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Herniated discs are very serious injuries, and may result from car accidents, falls or heavy lifting. The normal spine is S-shaped, when viewed from the side. The curvature actually helps absorb the repeated shock of walking, running and jumping. The spine is wonderfully flexible, but this diminishes with age. The discs of the spine are the shock absorbers, the flexible parts of the spine. They separate the bony segments of the spine, which are very rigid. When the spine is injured by abnormal forces, such as a car accident, sometimes the disc will move, in relation to the bones of the spine. This is a herniated disc. This shift alone might not matter so much, except that the disc often impinges on the nerves that exit from the spine, most often the ones affecting the legs, but sometimes the bowels, bladder or genitals. In automobile accidents, especially frontal collisions, the lower spine is suddenly flexed severely, which may cause protrusion of the disc backward. Back pain tends to be severe, but more worrisome is the possibility of nerve pressure or injury. This is typically manifested by numbness and tingling in the leg, commonly on the outside of the thigh, back of the calf and down into the foot, sometimes involving the big toe. Weakness in the ankle may occur, and the reflexes that the doctor elicits with his little rubber hammer, may diminish. Many patients complain of an electric shock sensation with or without tingling and numbness.
Standard X-rays generally are not as effective as the newer Magnetic Resonance Imaging, which clearly demonstrates the relative position of the discs to the bony spine and the nerves. This study will usually clearly mark the site of the problem.
Generally, physicians will try the simple things first, to provide relief of herniated disc symptoms. Back rest is the most important. Anti-inflammatory drugs, muscle relaxers, and sometimes injection of special steroid medicines directly into the area of inflammation may be used. Physical therapy can strengthen the back muscles, which helps to stabilize the spine. If relief is not forthcoming, then surgery must be considered. Some patients may only need "bandaid" surgery, wherein a lighted scope is inserted through a small incision directly over the disc, and a portion of the disc is removed with tiny instruments. In those patients where there are bony changes associated with aging, a more aggressive open surgery is needed to remove sufficient parts of the disc to prevent recurrence. In some patients, the disc is removed completely, and means are used to stabilize the bones, called a fusion. A recent development is the artificial disc, which is a spongy, flexible piece of plastic. It is placed exactly where the real disc was removed. Since it also replaces the shock absorbing nature of a good disc, this innovation seems promising.
On discharge from the hospital, the patient may be asked to wear some sort of back support or brace for several weeks, and to avoid any lifting whatever, until the back heals. In some patients, the herniated disc is removed, but the pain and tingling persists. In others, the initial surgery must be repeated, and a larger amount of the offending disc removed. A very serious medical consequence of a major herniation is called Cauda Equina, in which the disc affects the nerves of the bowel, urinary bladder and the genital organs. In these cases, surgery is a must, and must be done quickly, to avoid permanent damage to those organs. Any delay in diagnosis of nerve injuries risks long-term disability, since prolonged compression of a nerve will often cause irreparable damage.
Broken hip injuries can occur at any age, but increase in frequency directly with age, being much more common in people over age 65. In the U.S., there are over 300,000 hip fractures each year. For the elderly, falls are the most common cause of broken hips, but the underlying cause is typically a decrease in bone density associated with aging. A person with a bone density of only one standard-deviation above others of the same age, will have a likelihood of hip fracture more than 20 times those with stronger bones. Not only that, but the death rate for elderly people is very high within a year of the fracture, ranging from 10% to 40%. Only a minority of older patients ever achieves normal mobility after a broken hip. Even younger patients are fortunate if they have a normal walking gait after a hip fracture heals. For younger people, car accidents and motorcycle accidents tend to lead the list of causes of broken hips.
Most hip fractures occur in the short area of bone that rather sharply angles inward at the top of the long thigh bone (femur). A normally-smooth ball swings in a socket of the pelvis, forming the hip joint. Younger patients heal better and more quickly than older patients. If the bone fragments have not moved, then sometimes very conservative treatment, such as using crutches and wheel chairs, is sufficient. If the bones have moved, then surgery is likely needed to fix the bones in proper position. Pins (screws) and metal plates are often used to hold things where they should be, when the femur is the only fractured bone. When the pelvis is also fractured, the outcome of broken hip repair is less predictable, since the joint-surface healing is more difficult to predict, and more likely to cause restrictions in joint movement. Family members of older patients are often shocked when death results shortly after surgery or several months after a broken hip, but the correlation is, as noted, very high. The precise mechanisms responsible for this correlation have been poorly identified, in most cases. It appears that these patients are much more likely to contract pneumonia and other infections, related to decrease in mobility.
