Most bone fractures mend very easily with proper medical treatment and rest. However, in rare cases, a fracture caused by trauma may not mend even after adequate treatment. When a broken bone fails to heal, it is known as non-union. There are two major reasons for non-union:

  Bone lacks adequate stability

All broken bones require stability to heal. In case of a fracture, doctors place the dislocated bone in its original place and use an external device to hold the broken part in place. Usually, this stability is provided by a splint or cast, but can also be offered by frames and rods as well. However, if the broken bone lacks the required support, it may not set or heal properly, leading to the non-union.

  Fracture lacks proper blood supply

Even with proper stability, a broken bone requires a proper blood supply to start the healing process. The blood carries oxygen and other chemicals that aid in the repair of the bone and makes it crucial during the recovery stage. However, if the blood supply is disrupted, the bone cannot heal and leads to non-union.



Risk factors of non-union:

You are more likely to suffer from non-union if one or more of the following is true in your case-

  People who engage in cigarette smoking and any other form of nicotine addiction have a higher risk of non-unions after a fracture
  Older people can often face non-union, which is why fractures may take longer to heal in these people
  Severe anaemia can often restrict proper blood flow to the broken bone, thus inhibiting the healing procedure
  Similarly, people suffering from diabetes face a greater risk of non-unions
  Lack of proper nutrition may also be blamed for the non-union
  Non-union risks may increase because of side effects from certain medication, such as prednisone, ibuprofen, and aspirin. Consult your doctor in such a case, so that proper precautions can be taken accordingly.

Non-surgical treatment can be used for treating the non-union. Electromagnetic and ultrasound waves are passed through the skin and into the affected bone, in order to treat the non-union. In most cases, this treatment is very effective in curing the fracture. However, if the non-surgical treatment proves ineffective, surgical procedures, such as bone grafts and allograft can be utilized.

Trauma And Nonunion - The Various Risks Involved With It!

Clubfoot is a deformity of the foot in infants. The condition is usually present from birth. This happens when the tissues linking the muscles to the tendons are shorter than usual, as a result of which the infant s foot appears twisted and out of shape. The condition can be mild or severe, depending on the symptoms. Often times, babies who are born with clubfoot have it in both the legs.

How to identify if your child has clubfoot?

Since the condition is present from birth, the symptoms are also easily observable. Identifying the following signs can help detect if your child is born with clubfoot-

  A foot that turns downward and inward and toes that point towards the opposite foot
  The affected foot may appear half an inch shorter than the normal foot size
  The heel of the affected foot may be smaller in size than it normally should be
  The calf muscle on the affected leg will be underdeveloped (appear slightly smaller)
  If the condition is severe, the foot may be twisted upside down

Despite its unusual shape, clubfoot does not cause pain or discomfort. The doctor will most likely notice the symptoms after the infant s birth. He/she will recommend appropriate treatment of the condition, or refer to an orthopaedic who specializes in muscle and bone ailments.

What is the treatment of clubfoot?

Clubfoot is curable so parents need not worry about their child living with a lifelong deformity.

Depending on the severity of the condition, the orthopaedic will either use devices, resort to stretching methods, or will recommend surgery.

  Ponseti Method (stretching and casting) - It is the standard treatment worldover. It starts at birth or anytime within two weeks of age and has best results in younger kids. It involves stretching the clubfoot and casting it in correct position several times over the months to restore the foot shape.
  French Functional Method (stretching and taping) - The doctor will stretch the affected foot and tape it in position several times over a couple of months to realign the shape. It, however, has very limites following.
  Surgery - Surgeries may be needed in older neglected kids or adults. The surgeon performs a surgical procedure (Achilles tenotomy) to lengthen the tendon of the clubfoot and realigns the joints and bones. Following the surgery, the child will need to be in a cast for about 2 months. Further, to prevent the recurrence of the condition, the child will be advised to wear braces for a year at least.
  Devices - They are adjunctive maintenance devices which are used by doctors in treatment of clubfoot. They are applied to the body to stabilize and limit or protect the movement of the damaged joint.

Parents should seek medical intervention if their baby is born with clubfoot. If the condition is not treated early, the child may face difficulty walking, or may even develop other disorders affecting the joints, like arthritis.

Clubfoot - Ways To Identify & Treat It Well!

The human body allows for movement through the complex system of bones, muscles and joints. A break in the bone is medically known as a fracture and can be caused by constant stress, pressure or impact. It is common knowledge that with age, the bone strength decreases and incidence of fractures (osteoporotic fracture) increases. Based on the affected bone and impact, different types of fractures are commonly identified as:

Complete: When the breakage of the bone is complete, producing two or more pieces, it is referred to as a complete fracture.
Incomplete: When the breakage is incomplete, where the bone has cracked, but does not break into pieces, it is known as an incomplete fracture.
Another type would be the open or closed fracture:
Open fracture: When the skin is exposed and the bone breaks through this exposed skin, it is known as compound or open fracture.
Simple or closed fracture: The bone breaks, but the skin continuity is maintained. Again, here are different types including hairline, greenstick, oblique, etc.
What is the reason behind a fracture?
A bone will fracture when force is applied to it that is stronger than the bone itself. A key factor in a bone s susceptibility to fracturing is age. Both children and older people are prone to bone fractures. Children s bones are constantly growing and have not reached their full strength. Elderly people have brittle bones with old age and are prone to develop bone diseases, making them susceptible to fractures.

How they are treated?
Splint and pain medications are commonly used. Closed reduction where the fracture is reduced without opening up the tissues and open reduction, where the tissues are opened up are common approaches to managing fractures.

Can they be prevented?
Especially with children and in the elderly, extra precaution should be taken to avoid any kind of injury and fracture.

Develop an exercise routine to strengthen the muscles
Manage weight
Use the right footwear and exercise gear
Watch your medications (avoid sleep inducing ones)
Increase lighting in the room/home to improve clarity of vision for elderly
Make the home/living area fall-proof by reducing clutter, using railing in the bathroom and bedroom, using rubber mat, etc.
While a fall may seem inevitable, taking the above steps can help reduce the incidence and severity of a fall, thereby minimizing damage.

Bone Fracture - Common Types and How They Can be Prevented?

Pregnancy places a lot of demand on the expectant mother. While the emotional demands are not very evident, the physical ones are. The mother has to ensure that the developing baby gets all the required nutrients through her. Some of them are very critical, and not getting adequate amounts of these manifest as problems, which cannot be rectified later. Calcium supply and associated problems that may arise is one such example.
If there is a reduced supply of calcium and the bones and teeth are not formed properly, taking any amount of calcium is not going to correct the situation later, after delivery.

The bones which are forming in the developing baby are dependent on the mother for adequate supply of calcium. It is common knowledge that calcium is an integral component of bones, teeth, and skeleton. Hypocalcemia, which is a condition where there is reduced amounts of calcium in the body, can be quite severe during pregnancy.
In addition to the growing baby s needs, calcium also plays a vital role in the pregnant mother for muscular contractions, nerve conduction, hormone secretion, and blood clotting. So adequate intake of calcium during pregnancy is essential.
Now, the question arises as to how much calcium is good enough. For a normal female, about 1000 mg of calcium is required on a daily basis. This goes up by another 200 to 300 mg for a pregnant woman, especially during the third trimester when the bone and teeth formation is in full speed. This extra amount of calcium should be continued even after pregnancy, as calcium continues to be provided to the baby during the lactation phase.

Some of the symptoms of reduced calcium intake during pregnancy are aching muscles, brittle nails, weakened bones, severe cramping, and dry skin. If there is suspected hypocalcemia, it is best to seek medical advice. It is not advisable to take supplements without medical supervision. Increased amounts of calcium can produce a different set of symptoms.

While these are evident symptoms, there are other detrimental effects on the baby too. Calcium deficiency affects development of heart and associated structures and puts the newborn at a higher risk of developing hypertension. The baby s fat percentage and triglycerides are also increased. The bone mineral density is reduced. The delivery period could be prolonged, as muscular contractions and nerve conduction are severely impacted when there is less calcium in the system. Recovery from labor is also delayed.

It is possible that you are taking adequate amounts of calcium, but its absorption is affected. Reducing caffeine intake helps in better absorption of calcium. Iron, which is often given during pregnancy, prevents calcium absorption and so needs to be spaced out.

Calcium & Bone Disorders - How to Know If Your Are Suffering From Them?

Knee is a complex structure of your body made up of bones, ligaments, tendons, articular cartilage, muscles and meniscus. Knee is a very important joint as it plays a crucial role in human movement and is also very much prone to injuries. Your shoulder like your knee is also composed of bones, ligaments, tendons and muscles. It is the most flexible joint of your body and because of its frequent movement is also vulnerable to injuries. Knee and shoulder injuries can happen due to various reasons such as while playing sports, carelessly falling down or accidents. Your knee is made up of many important structures, any of which can be injured.

Pain and swelling are the most common signs of knee injury. In addition, your knee may catch or lock up. Many knee injuries cause instability, the feeling that your knee is giving way.

The most common knee injuries are as follows-

Fracture- In case of a fracture usually the patella gets affected. But sometimes the ends of femur or tibia can also get fractured.
Sprains and Strains- This is the most common injury that can happen while playing sports. Sprains and strains refer to the injury of the ACL or MCL.
Dislocation- Sometimes bones like femur or tibia gets displaced from their usual alignment.
Ligament Injuries- Your ligaments may get injured if the position of your knee is in a bent condition during the injury. Ligament injuries are common to sportspersons and can also happen if you encounter an accident.
Meniscal Tear and Tendon Tear- These are very common knee injuries which can happen while playing sports or falling down carelessly.
Treatment of Knee Injuries- 

When you are first injured, the RICE method   rest, ice, gentle compression and elevation   can help speed your recovery. The type of treatment your doctor recommends will depend on several factors, such as the severity of your injury, your age, general health, and activity level.

Nonsurgical Treatment-

Many knee injuries can be treated with simple measures, such as:

Immobilization: Your doctor may recommend a brace to prevent your knee from moving.
Physical Therapy: Specific exercises will restore function to your knee and strengthen the leg muscles that support it.
Non-steroidal anti-inflammatory medicines: Drugs like aspirin and ibuprofen reduce pain and swelling.
Surgical Treatment-

Many fractures and injuries around the knee require surgery to fully restore function to your leg. In some cases   such as ACL, PCL, Meniscal tears, surgery can be done arthroscopically using small incisions and minimally Invasive techniques.

The most common shoulder injuries are stated below-

Dislocation- Sometimes joints may get dislocated from their usual alignment
Fractures- Fractures of the collar bone, humerus and scapular fracture
Frozen Shoulder- It occurs due to the stiffness of the shoulder joint
AC Joint Injury- The ligaments may get injured in this type of an injury. It is common in sportsperson or may also happen due to falling down
Shoulder Impingement- In this case the muscles gets injured
Rotator Cuff Disease (Tendinitis and Bursitis)- In tendinitis of the shoulder, tendons become inflamed (red, sore, and swollen) from being pinched by parts around the shoulder. However, Bursitis occurs when the bursa, a small fluid-filled sac that helps protect the shoulder joint is inflamed.
Rotator Cuff Tear- Rotator cuff tendons can become inflamed from frequent use or aging. Sometimes they are injured from a fall on an outstretched hand.
Treatment of Shoulder Injuries-

Early detection is the key to preventing serious shoulder injuries.
Shoulder Exercises
Anti-inflammatory medication also may be prescribed to reduce pain and swelling.
Shoulder injuries can be treated by exercises and physiotherapy
Shoulder arthroscopy surgery is a small key hole, Day care surgery done for various problems like Periarthritis, Recurrent Shoulder Dislocation, Rotator Cuff Tear

Sports Injury - Its Surgical And Non-Surgical Treatment!

Bones are similar to a porous framework which is filled with minerals that make it hard and strong. With age, there is gradual degradation and the mineralized portion is lost, thereby leading to thinning of the bone. The word osteoporosis literally translates to porous bones, which is due to the gradual demineralisation. In addition to the natural ageing process, there are other diseases that can accelerate the demineralization process.

Women are more prone to demineralisation, and after the age of 40, they should take extra precaution to slow down the onset of the condition. The following are some ways to improve bone health and halt osteoporosis in the long run-

Diet: Ensure that your diet has sufficient amounts of vitamin D and calcium. Though calcium is the essential mineral for bone formation, vitamin D is required for the absorption of calcium, and therefore both these elements play a vital role in maintaining the quality of the bones in our body. Most people require about 1,000 mg of calcium and about 500 units of vitamin D for optimal bone health. This requirement goes up slightly in postmenopausal women.

Sun Exposure: In most people, exposure to the sun allows the body to make vitamin D, but careful sun protection prevents this from happening. Also, with age, the body s ability to form intrinsic vitamin D also declines. The body, therefore, relies on supplements. Most dairy products are good sources of calcium. In addition, spinach, salmon, turnips, and broccoli are some calcium-rich foods. Supplements of calcium carbonate or calcium citrate can be taken if your diet is lacking in calcium. Vitamin D also should be included in the supplementation. The treatment for osteoporosis is incomplete without these two supplements.

Exercise With Weights: The constructive tension that exercise puts on the body helps in bone building, whatever the age may be, which prevents the onset of osteoporosis. Any exercise which improves muscle mass strengthens the bones, and puts stress on the bones is advisable. Since the fractured area due to osteoporosis mainly includes the spine, lower back exercises, yoga, tai chi, and abdominal exercises all work wonders. Pick any of these and do them for 30 minutes three times a week.

Quit Smoking: Continuing to smoke while taking osteoporosis medications is completely useless. Nicotine negates all the effects which defeat the purpose of taking the medication and is as good as taking no medication at all. So if you want the bone thinning to stop, stop smoking.

Alcohol Consumption: While a drink or two per week is permissible, more than this can harm the bones significantly.

Constant Health Watch: Talk to your doctor about how other routine medications (if any) can affect your bone health. Also, identify how frequently you should check your bone mineral density and stick to the schedule.

Bone health and osteoporosis can be managed with some conscious efforts.

Bone Health And Osteoporosis - Know More About Them!

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