Tag Archives: fractures

NBA’s Kevin Durant Out With Jones Fracture

13 Oct

kevin durant jones fracture
The NBA’s MVP and four time scoring champ Kevin Durant has a Jones fracture in his right foot and will be sitting on the bench for 6-8 weeks, Oklahoma City Thunder Executive Vice President and General Manager Sam Presti announced over the weekend. The fracture is most likely the result of stress and occurred over time, and wasn’t due to a specific event. “From what I’ve been told, a Jones fracture is the most common surgical procedure performed on NBA players as of late,” Presti said.

A Jones fracture is a potentially serious injury for an athlete. It is a stress fracture of the fifth metatarsal of the foot, the outermost bone, which begins at the base of the small toe. The Jones fracture occurs in the midportion of the bone, causing swelling and pain. Many don’t realize they have it, try to play through the at-first mild pain, and this stress on the fracture makes it much worse. Non weight-bearing is essential for proper healing.

The Jones fracture is also particularly difficult to heal well, and frequently requires surgery to successfully repair, along with 4-6 weeks of physical rehab. The good news is, Durant informed his team trainers during practice Saturday about the aching and discomfort in his foot. They performed imaging scans on the sore area, which revealed the jones fracture. Had Durant played another game or two on the injured foot, the fracture may have become much worse and kept him out all season. At this point, it appears he’ll be back on the court sometime in December to finish out the season. Durant, entering his eighth season, has only thus far missed a total of 16 games.

Treating a Jones fracture

For those who aren’t professional athletes, the normal course of treatment for a Jones fracture is to immobilize the foot in a cast, splint, or walking boot for 6-8 weeks. This is usually sufficient treatment in 75% of cases. However, if you’re an athlete and your career depends on the health of your feet, surgery is usually performed to secure the bones in place with screws, plates, wires, or pins, so the metatarsal heals as close to perfect as possible. The 5th metatarsal has a limited blood supply due to its size, and surgery insures that the bone will set correctly and hold up under the pounding of playing on a hard court every day.

jones fracture

Jones fracture symptoms

  • Pain, swelling, and/or bruising in the region of the 5th metatarsal bone – below your small toe
  • Severe pain when walking

Jones fracture treatment

  • In most cases, immobilization of the fractured foot in a walking boot or cast
  • Non weight-bearing
  • Over the counter ant-inflammatory pain relievers such as advil (ibuprofen) or aleve (naproxen)
  • Foot surgery if necessary
  • 2-3 weeks of physical rehabilitation after immobilization to insure proper healing of the bone

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A Question From India: Can Charcot Foot Be Cured?

6 Aug charcot foot diabetes

The PA Foot and Ankle Associates blog gets questions from all over the world about foot and ankle health. Today we received this one from Manohar in Bangalore City, India.

“Hello sir. This is Manohar from India, Bangalore City. My father is suffering with charcot joint disease and also a diabetic neuropathy. In the last month his leg is completely swelling. An orthopedic surgeon has suggested amputation. My question is how can it be cured?”

Thanks for your question, Manohar. The doctors at PA Foot and Ankle Associates, and particularly Dr. Thomas Rocchio, are one of the United States’ foremost experts on Charcot foot disorder.

Charcot foot disorder is a side effect of diabetes and is accompanied by diabetic peripheral neuropathy. Diabetes damages blood vessels, causing a decrease in blood flow to the feet. Poor circulation weakens bones, resulting in a disintegration of bones and joints in the foot and ankle. This puts the bones at high risk of fracture. Unfortunately, a diabetic who has nerve damage from DPN has a loss of sensation in their feet, and will be unaware of the bones fracturing. They continue to walk on the foot, causing the joints to eventually collapse and the foot to change shape, most notably to a rocker-bottom appearance. Sharp edges of bone may put pressure on the skin, creating the risk of chronic skin sores. It’s this end result – a combination of bone disintegration and trauma – which is known as Charcot foot disorder. It’s one of the most serious complications of diabetes.

charcot foot diagramcharcot foot disorder

Charcot is a very dangerous disease, as it is in many cases accompanied by bone infection. In highly advanced cases, sometimes amputation is the only realistic treatment. However, it is far from the only treatment.

