Spinal fractures occur as a result of an injury or dislocation of the bony vertebra. This causes the bone fragments to pinch and damage the spinal cord. Fractures can occur anywhere along the spine but the most common site of fracture is the lower back.

What causes spinal fractures?

Spinal fractures are often a result of the following-

  A sudden traumatic injury
  A high-velocity accident
  Falling from a height
  Sports injuries
  Spinal instability
  A whiplash

Types of spinal fractures:

Spinal fractures are classified into three categories, such as the following-

  Compression fracture - If you exert excessive pressure on the vertebra, it will break. This type of fracture occurs when the bones in the spine become fragile or weak to the extent that they easily crumble. People living with osteoporosis, certain types of cancer or tumours are prone to a compression fracture.

  Dislocation - When the discs and/or ligaments linking the vertebrae is torn or stretched, the bones may dislocate or come out of alignment.

  Fracture-dislocation - Torn ligament and broken bone lead to this condition. A fracture-dislocation is a debilitating condition and often requires surgical intervention.

Symptoms of spine fractures:

Following an accident or an injury, you can tell if you have ended up fracturing your spinal column by identifying these symptoms-

  Excruciating pain
  Tingling sensation
  Numbness
  Muscle spasm
  Swelling of the muscle
  Sudden onset of back pain
  Restricted spinal mobility
  The pain worsens if you walk or stand for long
  Deformity or disability of the spine

How are spinal fractures treated?

Spinal fracture treatment begins with administering pain-management drugs and medications to ease the symptoms, and stabilization methods to prevent injury. Depending on the nature of the fracture, your doctor may follow these lines of treatment-

  Fusion and instrumentation - These are surgical procedures to cure unstable fractures. Fusion refers to the joining of the vertebrae using a bone graft along with hardware such as hooks, rods, plates, or pedicle screws. The bone graft joins the vertebrae below and above to form a solid piece of bone.

  Kyphoplasty and vertebroplasty - These are minimally invasive procedures, wherein the surgeon injects bone cement into the fractured body through a needle. During kyphoplasty, the surgeon first inserts and inflates a balloon to expand the compressed vertebrae and then fills it with bone cement.

Spinal fractures are an extremely uncomfortable and painful condition to live with. It can hinder your day-to-day activities and affect your quality of life. It is imperative that you seek immediate treatment if you end up with fractures or dislocation of the spine.

Spine Fracture - How Can You Get It Fixed?

Tennis elbow is a condition, which is characterized by the inflammation of the tendons occurring in the elbow region due to excess use of the muscle groups present in the overarm. Tennis elbow can cause a lot of distress once it occurs so it is best to perform certain exercises to strengthen the muscle groups in your overarm so that muscle strain does not occur during your physical activities. Read on more to find about all the different ways to strengthen your muscle groups to prevent tennis elbow.

1. Staying in good physical shape overall tones your body and strengthens your muscle groups, thus reducing the likelihood of tennis elbow.

2. It is also important that the physical activities, which are performed by you are done using proper technique as otherwise undue strain might cause unnecessary discomfort and pain.

3. You should try strengthening the muscles in your shoulder, arm and upper back to reduce the stress your elbow undergoes during physical activity.

4. Using a counterforce brace for activities, which include twisting or grasping of the arm can also help. The use of a counterforce brace is to distribute the pressure throughout the arm, which reduces the stress on the elbow. The brace is highly recommended for people who are likely to develop tennis elbow. One should consult a doctor before opting for a counter brace. 

However, it is not a substitute for rehab exercises. If repeated arm movements or certain physical activities are causing discomfort or pain in the elbow region, check for alternative ways of performing the task. If you have taken up tennis, cricket or golf as a sport, it is highly recommended that you take proper lessons in technique as these sports involve twisting and grasping your arm, which can cause injuries if you do not follow proper techniques. Also keep in mind to choose sports equipments which are at par with your physical fitness, flexibility and strength.

For daily activities, take a note of the activities, which involve putting stress on your elbows. In such instances follow techniques or different ways to perform the tasks, which will put minimum stress or pressure on your elbows. Also, apart from using the technique one has to stay fit, for which getting regular body health check up is very important.

How to Prevent Tennis Elbow

Human bones are continuously being removed and formed, which is necessary for its proper maintenance. However, in certain cases, especially with aging, some bones and joints will be worn down to an extent where the body will not be able to reform them. This is especially true in the case of hips, which may become worn due to age or other problems within the body. 

Hip replacement surgery 
When this happens, a hip replacement surgery can be performed to replace the original joints with a prosthesis or artificial hip, which is usually made out of metal or a specially formed composite material or even a combination of the two. Along with other parts, it replaces the natural hip with an artificial hip to restore mobility and other related functions.

Benefits of hip replacement surgery:
1. Lessening hip pain: This is one of the major factors as well as symptoms of requiring hip replacement surgery. Due to the grinding down of the bones, even the slightest movement causes pain and after the surgery and the recovery period, the pain is lessened.

