Dr. Vipul Khera

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.

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.

Pregnancy is a joyful time in a woman’s life. Yet, this is also a challenging time for the pregnant lady as it brings a lot aches and pains as well as swelling in various parts of the body. Back pain and foot pain are common occurrences during pregnancy. Leg cramps and pain in the feet are often experienced at night. This may be caused primarily due to lack of proper blood circulation in the feet and also due to the swelling that one experiences in this region.

Also, not getting enough rest is one of the main culprits of this condition. Let us find out how to deal with the same.

1. Nutrition: This is one of the biggest factors that can go a long way in ensuring that you have a healthy pregnancy in general. But nutrition is also a major factor when it comes to preventing foot pain during pregnancy. When you indulge in proper nutrition with healthy ingredients, the various vitamins and minerals get absorbed in a proper manner within the body. Not only does this help in reducing the swelling and keeping it at bay, but it also helps in alleviating various aches and pains felt in various parts of the body, especially the feet. Magnesium supplements can also be prescribed in order to reduce the leg and foot pain during this time. You can also have magnesium-rich food like nuts, dry fruits, and seeds so that you get plenty of magnesium during your pregnancy.
2. Rest: It is important to put your feet up, literally, more often that you would when you are not pregnant. Pregnancy can be an exhausting time, and it is important to give your body ample rest so that you do not suffer from stress responses that can give rise to spasms in various parts of the body – most notably, the feet and legs.
3. Exercise: You must also exercise a little during this time, especially in the last trimester when foot pain becomes quite severe. This will help in reducing the cramping in the muscles, which can arise due to too much of inactivity. One of the best exercises involves pushing against the wall with one leg, and maintaining the position for about five seconds. While you are doing this, you will also need to lean forward and place your hands on the walls. You can try this a few times for each leg before taking a break.
4. Weight: Your average pregnancy weight gain should not be more than 15 to 20 kilograms. Anything more than this will lead to severe pain in the back and legs. So monitor your weight to reduce foot pain significantly.

The wrist is one of the most common areas that can go through a fracture or an injury. This is especially true for patients over the age of 65 years. There are many kinds of fractures, including simple or closed fractures, as well as compound or open fractures and comminuted or greenstick fractures. Hairline fractures are considered as the most common kind of fracture, and can be easily detected in an x-Ray. While it is easy for children to recover from a fracture, it is that much more difficult for the elderly to recover from one.

Read on to know the various ways in which the elderly can recover from a hand fracture.

1. Time and trauma: Usually, an adult will take six to eight weeks to recover from a fracture completely. Children take almost half the time to recover as their bones are more tender and willing to fuse back together in lesser time, which is not always possible for more mature bones. Also, the elderly experience more trauma when it comes to a fracture and broken bones. Further, these individuals are already a part of a high risk group when it comes to such fractures due to problems with vision, gait and even the bone density.
2. Physiotherapy: This is one of the most important parts of the treatment that elderly people have to follow after a hand fracture. This can help them in restoring normal mobility in the hand and wrist eventually, with regular practice. Physiotherapy must be practiced under the guidance of a trained expert, and thereafter, the exercises can be continued at home on a regular basis. These exercises will help in restoring the strength of the hand as well as the wrist.
3. Changes in the hand: The knuckles and wrists may look different after a fracture. This depends on the kind of injury and fracture that has been sustained by the patient. The different types of hand fractures can occur on the knuckles or right below them, in the shaft of the main bone, at the base of the bone, on the wrist, and also with a dislocation of the bone and wrist. These kinds of changes should be referred to an orthopaedic surgeon who can help by inserting pins and braces to repair the fracture and bring the hand back to normal.
4. Medication and self care: It is important to keep your hand above the heart level at all times during the recovery process. Also, an ice pack can help in stemming the pain. Further, you can wear a splint and take pain relief medication as prescribed by your doctor, in keeping with any other ailments you may be suffering from.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Osteoporosis is a degenerative condition connected with the bones. In this condition, the bones become absolutely brittle and hollow over a period of time. In normal scenarios, bones usually get broken down and repaired over time. They are known as the living tissue of the body. But when the old bone does not get removed due to the lack of new bone creation, this is known as osteoporosis. This disease can affect both men and women. Many women go through this condition after menopause. Let us find out more about the symptoms of this condition.

