Dr. Nachappa Sivanesan Uthraraj

Fractures are simply a break in a bone. They can be caused due to injury, (traumatic fractures) or a pre-existing condition like osteoporosis that causes weakening of bones (pathologic fractures). There are many ways to classify fractures. All fractures fall into the major categories of simple and compound fractures. Simple fractures are fractures where bones remain inside the skin and don’t jut out. They are also called closed fractures.

Compound fractures, also called open fractures, are broken bones that penetrate through the skin. These types expose the bone and deep tissues to the environment. Compound fractures are more serious of the two. The healing here may be affected due to deep infections for which antibiotics need to be used. There are many different sub types of fractures and we’re only going to skim through them here.

1. Comminuted fractures: Severe fractures in which a bone breaks into several smaller pieces.
2. Avulsion fractures: A small piece of bone is completely torn off from the main bone due to fierce pulling off a part of the body.

Other types of fractures are characterised by the many different angles the bone breaks into like transverse, oblique and spiral fractures.

Diagnosis
When a bone is broken there are symptoms like swelling that doesn’t subside on its own and pain. In such a case it’s imperative that one goes to a doctor for a diagnosis. Doctors can usually recognise most fractures by examining the injury and taking an X-ray. The X-ray also provides a clear idea about the type of fracture and the degree of displacement of the bone. And, it’s important that the patient doesn’t wait too long before approaching a doctor. This is because bones begin to heal very quickly after a fracture and the bone tissue will heal using any tissue available. This can lead to a misalignment of broken pieces of bone and cause disability and loss of function.

There are cases when X-ray may not show a fracture. This is especially common in fractures in the hip and wrist in older people. For diagnosing these, doctors will get some other tests done such as a computed tomography (CT) scan, magnetic resonance imaging (MRI), or a bone scan.

Treatments
Fractures have to be treated by doctors. The doctors set the fractured bones in their proper place and hold them there so that they can heal. Setting a bone is called "reduction." Reduction without surgery is called "closed reduction." But if the fracture is serious, it’s going to require surgery with bone repositioning, called open reduction.

In extreme cases, pins, plates, screws, rods, or glue are used to hold the fractured bones in place, inside the body. Once the bone abutment has been treated, the bone is immobilised to allow the broken pieces to heal. In most cases, the fractured part is set in a rigid cast. The fractured ends of the bone can be fixed into place using metal pins connected to an external frame. This is removed after the bone has healed. If you wish to discuss about any specific problem, you can consult an orthopedist.

Heel bone spur is a form of calcium deposit that causes a bony protrusion under the heel bone. An X-ray can reveal up to a half inch elongation under the hill. Without image report, this condition is commonly known as heel spur syndrome. Heel spurs are mostly painless but reports of pain in not uncommon. They are often related to plantar fasciitis. The latter is an inflammation of the connective tissue that stretches through the foot bottom connecting the heel bone and the football.

What causes heel spurs?
Heel spurs are a result of prolonged calcium deposit. This condition can result from the heavy strain on the muscle of the foot and ligament, stretching of fascia and wear and tear of the heel bone membrane. These injuries are frequently observed among athletes who are involved with activities such as jumping and running. 

What are the risk factors?
1. Walking abnormalities that involve putting more than normal stress on the bone, nerve and ligament in and around the heel.
2. Running on surfaces that are hard in nature
3. Shoes lacking arch support
4. More than normal body weight 
5. Spending too much time on the feet
6. Too flat or too high arches
7. A person suffering from diabetes
8. In case the protective pad of the heel is fading away due to old age or other bone disorder

Non-Surgical treatment
Unlike common belief, only rest may not be the best way to treat heel bone spurs. On the contrary, a patient might feel sharp pain immediately after sleep. This happens when he tries to walk and the plantar fascia elongates all of a sudden. The pain decreases with more walking. Some treatment methods that work for 90 percent of the sufferers includes wearing the right shoe, stretching exercises, wearing orthotic devices inside the shoes and physical therapy. Over the counter medicine such as Aleve, Tylenol and Advil can be consumed to reduce the pain and for improving the overall condition. Corticosteroid injection also tends to give relief from the inflammation.

Surgical treatment
If heel spurs persist for more than 8-9 months, surgical options should be explored by the patient. There are two angles on which a doctor works, either removing the spur or release the plantar fascia. Pre-surgical exams are necessary to ensure that a person is eligible for surgery and all non-surgical avenues are explored. Post-surgical activities are equally important for the process of healing. Usage of bandages, crutches, splints and surgical shoes is a mandate to avoid complications such as infection, numbness, and scarring. Possible side effects should be discussed with the surgeon well before the surgery. The estimated healing time from this procedure is close to 8-12 weeks. If you wish to discuss about any specific problem, you can consult an orthopedist.

Torn cartilages are quite a common form of injury occurring in the human body. While one can’t always be too cautious of injuries, one can still try to be conscious of their muscles and do not move about in an abrupt manner to cause injury to themselves. Further, even though torn cartilages are very common, they are quite painful and most often they occur in the knee. Here are some tips to ensure that your torn cartilage heals well and you are exposed to less pain during the healing period:

1. Rest: You must take rest. While it is advised to take bed rest, humanly it is impossible to spend all day in bed. Thus one can move about a little but avoid walking and straining their legs and knee too much. At times crutches can be taken while taking a few steps in the room.

2. Ice Therapy: Putting ice bags in the affected area helps in relaxing the muscles and reducing the pain quite a lot. Though previously people adhered to putting hot water bags, the scenario is slowly changing to ice therapy.

3. Compress: When you are suffering from a torn cartilage, the doctor often puts a bandage on the knee to compress the area. This is done so that the muscles are brought together and they can heal on their own with time and rest.

4. Elevate the Knee: Often it is seen that during such cases, the knee or the hands are rested in an elevated platform. This platform is created with the help of a pillow mostly. This lets the cartilage get time to rest and heal on its own.

5. Avoid Strenuous Activities: This includes jumping, running, jogging, kicking etc, when it comes to the legs and writing, lifting weight etc. when it comes to the hands. These activities require a lot of strength and power and most of all the use of the cartilages. Since the cartilages are torn and in their healing mode, it is best to avoid such activities for a certain amount of time to not put pressure on the cartilages and damage them further.

6. Painkillers: It has been already mentioned that the healing period can be painful. Thus, the doctor may prescribe some painkillers to ease the pain during this time.

Thus, these are some of the easiest ways to deal with a torn cartilage. The recovery period may be painful, but it happens to many people and is completely healable in nature. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.

Reducing one's weight ( BMI is a reliable indicator and the BMI should be less than 30 ) is a good way to prevent osteoarthritis of the knees and hips and if you already have reducing your weight ( BMI ) would relieve the pain to some extent and also make any joint replacement surgery much more effective in cases of severe osteoarthritis.