2. Correction of bone deformity: When the bones grind down and are abnormally reformed, deformities may occur reducing mobility. Artificial hips will ensure that deformities are corrected and resulting problems are thus eliminated.

3. Return to normal activities: This is possibly one of the primary advantages of this surgery, although it entails a long recovery period. However, most patients can get back to their normal activities and are able to resume a pain free life.

4. Ability to have painless sleep: Many people who suffer from hip displacements or bone deformities are not able to sleep properly due to pain. After the surgery and the recovery period, they can return to normal functions and habits, thus are able to sleep properly.

5.  Leg strength increase: Many patients tend to have an increase in their leg strength as one side of the hip tends to become very weak due to bone problems before surgery. After surgery and recovery, the same side tends to have an increased strength due to the implant.

6. In most cases a lifelong solution to hip problems: As the hip replacement prosthesis is made out of metal and if the operation is successful, it usually tends to last till the end of a person's life and this area usually doesn't tend to have problems again.

Benefits of Hip Replacement Surgery

The hand is one of the most commonly used parts of our body and is susceptible to damage, wear and tear as well as injury. Pain in the hand can be attributed to numerous causes, including damage and other conditions that can affect the joints, cartilage, nerves and other parts of the hand.

Causes

De Quervain's tendinitis: This is also known as de Quervain's tendinosis. It causes pain on the thumb side of the wrist. The pain may grow slowly or suddenly. It can also spread to every part of the thumb and up the lower arm. On the off chance that you have de Quervain's tendinitis, you may experience pain while performing the following actions:

- Clenching The fist

- Handling on or holding objects

- Turning the wrist

Treatment for this includes the following:

- Wearing a prop to rest the thumb and wrist

- Calming drugs

- Cortisone infusions

Carpal tunnel disorder: This is common amongst the well-known nerve issues. It can cause pain in the following parts of the hand:

- Palm and a few fingers

- Wrist

- Lower arm


The treatment methods includes the following:

- Resting the hand and wrist

- Painkillers

- Wrist support

- Steroid infusions

- Active recuperation

- Breaks

Fracture: It's a crack or break in a bone that can cause immense pain in the hand. Other than this, the hand may also experience the following:

- Stiffness

- Swelling

- Loss of proper motion and movement

The kind of treatment depends on the kind of fracture. Braces are usually used for small fractures. Sticks, wires, or plates might be used to treat severe fractures. Likewise, surgery may also be recommended to set the broken bone properly.

Arthritis: This is a disease causing joint inflammation and stiffness of the joints. It causes the joints to lose the ligament that permits them to move easily against each other. This tears the ligament, giving rise to crippling pain and swelling.

In the hand, the regions where this regularly happens are as follows:

- Base of the thumb

- Center joint of one or more fingers

- End joint, which is nearest to the fingertip

The treatment depends on the seriousness of the injury and the following may be used:

- Painkillers

- Props for the fingers or wrist

- Heat

- Non-intrusive treatment

Trigger finger: Also known as stenosing tenosynovitis, this defect causes the fingers or the thumb to bend. It can be difficult, particularly when bowing or fixing the influenced finger or thumb.

Knobs may form on the influenced ligaments. Also, the sheath itself may thicken. In the long run, the ligament may get to be adhered when you attempt to fix a twisted finger or thumb.

Resting now and again while wearing a support may help resolve the issue. Over-the-counter torment pharmaceuticals can facilitate the agony. Corticosteroid infusions can mitigate side effects. Surgery might be recommended for extreme cases.

Causes of Common Hand Pain and How to Find Relief

As life expectancy is increasing so is the incidence of vertebral body (VB) fractures now being the commonest fracture of the body. PVP is an established interventional technique in which bone cement is injected under local anaesthesia via a needle into a fractured VB with imaging guidance providing instant pain relief, increased bone strength, stability, decreasing analgesic medicines, increased mobility with improved quality of life and early return to work in days.

In this era of minimally access surgery replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression fracture spine.

Morbidity & consequences of spinal fracture:

Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly
Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory & GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
High risk of primary or consequential damage to neural, bony or disc element
Increased wedging, deformity & increase incidence of adjacent VB
Chronic pain of altered spine mechanics
Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.
Cost of surgery and hospital treatment
Cost of implants
Phobia of surgery
Prolonged recovery period & Extensive rehabilitation
Changed spinal mechanics & transition syndrome
Major surgery & anesthesia with its own complications
Results / Outcome

PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral.
Different studies show an immediate pain relief in (85   90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
PVP does augment height of VB but ideal would be kyphoplasty
Patient is either off medicine or on reduced doses.
Patient feels so well that he almost forgets if he had VB

Percutaneous Vertebroplasty (PVP) is an emerging interventional technique in which surgical polymethyl methacrylate bone cement is injected under local anaesthesia via a large bore needle into a vertebral body (VB) under imaging guidance providing increased bone strength, stability, pain relief, decreased analgesics, increased mobility with improved QOL and early return to work. Started in 1984 by Galibert PVP is done in host of indications.

