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Bone Disease Tips

How To Resolve Leg Length Discrepancy?

Dr.Rohan Jain 88% (10ratings)
MS - Orthopaedics, DNB (Orthopedics), MBBS
Orthopedic Doctor, Jaipur
How To Resolve Leg Length Discrepancy?

With the advancement in the medical field, we are blessed to have doctors who specialize in various fields. We have cardiologists who specialize in the treatment of the heart, orthopedics who specialize in treating disorders that are related to the development and growth of muscles, skeleton, and joints in children and neurologists that determine treatment for the brain. Spine and limb deformities mainly occur in children as their bodies are still growing and they react differently to disorders, infections and injuries. Some of the deformities of the limb and spine that are treated by orthopedics include clubfoot, scoliosis, and limb length discrepancy.

Limb Length Discrepancy
Limb length discrepancy is referred to as a deformity when the legs and arms differ in their length. The difference in the length of legs and arms in several cases does not cause any change in the quality of life or in its functioning. However, in certain cases when there is an extreme difference in the length of the legs and the arms, the health of the patient is affected to a great extent. Limb length discrepancy is also caused due to injury to the leg, bone disease or due to bone infections that occur during growth. Depending on the severity of the injury or bone disease it becomes very difficult for the individual to even walk. In certain cases, when the condition is not very severe, then to help the patient to walk comfortably a shoe lift is suggested. It is only in extreme conditions that orthopedics suggest limb length surgery mainly to correct the discrepancy.

Limb Lengthening Surgery
Future proof and innovative solutions are provided these days to the patients for bone reconstruction. The surgery for limb lengthening is performed in many countries all over the world and by professional orthopedics. The patient is at first put under anesthesia after which a large slit is made in the legs, all the way through. The leg bone is sawed, after which a supporting bracket is placed which the patient needs to wear for nearly a year or till the completion of the procedure.

The area of the bone that is fractured is widened every week by the patient by inserting a key into the bracket and by turning it a little. Healing of the bone happens over time and two inches can be added to the height of the patient in six months. The bracket used during the surgery for the legs are very bulky and it is very important that the patient does not put more pressure on them. Immense pain is caused during this time as the limbs are bound to crutches. Hence, proper care should be taken to avoid more stress on the limbs.

1390 people found this helpful

AVN Hip - Its Causes, Diagnosis And Treatment!

Dr.Sanjay Kapoor 90% (234ratings)
M. Ch. (Orthopedic), MS - Orthopaedics, Diploma In Orthopaedics (D. Ortho), MBBS
Orthopedic Doctor, Gurgaon
AVN Hip - Its Causes, Diagnosis And Treatment!

AVN is the acronym for avascular necrosis, which mostly affects the hip bone. This complication develops when there is a loss of blood flow to the bones. Being a living tissue, bones require a continuous supply of blood, and if there is an interruption to this supply for a long time, bones suffer from avascular necrosis. The longer duration of this condition may cause bone death. Apart from the hips, AVN may also affect other sites like knees, shoulder, ankles, etc.


Symptoms -

Usually, there are no symptoms in the early stages. However, as the disease progresses, it begins to hurt as you sit down or put pressure on the hip bones. As the disease progresses unabated, the pain may refuse to go away. Progressively, the hip bone collapses along with its surrounding joint tissue. Pain becomes severe and begins to interfere with your daily activities. However, it may take several months and even a year for the bone and the surrounding tissue to collapse.


Causes -

Causes of avascular necrosis may include:

  • Dislocation of thigh bone affecting the blood supply to the bone. About 20% of people suffering from hip dislocation or fracture may suffer from AVN Hip.

  • Chronic use of corticosteroids. About 35% of patients undergoing chronic corticosteroid use may develop AVN Hip. It is considered that these drugs may interfere with the ability of the body to break down fat.

  • Alcohol abuse too may lead to avascular necrosis much in the same way as corticosteroids.

