A thumb sprain is a severe condition that can occur in athletes, physically active people, or simply anyone who experiences an injury relating to their hand. Many would consider this as a minor injury that will gradually heal on its own when, in fact, a thumb sprain can affect your ability to grasp, therefore impairing the functionality of the affected hand. So, it is necessary to consult a doctor, who will examine and treat you in time using orthopedic instruments, procured from reputed orthopedic instrument Manufacturer.
The main ligament that controls the function of your thumb is called the ulnar collateral ligament, spanning between the index finger and thumb. During a fall, instinctively one extends his arm to catch oneself, therefore causing the hand to bear most of the impact. This is the most common reason for thumb sprains, as the impact from a fall can cause an extensive tearing or stretching of the ulnar collateral ligament.
Skiers are usually most susceptible to severe thumb sprains, a condition also known as “skier’s thumb”. When a fall occurs in the process of skiing, the ski pole creates extra stress on the thumb ligament and increases the chances of a tear. Contact, ball sports, racket are other activities where the thumb is at risk of a sprain because of trauma such as a sudden hit or a fall.
Thumb sprains are among the toughest conditions to self-diagnose, as the onset of pain may not be immediate. Other symptoms may include swelling, tenderness, or bruising. If you experience any type of thumb injury, it is important to visit an orthopedic specialist whether you notice any symptoms or not, as leaving a sprain untreated may lead to complications in the thumb function.
When the ligament is partially torn your thumb will need to be immobilized with a splint or cast for approximately 4-6 weeks until the thumb regains its full stability. When the ligament is fully torn and/or there is any sign of bone fracture, you will need surgery followed by a recovery period of 6-8 weeks. The surgery is performed by the orthopedic surgeons using various instruments accessible from top orthopedic implant companies in India.
A bone plate may be placed so that it may be utilized for one of the following kinds of structural support:
- Compression Mode
- Neutralization Mode
- Buttress plate
- Antiglide plate
- Bridge plating or span plating
- Tension band
Plates are available in various shapes and sizes depending on the bone size and its anatomical shape. Similarly, Bone Screw size is dependent on the size & type of plate used. A small plate will typically be used for a small bone, which allows space only for the screw of smaller size.
Depending upon the fracture type and location, a plate can be used in any one of the following methods
Compression Mode
The word compression in fixation of a fracture means bringing the two fragments closer to one another so that the fragments oppose well.
When the plate is utilized to achieve compression with the fracture fixation, it is said to be utilized in compression mode. This mode is utilized on oblique and transverse fractures.
Neutralization Mode
In this kind of plating, a lag screw is utilized to neutralize shear, bending and rotational forces. The goal of this kind of plating is not to attain compression (this has already been attained by the lag screw).
This type of plating is also utilized as an adjunct where bone screws are used alone in long bones an accurate reconstruction with interfragmentary compression can be attained, but screws are not strong in resisting twisting or bending forces. Addition of a bone plate offers further resistance to such forces.
The fibular fracture normally seen in ankle injuries is usually fixed with lag screws protected by a neutralization plate.
The orthopedic plate is put on the tensile surface of the bone, but it is not pre-bent.
Buttress Plate
A buttress is an architectural structure built against or projecting from a wall which helps to reinforce or support the wall.
A buttress plate is utilized to prevent collapse in fracture patterns which are unstable under compressive forces.
A buttress plate is very thin in comparison to compression plate and is usually applied on the compressive surface of the bone.
This is the most commonly used plates around joints.
Here there is a comparatively soft cancellous bone core enclosed by a thin layer of cortical bone. Correct osteosynthesis may be attained by lag screws alone but under load, there may be a risk of screws cutting out of the bone or bending.
The addition of a bone plate will prevent such deformity under axial load. The plate should be located where the maximum load is predicted to be. Proximal tibia, for example, plates may be needed on one side or another to protect a fixation of tibial plateau fracture.
For the most common anatomical buttressing needs, there are specially shaped plates.