Senile osteoporotic compression remains the commonest Indication. Other indications are Metastatic VB, Multiple myeloma VB, VB haemangioma, Vertebral osteonecrosis & for strengthening VB before major spinal surgery. The benefit has been extended to the traumatic stable uncomplicated VB compression (VCF) which is commoner in younger age group with active life profile and prime of their career where strict bed rest and acute or chronic pain are unacceptable and they are more demanding for proactive treatment approach so as to be back to work ASAP.

Discovering the fact that VB is the commonest of body, its incidence >the hip, it becomes imperative to take it more seriously. With increasing life-span there is more of aged osteoporotic population, more so due to sedentary indoor lifestyle and post menopausal osteoporosis. Diabetics, smokers & alcoholics are at higher risk of developing osteoporosis. I have seen such alcoholic patient developing six spine fractures in just three months time from a single fracture being on complete bed rest.

Quick fix of fracture spine makes patient walk back same day instead of bed rest of months together avoiding morbidity & mortality of prolonged bed rest, making bedridden patient walk, in a way bringing patient back to normal life.

In this era of MAS replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression.

Morbidity & consequenses of spinal 

Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly.
Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory &
GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
High risk of primary or consequential damage to neural, bony or disc elements.
Increased wedging, deformity & increase incidence of adjacent VB
Chronic pain of altered spine mechanics.
Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.
Morbidity and complication of spinal surgery 

Cost of surgery and hospital treatment
Cost of implants
Phobia of surgery
Prolonged recovery period & Extensive rehabilitation
Changed spinal mechanics & transition syndrome
Major surgery & anesthesia with its own complications
Preparation & Procedure:
X-ray spine in a/p & lat view. CT is more informative of bone & morphology. MRI is good for soft tissue injuries. Ask for pedicle size in all dimensions and construct a 3D image aiming needle placement and cement filling in scan room itself as rehearsal of PVP. This reduces operative time & gives better results. Conventionally PVP is done by hammering the vertebroplasty needle through the bone. Here we use light weight drill to bore through the vertebra. It is important to set the needle at exact entry site & side with right trajectory aiming the defects.

In lateral view needle should go through middle of the pedicle going up to anterior 1/3 of VB. In P/A view the needle can be in midline or paramedian depending upon & if uni/bipedicular approach is planned. Approach varies as per location of vertebra, anterolateral in cervical, costotransverse/parapedicular in thoracic & transpedicular in lumbar vertebra.

Do bone biopsy if there is any doubt about lession. Do dye test (vertebral venography). Make cement more radiopaque by adding barium /or tungsten. Inject cement with 1or2 ml luerlock syringes strictly under fluoroscope in lateral view & cross checking in P/A view. Stop injecting either there is adequate filling or at the first sight of ectopic cement leak. Keep sample cement to see for hardening. Remove needle with rotational movement before cement hardens.

Pain relief is by virtue of different mechanisms postulated :

Cementing of fragments.
Thermal neurolysis of VB nerve ending due to heat of polymerization.
Washing away of nociceptor chemicals.
Neurolytic action of liquid monomer.
By allowing early ambulation decreasing pains of immobility & bed rest.
Complications 

PVP is generally safe with low risk.
Ectopic cement leak is frequent but generally inconsequential.
Outcome 

PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral
Different studies show an immediate pain relief in (85   90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
PVP does augment height of VB but ideal would be kyphoplasty.
Patient is either off medicine or on reduced doses.
Patient feels so well that he almost forgets if he had VB

Vertebroplasty (PVP) / Kyphoplasty - Approach To Management Of Vertebral Body Fractures!

A broken bone or a crack in the commonly known as a fracture. Any bone in the arm can be broken, but common areas for fractures in the arm is wrist, specifically the distal radius, forearm bones (radius and ulna), elbow, humerus and shoulder. 

What causes fracture in bones?

Fall: Falling an outstretched hand or elbow is the most common cause of a broken arm.
Sports injuries: Direct blows and injuries on the field or court are a common cause of all types of arm fractures.
Significant trauma: Any of your arm bones can break during a car accident, bike accident or other direct trauma.
Abuse: In children, a broken arm may be the result of child abuse.
How to identify?

An audible snap or cracking sound may be your first indication you've broken an arm.

Signs and symptoms include:

Severe pain, which may increase with movement
Swelling
Bruising
Deformity, such as a bent arm or wrist
Inability to turn your arm from palm up to palm down or vice versa
When to see a doctor?

If you have enough pain in your arm that you can't use it normally, see a doctor right away and do the same for your child. Delay in diagnosis and treatment of a broken arm, especially for children who heal faster than adults do, can lead to poor healing and deformity.

Fracture In Upper Limb Bones - 4 Things That Can Cause It

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