  • Blood clots, arterial damage, and inflammation may also contribute to blocking the flow of blood to bones and precipitate AVN Hip.


Treatment -

The objective of treating avascular necrosis is to improve the functioning of joints, reducing pain, and stopping bone damage. In the case of early diagnosis, treatment can be done by taking pain-relieving medicines and by limiting regular use of your hips. Taking crutches to limit weight bearing by the hips may help to relieve pain and limiting damage to the bone. You may also need to perform various range-of-motion exercises in order to ensure continued mobility of the joints.

Treatment Outcome -

Needless to say, that the damage already done cannot be reversed. This is why the earlier the problem is diagnosed, the better it is for the patients. The best outcome of treatment depends on:

  • Age of the patient

  • Stage of progression of the disease

  • Location of bone damage and its spread

  • Removing the cause of avascular necrosis, if possible, which means stopping alcohol and drug abuse, taking precautionary steps after femoral dislocations and fractures, stopping the use of corticosteroids, etc.


Take Away -

The symptoms are not visible in the early stage of the condition. This is why a consultation is advisable if a person experiences any of the above symptoms.

2087 people found this helpful

Paget's Disease Of Bones - Know How To Treat It!

Dr.Sanjay Kapoor 90% (234ratings)
M. Ch. (Orthopedic), MS - Orthopaedics, Diploma In Orthopaedics (D. Ortho), MBBS
Orthopedic Doctor, Gurgaon
Paget's Disease Of Bones - Know How To Treat It!

The bones in our body are constantly renewing themselves. The old bone tissue is broken down and absorbed by the body while new tissue takes its place. This process is known as 'remodelling'. Paget's disease is a condition that interferes with this process. Over time it can lead to the disfiguring of bones and a loss of bone density. The bones most affected by this condition are the bones of the legs, spine, pelvis and skull.

Diagnosis
Many patients suffering from this condition do not exhibit any characteristic symptoms. One of the most common complaints that can lead to a diagnosis of Paget’s disease is bone pain. Other symptoms, if any, depends on the part of the body that is affected. A physical examination and imaging tests help determine a diagnosis in such cases. This includes X-rays, bone scans and blood tests. X-rays are used to look for abnormalities in the bone structure. These can be seen in the form of enlarged bones, bowing of the bones or other deformities. Similarly, a bone scan provides a clear picture of the affected bones and allows the doctor to determine the severity of the case. Blood tests are used to look for elevated alkaline phosphatase levels that are also symptomatic of this condition.

Treatment
There are two aspects to the treatment of this condition; medication and surgery.

Medication can take the form of oral or injectable osteoporosis drugs. These are usually well tolerated but in some cases, it may irritate the digestive system. In rare cases, it may also be connected to joint pain and muscle pain. It may also increase the risk of suffering from deterioration of the jaw bone. In such cases, the medication is usually withdrawn and calcitonin may be prescribed as an alternative. This can be administered as a nasal spray or as an injection.

Surgery is advised only in rare cases. This is aimed at healing fractures, replacing damaged joints, realigning deformed bones and reducing pressure on surrounding nerves. Before the patient undergoes surgery for Paget’s disease, he or she may be advised to take a certain medication that helps reduce the severity of the disease. This, in turn, helps control blood loss during the surgery.

In addition to this, patients are also advised to be careful and use a cane or walker. This can help reduce the risk of fracturing a bone. A diet rich in vitamin D and calcium is also recommended.

1950 people found this helpful

PRP Therapy - Know Its Utility In Orthopaedics!

Chd City Hospital 86% (101ratings)
Multi Speciality, Chandigarh
PRP Therapy - Know Its Utility In Orthopaedics!

It is considered as the medical speciality, which caters to injuries and various diseases in the musculoskeletal system of the human body. This constitutes the joints, bones, tendons, nerves and muscles that enables a human being to move, be active and work. Orthopaedic surgeons perform special problems like diagnosis of the injury or disorder, treatment with right medication, rehabilitation that is by prescribing exercises and physical therapy in order to restore back movement, function and strength and finally prevention by providing information and plans of treatment to prevent the injury or reduce the progression of the disease.

