if your wrist is sprained or broken, and what you need to do to take care of it.

How long does it take for a sprained wrist to heal compared to a broken wrist?

The more pain you have with your injury, the longer it will take to heal. Sprained wrists can take anywhere from 2-10 weeks to heal.

Broken wrists can take a few months (or more) to heal fully – with most healing happening between 6-12 weeks.

How to care for your injured wrist at home

If you have a wrist injury, there are a few things you should do to reduce pain and get on the path to healing. If you have a mild sprain, these home treatments may be all you need to recover. But for breaks and more serious sprains, you’ll likely need medical attention.

  • Immediately – Stop doing anything that causes you pain, and not just for the day. For example, if you have a sports-related wrist injury, you’ll need to stay on the sidelines until you’re healed. Also, keep your jewelry off until the swelling is completely gone.
  • For the first 24 hours – Apply ice for 15-20 minutes at a time. Also, wrap a compression bandage around your hand to help with swelling.
  • For the first three days – Elevate your hand as much as possible, including overnight. This reduces blood flow to the hand and can decrease swelling.

Medical treatments for broken wrists and serious fractures

To diagnose your injury, your doctor will do a physical examination and possibly take X-rays. Your doctor may also do other imaging tests such as a CT scan or an MRI for more information before making a diagnosis or recommending the treatments that will work best for you. Possible treatment options include:

A cast or splint

Movement makes it harder for bones to heal. A cast or splint holds your wrist in place so that the broken bone can heal. So, what’s the difference between a cast and a splint, and how do you know which you need?

If your fracture isn’t too bad, a splint may be enough to protect your wrist. Splints come ready made and can usually be removed and adjusted. Casts provide greater support for severe injuries. They are custom made – usually from plaster or fiberglass – to fit your wrist and protect your injury.

How long you’ll need to wear a cast or a splint depends on your injury. For a mild fracture, it might be a week or two. For more serious injuries it might be months.

Do you need a cast for a sprained wrist?

No, you don’t usually need a cast for a sprained wrist. It’s more common for a doctor to recommend you wear a splint for 2-10 days. After this period of rest, you should begin moving your wrist as much as possible (as long as it’s not painful). Movement brings fluids to and from the injured area – something that’s necessary for healing.

Still, there are times when a doctor may recommend a cast for a sprain. For example, if moving the injured tendon or ligament causes severe pain or the doctor is concerned that improper healing could cause permanent changes in wrist function.

If you wear a cast for a sprained wrist, it’s usually for 3-4 weeks, but it can be for as long as 8 weeks.

Medications

Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, aspirin and naproxen sodium are great for temporary pain relief. If you have an open fracture and the bone has broken the skin, your doctor will likely prescribe antibiotics.

Hand therapy

As your injury heals, you’ll be able to move it more. At this point, you can start some exercises. Our hand therapists can help put together a tailored plan to help your hand regain the strength and abilities it had before injury. As part of therapy, your hand therapist may use ultrasound, manual therapy, kinesiology taping or neuromuscular re-education techniques.

Surgery

Your hand surgeon may need to implant plates, screws or rods to keep your bones in place while they heal. This is usually only necessary if:

  • Your bone broke in multiple places
  • The bone has pushed through the skin
  • The injury has damaged or could damage the surrounding ligaments, nerves, blood vessels or joints

You may also need surgery if your bone doesn’t heal properly after a break.

Get the help you need for your injured wrist

Wrists with mild sprains can usually be treated at home, but broken bones and severe fractures will heal best with medical attention.

If you have symptoms that could be from a broken or sprained wrist, make an appointment with a hand therapist or your primary care doctor. They’ll be able to tell if your wrist is sprained or broken, and what you need to do to get better.

If your wrist is obviously broken or your hand is numb, head to orthopedic urgent care to have it looked at right away.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

What to Know About a Broken Pinky Toe

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Article featured on Healthgrades

A broken pinky toe can cause significant pain, swelling, and difficulty walking. Rest and toe support can aid recovery and protect against complications.