“There are reconstruction options for many Charcot patients, but there needs to be circulation in the foot for it to heal.”, according to Dr. Rocchio. “Infection can affect the result as well. The remaining reconstructed bone must be free from infection and there must be enough healthy soft tissue to close the incisions. Usually an aggressive external fixation is needed to stabilize the reconstruction. Unfortunately, no complete answer can be given without an exam of the patient.”

Dr. Adam Teichman adds, “There are treatments to stabilize, correct, and prevent Charcot and the breakdown of the foot. For instance, if  ulcers can be healed, infection can be cured, which allows a number of options to save the foot. Amputation is not a therapy, it’s a last resort.”

Read more about Charcot foot disorder

Early diagnosis of Charcot is key to saving the foot, which is why every diabetic should have their feet checked regularly by a podiatrist. Manohar, we’d be happy to examine your father and give you a complete diagnosis and treatment plan if you and he can travel to the States.

Which physician is best to treat foot and ankle pain?

25 Jun

We sure take our feet and ankles for granted, don’t we?

best doctor for foot pain ankle pain toe pain

That is, until the Millenium Falcon breaks our ankle, or a foul ball clips our right foot. Ouch.

When your feet are painful, you’re miserable. Your lifestyle is instantly affected – pain forces you to dial back or give up walking, running, dancing, standing, or your favorite sports. Prolonged pain might even cause you to go from star athlete to couch potato.

It’s appropriate to visit the ER if you have an unusual amount of pain in your feet or ankles, especially if the pain is sudden and intense, is accompanied by bleeding or swelling, or if your foot and ankle have been involved in a trauma like a fall down the stairs. Or if you tried to break a cement block in half with absolutely no martial arts training.

For less painful events, like a suspected fracture, or wounds that won’t heal, many people choose to see their primary physician, which may or may not be a good choice, depending on that  physician’s field of expertise.

And for even less worrisome injuries, like a minor sprain, or minor heel pain, some seek no medical attention at all – which is never a good idea, as both injuries can develop into more complicated conditions, especially for athletes.

Which doctor is expert in treating foot and ankle problems?

When you have trouble with your ears, you should see an ENT. Trouble with your knees, an orthopedist. When you have pain or discomfort in your feet, toes, or ankles, you should see a podiatrist.

Podiatrists and podiatric surgeons are trained exclusively in the treatment of foot and ankle disorders – they do nothing but study the foot and ankle, it’s diseases and deformities. After all, 1/4 of all of the bones in your body are in your feet, and there are many conditions unique to this area of the body. That’s a lot of ground to cover in med school. If they choose to be a podiatric surgeon, they complete further schooling to study surgical techniques to correct these problems.

In 99% of cases, a podiatrist can resolve your ankle, toe, or foot problem much faster than a general physician. Podiatrists are also expert at spotting the early signs of diseases you can easily overlook, like diabetic foot disorders, rheumatoid arthritis and cardiovascular disease.

Without your feet in good working order, your life can be…. well, challenging. Don’t take them for granted.

Giants’ Jon Beason Sidelined With Sesamoid Injury

16 Jun

Here’s some potentially bad news for Giants fans: Middle linebacker Jon Beason injured his right foot during off season training Friday. It appears he suffered a ligament tear and a fracture of the sesamoid bone.

jon beason foot injury

Beason at work against the Redskins in 2013

“You have freak injuries,” Beason said. “I was just changing directions… the movement was a little unorthodox, I was flexing with the big toe in the ground and then I pivoted on it all the way around. It’s a movement that I often do… I literally felt like I stepped in like a sprinkler head hole. I just felt it give right away.

“I really felt that I that I had torn the extensor, which is the tendon with the muscle, it’s how your big toe functions. That would have been season-ending.”

