What’s the Best Treatment for a Child’s Broken Bone?

What’s the Best Treatment for a Child’s Broken Bone?

TUESDAY, Jan. 28, 2020 (HealthDay News) — Fiberglass and plaster casts are widely used to treat broken bones in kids, but they have drawbacks compared with other methods such as braces and splints, experts say.

Doctors and patients should review the available options, considering not only treatment of the fracture, but also patient comfort and compliance as well as the burden on the family, according to a review article in the January issue of the Journal of the American Academy of Orthopaedic Surgeons.

Children “may be eager to get a cast, choosing a color that fits their personality,” said lead author Dr. Eric Shirley, a pediatric orthopedic surgeon at Naval Medical Center Portsmouth in Virginia.

“However, the thrill soon wears off when they learn that they will be unable to play, swim or engage in high-impact activities while wearing a cast. What’s more, complications like itching, blisters or dermatitis associated with cast management can lead to added frustration,” he said in a journal news release.

A cast can also be a challenge for children attending school, and families have to schedule follow-up visits for cast removal. For every 100 pediatric fracture clinic appointments, 54 school days and 25 workdays are missed.

And complications with casts can require emergency department visits that put time and cost burdens on both the family and the health care system.

“Pediatric patients are often seen in the emergency department with issues related to wet or damaged casts,” Shirley said. “These complications can nearly always be addressed during normal clinic hours; however, we find that families do not want to wait or feel anxious when caring for a cast.”

Using alternatives such as braces, soft casts or splints could help reduce patient anxiety, eliminate cast complications, and reduce follow-up visits, care costs and time missed from school and work, according to the review.

These alternatives are acceptable and effective for certain fractures to the forearm, shin, foot or ankle, but are not used not as often as they could be in children, the authors said.

Parents should talk with their orthopedic surgeon about the benefits and drawbacks of the different treatment options for children with broken bones, Shirley advised.

More information

The American Academy of Pediatrics has more on children and broken bones.

SOURCE: Journal of the American Academy of Orthopaedic Surgeons, news release, Jan. 9, 2020

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Shovel That Snow, but Spare Your Back

Shovel That Snow, but Spare Your Back

SATURDAY, Feb. 1, 2020 (HealthDay News) — Almost everyone gets stuck shoveling snow at some point during the winter. To prevent back pain and strain, one spinal expert has some advice.

Orthopedic surgeon Dr. Srinivasu Kusuma, from the University of Chicago Medicine Medical Group, noted it’s all in the precautions you take before you tackle your snow-covered driveway.

  • Decide if it’s safe to shovel. If you already have back issues and don’t exercise often, or if you are prone to lightheadedness or shortness of breath, maybe you shouldn’t be shoveling. Instead, consider using a snowblower. For those with heart problems or chest pains during exercise, Kusuma urges they check with their doctor about shoveling.
  • Warm up your muscles. “Make sure to warm up before you shovel, just as you would before a workout,” Kusuma said in a university news release. Stretching and strolling can warm up your muscles. If you’re going to shovel bright and early, make sure your muscles are loose before shoveling. Don’t have time to stretch out in the a.m.? You might want to shovel in the evening then.
  • Appropriate winter gear is important. A coat, pants, hat and gloves will keep you warm in frigid weather. Wearing waterproof boots can also give you traction and prevent slips and falls, Kusuma said. Use a lightweight shovel with an adjustable handle.
  • Use proper technique. Push the snow to the side instead of picking it up. If you need to lift the snow, don’t fill the shovel more than halfway. “Bend with your knees and not your back, using your powerful leg muscles instead of core muscles,” Kusuma said. Always keep your shoulders and hips square with the shovel and avoid twisting at the waist.
  • Take your time. “People are usually in a rush to get to work or to get out the door,” Kusuma said. “I see injuries like strains, sprains and herniated disks when people try to do too much too fast.” Stretch your arms and legs every 10 to 15 minutes to stay limber. “You’re less likely to [get] hurt if you plan ahead and take breaks so your muscles stay flexible,” he noted.

More information

The American Academy of Orthopaedic Surgeons has more on safe shoveling.