Some broken toes can be easily treated at home. However, severe symptoms may require a checkup to monitor healing or prevent complications.

This article reviews the symptoms, causes, and treatment of broken pinky toes.

Symptoms

You may have noticed broken toe symptoms when injured, such as pain or a grinding or snapping noise. Other symptoms of a broken pinky toe can include:

  • continued pain
  • skin discoloration or redness
  • bruising
  • swelling
  • the toe appears crooked or different from its usual shape
  • pain or difficulty when moving the toe or placing weight on it

Some people suggest that being able to walk means your toe may not be broken. However, the American College of Foot and Ankle Surgeons notes that this is a myth.

When to See a Doctor

Contact your doctor if you have any broken toe symptoms, including if:

  • symptoms of pain and swelling haven’t started to improve within 2–3 days of the injury
    you continue to have symptoms weeks after the injury, such as pain when walking or difficulty moving the toe
  • you have an open wound, or the injury broke the skin
  • you have diabetes and toe symptoms
  • you have questions about your symptoms

Some cases of broken toes require immediate care. Visit your local urgent care or call 911 if:

  • your toe is misshapen or is at an unusual angle
  • you can see bone
  • you feel tingling or numbness in your toe or foot
  • you heard a snap, grinding, or pop when the injury occurred
  • you believe your big or first toe may be broken

Can a broken pinky toe heal on its own?

While some mild toe breaks or injuries may heal on their own with at-home care, it’s best to contact a doctor if you suspect a break. Untreated breaks can lead to complications, such as chronic pain or impaired healing.

Doctors can assess the severity of the injury and provide treatment.

Possible Causes

Broken pinky toes are often caused by a direct blow or injury, such as:

  • dropping something on the toe
  • accidentally stubbing your toe
  • kicking something hard

Also, other conditions may cause the same symptoms as a broken toe, such as the following:

Sprains

A sprain is when the ligaments, which connect the bones, become torn or stretched. A pinky toe sprain may occur if the toe is hit or twisted or you fall over.

Symptoms can be similar to a broken pinky toe and may include:

  • pain
  • swelling or bruising
  • difficulty moving the toe a tearing or popping sound when you became injured

Treatment

Treatment for a sprain can include:

  • resting the toe
  • applying a cool compress
  • wearing a bandage or splint
  • anti-inflammatory or pain relief medication

Fractures

A toe fracture is when a toe bone cracks rather than breaks. Sometimes, a fracture can be displaced, in which pieces of broken bone may have separated.

Fractures may develop from one direct injury or repetitive activity, known as a stress fracture. Fractured toe symptoms can include pain, swelling, and difficulty walking.

Treatment

Treatment for a fractured toe can include:

  • resting the toe
  • wearing a bandage, cast, or walking boot
  • pain relief medication

Dislocation

Dislocation is when the bones come out of position in the joint. It can occur due to a direct injury or fall. Symptoms of dislocated pinky toe include:

  • swelling
  • pain
  • a visible change in the shape of the joint or toe
  • difficulty moving the toe or walking

Treatment

Treatment for dislocated bones can include:

  • resting the toe
  • strapping the toe to the next toe for support
  • wearing a splint or bandage
  • pain medication

Differences in toe structure

Hammer toe, claw toe, and mallet toe occur when the toes can become bent out of their typical shape. They can be caused by:

  • muscle and pressure imbalances
  • wearing improperly fitting shoes or shoes that apply pressure
  • nerve damage

Also, some people may be born with an overlapping toe, whereby the pinky toe rests over the fourth toe.

Because these conditions can change the shape of the toe and cause soreness or difficulty walking, they can resemble a broken toe.

Treatment

Treatment toe structural differences can include:

  • wearing sturdy, properly-fitting shoes
  • conducting exercises to strengthen the toe and feet muscles
  • over-the-counter (OTC) straps, splints, cushions, or corn pads
  • surgery

Corns or bunions

Corns are a hardened buildup of skin formed by persistent pressure or friction. Bunions form when bone or tissue around a joint swells due to genetics and tight shoes.