After limping to the sidelines and huddling with the training staff, Beason was carted off the field and taken to the Hospital for Special Surgery where he underwent an array of tests: MRI, CT, and x-rays. A definitive treatment plan has yet to be announced, but Beason’s status for the Giants’ regular season opener in Detroit is up in the air, as an injury like his typically requires a 12 week recovery period.

Beason, a 3-time Pro Bowler, was drafted by the Carolina Panthers in 2007. He played only one game for the Panthers in the 2011 season when he ruptured his left achilles tendon, and in 2012, played in just four games before suffering a microfracture in his right knee, requiring surgery.

Beason was traded to the Giants in October of 2013, and played in all 12 remaining games. At the end of the season, he was second on the team with 93 tackles. The Giants re-signed him in March and expected him to be a cornerstone of their defense this year.

So what’s a sesamoid anyway?

Most bones in our bodies are connected at joints, but not the sesamoids, which are connected only to tendons or embedded in muscle. Your kneecap is the largest sesamoid in your body, and the smallest are those found in the foot, two tiny, pea-shaped bones in the front of each foot that most people are unfamiliar with until they’re injured.

Located just behind the big toe, the sesamoids act like pulleys, providing a smooth surface over which the tendons glide, increasing the leverage of the tendons controlling the big toe. The sesamoids also assist with weightbearing and elevate the bones in your biggest toe. But that’s assuming you have sesamoids – some people are born without sesamoids in their feet and experience no problems.

Read more about sesamoiditis

If you damage the sesamoid bones in your feet, you’ll feel the pain in the ball of your foot, just behind the joint of the big toe. You may simply have an irritation of the tendons around the bones – called sesamoiditis, or you may have actually broken one of the tiny bones.

If you suspect an unjury to the sesamoids, seek an evaluation from a podiatrist, the most knowledgeable physician to treat this uncommon injury. Before your appointment, stop the activity which caused the pain, take over the counter pain medicine like advil or aleve to manage the pain and soreness, and use ice to reduce swelling.

If after a diagnosis, your podiatrist confirms an injury to the sesamoid bones, she or he may recommend any of the following:

  • custom orthotics to shift your body weight off of the forefoot
  • steroid injections to relieve swelling and pain
  • immobilization with a surgical boot
  • physical therapy
  • strapping or taping the big toe
  • surgery to remove or repair the sesamoids

The podiatrists at PA Foot and Ankle Associates are experts at treating sports injuries and are the best qualified physicians to diagnose and treat uncommon injuries of the foot and ankle.

Millenium Falcon Breaks Han Solo’s Ankle

16 Jun

Harrison Ford, the original Han Solo in the Star Wars film franchise, broke his ankle Thursday while filming a scene in the series’ reboot. He’ll be off the set of “Star Wars: Episode VII” for 6-7 weeks until his ankle heals.

Harrison Ford as Han Solo in Star Wars Episode IV: A New Hope (1977).

Harrison Ford as Han Solo in the original Star Wars

harrison-ford-star-wars-episode 7 2014

Harrison Ford as Han Solo in Star Wars: Episode VII

Ford, 71, is reprising his role as Han Solo in the movie. As all things are not magical in filmmaking, a hydraulic door fell off the iconic Millenium Falcon spaceship while he was stepping from it. The injury was serious enough that Ford was air lifted from the set to a local hospital in Oxford, England. The ankle may require surgery to fixate the bones with a plate and screws.

***Yes, we noticed that too – he was airlifted to a hospital for an ankle injury – but YOU never helped save the entire universe, and he did!

You’re not a famous Hollywood actor with a helicopter at your disposal, but your broken ankle needs treatment, too.

broken ankle, also known as an ankle fracture can range in seriousness from a hairline fracture in one bone, to multiple fractures which make the ankle very unstable. In addition to the broken bones, soft tissue is usually damaged as well, most commonly the ligaments which hold the ankle bones in position. In Ford’s case, his broken ankle was caused by trauma, but an ankle can also break after a sudden, forceful twisting, rolling, or by tripping or falling. The ankle is a very complex anatomical structure with many parts and a break in one of the bones poses risk to others.