Antiglide Plate
In antiglide plating, the plate is fixed to the bone in such a manner that it prevents the distal fragment from overriding when force is applied along the long bone axis.
The distal fragment is firmly impacted between the plate and the fracture surface of the proximal plane.
This principle is generally applied in distal fibula fracture. It can be termed as a variation of compression plating.
Excellent results of fractured bones by plate and screws can be achieved not only by following biomechanical principles but also depends on the quality and design of plate, screw and bone health.
Various Factors Can Be Responsible for Good Results.
Plate material should be adequate in its strength. The strength of the plate varies with the cube of the thickness of the material. Titanium material’s plate stiffness is less than steel. Moreover, the very stiff plate can weaken the bone after fracture healing is complete. Hence, titanium has a distinct advantage over stainless steel.
The contact surface of the plate also has an important role in the excellent results. Conventional plate due to larger contactareahampers the underneath blood supply of bone leading into immediate post-fixation osteoporosis.
Based on Above Observations the Need for New Design Was Felt.
To minimize the surface contact area substantial material is removed from the undersurface of the plate between the screw holes. This arched appearance has following distinct advantages over the conventional plates.
A: = It reduces the stiffness of the plate to the same level as that of the screw hole area Resulting in less chance of breakage as compared to conventional plates.
B: = Since it has uniform stiffness throughout the plate in spite of holes. The newer Designed plates can be contoured in a continuous curvature. It evenly distributes the Bending and torsional stresses over a long segment along with the plate. Moreover the Screw head has a good fit despite the bending of the plate. Also, the even distribution of holes in Long length plate prolongs the fatigue life of the plate.
C: = The design of plate holes also contributes to the longevity and modularity of the Implant. Plate holes are distributed evenly and symmetrically along with the plate with Oblique undercuts on the inner side of the plate.
Undercut allows unhindered inclination of lag screw up to 40 degrees Longitudinally and 7 degrees in the transverse plane. A proper compression across the fracture can be achieved through plate holes with the modularity of bi-directional Screws.
One more advantage of even distribution of holes is that in case of an exchange or Revision surgery of plates, the longer plate can be used without conflicting with Previously drilled holes.
As regards the surgeon’s factor, proper exposure of fracture, good surgical Technique and choosing the proper length of the ortho implant (plate) also contributes to the excellent Final result. Choosing the short implant (plate) will make the construct unstable while Too long an implant (plate) will cause unnecessary damage to soft tissues and prolongs the operating time as well.
BY:
PIYUSH CHANSOURIYA
M.S. (ORTHO.)
VARANASI, INDIA.
Email-pchansouria@gmail.com
The wrist contains two forearm bones: the ulna and the radius. The most commonly encountered fracture in the wrist is that of the distal radius, the end of the larger of the two arm bones at the thumb-side of the wrist. Generally, Distal radius fractures occur about one inch from the end of the radius and are caused due to injury when one falls on an outstretched hand or if one has osteoporosis or low bone density. The injury causes swelling, pain, and bruising and can create a deformed appearance to the wrist.
The length of time for recovery differs greatly between patients. It is essential to have your recovery guided by your physician and a certified hand therapist. It is necessary to keep the wrist elevated and to keep the fingers moving by making a tight fist as often as possible. There is no reason to use a squeeze ball. An empty fist is the best. It is very common to have swelling and stiffness in the fingers and hand for quite some time after a wrist fracture.
Treatment Options
Stable fractures that do not affect the joint alignment are treated without surgery. Initial treatment generally includes elevating the arm, icing, and anti-inflammatory medications to control swelling and pain. A splint may be used for 1 to 3 weeks to allow for swelling. After the swelling is subsided, the splint will be replaced by a fiberglass cast. After the injury, the wrist is typically immobilized for as many as 6 weeks. A sling may be worn for comfort, but it is important to work on maintaining a full range of movement of the elbow and shoulder to prevent stiffness. Regaining range of motion of the forearm and wrist is the focus for the first few months, followed by strengthening. In most cases, a return to sports may be expected no before 3 months from the start of treatment. After the cast is taken off, a removable splint can be worn either for strenuous or full-time activities until the fracture is fully healed.
