April 2021 - Comprehensive Orthopaedics

How to Tell the Difference Between an Ankle Fracture and an Ankle Sprain

by Comp Ortho | Apr 28, 2021 | Ankle, pain, surgery, Wellness

Do you have an ankle sprain or an ankle fracture? Learn how to spot the signs for each condition.

Considering how much weight our ankles carry and the mobility this hard-working joint provides, it’s not surprising that ankle sprains and fractures are quite common. Sports injuries, car accidents, and bad falls can wrench the ankle joint out of alignment and result in either a fracture or a sprain. But how do you know which one it is?

Severe pain, swelling, and impaired mobility all indicate significant ankle trauma. An orthopedic specialist can determine with an X-Ray or other imaging tests whether your ankle is sprained or broken. But before you book your appointment, here are some clues as to which injury you may have suffered.

Ankle Sprain Vs. Fracture

Both injuries cause similar symptoms — pain, swelling, and an inability to put weight on the joint. At the same time, there are some key differences. It’s important to know these differences and get a quick diagnosis so you can receive the proper treatment.

Ankle Fracture. Your ankle consists of three main bones: the tibia (shinbone), fibula (lower leg), and the ankle bone (talus). All three join together at the ankle to give the joint its wide range of motion. Ankle fractures occur most often due to a car accident or a severe fall that breaks or chips one or all three bones. A swollen, painful ankle is a sign of an ankle fracture, particularly if the area over the ankle bone is tender to the touch. If you’ve fractured your ankle, you may also experience numbness in your toes and notice your ankle appears misshapen. An ankle fracture is usually accompanied by a cracking sound.

Ankle Sprain. Holding the ankle bones together is a network of flexible but strong ligaments. When those ligaments are stretched or twisted beyond their normal range of motion, they can become strained, partially torn, or completely torn. Soreness, tenderness, bruising, swelling, stiffness, and pain when trying to put weight on the ankle are signs of an ankle sprain. Depending on the severity of the sprain, you may hear a popping sound, although in most cases there is no discernable sound. If you feel pain when you touch the soft part of the ankle, it’s most likely a sprain.

How to Treat Ankle Fractures and Sprains

An immediate diagnosis of either a sprain or fracture prevents the injury from worsening and doing more damage to the ligaments or bones. Do not delay treatment if you think you’ve broken your ankle, or your ankle sprain doesn’t improve in a day or two.

Treatment for an ankle sprain begins with the PRICE method: Protecting the ankle from further harm, Rest, Ice, Compression, and Elevation. You may need to wear to a brace to support the ankle and use crutches to take weight off the joint as you heal. Over-the-counter pain medications can alleviate the discomfort. Mild sprains clear up in about two weeks, but it may take longer for more significant sprains to heal. Surgery is not recommended unless there is a severe ligament tear. Physical therapy can also help restore flexibility and range of motion to the joint.

How an ankle fracture is treated depends on whether the bone is stable — meaning it’s broken but not out of alignment — or knocked out of place. A stable fracture can heal in about six weeks immobilized in a cast. If the bones are shattered into small bits and/or out of place, surgery may be necessary to attach the bones together with plates, screws, rods, or wires in a procedure known as reduction. Similar to ankle sprains, treatments for fractures include PRICE, taping around the ankle or a boot to stabilize the joint, crutches while walking to reduce pressure on the ankle, and physical therapy to strengthen and increase flexibility in the joint.

Treat Your Ankle at Comprehensive Orthopaedics

Ankle injuries can be especially debilitating. Fortunately, the physicians at Comprehensive Orthopaedics have years of experience in diagnosing and treating orthopedic injuries like ankle sprains and fractures. We use the latest equipment and techniques to quickly heal your ankle. Contact us today to set up an appointment.

Preventing Orthopedic Injuries At Home

by Comp Ortho | Apr 22, 2021 | Wellness

After a year of working from home, Americans are seeing a rise in back and shoulder injuries. Here’s how to address these common orthopedic problems.

