Bone Fracture Category

As kids head back to school, excitement often comes with increased physical activity, whether through sports, recess, or simple playground fun. However, this surge in activity can also lead to common foot and ankle injuries, many of which are specific to growing children.

Understanding these injuries and knowing how to prevent and treat them is crucial to keeping your child healthy and active. Below are the most common podiatric injuries parents should be aware of as their kids return to school.

Fracture of the Growth Plate

Growth plates are the softer areas of cartilage located at the ends of long bones in growing children. These plates determine the future length and shape of bones, making them vulnerable to fractures.

A growth plate fracture occurs when the bone is subjected to excessive force, which can happen during falls, sports, or other physical activities.

• Symptoms: Swelling, pain, and difficulty moving the affected limb are common signs.
• Diagnosis & Treatment: X-rays are typically needed to confirm the fracture. Treatment often involves immobilization with a cast or splint. In severe cases, surgical intervention may be necessary to ensure proper healing and to prevent future growth disturbances.

Because the growth plate controls bone development, untreated fractures can lead to uneven bone growth or deformities. Early diagnosis is essential to avoid long-term complications.

Inflammation of the Growth Plate: Severs Disease

One of the most common causes of heel pain in children is Severs Disease, also known as calcaneal apophysitis. This condition involves inflammation of the growth plate in the heel, often caused by repetitive stress and strain from running and jumping.

• Risk Factors: Severs Disease primarily affects children during growth spurts, typically between the ages of 8 and 14, especially those involved in high-impact sports like soccer, basketball, or track.
• Symptoms: Pain at the back of the heel, which may worsen with activity and improve with rest, is a key symptom.
• Treatment: Rest, ice, and over-the-counter anti-inflammatory medications are effective. Physical therapy exercises may also be recommended to strengthen the muscles and tendons around the heel.

Proper footwear with good arch support and cushioning is crucial in preventing Severs Disease from recurring.

Ligament Sprains

Ligament sprains are a frequent occurrence in children, particularly as they return to school sports. Ligaments are bands of tissue that connect bones and provide stability to the joints.

When a ligament is overstretched or torn, a sprain occurs.

Ankle Ligament Sprains

Ankle sprains are among the most common injuries in active children, often resulting from a twist or turn of the foot during sports.

• Symptoms: Swelling, bruising, and a loss of range of motion are common signs of an ankle sprain.
• Treatment: Rest, Ice, Compression, and Elevation (R.I.C.E.) is the first step in managing an ankle sprain. More severe sprains may require physical therapy or the use of a brace to promote healing and prevent re-injury.

Midfoot Ligament Sprains

While less common than ankle sprains, midfoot sprains can occur due to falls, trips, or direct impact injuries.

• Symptoms: Pain, swelling, and tenderness in the middle of the foot are typical symptoms.
• Treatment: Like ankle sprains, midfoot sprains respond well to R.I.C.E. and, in some cases, immobilization with a cast or boot may be necessary for proper healing.

Preventing ligament sprains involves proper warm-up routines before physical activities, supportive footwear, and strengthening exercises to maintain joint stability.

Turf Toe

Turf toe is a sprain of the main joint of the big toe, often caused by excessive upward bending during sports like football, soccer, or basketball. It occurs when the toe is forcibly jammed or bent beyond its normal range of motion.

• Symptoms: Pain, swelling, and limited movement at the base of the big toe are typical.
• Treatment: Rest, icing, and taping the toe can alleviate the symptoms. In severe cases, immobilization may be required to allow the joint to heal properly.

Wearing stiff-soled shoes and using orthotic inserts can prevent turf toe by limiting the range of motion of the big toe.

Sesamoiditis

The sesamoid bones are two small bones located beneath the big toe that help absorb the impact of walking and running. When these bones become irritated or inflamed due to repetitive pressure, it leads to sesamoiditis.