SOURCE: University of Chicago Medical Center, news release, January 2020

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How to Manage Your Osteoarthritis

How to Manage Your Osteoarthritis

(HealthDay News) — Osteoarthritis is the most common form of arthritis, affecting about 31 million Americans, and is the leading cause of disability among adults.

Known as OA, it causes pain and other symptoms in joints, which can affect the ability to do everyday tasks. There’s no known cure, but there are treatments that can relieve pain and maintain joint function, according to a rheumatologist at Wake Forest Baptist Health in Winston-Salem, N.C.

“Osteoarthritis is the thinning or wearing down of cartilage, which is the cushion between the separate bones in a joint,” Dr. Francis Luk said in a health system news release. “When your doctor says you have arthritis, most often they are referring to osteoarthritis.”

The main risk factors are aging, obesity, prior injury, repetitive stress on a joint and genetics. OA can occur in any joint, but the most common are knees, hips and hands.

“Symptoms vary from person to person but someone with osteoarthritis of the knee typically will have pain when they stand up from a seated position or when they’re walking, especially when going up and down stairs,” Luk said.

“With osteoarthritis of the hands, people typically experience pain when they do things that involve gripping — washing dishes, holding a wrench, opening a jar, things like that,” he added.

Treatments include over-the-counter drugs such as acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs, or NSAIDs, such as aspirin, ibuprofen (Advil, Motrin) and naproxen sodium (Aleve).

Other nonprescription options include topical creams and gels, such as those containing trolamine salicylate (Aspercreme), and the use of heating pads and ice packs.

Assistive devices such as canes, shoe orthotics, jar openers and tools with thicker handles can help with routine tasks.

For more advanced cases of OA, there are prescription pills and creams and steroid injections. The last resort is joint replacement surgery, especially of knees and hips.

“We always try to delay turning to surgery for as long as we can,” Luk said. “However, if you get to a point where you can’t walk from your living room chair to the bedroom, it would be a good idea to see an orthopedic surgeon.”

And, remember, two of the best ways to combat OA are maintaining a normal weight and getting regular exercise, he said.

“I tell people to do as much as they can tolerate until they have some pain and then rest,” Luk said. “I never recommend completely stopping activities, because the downside of inactivity is worse than osteoarthritis.”

More information

The American Academy of Family Physicians has more on osteoarthritis.

SOURCE: Wake Forest Baptist Health System, news release, Oct. 10, 2019

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Health Tip: Signs of a Herniated Disc

Health Tip: Signs of a Herniated Disc

(HealthDay News) — The bones that form your spine are cushioned by round discs. A herniated disc is a disc that has been pushed out of place, says the American Association of Neurological Surgeons.

The group mentions warning signs of a herniated disc:

  • Low backache.
  • Numbness or weakness in parts of the body.
  • A sharp, electric shock-like pain on one side of the body.
  • Burning or tingling that radiates into the leg or shoulder.

Sometimes, these symptoms can worsen with standing, walking or sitting.

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Get Moving: Exercise Can Help Lower Older Women’s Fracture Risk

Get Moving: Exercise Can Help Lower Older Women’s Fracture Risk

FRIDAY, Oct. 25, 2019 (HealthDay News) — Older women who get even light exercise, like a daily walk, may lower their risk of suffering a broken hip, a large study suggests.

A number of studies have linked regular exercise to a lower risk of hip fracture — a potentially disabling or even fatal injury for older adults. Each year, more than 300,000 people in the United States aged 65 or older are hospitalized for a broken hip, according to the U.S. Centers for Disease Control and Prevention.

The new study, of more than 77,000 older U.S. women, took a deeper look at the types of exercise that are related to the risk of hip fracture and other bone breaks.

The researchers found that, on average, women who regularly exercised at any intensity — from walking, to doing yard work, to jogging — had a lower risk of hip fracture over 14 years, compared to inactive women.

It all suggests that even light activity is enough to curb the risk of these serious injuries, said study leader Michael LaMonte, a research associate professor at the State University of New York at Buffalo.

“We were happy to see a strong relationship between walking and lower hip fracture risk,” he said. “As we get older, we naturally do less-strenuous physical activity. This suggests that to lower your risk of hip fracture, you don’t need to do anything fancy. It can be as simple as walking.”