Platelet Rich Plasma Therapy (PRP)
PRP is the next generation injection method which is used commonly for conditions like knee, hip, shoulder and spine osteoarthritis, cuff tears, ACL injuries, pelvic instability, tennis elbow, back and neck injuries, ankle sprains, ligament sprains and tendinitis. It includes higher blood rate platelet concentrations and the patient experiences fewer chances of inflammatory side effects due to its pure PRP mixture.

How does it heal the body?

  1. The human body at first responds to the soft tissues injury which is to have the platelet cells.
  2. They are packed with healing factors that initiate repair and also attract critical assistance of the stem cells.
  3. The process intensifies the human body’s efforts which directly delivers a higher platelet concentration into the area of need.
  4. To create the PRP, a small section of the patient’s blood is drawn and it is placed into centrifuge which spins blood at a higher speed and separates the platelets from the components.
  5. It is injected into and at around the mark of injury and it significantly strengthens the process of healing.
  6. Just because the patient’s own blood is used in the process there is no risk of transmissible infection and also has less chance of allergic reaction.
  7. The procedure takes a couple of hours inclusive of the recovery and preparation time. It offers instant recovery as well avoids a long stay in the hospitals and application of anesthesia.


Outcome of PRP?

As the goal of PRP therapy is just to resolve pain by healing, it can prove to have long-lasting results. Initially, improvements are seen within few weeks eventually increases with the healing progress. The research studies have shown that PRP therapy is safe and effective and enables the patient to get back to their normal daily routine.

The PRP is very rich in platelets and it is a very old therapy that is adopted. It is a simple process and has multiple injections lasting 60-90 minutes and above all, it has natural end results, for example, PRP therapy is applied in hair restoration that provides natural appearing end results. It is a reliable process and therapy.

6579 people found this helpful

Machine Crush Injury In Hand - Know More!

MBBS, MS - Orthopaedics, Fellowship in Hand Micro Surgery
Orthopedic Doctor, Ahmedabad
Machine Crush Injury In Hand - Know More!

Machine injuries in hand, as the name suggests, occurs when a part of your hand – the palm, wrist, or arm – gets caught between machinery or sustains severe injuries under the influence of a high magnitude force.
Industrial and factory workers whose job role involves working with or around machine equipment are at risk of getting machine crush hand injuries.

Symptoms

The symptoms of machine crush hand injuries depend on the type of injury. For minor injuries, such as fingers getting trapped in a machine, the symptoms may be mild –

  • Lacerations
  • Bruises
  • Moderate pain

For major crush injuries that happen due to high impact forces or for a prolonged time, the damages are severe and usually are seen below the skin, affecting the bones, tissues, and muscles. In case the injury leads to loss of blood supply, damage to the tissues and muscles could be grave, and in rare cases, may lead to paralysis. Symptoms include –

  • Severe bruising
  • Open wounds
  • Damage to the skin layers
  • Extreme pain

If left untreated, the open wounds could become infectious and acquire deformity. In extreme cases, this may even lead to amputation. Worst cases of machine crush injuries may reveal symptoms like –

  • Swollen skin
  • Paralysis of the arms
  • Loss of pulse in the injured hand
  • A tingling sensation in the injured hand

Treatment for Machine Crush Injuries

Treatment depends on the severity of the injury.

  • If you sustain minor damages, cleaning the wound with disinfectant and clean water should suffice. First aid is immediately required to stop bleeding and address bruises.
  • Applying ice packs on the injured limb or hand can help ease pain
  • For mild to moderate crush injuries, the doctor may prescribe antibiotics to avoid the risk of infection
  • Severe cases are treated with fasciotomy. It is a surgical procedure, which involves cutting the fascia to release pressure or tension and restore the flow of blood to the muscles and tissues. In some cases, multiple surgeries are required to repair the nerves, tendons, and muscles completely.