• Symptoms: Pain beneath the big toe, especially when pushing off during walking or running, is the primary symptom.
• Treatment: Reducing activity, icing the affected area, and using custom orthotic inserts can relieve pressure on the sesamoid bones. In chronic cases, a podiatrist may recommend physical therapy or even surgery.

Tendonitis

Tendonitis refers to inflammation of the tendons, the thick cords that connect muscle to bone. In children, the most commonly affected tendons are the Achilles tendon and the tendons on the outside of the ankle (peroneal tendons).

• Symptoms: Pain, swelling, and tenderness along the affected tendon, particularly with activity.
• Treatment: Rest, stretching exercises, and physical therapy are typically recommended. Orthotic devices can also help alleviate stress on the tendons.

Encouraging proper stretching before physical activity can reduce the risk of developing tendonitis.

Subungual Hematoma

A subungual hematoma occurs when blood collects under a toenail, often caused by a heavy object falling on the toe or repetitive trauma from activities like running or playing sports.

• Symptoms: Intense pain, throbbing, and a visible dark spot beneath the nail.
• Treatment: Small hematomas may heal on their own, but larger ones may require a podiatrist to drain the blood to relieve pressure and prevent complications.

Wearing properly fitted shoes with adequate toe protection can prevent subungual hematomas from occurring.

For Treatment of Injuries at School, Call Salt Lake City Podiatrist Dr. Elizabeth Auger, DPM

As children head back to school, they become more susceptible to various foot and ankle injuries due to increased physical activity. Recognizing these common podiatric conditions—ranging from growth plate fractures to tendonitis—can help parents take the necessary steps to ensure proper treatment and prevent long-term complications.

If your child complains of foot or ankle pain after a sports injury, consult with Dr. Elizabeth Auger for a comprehensive evaluation and treatment plan. Early intervention is key to keeping your child healthy, active, and pain-free throughout the school year. Call SLC Podiatrist today at (801) 845-3960.

Bone nonunion is a painful and potentially disabling medical condition that occurs when a fractured bone fails to heal properly. This can lead to chronic pain, disability, and decreased quality of life for those affected. In this article, we will explore the causes, risk factors, diagnosis, treatment options, and ways to manage symptoms associated with bone nonunion. By understanding why it happens and how it can be treated, you can ensure you get the best possible outcome from your bone healing process.

Understanding Bone Nonunion

Bone nonunion is a medical condition that occurs when a fractured bone fails to heal in the normal 9-12 month time frame. It is characterized by the inability of two ends of bone to be fused, leading to chronic pain and potential disability. The causes of this condition can vary, but common ones include smoking, osteoporosis, poor nutrition, and instability at the intended fusion site due to poor surgical technique or patient non-compliance.

When diagnosing bone nonunion, physical examination and imaging tests are typically used in combination with blood tests to determine the cause. Treatment options range from using bone stimulators, surgery, immobilization or bone grafts to managing symptoms through diet, exercise, elevation, pain medication and physical therapy. Additionally, research into new advances in treatment for this condition is ongoing as doctors strive for improved outcomes for those affected by it.

Causes and Risk Factors

Bone nonunion can be caused by a variety of different factors, including lifestyle choices and age-related issues. Smoking has been linked to a decreased oxygen supply, leading to an increased risk of developing nonunion fractures and an extended healing time. Additionally, osteoporosis weakens bones and increases the likelihood of fracture. Poor nutrition can also lead to slower healing, as vital nutrients are needed for tissue repair. Prednisone and other medications may interfere with the healing process as well.

Older age is associated with higher risk due to weaker bones over time; however, there are other factors that can slow healing that should be taken into consideration, such as anemia or low levels of vitamin D3, which prevent calcium from being absorbed into the bone matrix. Lastly, if any infection is present at the fracture site, it must be treated before healing can occur since bacteria consume essential nutrients required for repair.

