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.

Comminuted fractures: Severe fractures in which a bone breaks into several smaller pieces.
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.

Fractures - How To Diagnose Them?

Spine surgery is conventionally performed as  open surgery , which means the region being worked on is opened with a long entry point to permit the surgeon to view and access the area. Technical and scientific advances have permitted more back and neck conditions to be treated with a less obtrusive surgical technique. The minimal invasive spine surgery (MISS) does not include a long cut, and it prevents causing damage to the muscles around the spine. As a rule, this causes less pain after the surgery and a speedier and healthy recovery.

Spine surgery is normally suggested when non-surgical treatments like medicinal or exercise based methods have not helped in lessening the excruciating symptoms of your back problem. Moreover, surgery is just considered if your doctor can pinpoint the correct reason of your pain, for example, a herniated circle or spinal stenosis. 

MISS is also called less obtrusive spine surgery. In these procedures, surgeons utilise particular instruments to get to the spine through little cuts. The surgery process is as follows:

During the surgery, a little entry point is made and the tubular retractor is embedded through the skin.
It is also inserted into the delicate tissues down to the spinal cord.
This makes a passage to the little range where the problem exists in the spine.
The tubular retractor holds the muscles open and is set up all through the surgery.
The surgeon gets to the spine utilising the little instruments that fit through the focal point of the tubular retractor.
Any bone or disk material that is expelled goes out from the retractor.
Any gadgets needed for the fusion process, for example, screws or rods, are embedded through the retractor.
A few surgeries require more than one retractor.
Keeping in mind the end goal to see where to put the entry point and embed the retractor, the surgeon is guided by fluoroscopy.
This strategy shows ongoing X-ray pictures of the patient's spine on a screen throughout the surgery.
The surgeon additionally utilises a microscope to enlarge the view through the retractor.
Towards the end of the procedure, the tubular retractor is expelled and the muscles come back to their original position.
This restrains the muscle damage that is more ordinarily found in open surgeries.
It is very important to talk about these risks with your doctor before your surgery or procedure.

Infection: Antibiotics are consistently given to the patient some time before, during, and regularly after the surgery to reduce the danger of infections.
Bleeding: A specific measure of bleeding is normal; however, this is not commonly dangerous.
Pain in the grafted area: Some patients will encounter surgical pain at the bone joint site.
Recurring symptoms: A few patients may encounter a repeat of their side effects.
Pseudarthrosis: Patients who tend to smoke are more prone to pseudarthrosis. This is a condition wherein there is insufficient bone formation. In case that this happens, a minor surgery may be required.
Nerve damage: It is possible that the nerves or veins might be harmed during these operations. These complications are extremely uncommon.
Blood clots: Another complication is blood clots in the legs. This poses a threat because these clots can break off and settle in the lungs.

Minimally Invasive Spine Surgery - A Guide On What To Expect?

A stinging pain in the neck that makes you feel broken from the neck joint could be a reason to worry. It is often accompanied by an aching head or a throbbing shoulder joint. Neck pain, such as this occurs due to an injury in the area resulting from sudden back and forth movement of the neck. It is referred to as whiplash as the nature of the pain and subsequent discomfort resembles the snapping of a whip. The pain is more like a sprain, but not exactly so. This can affect athletes or even any person in general who has faced an accident in recent past. Whiplash is characterized by a tearing of ligaments and tendons that connect one bone to another.

Causes of whiplash:

1. Sports that involve contact- any extracurricular activity involving collisions or other forms of physical contact can cause neck injuries. Football and rugby players frequently suffer from whiplash.

2. Road accidents- public transport has a host of disadvantages. Reckless driving can make the tendons of your neck tear. Auto accidents cause immense strain on your neck; it can also lead to whiplash.

3. Any kind of physical abuse- if you have gotten into a violent fight with someone your neck could suffer from a whiplash. Instances of physical abuse where the neck is jerked or punched at can also result in neck strains. Domestic violence often leads to instances of neck strains.