If you suffered a broken ankle, you may feel immediate and severe pain, swelling, bruising, an inability to move your toes or bear weight, and/or a cold or blue foot. Treatment by your podiatrist may include splinting the broken ankle, immobilization with a cast or walking boot, crutches, or surgical realignment of the bones if necessary. Physical therapy is always recommended to strengthen the muscles and the bones after the injury heals.

We’re excited about this movie, because Ford’s original Star Wars cohorts are in this one as well: Carrie Fisher (Princess Leia), Mark Hamill (Luke Skywalker), Anthony Daniels (C-3PO), Peter Mayhew (Chewbacca), and Kenny Baker (R2-D2).

“Episode VII,” the first installment of a brand new “Star Wars” trilogy, is scheduled to be in theaters Christmas, 2015.

Red Sox’ Mike Carp on DL with Broken Foot

5 Jun

We’re always happy to see an athlete and clubhouse taking their foot and ankle injuries seriously and giving them time to heal.

red sox mike carp

The world champion Boston Red Sox announced that 1st baseman and outfielder Mike Carp is on the 15 day DL with a fractured right foot. Last week, Carp was struck by a pitch during a game against Atlanta when he fouled it off his foot. He continued to play (risky!) and post-game x-rays were negative. So he also started Friday’s and Saturday’s games.

But after Sunday’s game against Tampa Bay, Carp’s foot was still hurting, so he had further tests done. No surprise to us that a CT scan revealed a fracture. After all, the pitch from the Braves’ David Hale was flying at 83 mph BEFORE Carp fouled it off his right foot. After the scan, doctors immediately ordered Carp into a walking boot and he’ll be on the bench for 2-3 weeks, according to Red Sox manager John Farell.

It’s necessary to rest a fractured bone in the foot for at least a week. After that, a strict regimen of physical therapy is required for an athlete to get the bone back in shape. If Carp resumes playing before the bone is properly healed, the fracture can become much worse. Or due to weakness in the bone, the foot may be injured in another way, such as an ankle sprain, tendon rupture, or fracture elsewhere in the foot.

The Red Sox and every baseball club – or for that matter any sport organization – should move cautiously when allowing a team member to resume playing. What’s best for the team isn’t always what’s best for the player (see: concussion lawsuit/NFL).

If you’re an athlete and experience any tenderness or pain in your feet, ankles, or lower legs, it’s always best to have it checked by a podiatrist at PA Foot and Ankle Associates, even if your trainer has given you the green light. Podiatrists and podiatric surgeons are the only physicians trained exclusively to treat the diseases and conditions of the foot and ankle and are expert in diagnosing and treating minor injuries before they become big problems.

Landscaping: How To Protect Your Feet From Injuries

15 May

Which would you rather say to your podiatrist?

“I got this monumental ankle sprain when I was pushing my lawnmower and rolled my foot in a gopher hole.”
or
“I got this monumental ankle sprain when I rolled my foot AFTER THE MOST SPECTACULAR JUMP SHOT EVER!

If you picked “gopher hole”, you’re in the minority.

Landscaping – and even gardening – cause their share of foot and ankle injuries, especially in spring when we’re out of shape. We tend to jump right in where we left off in October, and our bodies just aren’t up to it. Bending, twisting, and lifting or pushing heavy and sharp equipment can cause an injury quite quickly if you don’t take a few precautions.

chainsaw

We hope he’s wearing a good pair of work boots

Wear proper footwear.

It may have been fine when you were a teenager to wear worn-out sneakers when you cut the lawn. As an adult, you should wear athletic shoes which support your feet well and will protect them if you step on a rock you didn’t expect to be there. Or in the groundhog hole which magically appeared overnight.

If your ankles or feet have been subject to injuries in the past, or if you’re landscaping with sharp equipment, wear a quality pair of work boots (not garden boots, which offer little protection beyond moisture). If you’re a landscaper, work boots with good support and metal-tipped toes should always be on your feet. Work boots will also protect your feet in the event you accidentally drop any equipment with sharp blades or heavy bottoms (like a tamper).