Causes: There are a variety of things that cause the painful symptoms of osteoporosis. Hormonal changes that affect the sex and thyroid hormones as well as adrenal and parathyroid glands are known to cause this condition. Also, low calcium intake over a prolonged period, especially after childbirth and during menopause can cause this condition in many women. Further, eating disorders where the patient practices severe restrictions when it comes to food intake, can also have a bearing on the person, which keeps the right nutrients from reaching the bones. Steroids and other kinds of medicines that have been used on a prolonged basis in order to treat cancer, gastric reflux, seizures and to cure transplant rejections, can also lead to this condition. Celiac disease, lupus, rheumatoid arthritis, inflammatory bowel conditions and liver or kidney disease can also lead to osteoporosis.

Symptoms 

1. Fracture: One of the most common symptoms of osteoporosis includes fragile bones that may lead to fractures. Even a minor movement or a fall can cause a fracture as the bones are brittle and hollow. Because the bones are more delicate than usual, these fractures can be triggered easily by an impactful action like a particularly loud sneeze or a persistent cough.
2. Neck and Back Pain: Compression fractures in the spine are a common occurrence for people who are suffering from osteoporosis. The vertebrae that have collapsed can pinch the nerves radiating from the spinal cord. This can be a very painful condition that goes from tender pain to debilitating sharp pain.
3. Height: One of the most noticeable symptoms of osteoporosis includes the visible loss of height. A patient suffering from this condition will appear to have shrunk suddenly, in a very mild way. It can cause a condition known as kyphosis, which is basically a stooped back. Owing to this condition, there may be severe pain in the neck and lumbar, or lower back region as well.
4. Emergency Situation: If you happen to be experiencing debilitating and sudden pain in the hip or wrists or other such areas, then it is recommended to see a doctor immediately as this could indicate a fracture. In case you have a concern or query you can always consult an expert & get answers to your questions!

Excessive and persistent pain in the feet as well as the ankle joints could point at the existence of a condition known as flat foot pain. This happens due to the difference between a normal foot and a flat foot. While a normal foot will have an upward arch under the foot, right in the middle, the flat foot does not have such a support. This arch is usually formed by the tendons and ligaments that help in rendering support to the foot as well as stabilising the rest of the body. When these tendons and ligaments become weak, the arch begins to diminish before finally disappearing, which leaves the patient with a flat foot.

This can be a painful condition. Let us look at the ways in which it may be cured.

1. Foot Wear: When you are suffering from this condition, it is important to wear comfortable and supportive foot wear like shoes, sandals and slippers which can support the arch and help in giving stability to the rest of the body. Besides looking for shoes that will provide the right amount of comfort, one can also use additional support like insoles that will help in giving comfort while you are walking, standing or running.
2. Orthotics: These are tools that can be recommended by your doctor in order to help in minimising the pressure that one feels in the foot. The orthotics usually distributes this pressure by giving much needed additional support to the arch of the foot. These tools also help in realigning the foot’s ankle with its bones as well as the joints, which can help in successfully treating this condition to a great extent. They are usually customised as per your exact foot shape and size, as well as the problem you are facing, so that you have plenty of support when you are using your feet for varied activities.
3. Arch inserts and wraps: If your normal shoes are lacking the arch support that you require for flat feet, then you can also invest in arch inserts and wraps which will reduce the pain and prevent it from reoccurring. Also, these will help you to remain standing or walking for longer periods of time, as they add that extra bit of support to your feet for normal functioning.
4. Surgery: If the various non surgical treatments do not help you over a period of a few months, then it may be time to speak with your podiatrist or orthopaedic specialist so that you can go in for a surgery that will fix this problem. This kind of surgery will help in stabilising the feet and ankle bones by applying corrective foot support.