Knee injuries may occur from car accidents, in which the knee is jammed into the dash of the car, in frontal collisions, or from slip and fall type injuries, usually involving a twisting motion of the knee, while cutting or changing direction suddenly. Football, basketball, rugby, and similar sports often require sudden changes of direction by the runner. This, with or without a hit from the side, often tears the Anterior Cruciate Ligament (ACL) of the knee joint.
The ACL offers stability from excessive rotation of the big bones of the leg, as well as excessive forward movement of the shin bone (tibia) with respect to the femur. The patient typically complains that the knee simply "gave way", and she heard a loud pop, at the time of injury. Invariably, there is severe swelling, pain and tenderness of the knee, following the injury.
Early definitive diagnosis is not always possible until the knee cools down, and the swelling associated is reduced, which sometimes takes several weeks, commonly a month or so. When the pain and swelling have diminished significantly, then the physician can push and pull on the knee to see if there is evidence of a ligament tear. Prior to that, there is simply too much pain to make assessment accurate. In the case of torn ACL, the tibia (shin bone) will move too far forward, when pulled relative to the femur. An MRI (magnetic resonance imaging device) will show the tear of the ligament, but is usually not necessary for the diagnosis to be correct. A sloppy, unstable joint simply will not function on the playing field, nor will it function for many kinds of labor. The ligament need not always be repaired, especially if the patient is not an athlete or if her work does not require agility. Women are much more prone to ACL tears than are men.
If a stable knee is important to the patient, especially regarding the young person involved in sports, then surgery must be performed. The ACL is not actually repaired, but replaced with a strip of the ligament that runs over the knee cap (patella). It is generally very strong and easy to reach, and makes an excellent replacement ligament. Occasionally another ligament of the back of the thigh is used, but much less often. Unfortunately, the healing time is very long, often seven months to a year, from the time of surgery. Some physicians will suggest the use of a machine that continuously moves the knee joint, while it is healing. Other physicians will recommend a knee brace. A large percentage of younger patients will recover all or nearly all of their normal knee function after a torn ACL, but the lengthy recovery time is trying. Some older patients will decide that the surgery is simply not worth it, and will limit their activities, rather than endure this protracted course.
Unfortunately, an unrepaired torn ACL will make the patient more likely to develop arthritis of the knee or to sustain a tear of one of the cartilaginous plates that line the knee joint (meniscus). This is again especially important for the young worker or athlete. Many types of manual labor require a normally functioning knee joint: carpenters, plumbers, roofers, masons, and so forth. The knee is an amazing joint, and one of the key players is the ACL. Tearing the ACL is often associated with difficult decisions and emotional trauma, loss of work and loss of self-esteem. The extensive healing time required is troublesome, at best.
Low back strain is a very common injury, and is often associated with heavy lifting, although there are many other types of movement that can produce a strain of the lower back muscles, such as the unavoidable twisting in sports like golf and tennis, and direct contusions (impacts causing injury) to the back. Car accidents are frequently a cause of low back injury and strain. This is one of the injuries that a seat belt does not necessarily prevent, since there is often violent flexion of the lower spine, with the belt as the pivot point. It is also one of the leading consequences of industrial, work-related injuries, especially in those who must lift, turn, throw and reach with some frequency. The lower spine is actually centrally related to nearly every movement we make. It balances the entire upper body on the hip joints, and facilitates the entire panoply of movement of the arms, chest and head.
When the muscles are stretched, the injury is called a strain. When the ligaments that hold the muscles to the lower back vertebrae are torn, the more serious "sprain" occurs.
Sometimes a physician is comfortable making the diagnosis of back muscle strain, and X-rays are not done, or they are deferred until a trial of conservative treatment has been tried. More often, X-rays are performed to detect the unexpected fracture or other less common explanations for the pain. In most cases the diagnosis is fairly straightforward. There was a sudden movement, with or without lifting, followed by excruciating low back and/or buttock pain, unresponsive to rest and mild pain medications.