By taking steps towards reducing your risk for bone nonunion you can greatly increase your chances of successful healing should you ever suffer a fracture or break in your bones. Avoiding smoking and high impact activities if you have weak bones or osteoporosis is key; additionally, eating balanced meals rich in minerals and vitamins including calcium and Vitamin D3 will provide your body with all it needs for healthy tissue repair processes. Exercise regularly but avoid any exercises that could place too much stress on injured areas until they are fully healed. Speak with your doctor if you experience any unusual symptoms near a fracture site like pain or swelling, which could indicate infection needing treatment.

Diagnosing Bone Nonunion

Diagnosing bone nonunion is an important step for medical professionals to take when a fracture does not heal correctly. The first step in diagnosis is typically a physical examination and medical history, as this allows the doctor to assess the patient’s overall health and determine the extent of pain and other symptoms associated with the nonunion. Imaging tests such as X-rays, CT scans, or MRI scans may be ordered to evaluate the extent of bone nonunion and identify any underlying causes.

In addition to imaging tests, blood tests may be ordered to assess the patient’s overall health. This includes testing for calcium levels, Vitamin D3 levels, hormone levels, and other laboratory findings that can provide insight into why a fracture has failed to heal properly. Depending on results from these initial diagnostic tests, additional tests may be ordered to rule out other potential conditions such as infection or cancer.

It is important for doctors to accurately diagnose bone nonunion in order to offer effective treatment options and minimize risks associated with the condition. An accurate diagnosis can help inform decisions about treatments such as bone stimulators, surgery, immobilization, or bone grafts that will best facilitate the healing of the fractured bone. With an accurate diagnosis in hand, doctors can also recommend lifestyle modifications such as diet changes, exercise regimens, elevation therapy, and pain medication that can help manage symptoms.

Treatment Options for Bone Nonunion

Treatment options for bone nonunion vary, depending on the severity of the condition. Bone stimulators are one option for treating nonunion fractures. These devices use either ultrasonic or pulsed electromagnetic waves to help stimulate the healing process in cases where the body is not responding to traditional treatments. Surgery may also be necessary to stabilize the bone fragments and immobilize the affected area. In some cases, a bone graft may be needed as well, in order to provide additional structural support for healing.

In addition to medical interventions, managing symptoms through diet, exercise, elevation, pain medication, and physical therapy can also be beneficial in helping to treat bone nonunion. Eating a balanced diet with minerals and vitamins helps ensure that your body has all it needs for fracture healing. Exercise can help strengthen bones while reducing inflammation and promoting blood flow. Elevation can reduce swelling and discomfort at an affected site while pain medications like ibuprofen or acetaminophen can help manage pain levels. Finally, physical therapy is important to restore motion at the fracture site and improve function throughout your body.

It is important to note that no single treatment option works for everyone; it is best to work with your doctor or healthcare provider in order to find out what treatment plan will work best for you based on your individual needs and lifestyle factors. Additionally, it is recommended that you follow up regularly with your doctor after treatment begins in order to monitor progress and make any necessary adjustments moving forward.

Managing Symptoms of Bone Nonunion

Living with bone nonunion can be difficult, but there are ways to reduce the associated discomfort and improve overall quality of life. By maintaining a healthy diet full of vitamins and minerals, exercising in low-impact activities, elevating the affected area when possible, taking pain medications if prescribed by a doctor, and undergoing physical therapy as needed, individuals can help manage their symptoms more effectively. It is important for each patient to consult with their physician about what treatments they should consider based on their individual condition; this way they will ensure that they receive the most personalized care for their specific situation while reducing risk of further injury.

A Case Study From My Clinic in Salt Lake City

 

To illustrate the impact of bone nonunion, let’s consider a patient who came to my clinic with toe pain and swelling. Upon evaluation, we discovered two nonunions. The first occurred due to poor surgical technique during a joint fusion procedure in her toe, which took place ten years ago. The instability in that area even affected the joint distal to the failed union site. The second nonunion resulted from an avulsion fracture that failed to heal, possibly due to instability at the site. To address the nonunions, the patient underwent surgery to remove the fracture fragment and implant.

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