For more serious fractures, surgery may be needed to correct the alignment of the bone. Sometimes a cast alone can be used, or it may be essential to insert metal pins, bone screws and an orthopedic plate.
Another common fracture is of the scaphoid bone which is a small bone in the thumb-side of the wrist. It is a common sports injury and is often a result of a fall toward an outstretched arm.
Treatment depends on the location of the break. Fractures at the end of the bone, close to the thumb, often heal in a few weeks when placed in a cast. If the scaphoid is broken in the middle of the bone or closer to the forearm, healing can be more difficult and need a long-arm cast or surgery.
When the scaphoid is broken at the proximal pole or waist, surgery may also be recommended. For surgery locking hand plates require that can be accessed from the top orthopedic implant manufacturers in India. Wires and bone screws are used to stabilize the bone, so it can heal properly. After surgery, the wrist may be put into a cast, however, even with surgery, these fractures can be hard to heal.
What is a Hip Fracture?
A hip fracture is a severe injury that may hamper your ability to walk. Most people fracture their hips at the upper area of the femur, where the thighbone meets the hip joint. The injury usually requires surgery and physical therapy for a full recovery. The surgeons use ortho implants and orthopedic tools in the surgical procedure.
Hip Fracture Treatments
A fractured hip is a far more serious injury than just any broken bone. A hip fracture, especially in the old age, can greatly hinder the quality of life. If you suspect you have fractured your hip, the best thing to do is to take immediate medical treatment.
When to Seek Medical Attention
While women over the age of 65 are at the highest risk, anyone can suffer a fracture of the hip. If you have any of the following symptoms, you must consult an Orthopedic Specialist at once.
- Severe pain from the hip or groin area- Swelling or inflammation in the hip
- Bruising- Unable to put pressure or weight on the leg
- If you have recently suffered an accident or fall and are experiencing any of these symptoms, seek immediate medical attention.
Do I Need Surgery?
In most cases, surgery is the best way to fix a fractured hip with the help of orthopedic Hip implants. If you are in stable medical condition, most surgeons will want to operate 8 to 24 hours after you have arrived at the hospital. Delaying further will only add to your suffering and pain and increase the chance for complications and infections.
What to Expect if you Need Hip Surgery?
When you first go to the hospital, your doctor will most likely need to do some imaging test to confirm the diagnosis. This could mean either computed tomography (CT) scan or magnetic resonance imaging (MRI).
After you are properly diagnosed, your doctor will schedule surgery as soon as possible. If you have any other health problems, your doctor might delay your procedure and wait until you are in stable enough medical condition for hip surgery.
Recovery After Hip Surgery
After your surgery, your physician will work with you to customize a recovery plan that fulfills your needs. Every patient is different and there recovering pace too. In most cases, you will stay in the hospital for around 4 days before being discharged to initiate your physical therapy. A rehab program is vital and reduces the need for a walker or cane.
The most important thing to remember after your surgery is to be patient. Recovery can be a challenging and long effort and could take as long as a year. Even then, some patients may never be able to move around as they could before their hip fracture. The best thing is to keep a positive outlook and not be discouraged.
Who at a Risk of a Broken Hip?
While anyone can break their hip, these fractures are more common among women and old people, because of decreased bone density and length. Here are some more aspects that put one at greater risk of fracturing their hip:
- Heredity: If your family members typically have a thin, tall frame or if any of them have fractured their hips before.
- Lack of activity: Those who do not get enough exercise that bears weight on their hips (even something as simple as walking) may not have strong hip bones.
- Improper nutrition: Vitamin D and calcium help our bones grow strong. Diets that do not have these components may result in weak bones.
- Arthritis: Those with arthritis typically have weakened bones, putting them at higher risk of a hip fracture.
- Other medical conditions: Any conditions that cause problems with balance or dizziness may put one at greater risk of falling, which can result in a broken hip.
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