In most cases, the treatment is the same, requiring rest, pain medications, muscle relaxers and physical therapy. On occasion, the physician will elect to inject anti-inflammatory steroids directly into the area of pain, which may provide dramatic relief. Sometimes a back brace or elastic support is used to restrict movement of the muscles while healing occurs. The pain is often very severe and debilitating, but is confined to the lower back and the buttock muscles. If there is weakness in the legs, or bowel and bladder problems, one must quickly assess the possibility of a slipped disc and nerve injury, which must be considered a real emergency.
Presuming that the lower back injury is localized, one can count on getting better over a few days, or no more than 3 or 4 weeks. Generally, several days of work are missed after a back strain. In fact, back strain is one of the leading causes of missed work-days. Those who are too eager to return to their regular work often pay the high price of having to repeat all the steps noted above. Fortunately, the back is one of the more resilient muscle groups of the body. If care and caution are used, one can expect a full recovery.
A spinal cord injury is usually caused by a traumatic blow to the head, neck, or back that fractures or dislocates the vertebrate. Each year in the United States, more than 11,000 people suffer from a spinal cord injury, not including those who die at the scene of an accident. There are currently 250,000 people in the United States living with a spinal cord injury.
The spinal cord is the bundle of nerves that transmits information between the brain and the rest of the body. When a spinal cord injury occurs, this system is damaged, often resulting in physical impairment. Spinal cord injury usually starts with a sudden, traumatic blow to the spine that fractures or dislocates vertebrae. The impact causes the vertebrae to fracture or compress, which in turn crushes the extensive nerve cells (axons) that carry signals along the spinal cord between the brain and the body. Specific effects of a spinal cord injury on the body usually depend on the location and severity of the injury. An injury to the spinal cord can damage a small number of axons or almost all of them. Spinal cord injuries are called either “complete” or “incomplete”. The victim of a complete injury totally lacks sensory and motor function below the injury. An incomplete spinal cord injury victim retains some sensory motor function below the injury.
Tragically, many brain and spinal cord injures are irreversible. Automobile accidents cause the majority of spinal cord injuries, followed by sports mishaps, falls, birth trauma, violence and disease. In addition to draining the victim both physically and emotionally, SCI can also drain a family’s finances because medical care for spinal cord injuries is costly and long-term. Many people who live with spinal cord injury have secondary complications including pain, respiratory and heart problems, bladder and bowel dysfunction, pressure sores, respiratory complications, urinary tract infections, spasticity, and scoliosis.
Quadriplegia and paraplegia are medical terms that indicate the type of paralysis suffered by those with a spinal cord injury. Paralysis, or loss of movement and sensation, can be complete or incomplete with a spinal cord injury. The complete/incomplete classification indicates how much movement and feeling is left in the affected areas after initial recovery. Less than one percent of those hospitalized with a spinal cord injury completely recover. The major of those with spinal cord injuries have incomplete quadriplegia, followed by complete paraplegia, complete quadriplegia, and incomplete paraplegia.
Caring for those who have survived a spinal cord injury is often a life long endeavor. Treating a patient with a spinal cord injury often involves a team of medical professionals dedicated to every aspect of a patient’s well being. The injury can cause more than physical harm; it can impact the victims’ family, finances and future. Monetary compensation can help spinal cord injury victims and their families meet the challenges of the future with less worry about medical bills, employment and rehabilitation.
Mistakes in prescribing medications are more common than commonly supposed. Some estimates are that physicians will make one error for each 250 patients that she sees. In addition, we must consider the mistakes made by allied medical personnel, such as nurses and pharmacists.
Often, the patient fails to notify the physician of known allergies to medications, but since there are over 8000 prescription drugs available, and climbing, it is no surprise that the system itself can cause many mistakes. Many drug names are very similar. There are known, major-company brands and generic look-a-likes. Drugs can only come in so many colors, shapes and sizes. Some foreign drug manufacturers are rather fly-by-night, and have limited or no quality control mechanisms, so the drugs might contain contaminants or be completely fraudulent. This is one of the unexpected consequences of the effort to reduce the cost of medications to the patients, by permitting drug substitutes by pharmacists, with cost being the primary consideration. Pharmacists and nurses may misread the name of the drug, which can be catastrophic, or even the amount of the drug to be given, which can be equally devastating. Physicians, nurses and pharmacist often work long hours, and fatigue may result in mistakes in prescribing or dispensing medications. Sometimes the patient's condition improves, and the original dosage is no longer reasonable.