As the pandemic continues to reshape daily life, many people are recognizing the drawbacks of setting up an in-house office. Working from the couch or kitchen table may be more convenient and less stressful than a long commute, but it’s taking a toll on our orthopedic health.

At-home workers report a rise in back, shoulder, and neck pain, according to one study. Hinge Health also surveyed about 900 employees and found that nearly half (45 percent) reported back and joint pain since switching to their home office.

Yet there are simple ways to avoid orthopedic injuries while working from home — it just takes a few updates to your home-based workstation.

Unfortunately, most home offices lack the perks that support your spine, namely an office chair and a computer with a separate keyboard. In fact, the Hinge Health survey found that only 48 percent of respondents reported having a comfortable desk chair at home. And only about 40 percent said they had a computer monitor with an external keyboard. This means you’re likely hunched over a laptop as you sit at a kitchen chair or stool that provides little to no support for the spine.

Another issue is the lack of activity while working from home. When sprawled out in your house or apartment, you’re more likely to sit and work all day instead of taking coffee or lunch breaks. While walking around an office may not seem like a lot of exercise, it does force you to occasionally unlock stiff muscles.

Fortunately, you don’t have to spend a lot of money on a new office chair and desk for your house. Instead, you can make your home workspace more ergonomic with a few tweaks:

Align Your Spine. Aligning your spine doesn’t mean keeping your back straight; it means maintaining your spine’s natural S-curve as you sit. A straight-backed kitchen chair won’t do that, but it will if you wedge a rolled up towel behind your lower back. Your feet should be flat on the floor, with your thighs parallel to the floor and knees even with your hips. If your feet don’t reach the floor because the chair is too high, rest your feet on a footrest or even a pile of books.

Get an External Keyboard. If you make one investment while working from home, it should be an external keyboard and mouse for your laptop. A laptop with a connected keyboard isn’t the optimal ergonomic setup because you’re forced to look down, which puts pressure on the spine and throws the neck out of alignment. With a separate keyboard and mouse, however, you can arrange your workspace similar to your office desk by propping the laptop on a riser or pile of books with the keyboard below.

Adjust Monitor Level. Position the top of your monitor at or slightly below eye level so your eyes view the middle of the screen when looking slightly downward. You should be able to comfortably view the top third of your screen without looking down. Hold your neck straight; if you have to bend your neck too far up or down, you need to change the monitor height. To get the right monitor height, prop it on a riser or pile of books, or adjust your chair height if you can. In addition, place the monitor about an arm’s length away from you, with your elbows positioned comfortably at your sides. Be aware of your wrist placement, as well. A flat keyboard or a keyboard where the bottom row is raised helps keep your wrists in a straight line.

Take a Break. Taking frequent breaks to walk around prevents your muscles from stiffening up and getting sore. Much of the orthopedic injuries caused by working from home are due to repetitive actions. Disrupt that cycle by moving whenever you can.

Taking Care of Your Orthopedic Health at Home

Experiencing back and shoulder pain while working from home? The specialists at Comprehensive Orthopaedics are ready to examine you and recommend exercises and other ways to make your home office more comfortable.

Whether working in an office or at home, you have the power to combat orthopedic pain. Contact us today for a consultation.

Not Just Keyboards: Many Types of Workers Can Develop Carpal Tunnel

by Comp Ortho | Apr 12, 2021 | Wellness, Wrist

THURSDAY, April 8, 2021 (HealthDay News) — In a discovery that shows carpal tunnel syndrome doesn’t strike just office workers, researchers report that people who work in construction or manufacturing have a higher risk of carpal tunnel syndrome than those with desk jobs.

Why the higher rates of injury among manual laborers? Investigators found such work requires lifting, gripping and forceful wrist motion, all of which are associated with higher rates of carpal tunnel syndrome.