Symptoms related to this condition:

1. You may or may not suffer from tinnitus. Tinnitus is a physical disorder where you hear ringing sounds. It is quite distracting.
2. Your vision might get blurry.
3. You can experience irregular sleep patterns.
4. You can find it hard to concentrate on any one thing for more than a while.
5. You can grow irritable at the drop of a hat.
6. Your memory may fail you. You might find it next to impossible to trace back a day's activity.

Some of the other direct symptoms are:

1. Your neck might turn stiff preventing you from moving it left, right, up or down.
2. Pangs of pain can be felt in and around your shoulders.
3. Your upper arms can grow numb and tender.
4. Your head can spin repeatedly or you could feel dizzy.
5. Whiplash can also result in serious fatigue.

All About Whiplash

Also known as Median Nerve Compression, Carpal Tunnel Syndrome is characterized by a sensation of tingling and numbness in the hands or the arm caused due to a strained nerve of the wrist. This condition occurs due to stress which affects the functioning of the part of median nerve, situated along the wrist.

Various Causes of Carpal Tunnel Syndrome:
Constant movement of the hands in activities such as typing on the computer
Pregnancy
Arthritis

Various Symptoms of Carpal Tunnel Syndrome:
The symptoms of this syndrome start to show up when there is excessive pressure build up in the median nerve of the wrist. You may experience-

A sensation of numbness
A sensation akin to the pain experienced when needles are inserted into the skin
Pain (mostly at night)
The build- up of pressure can occur due to a number of reasons. They are-

Painful injury
Fracture
Tenosynovitis (a condition that affects the tendons along the sides of the thumb)
The compression of the nerve may develop anywhere, and not necessarily the wrist only.
Diagnosis of Carpal Tunnel Syndrome:
Doctors base their diagnosis of the condition on the symptoms and certain tests. These include-

Phalen s test (a test that is carried out to determine any pain or numbness in the fingers within one minute of this activity)
Wrist flexion/median nerve compression test
Tinel s test (a test that is used to diagnose irritated nerves)
Few nerve enlargements may be revealed by an ultrasound, X-Ray, MRI scan, CT scans etc. The doctor generally recommends any of the above tests to determine carpal tunnel syndrome.
Important measures that help treat the condition are

Getting ample rest
Educating yourself on the various symptoms
Knowing certain activities or movements that trigger symptoms
Attending physiotherapy sessions
Physiotherapy as an important form of treatment for Carpal tunnel syndrome
Extensibility of muscle as well as soft tissue
Strengthening the forearms and the ability to grip things and pinch too
Maintaining posture and performing hand agility exercises can improve the hand movement
Mobilization of the Carpal bone and stretching of the flexor retinaculum (a fibrous band near one s wrist) so as to widen the carpal tunnel
Gliding training for nerves/ tendons for unrestricted motion
Endurance training for strengthening the upper limb as well as the wrist

Carpal Tunnel Syndrome - Measures That Can Help Treat It!

One month, the injury is still healing, two months, just a little bit longer, three months? Well, you, believe it or not, it has probably become a chronic pain and is affecting every aspect of your life. Chronic pain may be a novel notion to accept but is now understood to be a disease and generally defined as pain persisting for longer than 12 weeks. Pain management in such cases is traditionally treated through prescription drugs, the other option being amputation.

This is a major cause of patients having qualms about these pills and a need for an alternative. In response to this, doctors have a new tool to help decrease the perception of pain which is a small implant placed in the back to help patients shake off the pain. This small device that could bring you back to your feet is the spinal cord stimulator.

What is spinal cord stimulation?

Theoretically, the spinal cord stimulation is a type of neurostimulation which produces an effect that interferes with the brain s ability to interpret the signal as pain by using electrical pulses. The brain, instead, experiences it as a pleasant numbing sensation. The implant is placed which takes place in two parts i.e. placing the lead device in the spine and placing the pulse generator in abdomen or buttock.