Modern computer software is available that, if utilized, is quick to assist medical professionals in detecting potential drug interactions and obvious drug dosage errors. There is a steady movement afoot by hospitals and pharmacists to constantly input patient drug data into computers, which do not get fatigued. Bar-coding of medications or medicine containers is increasingly being used to avoid mistakes. At least they may cause the practitioner to look twice at what she is doing.
Too often, the patients are too-trusting in the system, and fail to ask critical questions about drug interactions or side-effects. It is not uncommon for some elderly patients to stockpile medications from previous prescriptions, and not mention these to the most current physician they see. Some states now require that pharmacists give out an information sheet about each drug they deliver. It may well be that, in the future, medication errors will be uncommon, primarily due to the increasing computerization of medicine, but we still have a way to go before that day arrives. Until then, the patient should be on her toes to detect mistakes by all the people who are treating her. Remember, physicians and other medical professionals really do, on occasion, bury their mistakes, even with the best of intentions.
The rotator cuff of the shoulder is actually a composite of four major muscles that work in harmony to move the shoulder through a magnificent array of movement possibilities, enabling humans to use the hand in a startling array of possibilities. The precise placement of the ligaments and muscles onto the upper long bone of the arm (humerus) enables the arm and hand to swivel and arc, as well as rotate on its long axis. The majesty of this mechanism almost cannot be overstated, and is generally not sufficiently well appreciated. Almost none of the sports at which we marvel could be performed without this engineering masterpiece.
Rotator cuff injuries are, for the most part, tendon injuries, where the tendons insert or connect to the bone. Partial tears may involve the muscle itself, but complete tears generally mean that the tendon attachments have been disrupted. The muscles swing over the shoulder and attach to the wing-bone of the back (scapula). Other crucial muscle-tendon attachments are to the collarbone and some of the bony side-projections of the upper spine. The brain, of course, coordinates the various muscle tensions necessary to make the arm move when and where it is wanted.
The most common cause of a torn rotator cuff injury in a young person is a fall onto an outstretched hand or a direct hit to the shoulder in something like a side-impact car accident. The pain is typically severe, although localizing the exact spot of the pain is often problematic for the patient. She only knows that the pain is severe and the arm is nearly useless. The majority of cuff injuries occur in older people, since the tendons wear thin with age, and are more easily prone to breakage with stress. Some patients, especially older ones, may tear the rotator cuff with repetitive movements, such as stocking shelves overhead, for example. A common complaint is that one is unable to open cabinets overhead, or even comb her hair.
Many older patients are happy to treat their torn rotator cuffs conservatively, with anti-inflammatory medicines and physical therapy to strengthen the intact muscles of the shoulder. For many, injections of steroids directly into the area of pain affords relief from pain for weeks. For younger patients the need for surgery is generally imperative, since the long-term disability of a bad shoulder is too great to bear, especially with the dominant arm. The MRI is the most commonly used diagnostic tool in determining that a tear has occurred. In the hands of some technicians, ultrasound can be nearly as good. Injection of dye into the shoulder joint to make a diagnosis has largely, if not completely, been abandoned. Surgery can involve large incisions, which make it easier for the surgeon, or smaller incisions, which require the use of scopes and cameras to hook things back where they belong. In some older patients, the spurring of the bones that may develop with age makes the larger incision nearly a necessity, and this only for those who have intractable pain or nearly complete disuse of the arm, unresponsive to conservative treatment. Even in younger patients, healing often requires six months or more. A gentle physical therapy routine is increased progressively over these months, to strengthen the shoulder. One must be careful not to push the limits in the early months. A properly diagnosed and repaired rotator cuff in a younger person will typically heal perfectly, restoring complete and normal use of the arm. Significant delays in accurate diagnosis may make complete repair impossible, since the tendons and muscles may atrophy with time. The younger the patient, the more important that one be aggressive in diagnosis and repair.
