There's a lot of ways to stabilize an ankle - why has the Broström procedure become the most popular surgical solution for lateral ankle instability? Lateral ankle sprains are the most common injury seen by sports medicine physicians.(1) Many ankle...
Why are talar neck fractures so prone to avascular necrosis? Sometimes a simple x-ray can say it all. With all of the advanced testing that we have today, a simple x-ray can speak volumes. You aren’t always able to capture...
What's the confusion about the contusion? It was December 2008 when I posted a blog entitled, Bone contusions – are they really fractures? The conversation from readers was absolutely intriguing. But the irony of the post is that in the...
How has internal fixation changed our thinking about cast disease? Immobilization is one of the primary tenants of injury management. But prolonged immobilization can result in problems. Cast disease describes the problems associated with immobilization of an injury with rigid...
How is micro-fracture used in foot and ankle surgery? The surface of every joint is covered with a smooth, glistening material called cartilage. Cartilage is an avascular structure that is supplied with oxygen and essential nutrients by the synovial fluid...
A unique fracture of the calcaneus not found within any fracture classification. I saw a unique fracture of the heel bone (calcaneus) this week that in 32 years of practice, I don’t believe I have ever seen before. This fracture...
Every doctor who works with a geriatric population knows that when the falls begin, the geriatric patient is entering the final stages of his or her life. Falls in the geriatric population are difficult to heal for a number of reasons but can be prevented with some simple steps. This article outlines 5 steps that can be taken to prevent falls.
Are bone contusions really considered to be fractures? This article discusses the classification of bone contusions.
A stress fracture is a nondisplaced defect in a bone that occurs due to repetitive load or trauma. A calcaneal stress fracture (fracture of the heel bone) is most often the result of a sudden abrupt injury but can occur without a history of trauma.
Walking on a fixed surface is dramatically different from walking on a moving surface like a treadmill. This article explores treadmill injuries and how to prevent them.
What is a plantar plate tear and how is it treated? This article explores the treatment of plantar plate tears.
A large percentage of my practice is an older population that is prone to falls. A history of falls defines the aging person. A single fall or series of falls are the hallmark of the final stages of aging. In many cases, seniors don't have the physical ability to recover from the secondary effects of falls and succumb to pneumonia or stroke.
With the advent of MRI, we now have a new category of bone injury called a bone contusion (also called bone swelling). Is a bone contusion really a fracture? I think so, but thus far, we don’t really have the vocabulary in the literature to call a bone contusion a fracture.
Bone edema is the term used by doctors (radiologists) to describe swelling within bone. Bone swelling is typically identified on MRI and is the result of either a direct injury to bone or load bearing that is greater than what can be sustained by the bone (stress injuries). Bone edema can also be found secondary to an inflammatory injury of bone. Inflammatory injuries include various forms of infection or arthritis.
Methotrexate is an antimetabolite that works by inhibiting dihydrofolic reductase. This enzyme is important in the production of DNA. Methotrexate targets rapidly growing cells such as inflammatory cells in rheumatoid arthritis or psoriasis. Methotrexate was originally used as a cancer drug for malignancies including acute lymphoblastic leukemia and lymphomas.