For test stimulation, the several stimulation settings are tried so that the pulse generator can be programmed using these settings. The procedure typically takes 1-2 hours and post-procedure, patients are given a handy device to control the simulations which they are to use in their day-to-day lives.

It has been observed to reduce the pain by at least 50%. However, this too has its limitations. Typical candidates are people with chronic back and limb pain who may have a failed back or disc procedure. The most common risks associated are device-related, example, unintended movement of the leads. Serious effects include hemorrhage in the epidural space or injury to a spinal cord leading to neural damage, but these are highly uncommon.

Quick facts about it

The best product which works for spinal cord stimulation is a long-lasting solution with a need to change the battery of the lead device every 9 years.
The most recommended device today is the implant because of its compact size and the device costs is quite nominal.
The quality of the product matters a lot as there are ample of cheap products available on the same lines. The same can be fitted within the body via a procedure.
The procedure conducted is also called the pain pacemaker.
Earlier, the procedure was used to conduct only in the international countries, but nowadays the implant can be done in India as well. If you are apprehensive about consuming painkillers for your chronic pain, you can explore this option with your Interventional Pain Specialist.
As it is said, lasting pain can lead to damage, hence don t wait until the damage repair has a complete null chance, rather reach out to your doctor to understand more about the concept of SCS so that you can get treated in no time. Explore the option with your "Interventional Pain Specialist".

Spinal Cord Stimulator - How Is It Beneficial In Pain Management?

Paralysis is characterized by loss of movement, muscle function, and sensation. The patient is unable to function normally in the aftermath of a paralysis attack. The disorder affects people in different ways. It is either partial or complete. It afflicts one or both sides of the body. It arises in one or several areas and can either be short-term (post a stroke) or long-term (due to spinal cord damage). There are different types of paralysis such as Monoplegia, Hemiplegia, Paraplegia, and Quadriplegia. Some symptoms that are associated with paralysis include loss of memory, loss of hearing, clumsiness, drooling, and changes in behavioural patterns.

Why Physiotherapy for Paralysis?

Physiotherapy is recommended for people affected by paralysis for many reasons. Physiotherapy helps relax the muscles and boosts the flow of blood within the body. Patients are advised to use braces, splints, orthosis, and canes by physiotherapists to facilitate movement in their condition. Wheelchairs are also advised so that the patient can move about a little if they have lost sensation in the lower limbs.
In case of brain injuries, the practice can reduce the swelling and promote healing.
Paralytics are also given counselling sessions for boosting their morale. They are encouraged, educated by their practitioners and can go a long way in improving their condition.
Physiotherapy exercises are also useful for restoring lost strength in the afflicted muscles, which, in turn, prevents deformity in the limbs. Physiotherapy exercises can restore sensation and subsequently the movement in the affected area.
The health problems of the patients are also addressed during physiotherapy. Also, the underlying causes of the disorder are treated, and this helps in restoring mobility for the patient.
Physiotherapy treatment helps the patient to adjust to daily life after suffering a stroke. The efforts are directed towards making them independent. As part of the treatment program, the patients are advised about various aspects, including exercises, surgical procedures, medicines and other self-care methods. Physiotherapy produces results over time and is not an immediate solution to the problem.
Paralysis   What type of diet should you go for?

Physiotherapists advise the patients suffering from paralysis to eat a nutritious diet. Intake of B-complex vitamins is very important, such as vitamin-B12 and niacin, the patients can improve the functioning of their nervous system.
Essential fats are also recommended due to their anti-inflammatory properties and ability to restore the health of the nervous system. Some food sources of these nutrients include walnuts, flaxseeds, beans, bananas, pumpkin seed oil, potatoes, and lentils.
It is important to note that physiotherapy practices can help people with paralysis in several ways. Most importantly, the victims receive encouragement and counseling from the physiotherapists who guide them towards a treatment option that can help restore normalcy in their lives.

Paralysis - How Physiotherapy Will Help In Treating It?

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