Don’t work on a wet lawn.

When grass is even a little wet, it can be very slippery. If you have a slope or hill on your lawn, cutting it when wet can be especially dangerous. Wait to mow your lawn until the turf is completely dry.

Use equipment with safety shutoffs.

Decades ago, equipment with sharp blades only stopped turning when you intentionally shut it off, which allowed chainsaws to run out of control, and feet to slide under lawnmowers while the blades were still turning. Fortunately, most modern lawnmowers, edgers, tillers, cultivators, post hole diggers, chain saws, and other equipment with high speed, rotating blades or teeth, stop as soon as you let go of the handle or trigger. If you’re still using decades-old equipment which doesn’t have a shutoff feature, it’s time to upgrade.

Shovels and other step-on equipment can cause surprising damage to your feet.

If you’re doing a project that requires a lot of digging, or using equipment like manual aerators for your lawn, wear quality work boots at all times. The repeated stepping-on-with-force required with these tools can cause injuries like sesamoiditis, plantar fasciitis, sprains and fractures.

If you have ankle, foot, leg, or back issues, stretch before you start.

In gardening and landscaping, lots of bending, squatting, twisting and turning is required, sometimes while holding or moving heavy equipment. Injuries happen remarkably quickly when your body isn’t prepared for them. We recommend that those who have previous injuries of the back, hip, legs, feet, or ankles, or are over 50, stretch before they begin their activities.

Taking these precautions and wearing work boots when you garden or landscape may not make you look like the coolest guy or girl on the block, but they’ll keep you out of the podiatrist’s office. Or the ER.

 

Why You Should Skip the Flip-Flops This Summer

7 May
Flip-flops are just so easy – slip ’em on and run out the door. Seems like everybody starts wearing them as soon as outdoor temps climb above 50 degrees.

flip-flops-bad-for-your-feet

Unfortunately, flip-flops are just about the worst thing you can wear on your feet. In fact, there is a growing problem of heel pain among teens and young adults, which podiatrists are attributing to wearing this paper-thin footwear (no doubt intensified by the obesity epidemic).

Walking barefoot is better for your feet than walking in flip-flops. If your feet have any abnormal biomechanics, flip-flops can accentuate these problems, leading to plantar fasciitis and accelerating other foot problems.

Think about it: the bones in your feet are the base of your skeleton and your body weight is riding on them. If your feet aren’t supported correctly, the rest of your bones, joint, tendons, and muscles have to make up for it. The stress shifts elsewhere and that leads to foot pain, heel pain, leg pain, hip pain, bad knees, sore back, and any number of other ailments.

Naturally, wearing flip-flops in the sauna, locker room, or by the pool won’t cause any harm. But as everyday footwear, we suggest you make a smarter choice.

So how exactly do flip-flops affect your feet?

Toes: That little thong that slips between your toes actually makes the muscles in your feet work overtime. The perpetual gripping this requires of your feet can lead to a nasty case of tendinitis, hammertoes, and bunions. Additionally, bare skin rubbing against the plastic or leather thong can lead to nasty blisters.

Fractures: With no support under your feet, all of that pressure from your body weight can create stress fractures in the bones of your feet. If you spend a lot of time on your feet in flip-flops, this is very likely to occur.

Bottom of your feet: The flip-flop isn’t stationary on your foot like an athletic shoe is. Since the bottom of your foot is in a constant sliding motion against the material, it can create a burning feeling or blisters, especially on hot days.

Arch and heel pain: If your footwear doesn’t support your arch, you run an excellent chance of developing plantar fasciitis, the inflammation of the band of tissue which runs along the bottom of your foot, connecting your heel to your arch. Pain may be felt anywhere along the plantar fascia.

For summer footwear, we suggest that you always wear athletic shoes that fit properly or a solid, rugged pair of sandals with significant arch support and a heavy sole.

Thanks to Huffington Post for this excellent infographic on what happens to your feet when you wear flip-flops.

flip flops

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