If you have undergone traumatic machine crush injuries, industrial accidents, or if your hands have been stuck between machines, under heavy weights for long hours, you are advised to consult a doctor at the earliest.

2465 people found this helpful

Metabolic Bone Disease - Causes & Symptoms Of It!

MBBS, MS - Orthopaedics, Fellowship In Arthroscopy & Sports Medicine
Orthopedic Doctor, Raipur
Metabolic Bone Disease - Causes & Symptoms Of It!

Metabolic Bone Disease is a term used for various conditions of the bones that can be caused by a number of different disorders. Most of these disorders are developed due to nutritional deficiencies, defects in the bone metabolism procedure or due to hereditary defects in the skeletal structure. Conditions that fall under the category are osteoporosisosteomalaciarickets, Paget's disease, parathyroid conditions, chemotherapy induced bone loss and menopauseinduced bone loss.

Causes of Metabolic Bone Diseases:

  1. Imbalance in the level of calcium : Too much calcium or too little calcium can cause bone diseases. While the overabundance of calcium (hypercalcemia) in the body will lead to calculi formation, which can be harmful for the body, the lack of calcium (hypocalcemia) causes weakness, bone pain and restricted growth. 
  2. Deficiency of phosphorus: Low phosphorus in blood (hypophosphatemia) leads to softening of the bone tissue and bone loss. Osteomalacia is commonly caused by phosphorus deficiencies.
  3. Deficiency of Vitamin D: Vitamin D is essential for the body to absorb calcium. Cells called osteoblasts need vitamin D in order to absorb calcium and secrete the bone tissue proteins. A deficiency of vitamin D can lead to a number of metabolic bone diseases like rickets and osteoporosis.
  4. Over or under secretion of the parathyroid hormone:The parathyroid hormone (PTH) stimulates the secretion of an enzyme, which converts the inactive circulatory form of vitamin D into its active usable form. The hormone can also increase the circulation of free or ionized calcium (Ca2+), which is not attached to proteins. Both underproduction and overproduction of the hormone causes skeletal problems.

Symptoms of Metabolic Bone Diseases:

The symptoms of most of the Metabolic Bone Diseases are similar, such as 

  1. A dull, throbbing pain in the bones is the most common symptom. The pain is frequent and lasts for a long amount of time, but unlike muscular pain, the exact region of bone pain cannot be specified.
  2. Severe joint pains accompanied by stiffness and swelling of the joints. The patient experience pain during regular physical activities, especially during cold weather conditions.
  3. Frequent fractures are caused by most bone diseases because the bone mineral density decreases drastically. Severe bone injury may be caused by mild trauma.
  4. Defects in the bones can cause bowed out legs and a bent backbone.
  5. A general feeling of exhaustion is often caused by bone diseases.
  6. Kidney stones are an associated complication of metabolic bone diseases.
5071 people found this helpful

Bone Cancer - All You Should Know About It!

MBBS, MS - Orthopaedics, Fellowship In Arthroscopy & Sports Medicine
Orthopedic Doctor, Raipur
Bone Cancer - All You Should Know About It!

Cancer that originates in the bones of a human body is referred to as bone cancer. Any bone could come under the threat of this disease, but generally the longer bones of your body, so to say the bones of your limbs, are at a greater risk. 

A few factors that might push you an inch closer to bone cancer are:

  1. Genes could jinx your health: A few typical genetic syndromes could increase a person's chances of contracting bone cancer. These syndromes could have been active in any person belonging to your lineage. One such syndrome is Li-Fraumeni.
  2. Treatment for one kind of cancer can make you prone to some other kind:Radiation affects your bones adversely. A patient of breast cancer might be undergoing radiation therapy that further increases his or her risk of contracting bone cancer in future.  
  3. Paget's disease can have unfavorable implications: Paget's disease is a disease that affects elderly people. This condition, if left untreated, can turn into bone cancer at a later stage. 