Corns and bunions can cause the toe to:

  • appear a different shape
  • swell
  • be painful

Treatment

Treatment for corns and bunions can include:

  • wearing properly fitting shoes
  • OTC products such as cushions or toe spacers
  • corn removal by a podiatrist or chiropodist

Surgery may be an option for severe bunions.

Broken pinky toe treatment and management

Treatment will depend on the severity of the break. A healthcare team can X-ray the toe, which can also help rule out other conditions like fractures.

You may be able to heal some broken pinky toes at home. If your break is mild, your doctor may recommend:

  • resting the toe
  • avoiding unnecessary walking or weight-bearing
  • placing a small, clean piece of gauze or cotton between the pinky toe and the next toe and gently taping them together for support
  • wearing comfortable, well-secured, nonrestrictive shoes
  • taking OTC medications to relieve pain

If you have a more severe injury, your medical team may also suggest:

  • wearing a protective boot or brace around the foot
  • surgery for multiple breaks or if other treatment doesn’t help
  • antibiotics for any bacterial infection
  • nail removal

How not to care for a broken toe

When caring for a broken pinky toe, the NHS recommends not to:

  • strap up or apply pressure to your toe if it’s misshapen or at an unusual angle
  • apply ice directly on the skin
  • stand or walk for long periods
  • wear tight or pointed shoes
  • play contact sports until the pain has resolved
  • treat a child’s toe without talking with a doctor first

Outlook

According to the NHS, broken toes typically heal within 4–6 weeks. However, healing can take several months for some people.

Without effective treatment, you may experience long-term complications such as:

  • toe deformity
  • limited range of motion
  • persistent pain
  • infection

Summary

A broken pinky toe may be painful, swollen, and bruised.

Some cases can be easily cared for at home with toe taping, rest, and OTC pain medications. However, talk with a doctor if you suspect a broken toe. Severe or untreated breaks may lead to long-term effects such as persistent pain or limited use.

Contact your doctor if you have any broken pinky toe symptoms.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Foot or Ankle Fractures & Dislocations

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Article featured on Mercy Health

Causes of foot or ankle fractures or dislocations

A foot or ankle fracture or dislocation can be caused by a variety of factors. Some of these include:

  • An acute injury caused by direct force like a fall, car accident or a sporting accident
  • Overuse or repeated movements that wear down the musculoskeletal tissues

Risk factors for foot or ankle fractures and dislocations

Risk factors for fractures and dislocations are:

  • Foot or ankle fractures and dislocations are most common in high impact or extreme sports such as downhill skiing, football, basketball, soccer or rugby
  • Jobs and sports (such as running) that require repetitive movements lead to a higher risk for stress fractures

Symptoms of foot or ankle fractures or dislocations

The most obvious symptoms of a foot or ankle fracture or dislocation are severe pain, swelling and bruising.

Other symptoms of foot or ankle fractures and dislocations include:

  • Misaligned foot or ankle
  • Numbness to the impacted area
  • Loss of use of the injured area
  • Muscle spasms around the injured area

Not all fractures or dislocations will cause the person to lose mobility. Contact your orthopedic physician if you suspect you have a fracture or dislocation or you have several of the above symptoms. The longer you wait to see a physician, the longer the healing process will be.

Stress fractures are more challenging to self-diagnose because they can be caused by minor injuries and can be mistaken as a sprain or a strain .  If the pain does not subside in 3 – 5 days after a minor injury, schedule a consult with your physician.

Visit the emergency room immediately if the injury is severe and multiple body parts have been impacted.

Diagnosis of foot or ankle fractures or dislocations

A foot or ankle fracture or dislocation is diagnosed under the care of your orthopedic or sports medicine provider.

Typically, the physician will order an x-ray to identify the fracture. In more severe cases, your orthopedic physician will order an MRI (magnetic resonance imaging) or CT (computed tomography) scan.

Treatment for foot or ankle fractures or dislocations

After suffering a fracture or dislocation apply pressure to the impacted foot or ankle, splint the area, and call for a medical appointment as soon as possible.