Accidents and falls are the primary cause of neck injuries. Neck injuries can vary widely in effects and severity: some neck injuries result in temporary symptoms that resolve with time, while neck injuries that are more serious can lead to complete paralysis of the trunk and limbs. Whiplash injuries are one of the most common forms of neck injury, and are particularly common in vehicle accidents. Nerve damage, disc damage, ruptured ligaments, fractures of the vertebrae, and spinal cord injuries are other common neck injuries often caused by accidents and falls.
Neck injuries involving strains and sprains (such as whiplash) are the most frequently reported injuries on US insurance claims, according to Insurance Institute for Highway Safety.
Special Consideration for helping a person with possible neck injuries:
If you are at the scene of an accident where you suspect a person has suffered neck injuries, it is imperative to leave the person exactly as they are unless it is absolutely necessary to move them (such as pulling them out of a burning car or body of water). Moving a person with a possible neck injury can seriously aggravate a person's injury and can even cause death. It is vital to call for emergency help. If you must move a person, support the head and neck and move the body as a single unit.
Whiplash, also called neck strain or neck sprain, is one of the most common types of neck injuries. It is often called a car accident neck injury, because vehicle crashes are the most common cause of this injury. The sudden and violent jerking of the head back and forward (hypertension/flexion), such as in rear-end collisions, is what causes whiplash neck injuries. Whiplash and related neck injuries can range in severity from mild to severe and debilitating.
Most symptoms of whiplash develop immediately or in the hours or days following the accident. The most common symptom of neck injury is pain, which can range from mild to extreme. Other symptoms include:
If a person with neck injuries experiences extreme and/or unrelenting pain, severe headaches, weakness, tingling, numbness, or loss of functioning in part of the body, it is imperative for him/her to seek immediate medical attention, as their injury could be serious.
In vehicle accidents, the following factors and increase the severity of a patient's car accident neck injury:
A doctor will diagnose whiplash by taking in a detailed account of the accident, conducting a thorough physical exam, and inquiring about one's medical history. While most whiplash injuries involve damage to the soft tissues in the neck area, a medical professional will typically take an x-ray of the spine to ensure that you have not suffered any spinal injuries or delayed symptoms that indicate a more serious condition.
Luckily, whiplash is often a treatable and temporary neck injury. A soft cervical collar, which stabilizes the neck, is often used to treat whiplash in the first two to three weeks. Other treatments for uncomplicated whiplash neck injuries include:
If symptoms subsist or get worse after a month or two, additional tests may be necessary to determine the extent of the injury. In more serious cases, where whiplash has resulted in cervical disc damage, surgery may be required to repair the disc. See also herniated disc. Surgery is rarely necessary following whiplash neck injuries.
If surgery is required, discectomy can be performed to remove part of a damaged disc; microdiscectomy is the removal of a disc with the help of a microscope; percutaneous procedures, while not common for cervical neck injuries, can remove the disc through a small incision and aspiration; spinal instrumentation and fusion works to stabilize the spine.
Cervical fracture is the breaking of one or more of the cervical bones, or vertebrae, in the neck area. This neck injury can be very serious when the spinal cord sustains damage, which can lead to paralysis. The most common cervical fracture causes are falls and traumatic accidents, such as a motorcycle accident or car accident. Other common causes of cervical fracture are dives into shallow water, sports injuries, violence, and other sudden and severe blows or twists of the neck.
If a person has sustained a neck injury where cervical fracture is suspected, it is important to seek medical treatment, as the condition could be serious. Cervical fracture symptoms include pain (which may or may not be severe), bruising, swelling, tenderness, muscle weakness or paralysis, or loss of feeling in the limbs. If the latter symptoms are present, it is extremely important to seek immediate medical attention, due to the possibility of spinal cord injury.
To diagnose cervical fracture neck injuries, a physician may conduct x-ray tests, an MRI scan, and/or a CT scan.
Treatment of cervical fracture will typically depend on the patient's individual condition. The following factors will affect cervical fracture treatment: the presence of muscle weakness or paralysis, what cervical bones are affected, how severe the fracture is, and whether dislocation occurred. Cervical fracture treatments can include:
Brace or cervical collar: for mild cervical fractures, a brace or collar is worn to immobilize the neck for eight to twelve weeks. Over-the-counter pain medications may also be recommended.
Exercises: after an initial period of time, your doctor will recommend a rehabilitative exercise plan to increase your range of motion and muscle strength. It is important not to resume exercise until your doctor has determined you are ready.