“This study is an important reminder that carpal tunnel is a primary contributor to hand and upper extremity pain in both the clerical and manufacturing work places, and that ergonomic conditions for workers in both industries should be equally considered,” said study senior investigator Dr. Charles Day. He is executive vice chair and chief of hand and upper extremity surgery in the department of orthopedic surgery at Henry Ford Health System in Detroit.

Carpal tunnel syndrome is one of the most common work-related injuries. It causes swelling of the ligaments and bones in the wrist, leading to nerve compression. Common symptoms range from mild occasional numbness in the fingers to hand weakness, loss of feeling, extreme night pain and loss of hand function.

Motions associated with a risk of developing carpal tunnel syndrome include high-force hammering, long-term use, extreme wrist motions and vibration, the study authors noted in a health system news release.

Carpal tunnel injuries in the United States have steadily declined, from 1.3 million in 2003 to 900,380 in 2018, according to U.S. Department of Labor figures.

When health care costs, reduced productivity, missed work and the potential lost income from changing careers are considered, the typical carpal tunnel syndrome case may have an overall societal cost of between $47,000 and $119,000, the study findings showed.

Carpal tunnel syndrome in the United States is estimated to cost more than $2 billion a year, mainly due to surgery, mental health treatment, and loss of earnings and productivity.

The report was published in the March issue of the Journal of Occupational and Environmental Medicine.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more on carpal tunnel syndrome.

SOURCE: Henry Ford Health System, news release, April 6, 2021

Spring Activity Can Sometimes Bring Stress Fractures

by Comp Ortho | Apr 8, 2021 | Wellness

SUNDAY, March 28, 2021 (HealthDay News) — If you’re getting back into walking, running or outdoor sports this spring after months on the couch, you could be at risk for a common injury known as a stress fracture.

It’s a small break or crack caused by repeated impact on a bone that is starting to weaken from overdoing it, and feet are particularly vulnerable, according to Dr. Mark Drakos. He is an orthopedic surgeon specializing in foot and ankle injuries at the Hospital for Special Surgery (HSS) in New York City.

“When people think of bones, they think they’re hard like metal, but the bones in the foot are more like tree branches. They can bend a little bit, and if you bend them enough times, they can crack,” Drakos said in a hospital news release.

Stress fractures often occur in runners, people who play high-impact repetitive sports and in older people who have weakened bones, noted Drakos, who is an assistant orthopedist for the New York Knicks pro basketball team.

Folks who don’t get enough rest between workouts or who keep playing a sport despite exhaustion are also vulnerable, as are people who take steroids, he warned.

Pain, swelling and bruising are symptoms of stress fracture. If you think you have one, immediately stop doing any activity that causes discomfort, he advised.

Rest is the primary treatment for a stress fracture. If pain comes on suddenly, apply ice and elevate your foot. If it’s not better after a few hours or if you have pain on days when you’re not exercising or playing sports, see a doctor, Drakos recommended.

Dr. David Wang, a primary sports medicine physician at HSS Paramus in New Jersey, saw an increase in stress fractures among people who were inactive during pandemic lockdowns and then resumed an activity too quickly.

“When you’ve been inactive for so long, the body gets weaker and cannot handle an activity at the previous intensity,” Wang said in the news release.

Wang said the key is to gradually build up your activity level to make sure your body can handle it.

“If you’ve never run before and want to start running, for example, start with walking first, then jogging and then gradually start running,” he advised.

Drakos said that many stress fractures of the foot can be treated by wearing a protective boot and that wearing supportive shoes is always important.

“We take more than a million steps a year,” he said. “So if you take 5,000 to 10,000 steps a day in shoes that aren’t giving you a lot of support, it’s that much extra stress on your feet with every step you take.”

More information

The American Academy of Orthopaedic Surgeons has more on stress fractures of the foot and ankle.

SOURCE: Hospital for Special Surgery, news release, March 22, 2021