The findings “strongly support” longstanding recommendations for people to fit physical activity into their daily routine, according to Dr. Richard Bockman.

“Get out there and walk,” said Bockman, chief of the endocrine service at the Hospital for Special Surgery, in New York City.

Lower-impact activities do not have a big effect on bone density. But Bockman, who was not involved in the study, said that while bone density matters in hip fracture risk, other factors are also involved. They include muscle strength in the lower body, balance and agility, since broken hips are almost always the result of a fall.

The findings, published online Oct. 25 in JAMA Network Open, come from the Women’s Health Initiative — a study begun in the 1990s at 40 U.S. medical centers. It involved more than 77,000 women who were between the ages of 50 and 79 when they enrolled.

At the outset, the women reported on their usual physical activities, among other lifestyle factors.

Over an average of 14 years, one-third of the women suffered a bone fracture. When it came to hip fractures, women who’d reported higher amounts of physical activity at the study’s start typically had a lower risk.

For example, women who regularly got moderate to vigorous exercise, such as brisk walking or jogging, had a 12% lower risk of hip fracture than those who were less active. But there was also a link between “mild activity” — like slow dancing, bowling or golfing — and lower hip fracture risk. And the more often women walked, at any speed, the lower their risk of a broken hip.

The news wasn’t all good: Women who exercised at moderate to vigorous intensities had a relatively higher risk of a wrist or forearm fracture, compared to less-active women.

It’s not clear why, but LaMonte offered a guess: When women with more “functional ability” do fall, they may be more likely to stretch out an arm to break the fall, which is how wrist and forearm fractures often happen.

One question the study cannot address, LaMonte said, is whether starting exercise at an older age reduces hip fracture risk. Study participants who were physically active may have been active their whole lives.

But, he said, it is clear that “sitting less and moving more” is key in older adults’ overall health, with benefits such as better control of blood pressure and diabetes, and a lower risk of heart disease.

Besides exercise, older adults can take other steps to reduce their hip fracture risk, LaMonte noted. They include getting bone mass measurements as recommended by your doctor, and following a healthy diet with adequate amounts of calcium and vitamin D.

More information

The American Academy of Orthopaedic Surgeons has more on hip fracture prevention.

SOURCES: Michael LaMonte, Ph.D., M.P.H., research associate professor of epidemiology and environmental health, State University of New York at Buffalo; Richard Bockman, M.D., Ph.D., chief of endocrine service, Hospital for Special Surgery, and professor of medicine, Weill Cornell Medical College, New York City; Oct. 25, 2019, JAMA Network Open, online

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Your Noisy Knees May Be Trying to Tell You Something

Your Noisy Knees May Be Trying to Tell You Something

THURSDAY, Oct. 17, 2019 (HealthDay News) — Ever hear your joints clicking, creaking or crunching? Now, researchers say a new technique that listens closely to knees may help doctors diagnose and monitor osteoarthritis.

In the new study, researchers attached small microphones to participants’ knees, which allowed them to listen for high-frequency sounds as the person repeatedly stood up and sat down again.

Computer analysis of the sounds then provided information about the health of the knee, the study authors explained.

This study is the first to assess this technique in a large number of people with knee osteoarthritis. It was found to distinguish between healthy knees and those afflicted by this “wear-and-tear” form of arthritis.

The findings move the technique a step closer to use by doctors and in research, according to the report published Oct. 16 in the journal PLOS ONE.

“This work is very exciting because it involves scientists and clinicians working together as a team to develop an entirely new approach,” said project leader John Goodacre. He’s an emeritus professor at Lancaster University, in the United Kingdom.

“Potentially, this could transform ways in which knee osteoarthritis is managed. It will enable better diagnosis, and will enable treatments to be tailored more precisely according to individual knee condition. It will also enable faster, bigger and better clinical trials of new treatments,” Goodacre said in a university news release.

The next step for researchers is to develop a non-invasive portable device that health care providers could use to assess whether patients’ knees are changing or are responding to treatment for osteoarthritis.

This technique could provide a quicker, cheaper, more convenient and more accurate assessment than current methods, the study authors said.

More information

The American Academy of Family Physicians has more on osteoarthritis.

SOURCE: Lancaster University, news release, Oct. 16, 2019

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