Surgery: In more serious cases, surgery may be required to realign and stabilize the bones of the neck and spine.
Depending on the severity of one's neck injury, neck immobilization and rehabilitative efforts may be necessary for months or even years following the original injury. If spinal cord injury occurs as a result of a cervical fracture, the paralysis is often permanent.
Spinal cord injury is the most serious and severe neck injury a person can suffer. The spinal cord is responsible for sending messages from the brain to the rest of the body and back. It is protected by the spinal column, or vertebrae, as well as the other tissues in the neck and back. The most common cause of spinal cord injury is motor vehicle accidents.
In many cases, spinal cord injury results in paralysis. A person with paralysis will experience partial or complete loss of feeling and functioning in the limbs and/or trunk. Cervical spinal cord injuries are often the most severe because they happen further up on the spinal cord, diminishing or severing the function of everything below that point. With a cervical spinal cord injury, a patient typically loses feeling and function in the legs, arms, and trunk. Complications such as breathing problems, loss of bowel and bladder control, speech difficulties, and more can also occur with a cervical spinal cord injury.
Neck injury and neck pain can occur for reasons other than traumatic accidents and falls. Degenerative diseases, over-use of the neck or back at work, arthritis, herniated disc, and other conditions may cause or contribute to a neck injury.
A fracture is a break of one of the bones in the body. Fractures are common; the average individual experiences a fracture twice in their lifetime. While fractures can occur at any time throughout a person’s life, young children and older individuals experience fractures more commonly than adults do. Fractures occur when trauma or force exerted on the bone is stronger than the bone itself. A bone can be fractured in many ways, as discussed below, which determines the severity of the injury, the treatment necessary, and the time it will take for the bone to heal.
Fractures can happen in many ways, the three most common of which include:
In cases where another party caused or contributed to your traumatic accident, resulting in fracture or other serious injury, you may be able to recover compensation for your losses. Please contact us to learn more about your legal rights and options.
A bone can fracture in many ways. The main categories of fractures include incomplete, complete, simple, and compound. In an incomplete fracture, the bone cracks but does not break all the way through. Recovery from such a fracture typically takes less time than recovery from a complete fracture. In a complete fracture, the bone breaks all the way through, fracturing into two or more parts.
In a simple fracture (also called a closed fracture) the bone breaks but does not pierce through the skin, whereas a compound fracture causes the bone to break through the skin. A compound fracture (also called an open fracture) may result in a protruding bone or the bone may recede back into the wound and no longer be visible.
Fractures are further classified by how the bone breaks. The following are specific types of fractures, which can affect various bones throughout the body, though some types are more common in certain bones.
Greenstick fracture – this is an incomplete fracture, affecting only one side of the bone, which causes the bone to bend. Greenstick fractures are most common in children.
Transverse fracture – in this fracture, the bone breaks or fissures at a right angle. A transverse fracture, typically a stable fracture, is most common in traumatic injuries.
Impacted fracture – this is a complete fracture wherein the two broken edges of the bone become wedged together. This is typically a stable fracture, unless the bones are pulled apart. It can be difficult to diagnose this type of fracture without careful examination of x-rays.
Buckle fracture (also called Torus fracture) – this is an incomplete fracture caused by compression of a long bone. Buckle fractures are extremely common in children, often the result of falling on an outstretched hand. These fractures tend to heal more quickly than similar greenstick fractures.
Oblique fracture – this is an uncommon type of fracture, characterized by a sloped break of the bone, which is unstable. This type of fracture may be diagnosed as a spiral fracture.
Spiral fracture – (also called a torsion fracture) occurs when the bone has been twisted apart. These are commonly unstable fractures caused by a traumatic twisting of the limbs (as in a skiing accident).
Comminuted fracture – this is a complete fracture wherein the bone breaks into three or more pieces.
Displaced fracture – is a complete fracture in which the bone segments are not aligned, yet they are not at an angle to one another.
Avulsion fracture – this type of fracture occurs when trauma causes a ligament or tendon to tear from the bone it is attached to.
Occult fracture – In this type of fracture, the bone does not appear to be broken on x-rays, yet the bone shows signs of re-growth weeks later.