  • Surgical realignment
  • Splint/Brace
  • Cast

Recovery from foot or ankle fractures or dislocations

Recovering from a fractured or dislocated foot or ankle can take anywhere from 6 weeks to more than a year depending on the severity of the injury. Staying off the ankle and rest are crucial in allowing you to heal as quickly as possible.

It is important to follow your physician’s recommendations for recovery including follow up visits and x-rays of the injured area.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Simple Ankle Fractures Explained

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Article featured on Foot Health Facts

What Is an Ankle Fracture?

A fracture is a partial or complete break in a bone. Fractures in the ankle can range from the less serious avulsion injuries (small pieces of bone that have been pulled off) to severe shattering-type breaks of the tibia, fibula or both.

Ankle fractures are common injuries most often caused by the ankle rolling inward or outward. Many people mistake an ankle fracture for an ankle sprain, but they are quite different and therefore require an accurate and early diagnosis. They sometimes occur simultaneously.

Symptoms of an Ankle Fracture

An ankle fracture is accompanied by one or all of these symptoms:

  • Pain at the site of the fracture, which in some cases can extend from the foot to the knee.
  • Significant swelling, which may occur along the length of the leg or may be more localized.
  • Blisters may occur over the fracture site. These should be promptly treated by a foot and ankle surgeon.
  • Bruising that develops soon after the injury.
  • Inability to walk; however, it is possible to walk with less severe breaks, so never rely on walking as a test of whether or not a bone has been fractured.
  • Change in the appearance of the ankle—it will look different from the other ankle.
  • Bone protruding through the skin—a sign that immediate care is needed. Fractures that pierce the skin require immediate attention because they can lead to severe infection and prolonged recovery.

Diagnosis of an Ankle Fracture

Following an ankle injury, it is important to have the ankle evaluated by a foot and ankle surgeon for proper diagnosis and treatment. If you are unable to do so right away, go to the emergency room and then follow up with a foot and ankle surgeon as soon as possible for a more thorough assessment.

The affected limb will be examined by the foot and ankle surgeon who will touch specific areas to evaluate the injury. In addition, the surgeon may order x-rays and other imaging studies, as necessary.

Nonsurgical Treatment of an Ankle Fracture

Treatment of ankle fractures depends on the type and severity of the injury. At first, the foot and ankle surgeon will want you to follow the RICE protocol:

  • Rest: Stay off the injured ankle. Walking may cause further injury.
  • Ice: Apply an ice pack to the injured area, placing a thin towel between the ice and the skin. Use ice for 20 minutes and then wait at least 40 minutes before icing again.
  • Compression: An elastic wrap should be used to control swelling.
  • Elevation: The ankle should be raised slightly above the level of your heart to reduce swelling.

Additional treatment options include:

  • Immobilization. Certain fractures are treated by protecting and restricting the ankle and foot in a cast or splint. This allows the bone to heal.
  • Prescription medications. To help relieve the pain, the surgeon may prescribe pain medications or anti-inflammatory drugs.

When Is Surgery Needed?

For some ankle fractures, surgery is needed to repair the fracture and other soft tissue-related injuries, if present. The foot and ankle surgeon will select the procedure that is appropriate for your injury.

Follow-Up Care

It is important to follow your surgeon’s instructions after treatment. Failure to do so can lead to infection, deformity, arthritis and chronic pain.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

What is a Calcaneal Fracture?

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Article featured on Cedars Cinai

Overview

The calcaneus is the large bone at the heel of the foot. It is usually fractured after a fall from a great height or in a motor vehicle accident.

Symptoms

Some calcaneal fractures are obvious, resulting in an inability to put weight on the heel, swelling of the heel and bruising of the heel and ankle. Pain is usually severe enough to require an emergency room visit. If the fracture is caused by a stress fracture, over time, then symptoms may be far more vague. There may be some pain, increasing throughout the day, often described as being dull and achy. Bruising may or may not be present.