Rheumatoid Arthritis is a degenerative disease that progresses over time. It generally affects the fingers, feet, wrists, and ankles. It causes immobility due to inflammation and stiffness as well as severe pain. This is an autoimmune disease where the body mistakenly ends up attacking the joints instead of attacking bacteria and other substances as it normally should. Severe cartilage damage can be caused if this condition is not treated on time, which can make the spacing between the bones even smaller than usual.

Let us find out how one can tackle this condition.

1. Rest: While there is still no cure for this condition, one can take a number of measures in order to tackle it. One of the foremost ways of managing this condition is with the help of rest and relaxation. It is important to get plenty of sleep so that you can keep the condition from getting worse. There are a number of relaxation exercises that will help you in sleeping better, especially if you have been having trouble sleeping due to the aches and pains. 
2. Exercise: Depending on the doctor’s recommendations, you will need to exercise on a regular basis so as to keep the motion in your joints intact for as long as possible. Muscle and joint strengthening exercises include swimming, walking, and even gentle stretching that can help in reducing muscle fatigue. This can make your muscles stronger and increase the range of motions as well. 
3. Ointments and Lotions: One can turn to gels and lotions which can be topically applied. These can be prescribed by the doctor as well, so that the pain is soothed and temporary relief from pain and stiffness may be experienced. These are also available in the form of sprays. These ointments, gels or lotions usually contain camphor, menthol, capsaicin and salicylates. 
4. Fish Oil Supplements: Pain and stiffness can be significantly reduced with the help of fish oil, as per many medical studies. Before adding fish oil supplements to your food, you will need to talk to your orthopaedic specialist to find out if it may interfere with any medication that you may be taking for the condition or any other related disorder.
5. Plant Oils: Plant oils are also known to contain fatty acids known as gamma linolenic acid, which can give much relief when it comes to pain and stiffness, especially in the morning. One must remember, though, that excessive use of this oil can lead to liver damage. So it is imperative to speak with your doctor or therapist before taking any plant oils. 
6. Medications: Aspirin and other non-steroidal anti-inflammatory drugs can help in containing the pain and inflammation for severe cases.

Adhesive capsulitis is the medical term for a frozen shoulder, which can be caused due to a variety of reasons. Scar tissues can grow in the shoulder joint when the said joint becomes thicker. This development keeps the shoulder from rotating in a normal manner, which can lead to a frozen shoulder. The most common symptoms of this condition include severe pain and stiffness as well as inflammation. Here are the causes and ways to treat this condition.

Causes: A frozen shoulder can be caused due to a sports injury as well as an accident. Also, a hormonal imbalance can cause this condition. A weak immune system may cause inflammation in various joints of the body, which makes motion difficult. Also, diabetes can give rise to a frozen shoulder as a side effect. If you have a sedentary lifestyle and do not exercise often enough, or have just been through surgery which has led to a prolonged period of inactivity, then you can be prone to this condition. Surgery will also leave your tissue and adhesions sensitive to inflammation. Scar tissue may end up forming in very extreme cases, over a period of at least nine months. This can limit your motion.

Risk Factors: Besides diabetes, hormonal changes and inactivity, people who have been through a stroke or surgery are most susceptible to this condition. Also, patients who are suffering from thyroid disorders can end up developing a frozen shoulder too.

Physical Therapy: One of the most recommended ways to deal with this condition is with physical therapy. This kind of therapy will help you in stretching your shoulder so that you get back some motion over a period of time. This process can take anywhere between a few weeks to a few months, depending on the severity of your condition. You must ask your doctor about other treatment options if this kind of therapy does not show results even after six months of intense and regular practice. Physical therapy can also be practiced at home, once you have learnt the technique from a physiotherapist.

Medication: One of the other ways to deal with a frozen shoulder is with the help of medication. Anti-inflammatory and pain relieving medicines can soothe the discomfort. These include aspirin, ibuprofen, as well as naproxen sodium. Also, if you are undergoing a lot of pain, the doctor can administer a steroid injection in the shoulder joint.

Surgery: If medication and physical therapy do not help in treating the condition effectively, then one can go in for an arthroscopic surgery to remove the scar tissue with a small incision and other kinds of surgery for breaking the adhesions as well.