Hairline fracture (also called fissure fracture) - is an incomplete fracture whereby the bone is finely cracked, with no significant displacement. This stable fracture does not typically cause trauma to surrounding tissues.
Stress fractures are tiny hairline or fissure fractures, which are commonly the result of overuse or sports-related injuries. Stress fractures most commonly affect weight-bearing bones in the legs or foot. Stress fractures typically occur when a fatigued muscle is no longer able absorb the shock of impact. Impact with an unfamiliar surface, extreme physical stress and improper equipment use are common culprits in stress fractures.
The following is a list of fractures based on where the bone is located in the body.
Because children’s bones are still developing, they are more prone to greenstick and buckle fractures, whereby the bone bows instead of completely breaking. This is good because the bone’s cortex is not typically disrupted. However, fractures in children carry unique risks. Growth plate injuries and plastic deformation are two possible complications of fracture in children.
When the growth plate is affected by fracture, there is a risk of abnormal growth of the bones. Careful treatment and accurate reduction are necessary to make sure the bone continues to grow properly. Plastic deformation, whereby the bone permanently bends but doesn’t break, is another risk with fractures in children. This complication may require a surgery called osteotomy, in which the bone is cut for realignment, when closed realignment strategies have failed.
Because of the effects of aging on the bones, fractures can be particularly serious for older individuals. Falls are one of the most common culprits of fractures in seniors. In fact, among Americans over the age of 65, fall-related fractures and injuries are the leading cause of accidental death. Ninety percent of all hip fractures are the result of falls in older individuals.
Falls, which commonly lead to fractures in seniors, can be caused by a loss of footing or traction on unsafe surfaces or tripping due to hazardous conditions. Medications, alcohol use, changes in muscle mass, bone fragility, changes in vision, and other factors can increase the risk of falls and, in some cases, the severity of subsequent injuries. It is important for seniors to speak with their health provider about ways to reduce the risk of falls, which can lead to fractures and other serious injuries.
In most cases, a person knows when they have suffered a fracture. A snap or cracking sound in the bone is often enough to know that you have broken a bone. Other signs and symptoms of fractures include swelling, tenderness, deformity, or even part of the bone exposed through the skin. While some fractures can be obvious, others are more difficult to diagnose.
Stress fractures, occult fractures, and impacted fractures can be difficult to detect on an x-ray. In some cases, a fracture can be misdiagnosed as another type of fracture or injury, which is more common with spiral vs. oblique fractures, avulsion, and stress fractures.
Physical examination and x-rays are the common ways of diagnosing fractures.
Time is often the best treatment for stable fractures, in conjunction with devices that correctly position the bone during healing, such as casts, splits, and pins. Casts, made of either fiberglass or plaster, are external devices used to stabilize the area allowing the bone to heal. Casts, splits and other devices may be requires for weeks to months following fracture. Crutches may be used during this time if the affected bone is a weight-bearing bone.
In some cases, internal fixation is necessary to stabilize the bone as it heals. Metal plates, pins, or screws may be used to hold a bone in the proper position as it heals. These are often permanent.
In cases where complications arise or other tissues are affected by the trauma, additional treatments may be necessary, such as surgery. Pain medications or anti-inflammatory drugs are sometimes administered to help a patient reduce their symptoms of pain, particularly in the early stages of recovery.
After a fracture has occurred, the body starts the work of healing. Initially, the body acts to protect the injured area by creating a protective blood clot and callus/fibrous tissue. Then, new threads of bone tissue begin to develop on both sides of the fracture line, growing towards each other. Once the fracture is closed, the callus/fibrous tissue is re-absorbed by the body. Pain typically stops before healing is complete. This process can take several weeks to many months, depending on the type and severity of the fracture and how well a patient follows medical advice.
Activity may still be limited after a cast or brace is removed until the bone is solid enough and the surrounding tissues have healed and become stronger. The tissues surrounding the bone, such as ligaments and muscles, can become stiff or weak during fracture recovery from lack of use. Rehabilitative exercises, including stretches, weight-bearing activities, and other exercises, may be necessary to bring the body back to full health. It is important not to try to rush the healing process, as this can compromise your progress and lead to further injury.
When fractures or other serious injuries are the product of a preventable accident, the responsible party can be held liable and the injured party may be able to seek compensation for their damages, including medical expenses, loss of income, and more. If you believe that your injuries are the result of another party’s negligence or wrongdoing, please contact us to speak with a qualified attorney.