Causes and Risk Factors

Calcaneal fractures are most commonly suffered by roofers and climbers after a fall, although automobile accidents can also cause such fractures to the heel bone. Males between 30 and 50 years old fracture their calcaneal most often of any age group or sex.

Diagnosis

A physical examination followed by X-rays and/or CT scans are generally used to diagnosis calcaeneal fractures. Such diagnostic studies also help determine the extent of the fractures. An MRI can be used to distinguish a calcaneal fracture from plantar fascitis.

Treatment

Calcaneal fractures can be difficult to treat. The heel bone is like an egg with a strong shell and a soft interior. Therefore, the heel bone often shatters when it is traumatized by a fall or accident. Therefore, treatment requires the repair of multiple fractures in the heel bone, as well as restoring the subtalar joint. The subtalar joint connects the calcaneus and the talus, which is the small bone connecting the heel and the leg. Given the joints location, it carries most of the load of the body.

If the fracture has not displaced the bone, rest and partial to complete immobilization can heal the bone. Usually a cast of some sort is used to immobilize the heel. The time required to heal depends on age, degree of fracture and general health of the patient. Some such fractures take more than 6 months to heal.

Some calcaneal fractures can be treated by manipulating the foot while a patient is under anesthesia, but not involving surgery. This procedure is called closed reduction. If such a procedure does not treat the fracture or if the fracture is more extensive, then surgery may be required (called an open reduction). Surgery may be recommended immediately after a fracture or a few weeks later to allow inflammation to decrease. After both closed or open reduction, a patient must avoid putting weight on the foot, usually through the use of a cast or splint.

In severe cases, further surgery may be required to fuse the subtalar joint. If the subtalar joint is severely damaged, fusion is the only option.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Wrist Fractured: Causes, Symptoms & Treatments

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Article featured on the American Society for Surgery of the Hand

A wrist fracture is a medical term for a broken wrist. The wrist is made up of eight small bones which connect with the two long forearm bones called the radius and ulna. Although a broken wrist can happen in any of these 10 bones, by far the most common bone to break is the radius. This is called a distal radius fracture by hand surgeons.

Some wrist fractures are stable. “Non-displaced” breaks, in which the bones do not move out of place initially, can be stable. Some “displaced” breaks (which need to be put back into the right place, called “reduction” or “setting”) also can be stable enough to treat in a cast or splint. Other fractures are unstable. In unstable fractures, even if the bones are put back into position and a cast is placed, the bone pieces tend to move or shift into a bad position before they solidly heal. This can make the wrist appear crooked.

Some fractures are more severe than others. Fractures that break apart the smooth joint surface or fractures that shatter into many pieces (comminuted fractures) may make the bone unstable. These severe types of fractures often require surgery to restore and hold their alignment. An open fracture occurs when a fragment of bone breaks and is forced out through the skin. This can cause an increased risk of infection in the bone.

Causes

A wrist fracture occurs from an injury such as falling down onto an outstretched hand. Severe trauma such as car accidents, motorcycle accidents or falls from a ladder cause more severe injuries. Weak bones (for example, in osteoporosis) tend to break more easily.

Signs and Symptoms

When the wrist is broken, there is pain and swelling. It can be hard to move or use the hand and wrist. Some people can still move or use the hand or wrist even if there is a broken bone. Swelling or a bone out of place can make the wrist appear deformed. There is often pain right around the break and with finger movement. Sometimes the fingers tingle or feel numb at the tips.

Diagnosis

Your hand surgeon will do a physical examination and obtain x-rays to see if there is a broken bone. Sometimes, tests such as a CT scan or MRI scan may be needed to get better detail of the fracture fragments and other injuries. Ligaments (the soft tissues that hold the bones together), tendons, muscles and nerves may also be injured when the wrist is broken. These injuries may need to be treated also.

Treatment

Treatment depends on many factors, including:

  • Type of fracture, whether it is displaced, unstable or open
  • Your age, job, hobbies, activity level, and whether it is your “dominant” hand
  • Your overall general health
  • Presence of other injuries

A padded splint might be worn at first in order to align the bones and support the wrist to provide some relief from the initial pain. If the fracture is not too unstable, a cast may be used to hold a fracture that has been set. Other fractures may benefit from surgery to put the broken bones back together and hold them in correct place.