Several symptoms of bone cancer can be found below:

 

  1. Sudden loss of weight: If you lose a considerable amount of weight in a few weeks time without having made any effort at all, you should probably be worried about the health of your bones. Bone cancer can result in sudden and unintentional weight loss
  2. Unexpected bone fracture or breakage: Cancer of the bones is known to gnaw at the strength of your bones. Weakened and diseased bones can break or get fractured very easily. An unexpected fracture should not be overlooked so as to prevent chances of anything more harmful.
  3. Long spans of unyielding exhaustion: Constant fatigue and sleepiness might be hinting at a more serious underlying problem. The bones in your body hold you together; cancerous bone cells can make you feel exhausted without much exertion as your bones lose their inherent potency.
  4. Persistent pain in the bones: Excruciating cramps or pangs of stinging pain in a person's bones either continuously or at odd hours, could be indicative of bone cancer. Such instances require the advice and guidance of an experienced oncologist.
  5. Bone swellingThe area affected by bone cancer can grow big and tender or the bone itself can swell up.
4599 people found this helpful

Common Orthopedic Disorders In Children

MBBS, DNB (Orthopedics)
Orthopedic Doctor, Srinagar
Common Orthopedic Disorders In Children

Sometimes children suffer from conditions where their feet may not be in proper shape or size which can affect their posture. Most of the times the disorders correct themselves as they grow up but certainly there can be situations where medical attention is required. These conditions can be normal variations in the anatomy as well which don't essentially require treatment.

Some of the common orthopedic disorders found in children include:

1. Flatfeet

While most babies are born with flat feet which develop arches as they grow, in some case the arches remain underdeveloped even after they grow older. Their feet may turn inwards while they walk due to their flat nature. There is no inherent problem in this condition unless it becomes painful. Doctors may recommend special footwear with arches inserted for support to reduce the pain.

2. Toe Walking

Toe walking is not a disorder while your child is just learning to walk. Toddlers who continue to walk on their toes after the age of 3 may require medical attention. Toe walking on one leg or persistent toe walking can be due to other medical conditions like muscle weakness, cerebral palsy or autism. It is advisable to take your child to a therapist for casting the foot and ankle which can help stretch the muscles.

3. Pigeon Toes

In toeing or pigeon toeing is common among babies when they are first learning to walk. Sometimes children above 3 years walk with their toes inwards which can be due to femoral anteversion. This happens when upper part of the leg bends more than it naturally should causing inward rotation of the feet. Specially designed shoes and braces can help to correct this condition. Usually the condition corrects on its own with age and does not interfere with sport activities which involve running.

4. Knock-Knees

It is a common tendency among children aged between 3 and 6 to develop knock-knees (genu valgum), since their bodies go through natural shift in alignment. Usually treatment is not required as the legs straighten out eventually. Knock knees on one side or persistent knock knees may require medical attention. Children with this disorder may suffer from pain hence in some cases surgery is recommended after the age of 10.

4335 people found this helpful

Bone Disorder In Children!

Dr.Ashutosh Jha 90% (76ratings)
AO TRAUMA, DNB (Orthopedics), MS Ortho, MBBS
Orthopedic Doctor, Ghaziabad
Bone Disorder In Children!

Sometimes children suffer from conditions where their feet may not be in proper shape or size which can affect their posture. Most of the times the disorders correct themselves as they grow up but certainly, there can be situations where medical attention is required. These conditions can be normal variations in the anatomy as well which don't essentially require treatment. Some of the common orthopedic disorders found in children include:
1. Flatfeet-