Tempero-mandibular joint syndrome is manifested by pain in the joint that swings the jaw (mandible). Several million people in the U.S. have this problem. Presumed causes of the TMJ pain are stresses on the joint, caused by injury to the face and jaw which can occur due to facial injuries in car accidents or motorcycle accidents. The smooth cartilage of this fairly small joint can be damaged, even when no fracture occurs. The mandible bone diminishes in size near the pivot-point by the ear, making TJM more vulnerable to fractures. A large number of TMJ injuries go undetected within the first few months of the trauma, and only later does the chronic pain distress the victim sufficiently to seek relief from physicians or dentists. The debilitating effects of chronic TMJ pain are real, and the consequences often exceed expectations, compounding the stress which may have caused the initial problem.
The pain is sometimes thought to be that of an infected tooth. It is somewhat common for the person with TMJ injury to have a "popping" or "grinding" sensation in the joint, especially when eating. Generally, the pain on one side of the head is worse than the other, and chewing patterns alter. Generally, the pain can be controlled with mild analgesics, such as aspirin or ibuprofen, but occasionally that is not sufficient. When mild analgesics are not sufficient to control the pain, a mouth piece--- similar to those worn by football players--- can be worn at night, or even during the day, to prevent unnecessary movement of the TMJ. This period of rest for the joints is sometimes miraculous in providing many hours of relief. A notch higher in the treatment algorithm is injection of the joint(s) with a very low dose of anti-inflammatory steroid. Again, sometimes this is nearly curative, at least for weeks or even months. One cannot continue to repeat this treatment indefinitely, however, since there might be adverse effects on the joints caused by the anti-inflammatory steroids, namely, diminution and roughening of the normally smooth cartilage that enables the bones to glide gently over each other. In more radical cases, surgery is performed, to make the teeth align properly, either by removing a section of bone or inserting some sort of spacer to lengthen the mandible.
A birth injury is an impairment of the infant’s body function or structure due to adverse influences that occurred at birth.
Birth injuries usually result of trauma suffered by an infant during labor and delivery. Typically, birth injury is due to delivery complications. Birth injuries may range from something as innocuous as a small bruise, to something as serious as Erb Palsy, Dejerine-Klumpke Palsies, cerebral palsy or brain damage.
Improper use of forceps is a common cause of birth injury, this could result in a serious injury like shoulder dystocia. In attempting to dislodge a baby’s shoulder, a physician may apply improper traction on the baby’s head thus causing it harm. Birth injuries may also occur as a result of oxygen deprivation or improper positioning in the womb.
Mild birth injury is fairly common. In deliveries that are complicated by one of the situations mentioned above, however, birth injury can result in substantial harm suffered by the infant or mother. A delivery medical team should monitor the mother and child throughout labor and delivery in order to be aware of any complications that may develop. The physician must be aware of, among other things, possible complications resulting from a large baby, the mother’s medical history, irregularities in the fetal heartbeat, and umbilical cord positioning. If the doctor fails to monitor these and other things, or fails to respond properly to situations that arise during the delivery, he may be considered negligent with regard to the duty he owes his patients. Compounding this issue is the fact that birth certificate data may underreport or incorrectly report medical risk factor prevalence due to a lack of adherence to uniform definitions and difficulty in interpreting data from medical records.
Paraplegia is paralysis of the lower body. In paraplegia, usually only the area below the abdomen is affected. About 200,000 Americans are confined to wheelchairs because of spinal cord injury. Each year, more than 10,000 new serious spinal cord injuries occur, with two-thirds of the victims being under the age of 30.
Many of these injuries occur during everyday life and are due to three main factors, workplace injury, auto accidents and sporting accidents. The work place and auto injuries tend to occur more in older populations while the sport and athletic injuries occur in younger populations. Another damaging factor that one must consider with paraplegia injuries is the immense life style changes and costs that come with the injury.
Many people reported being employed before the injury, however 50% of people whom are injured cannot go back to their job. Wages are lost and medical bills build up; the costs incurred when a person suffers a spinal cord injury are greatest during the first year. Mortality rates are also higher among people with spinal cord and paraplegia injuries and both groups are marked by a shorter life expectancy.