Fractures may be fixed with many devices. Pins, screws, plates, rods or external fixation can all be used. A small camera might be used to help visualize the joint from the inside. Sometimes the bone is so severely crushed that there is a gap in the bone once it has been realigned. In these cases, a bone graft may be added to help the healing process. Your hand surgeon will discuss the options that are best for your healing and recovery.

Recovery

During recovery, it is very important to keep your fingers moving to keep them from getting stiff. Your hand surgeon will have you start moving your wrist at the right time for your fracture. Hand therapy is often helpful to recover motion, strength and function.

Recovery time varies and depends on a lot of factors. It is not unusual for recovery to take months. Even then, some patients may have stiffness or aching. Severe wrist fractures can result in arthritis in the joint. Occasionally, additional treatment or surgery is needed.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Bone Fractures: 10 Things Doctors Want You to Know

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Mending Your Bone Fracture: What Doctors Say

About 6 million people break bones in the United States every year. The most frequently broken bone is the clavicle, or collarbone. Other common bone fractures include those in the arms, wrists and ankles. If you’re over 65, you’re more likely to break your hip than any other bone. You can break bones due to injury or diseases like osteoporosis, which weakens bones. Orthopedic surgeons specialize in treating broken bones in all scenarios. Here’s what three board-certified orthopedists want you to know about bone fractures, risk factors associated with them, and tips for helping them heal properly.

1. “A fracture and a break are the same thing.”

Patients frequently think bone fractures and bone breaks are different. Sometimes people think “fracture” means a crack while “break” means a clearly separated bone, but this is not true. “Fracture” is simply the term doctors use to refer to any break or crack in a bone.

2. “If you smoke, your fracture might not heal as fast.”

If you ingest nicotine—whether through cigarettes, cigars, chew tobacco, or even the nicotine patch—you may find that your fracture takes longer to heal than for a non-smoker. This is due to the effect of nicotine on the healing process. If you quit smoking, it will take three months before your body responds to bone breaks like a non-smoker’s would.

3. “Try RICE for non-emergency injuries.”

If you have a broken bone cutting through your skin or your bones are looking crooked and weird (what doctors call a deformity), you need emergency medical care. But if you only have pain and swelling, and aren’t sure if it’s a break, he says, you could try treating your injury at home for a day or two with “RICE”: rest, ice, compression (wrapping with an ace-type bandage) and elevation. If that doesn’t work, then you can be seen by a doctor.

4. “Don’t wait too long to be seen.”

If you wait too long to bring your possible bone fracture to your doctor’s attention, your bone could start healing on its own—and possibly in a crooked way. That makes fixing the problem more difficult than if you’d come in earlier. Or you could have underlying damage to the surface of the joint or other problems that are harder to treat the longer you wait. Waiting can also make it more likely you’ll need surgery. For non-emergency fractures it is recommended patients be seen within a couple of days. If you require an operation, this gives you time to get it scheduled before bones start knitting back together (which usually happens within a few weeks).

5. “Even little fingers and toes need to be checked out.”

You crack your little toe against a table leg. Should you bother getting it checked for fracture? It depends how bad you feel, noting that in similar situations, he might wait a couple days and, if still in pain, see a doctor to have it X-rayed. But in general, it’s better to err on the side of caution and see your doctor. After all, broken toes that heal crookedly can cause your shoes not to fit right, resulting in pain. Similarly, ignoring finger fractures can cause “significant disability” and lead to longer surgeries once patients finally come in, he says.

6. “Moving it doesn’t mean it is not broken.”

Patients say they didn’t think their bone was broken because they could still move the affected body part. But, he says, this is a fallacy. There’s only one way to know if it’s broken and that’s with an X-ray. The idea that if I can move it, therefore it can’t be broken is ridiculous. You can almost always move it, even if it is broken. Signs that it could be a bone fracture include significant swelling, tenderness around the site, bruising, and an inability to bear weight on it even after a couple of days’ rest. 