While most babies are born with flat feet which develop arches as they grow, in some case the arches remain underdeveloped even after they grow older. Their feet may turn inwards while they walk due to their flat nature. There is no inherent problem in this condition unless it becomes painful. Doctors may recommend special footwear with arches inserted for support to reduce the pain.
2. Toe Walking-
Toe walking is not a disorder while your child is just learning to walk. Toddlers who continue to walk on their toes after the age of 3 may require medical attention. Toe walking on one leg or persistent toe walking can be due to other medical conditions like muscle weakness, cerebral palsy or autism. It is advisable to take your child to a therapist for casting the foot and ankle which can help stretch the muscles.
3. Pigeon Toes-
In-toeing or pigeon toeing is common among babies when they are first learning to walk. Sometimes children above 3 years walk with their toes inwards which can be due to femoral anteversion. This happens when the upper part of the leg bends more than it naturally should causing inward rotation of the feet. Specially designed shoes and braces can help to correct this condition. Usually, the condition corrects on its own with age and does not interfere with sports activities which involve running.
4. Knock-Knees-
It is a common tendency among children aged between 3 and 6 to develop knock-knees (genu valgum) since their bodies go through a natural shift in alignment. Usually, treatment is not required as the legs straighten out eventually. Knock knees on one side or persistent knock knees may require medical attention. Children with this disorder may suffer from pain hence in some cases surgery is recommended after the age of 10.

2553 people found this helpful

Metabolic Bone Disease - Knowing The Causes & Symptoms Of It!

Dr.Sunil Kumar Dash 90% (70ratings)
MBBS Bachelor of Medicine and Bachelor of Surgery, MS - Orthopedics, Fellowship, Depuy Joint Replacement
Orthopedic Doctor, Bhubaneswar
Metabolic Bone Disease - Knowing The Causes & Symptoms Of It!

Metabolic Bone Disease is a term used for various conditions of the bones that can be caused by a number of different disorders. Most of these disorders are developed due to nutritional deficiencies, defects in the bone metabolism procedure or due to hereditary defects in the skeletal structure. Conditions that fall under the category are osteoporosisosteomalaciarickets, Paget's disease, parathyroid conditions, chemotherapy induced bone loss and menopauseinduced bone loss.

Causes of Metabolic Bone Diseases:

  1. Imbalance in the level of calcium : Too much calcium or too little calcium can cause bone diseases. While the overabundance of calcium (hypercalcemia) in the body will lead to calculi formation, which can be harmful for the body, the lack of calcium (hypocalcemia) causes weakness, bone pain and restricted growth. 
  2. Deficiency of phosphorus: Low phosphorus in blood (hypophosphatemia) leads to softening of the bone tissue and bone loss. Osteomalacia is commonly caused by phosphorus deficiencies.
  3. Deficiency of Vitamin D: Vitamin D is essential for the body to absorb calcium. Cells called osteoblasts need vitamin D in order to absorb calcium and secrete the bone tissue proteins. A deficiency of vitamin D can lead to a number of metabolic bone diseases like rickets and osteoporosis.
  4. Over or under secretion of the parathyroid hormone:The parathyroid hormone (PTH) stimulates the secretion of an enzyme, which converts the inactive circulatory form of vitamin D into its active usable form. The hormone can also increase the circulation of free or ionized calcium (Ca2+), which is not attached to proteins. Both underproduction and overproduction of the hormone causes skeletal problems.

Symptoms of Metabolic Bone Diseases:

The symptoms of most of the Metabolic Bone Diseases are similar, such as 

  1. A dull, throbbing pain in the bones is the most common symptom. The pain is frequent and lasts for a long amount of time, but unlike muscular pain, the exact region of bone pain cannot be specified.
  2. Severe joint pains accompanied by stiffness and swelling of the joints. The patient experience pain during regular physical activities, especially during cold weather conditions.
  3. Frequent fractures are caused by most bone diseases because the bone mineral density decreases drastically. Severe bone injury may be caused by mild trauma.
  4. Defects in the bones can cause bowed out legs and a bent backbone.
  5. A general feeling of exhaustion is often caused by bone diseases.
  6. Kidney stones are an associated complication of metabolic bone diseases.
4686 people found this helpful
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