What is a fracture?

What is a Fracture?  

A fracture is an injury to a bone when the tissue of the bone is broken.  There are many types of fractures.  That's because a fracture is named by the bone involved, the part of the bone, and the description of the break.  A complete fracture is a bone break that completely severs the bone across its width.  When you hear about a complex fracture, that means that the soft tissue around the bone is extremely damaged.  A fragmented fracture is fun, if you like puzzles.  A fragment fracture results in many broken bone pieces.  When the end of a broken bone tears through the skin, we have what you call a compound or open fracture.  When a simple fracture occurs, the bone does not break the skin.  Then we have the multiple fracture.  A multiple fracture refers to a break in which there are several fracture lines in the bone.  A multiple fracture may also mean, a fracture of several bones at one time or from the same injury. 

Causes of fractures of healthy bones include incidents such as sporting injuries, vehicle accidents and falls. Overuse, is also a common cause of fracture. Repetitive motion can tire muscles and place more force on bone. This can result in stress fractures. Stress fractures are more common in athletes. As we get older, our bones usually become more brittle. Osteoporosis and some types of cancer can also cause the bones to fracture more easily.

Types of Fractures:

• Closed (simple) fracture – the skin remains intact and there is little damage to surrounding tissue.

• Open (compound) fracture – the broken bone protrudes through the skin or there is a wound that leads to the fracture site.

• Complicated fracture – in addition to the fracture, there is injury to the surrounding structures. There may be damage to the veins, arteries or nerves and there may also be injury to the lining of the bone (the periosteum).

Doctors use a variety of treatments to treat fractures:

•  Functional Cast or Brace: The cast or brace allows limited or "controlled" movement of nearby joints. This treatment is desirable for some, but not all, fractures.

• Traction: Traction is usually used to align a bone or bones by a gentle, steady pulling action.

• External Fixation:  In this type of operation, metal pins or screws are placed into the broken bone above and below the fracture site. The pins or screws are connected to a metal bar outside the skin. This device is a stabilizing frame that holds the bones in the proper position while they heal.

• Cast Immobilization:  A plaster or fiberglass cast is the most common type of fracture treatment, because most broken bones can heal successfully once they have been re-positioned and a cast has been applied to keep the broken ends in proper position while they heal.

Overuse Injuries in Children

Overuse Injuries in Children

In recent years, doctors have begun to see a significant increase in overuse injuries in children. In most cases, these injuries are associated with sports-related activity.

Sports participation promotes the physical and emotional well being of children, and also encourages the lifelong habit of exercise. Although the benefits of athletic activity are significant, too much activity can lead to injury.

Overuse injuries occur gradually over time, when an athletic activity is repeated so often, areas of the body do not have enough time to heal between playing. For example, overhand pitching in baseball can be associated with injuries to the elbow, and swimming is often associated with injuries to the shoulder.

Because young athletes are still growing, they are at a greater risk for injury than adults. The consequences of overdoing a sport can include injuries that impair growth, and may lead to long-term health problems.

When a young athlete repeatedly complains of pain, a period of rest from the sport is necessary. If pain persists, it is important to seek proper medical treatment. To ensure the best possible recovery, athletes, coaches, and parents must follow safe guidelines for returning to the game.

Overuse injuries occur in a wide range of sports, from baseball and basketball to track, soccer, and gymnastics. Some of these injuries are unique to a certain sport, such as throwing injuries of the elbow and shoulder that are prevalent in baseball players. The most common overuse injuries involve the knee and foot.

Overuse injuries can affect muscles, ligaments, tendons, bones, and growth plates. In children, these structures are still growing, and the growth is generally uneven. Bones grow first, which pulls at tight muscles and tendons. This uneven growth pattern makes younger athletes more susceptible to muscle, tendon, and growth plate injuries.