7. “I don’t always operate.”

People think orthopedic surgeons do surgery 99% of the time. This can cause some patients to avoid seeing them, because they think they’ll wind up in the operating room. It’s perhaps an understandable misconception, given that “surgeon” is part of his title. But, most of what they do isn’t surgery. Instead, orthopedists do the least invasive procedures possible first to promote bone fracture healing, only moving up to surgery if more conservative measures don’t work.

8. “When we tell you to elevate it, take us seriously.”

Folks come in a couple of days after a broken ankle, for example, and they may have been laying around on the couch but not with the ankle truly elevated—which is above the level of your heart. If you’re lying down, you can put two or three pillows under your leg to achieve proper elevation, but if you’re sitting, you’re going to have to use more than that to get your leg high enough. Elevation is key to preventing swelling, which also could delay surgery, if that’s needed.

 9. “Splints are not second-class citizens.”

Casts are non-removable and go all around your broken bone, while splints go only halfway around and can be taken off and on. Both casts and splints are used to immobilize your broken bone and both can be written on and decorated. Yet some patients think casts are best and get disappointed if they get a splint instead. A lot of times patients don’t give the splint a lot of respect. Doctors use splints for several reasons, including when a cast is difficult to place due to the location of the break or when doctors want to leave room for swelling.

10. “Forget the ‘6-week rule’ of bone healing.”

Patients think they know fractures are cured in six weeks, which is an incredible piece of misinformation; no adult is going to heal in six weeks. Most bone fractures take anywhere from 2 to 6 months to heal, depending on many factors, he says. There’s not just one rule for every broken bone. It’s important to understand there is specificity and details matter, such as where a bone is broken, what bone it is, what the fracture pattern looks like, and so on. It’s difficult to generalize.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Understanding Bone Fractures: The Basics

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Article featured on WebMD

What Are Fractures?

A fracture is the medical term for a broken bone.

Fractures are common; the average person has two during a lifetime. They occur when the physical force exerted on the bone is stronger than the bone itself.

Your risk of fracture depends, in part, on your age. Broken bones are very common in childhood, although children’s fractures are generally less complicated than fractures in adults. As you age, your bones become more brittle and you are more likely to suffer fractures from falls that would not occur when you were young.

There are many types of fractures, but the main categories are displaced, non-displaced, open, and closed. Displaced and non-displaced fractures refer to the alignment of the fractured bone.

In a displaced fracture, the bone snaps into two or more parts and moves so that the two ends are not lined up straight. If the bone is in many pieces, it is called a comminuted fracture. In a non-displaced fracture, the bone cracks either part or all of the way through, but does move and maintains its proper alignment.

A closed fracture is when the bone breaks but there is no puncture or open wound in the skin. An open fracture is one in which the bone breaks through the skin; it may then recede back into the wound and not be visible through the skin. This is an important difference from a closed fracture because with an open fracture there is a risk of a deep bone infection.basic information on female sexual problemsBecause of the unique properties of their bones, there are some defined fracture subtypes that present only in children. For example:

  • A greenstick fracture in which the bone is bent, but not broken all the way through
  • A buckle fracture results from compression of two bones driven into each other.
  • A growth plate fracture at the joint that can result in shorter bone length

These fracture subtypes can present in children and adults:

  • A comminuted fracture is when the bone breaks into several pieces
  • A transverse fracture is when the fracture line is perpendicular to the shaft (long part) of the bone.
  • An oblique fracture is when the break is on an angle through the bone
  • A pathologic fracture is caused by a disease that weakens the bone
  • A stress fracture is a hairline crack

The severity of a fracture depends upon the fracture subtype and location. Serious fractures can have dangerous complications if not treated promptly; possible complications include damage to blood vessels or nerves and infection of the bone (osteomyelitis) or surrounding tissue. Recuperation time varies depending on the age and health of the patient and the type of fracture. A minor fracture in a child may heal within a few weeks; a serious fracture in an older person may take months to heal.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday