We have 207 bones in the body and breaking of any one of them can be extremely painful. Broken bones are called fractures and are most often a result of accidents. The risk of breaking a bone depends largely on your age and fractures are most commonly suffered by children and elderly people. There are many types of fractures. The most important amongst these are:

Complete or incomplete fractures: This refers to the way a bone breaks. A complete fracture involves the breaking of a bone into two or more separate pieces while in an incomplete fracture, the bone does not break all the way through and may only be cracked.
Compound fractures: Compound fractures are also known as open fractures. This refers to fractures where the bone tears through the skin.
Simple fractures: Fractures where the bone does not tear through the skin are known as simple fractures. This can be further categorized as greenstick fractures, transverse fractures, oblique fractures and impacted fractures.
Severe pain is one of the most common symptoms of a fracture. Other symptoms include swelling or bruising over the bone area, loss of function and deformity. Any form of a fracture needs medical attention. In most cases, using a splint to reset and support the broken bones can help heal them. This process can be surgical or non-surgical depending on the extent of the fracture. In some cases a pin or metal plate may need to be implanted along with the bone to give them support while they heal.

Fractures can be easily prevented. In your home look out for things you could trip over or bang into. Keep all stairways clear of obstructions and do not use them when wet. Advise your children not to run in the house as tiles are slippery and they could fall and hurt themselves this way.

Follow general safety precautions like wearing a seatbelt while driving or wearing a helmet while riding a bike or bicycle. This can significantly reduce your chances of breaking a bone if caught in an automobile accident. 

The weaker your bones, the easier they are to break. Eat food rich in calcium and vitamin D to build stronger bones. Milk and other dairy products are rich in calcium while the best way to get vitamin D is by exposing yourself to the early morning sunlight.

If you suffer from osteoporosis, exercise regularly to improve your balance and increase the strength of your bones and muscles. Your doctor may also prescribe medication for the same.

Fractures - How They Can Be Prevented?

Sports injuries are a common problem, where various types of musculoskeletal injuries can occur during the physical activities. These injuries can either be acute or chronic in nature. In athletes, such injuries can pose as a risk to their careers, which makes it essential for the physicians to provide the most appropriate treatment. It is mandatory to provide a prompt, safe and quick treatment that can restore the athlete s preinjury level of participation in sports.

Various treatment approaches are present for treating sports injuries. The use of intra-lesion blood injection is being made for addressing the musculoskeletal injuries. An easy and minimally invasive method of using concentrated autologous growth factors in treating sports injuries is the use of platelet rich plasma (PRP). It is a fraction of the blood plasma that contains a higher concentration of platelets than normal plasma, along with growth factors.

PRP is used in the treatment of both soft tissue and bone injuries. Growth factors have a positively influencing effect on the healing process of connective tissue components.
There is a huge difference between the anatomy and functions of tendons, ligaments, muscles and joint capsules. Hence, the site of injection of PRP also varies.
The cellular tension in the tissue and the collagen structure is affected after the administration of PRP.
Use of PRP is popular in the treatment of an Achilles tendon. For injecting PRP, an ultrasound scan is done, the site of injection is accurately identified and then PRP is administered.
Proper location of the site of injury and deciding the accurate injection zone prior to the injection of PRP makes it easier to facilitate treatment and eliminate discomfort.
Administration of PRP should be considered secondary to physical therapy and other conservative means of treatment.
Enthesopathy is a discomfort in the area where the attachment of tendons, ligaments and the articular capsule is present. The use of PRP is increasing in the treatment of this condition. It has an inflammatory nature and presents as epicondylitis or capsulitis.
Studies have proved that PRP is an effective alternative to injection of steroids for an anti-inflammatory effect. Steroids majorly provide only symptomatic relief, whereas PRP is more definitive.
PRP has also found an increased use in the area of surgical procedures of knees. It is used to increase the efficiency of the healing grafts placed in the knee during reconstructive surgeries.
For treatment of bone injuries, use of PRP has shown an improved quality and rate of bone healing. Even in cases of an infected injury, PRP aids in healing efficiently.
No known side effects or complications after use of PRP have been observed, which makes it a sought after option in management of sports injuries.


Platelet Rich Plasma In Sports Injuries

Majority of bone tumours are benign, meaning they are localised and do not spread. Since benign tumours do not metastasize, they are not forms of cancer. Despite not being malignant, the severity of their presence should not be ignored as they may cause a lot of pain and lead to other problems such as damaged bones and fractures.

Benign Bone Tumors

Osteochondromas: These form over 40 per cent of all benign bone tumours. They are mostly found in children and teenagers. Osteochondroma is a growth abnormality and they are found in the growing ends of long bones. An osteochondroma might grow separately or might be accompanied by other similar tumours.
Osteoclastomas: They are also called giant cell tumours of the bone. They are common and are found in the epiphysis of long bones and around the knee.
Osteoid Osteoma: These grow mostly in adolescents and very rarely in adults above 50. They primarily grow in the legs but they might also be found in other bones in the body.
Enchondroma: It is a bone tumour that starts in the cartilage. It is mostly found in the cartilage of the inner lining of bones. Small long bones of the feet and the hands are affected the most. Teenagers get more affected than other age group.
Osteoblastoma: These are slow growing tumours that take about two years to get diagnosed. An osteoblastoma makes the surrounding bones weaker as they dissolve them and make them more susceptible to fracture caused by small injuries. Men are twice as more likely to be affected by an osteoblastoma than women. Surgery is essential in all cases of osteoblastoma as they destroy healthy functional bone and grow in size with time.
In rare cases, these have also known to become malignant over time, despite their benign nature. It affects people under 30 mostly.

Malignant Bone Tumours

Osteosarcoma: It affects the hip, knees and shoulders of mostly children and teenagers. It is also referred to as osteogenic sarcoma.
Ewing Sarcoma Family of Tumours: These generate from medullary cavities and can also grow in blood vessels and adipose tissues. It primarily affects children and teenagers.
Chondrosarcoma: It usually affects the hips, pelvis and shoulders of middle aged people.

5 Most Common Types Of Benign Tumours!

The shoulder is one of the most intricate joints in the body and given that it is subjected to a lot of lifting and movements, there are chances for it to tear or dislocate. The shoulder is a ball-and-socket joint with the socket in the shoulder, and the ball in the upper arm. The joint space between the two bones is surrounded by cartilage, and the space between the two is filled with fluid. Especially in athletes, due to forceful movement, this joint could get dislocated or the cartilage could tear.

The Bankart lesion is when there is a tear of the cartilage in the central anterior shoulder. This causes the cartilage to be damaged, allowing the humeral head to slip down from the socket. When the arm is extended down or to the side, it is commonly dislocated. This can happen posteriorly also, but this movement and so the injury is less likely than an anterior dislocation. If there is also a fracture of the shoulder bone with this dislocation, then it is known as bony or osseous Bankart lesion.

Causes: Bankart lesions can be acute or chronic. Acute is when there is sudden dislocation due to sports activity or accidents. Repetitive use of the shoulder can also lead to chronic Bankart lesions. This is usually seen in sportspersons like swimmers, tennis players, and weightlifters.

Signs and Symptoms:

Pain: The most common symptom with Bankart is shoulder pain that restricts any kind of movement. One may find it difficult pick up things or lifting your hands and in some cases, it is difficult to even sit straight.
Weakness: The shoulder feels weak and one is unable to perform normal activities
Instability: One may lose the grip and strength.
Limited movement: The range of motion of the shoulder may be reduced compared to before the injury.
Crackling: The damage to the fibrous cartilage produces a crackling sound, which can be heard during the movement of the shoulder.
Diagnosis: A combination of symptoms, physical examination, X-ray, and MRI can help in confirming the diagnosis.

The course of treatment depends on the cause and condition of the patient. An exercise regimen is prescribed as the first step in the treatment process. If there is inadequate progress, or if the pain seems to be recurrent, open or closed shoulder surgery may be recommended to include the following:

Arthroscopy (closed surgery) to repair the cartilage damage
Ligament re-attachment
Bone reshaping
Cartilage build up and reshaping
Ligament repair to improve stability
Any of these shoulder surgeries would be followed up with measures to reduce further injury. It is therefore advised to visit a doctor in case of any such discomfort as he/she will be able to find out the severity of the situation and devise a treatment plan accordingly.

Bankart's Lesion - What Exactly Is It?

Osteoporosis is a disease that affects the bones of a patient. This is most commonly found in women, especially in those women who are close to or going through, menopause. Hormonal changes around this period in a woman's life usually lead to various changes in her body. One of these changes include loss of bone tissue which can leave the patient with brittle and weak bones, a condition that is also known as osteoporosis. This condition literally imbibes the word porous, meaning hollow bones. It is born from an acute deficiency of calcium and vitamin D. The DEXA Scan or bone density test, also known as the Dual Energy X-ray Absorptiometry Scan, is one of the most effective tests that can help you in detecting this kind of damage or thinning bones. Here's why.

    Fractures: The DEXA Scan is an important one because it sends low energy beam to areas like your joints and tissues to show how susceptible you are to fractures. It does so by measuring the strength of the tissues as well as the bones to see how brittle they may be.
    Other Ailments: Measuring the thinning of your bones can also point to the presence of other ailments that may have gone unnoticed or undetected, earlier. These can include kidney disease, hyperparathyroidism which happens due to overactive secretions of the said gland, as well as liver disease due a malfunctioning liver, intestinal disease and various disorders in the intestinal tract, and a serious vitamin D deficiency. With this scan, you can get an insight into the other parts of the body affected by the bone density and whether or not they are functioning properly.
    Estrogen: Simply checking the estrogen levels cannot ascertain whether or not you have osteoporosis, as a high estrogen level can be credited to a particularly heavy period cycle. It does not show the bone health the way a DEXA Scan does.
    Easy and Standardised: This method of scanning usually happens with the help of a mounted X ray machine type, hand held gadget which can be extended to conduct the scan. This is an easy and standardised method that releases low levels of radiation which also makes it a healthier option.
    Bone Density Scores: The T Scores and Z scores point towards the bone density and help in diagnosing the condition efficiently. With a systematic scoring system, it is a sure shot test for osteoporosis.

Osteoporosis is a serious condition. The first step in treating the same is to get a detailed scan like the DEXA scan done, so as to test the extent of the bone thinning to ensure that proper and timely treatment takes place.

Why is the DEXA scan important for osteoporosis patients?

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!

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