Symptoms

Coaches and parents should be aware of the more common signs of overuse injury. These include:

• Pain. This pain cannot be tied to an acute injury, such as from a fall. The pain often increases with activity
• Swelling
• Changes in form or technique
• Decreased interest in practice

Common Overuse Injuries in Children

·         Sever’s Disease (Sever's disease is one of most common causes of heel pain in children)

·         Osgood-Schlatter Disease (children have pain at the front of the knee due to inflammation of the growth plate at the upper end of the tibia (shinbone))

·         Jumpers Knee

·         Throwing Injuries in the Elbow

·         Stress Fractures

·         Stress Reaction of Growth Plates (Physis)

·         Strains & Sprains

Prevention

Many overuse injuries in children can be prevented. Key to prevention is to avoid overdoing any single sport, and to give growing bodies adequate rest between practices or games.

• Limit the number of teams in which your child is playing in one season. Kids who play on more than one team are especially at risk for overuse injuries.
• Do not allow your child to play one sport year round — taking regular breaks and playing other sports is essential to skill development and injury prevention.

Nano Shoulder Replacement

Physician News: Dr. David Bailie

Nano Shoulder replacement

An FDA approved study for the Nano Shoulder Replacement is to begin soon. Only 12 Doctors in the US are allowed to participate in this study. Dr. David Bailie is the only physician in the Southwest. This is a new stemless total shoulder system of which Dr. Bailie is a a co-designer. This device is made by Biomet- one of the largest worldwide Ortho implant companies. Co-designers are docs at Mayo-Rochester, Johns Hopkins and University of Toronto.


This shoulder implant was released for use in Europe fall 2012 and surgeons from Italy, France, Germany are stating they love it and are switching to use it exclusively.  Hundreds have been placed. The Start date of the FDA study is currently unknown but sometime mid-late 2013.

Dr. Bailie is currently looking for patients who would like to participate in this FDA shoulder replacement study. The only way for a shoulder patient to receive this devices for the next 3 years will be through the FDA study, and will not be available to other surgeons not participating until the study is concluded. 

To read more about Dr. Bailie please visit: www.tocamd.com or http://sportsmeddoc.com/

If you can't Fly, then Run

"If you can't fly, then run,

If you can't run, than walk,

if you can't walk, then crawl,

but whatever you do,

you have to keep moving forward."

- Martin Luther King Jr.

Heat vs. Ice for Sports Injury

Do you know when to use ice and when to use heat on a sports injury? Most athletes know to apply ice to an acute injury, like a sprained ankle, but aren't so sure when to use heat. The following guidelines will help you sort it out.

There are two basic types of athletic injuries: acute and chronic.

Acute Pain is of rapid onset and short-lived, or

Chronic Pain develops slowly & is persistent and long-lasting.

Cold Therapy with Ice
Cold therapy with ice is the best immediate treatment for acute injuries because it reduces swelling and pain. Ice is a vaso-constrictor (it causes the blood vessels to narrow) and it limits internal bleeding at the injury site. 

To ice an injury, wrap ice in a thin towel and place it on the affected area for 10 minutes at a time. Allow the skin temperature to return to normal before icing a second or third time. You can ice an acute injury several times a day for up to three days.

Cold therapy is also helpful in treating some overuse injuries or chronic pain in athletes. An athlete who has chronic knee pain that increases after running may want to ice the injured area after each run to reduce or prevent inflammation.

The best way to ice an injury is with a high quality ice pack that conforms to the body part being iced. You can also get good results from a bag of frozen peas, an ice massage with water frozen in a paper cup (peel the cup down as the ice melts) or a bag of ice.

Heat Therapy
Heat is generally used for chronic injuries or injuries that have no inflammation or swelling. Sore, stiff, nagging muscle or joint pain is ideal for the use of heat therapy. Athletes with chronic pain or injuries may use heat therapy before exercise to increase the elasticity of joint connective tissues and to stimulate blood flow. Heat can also help relax tight muscles. Don't apply heat after exercise. After a workout, ice is the better choice on a chronic injury.

Because heat increases circulation and raises skin temperature, you should not apply heat to acute injuries or injuries that show signs of inflammation. Safely apply heat to an injury 15 to 20 minutes at a time and use enough layers between your skin and the heating source to prevent burns.

Moist heat is best, so you could try using a hot wet towel. Never leave heating pads on for more than 20 minutes at a time or while sleeping.

Because some injuries can be serious, you should see your doctor if your injury does not improve (or gets worse) within 48 hours.

The TOCA Patient Portal

Did you know that TOCA provides a Patient Portal Log-in on the TOCA website? Patients may complete new patient paperwork, request an appointment, request prescription refills and pay bills all from the comfort of their home or office!

Our mission at TOCA is to Serve our Patients through innovative & comprehensive Orthopedic care. And as such we are committed to continually improving our delivery of orthopedic care to meet the needs of our patients. 

www.tocamd.com

TOCA Welcomes Dr. Overlin to the Team

Dr. Amy Jo Overlin

Dr. Amy Jo Overlin is an expert in the field of primary care sports medicine.  She is board certified in both family medicine and primary care sports medicine. Currently she is providing non-operative orthopedic care here at TOCA and is serving as a team physician for the WNBA’s Phoenix, Mercury.  From 2006-2012 Dr. Overlin served as a team physician for Arizona State University covering a wide range of sports  In addition she served as the Associate Program Director for the ASU/St. Joseph’s Hospital Primary Care Sports Medicine Fellowship and is currently the Primary Care Sports Medicine Fellowship Director.

Dr. Overlin completed her undergraduate training at Ball State University with a BS in Exercise Science with a pre-med emphasis while being a scholarship athlete for the BSU gymnastics team.  She obtained her medical degree from Indiana University School of Medicine, and then completed a family medicine residency at Waukesha Family Medicine Center.  This was followed by her primary care sports medicine fellowship at Arizona State University. In addition, in 2010-11 Dr. Overlin completed the University of Arizona School of Medicine, Family and Community Medicine Department-Faculty Development Fellowship which focuses on improving physicians skills in the area of medical academics.    

In addition to her teaching and patient care responsibilities, Dr. Overlin has published articles on gymnastics injuries as well as co-authored the chapter on Gymnastics Injuries in the 1st edition of Netter’s Sports Medicine and has lectured on a wide range of primary care sports medicine topics.

To make an appointment with Dr. Overlin call 602-277-6211 or visit TOCA's website at www.tocamd.com 

Winter Sports Injury Prevention

Common winter sports injuries include sprains, strains, dislocations, and fractures. Many of these injuries happen at the end of the day, when people overexert themselves to finish that one last run before the day's end. A majority of these injuries can easily be prevented if participants prepare for their sport by keeping in good physical condition, staying alert, and stopping when they are tired or in pain.

There are many things you can do to help prevent injury during favorite winter activities:

• Never participate alone in a winter sport.
• Keep in shape and condition muscles before participating in winter activities.
• Warm up thoroughly before playing or participating. Cold muscles, tendons, and ligaments are vulnerable to injury.
• Wear appropriate protective gear, including goggles, helmets, gloves and padding.
• Check that equipment is working properly prior to use.
• Wear several layers of light, loose and water- and wind-resistant clothing for warmth and protection. Layering allows you to accommodate your body's constantly changing temperature. Wear proper footwear that provides warmth and dryness, as well as ample ankle support.
• Know and abide by all rules of the sport in which you are participating.
• Take a lesson (or several) from a qualified instructor, especially in sports like skiing and snow boarding. Learning how to fall correctly and safely can reduce the risk of injury.
• Pay attention to warnings about upcoming storms and severe drops in temperature to ensure safety.
• Seek shelter and medical attention immediately if you, or anyone with you, is experiencing hypothermia or frostbite. Make sure everyone is aware of proper procedures for getting help, if injuries occur.
• Drink plenty of water before, during, and after activities.
• Avoid participating in sports when you are in pain or exhausted.

Upper-Body Stretches to Prevent Injury:

Whenever you are performing a physical activity, stretching is important to keep your muscles safe from injury. With this video, you can get a look at some upper-body stretches that will give you a good start to your warm-up routine. Simple movements will stretch your shoulders, chest, and arms so that you do not over-stress any part of the upper body during rigorous activity. Warming up will also increase circulation of oxygenated blood, improving your flexibility and range of motion. Stretching should not be painful, especially if you focus on breathing correctly. If you are loose and limber from warming up, you will be less likely to incur injury. Watch this video for a demonstration of simple stretches.