Now this might sound a bit strange, but yes, it is absolutely true. However it is not that young children are running around using iPhones that result in broken faults.  On the contrary, the fault lies with their parents.

Research by a graduate student at Yale suggests that the explosive expansion of the 3G cellphone network has led to a remarkable widespread adoption of the iPhone. Parents who have discovered fascinating new apps on their phones, sometimes forget to pay attention to their young children. The studies conducted include only children under the age of 6 years, and the focus is on neighbourhood playgrounds only.

Information about playground accidents involving young children suffering sprains, broken bones and even concussion, gleaned from hospital emergency rooms, strongly points to parents not effectively watching their children. Visits to various playgrounds have also shown moms or dads engrossed in their new electronic toy, while small children clamber on potentially dangerous apparatus.

Most times it is the cry of pain from a child who has had a fall that attracts the attention of a parent! Depending on the nature of the fall, the injury could be nothing more than a scratch, or perhaps much more serious.

What kind of injury could my child suffer from a playground fall or accident?

The most common playground injuries seen are related to the wrist and elbow.

A wrist injury would include the following:

• A wrist sprain can occur from just a momentary loss of balance, quite easy for a young child. A tiny hand will naturally go out to break the fall and the force of impact can stretch and pull the ligaments that connect the wrist and hand bones. Severe wrist pain will follow.
• If the force of impact is very severe and the child falls awkwardly, it could result in a fracture.
• The best course of action will be to seek medical attention, especially if there is a lot of pain and swelling. If the wrist is hanging in an odd or bent way, it could signify a wrist fracture which would require immediate attention, and possibly even surgery.

Elbow injuries are common in children, and if not quickly and expertly attended to, can affect the growth and development of the bones, as bone growth continues throughout childhood. Symptoms and signs include the following,which could indicate an elbow sprain, fracture or another injury needing medical attention.

• Painful swelling in the area immediately above and below the elbow.
• A deformity of the elbow joint and elbow pain, could signify an elbow fracture.
• Any discolouration, bruising or redness.
• Pain and difficulty moving the elbow through a complete range of motion.

Fractures in children.

A broken bone or fracture in children cannot always be taken at face value. A simple fracture may heal well with just a cast treatment. Some types of childhood fractures might need surgical intervention for the bones to knit and promote future good growth. Medical diagnosis is of utmost importance.

Prevention is better than cure!

Parents, by all means enjoy your iPhone. But put it aside if you take your children to a playground with all its play apparatus and the potential for an accident or a fall for little ones.Paying attention to what your child is doing can prevent painful injuries from happening, as well as save you the added stress of coping with a child in pain from an injury, which could have been prevented.

If your child has sustained a wrist injury or has elbow pain, contact our pediatric sports medicine specialists at Orthopedic Surgery San Diego for a consultation.   

Many patients who experience knee or hip pain over the age of 40 may have underlying arthritis.  Sometimes various injection can provide adequate relief: steroid (cortisone), PRP (plate rich plasma)/ stem cells, and HA (hyaluronic acid).  Those active adults that have end stage or severe arthritis that do not improve with other options are best served ultimately undergoing joint replacement, also known as arthroplasty, which entails implanting prosthetic devices.

Many patients suffering from osteoarthritis or rheumatoid arthritis are able to relieve their symptoms by taking anti-inflammatory medications, receiving physical therapy and altering their activities.  For some, the hip or knee pain continues. The discomfort and stiffness make it difficult to walk, climb stairs, or rise from a seated position. The pain may persist even while the body is inactive. In such cases, orthopedists often recommend joint arthroplasty.

The procedure involves a surgeon removing damaged bone and cartilage; and implanting an artificial joint made of metal, plastic or polymers. The prosthetics are available in a range of designs for patients with differing ages, weights, activity levels and general health.  Over the last decade some designs have evolved to be customized to individual patients.
beste-potenzmittel.com
A recently published study concludes that a newly proposed grading system is an effective method of assessing complications following total knee and hip replacement surgeries.

While the surgery has a high success rate, orthopedists have continued to search for ways to accurately measure patients’ recovery.

“Reliable classification of postoperative complications is important for quality improvement efforts,” Dr. Dorothy Y. Harris and her associates noted in their report titled “Correlations Between a Dedicated Orthopaedic Complications Grading System and Early Adverse Outcomes in Joint Arthroplasty.”

They analyzed a grading system that the Knee Society proposed earlier this year. The study was needed because “a relationship between complication grades and surgical outcomes has not yet been established,” the researchers wrote.  Their goal was to identify the early adverse outcomes following total knee replacement or hip arthroplasties into different grades. The results indicated that the grading system “is applicable to TKA and THA, in terms of documentation of complication severity, and as an indicator of increased length of stay (in a hospital) and increased unplanned readmissions or reoperation rates,” the researchers explained.  This will help orthopedists to potentially identifier preoperatively those at risk of these complications.

If you are experiencing knee or hip pain, and have been diagnosed with arthritis in one of the joints, you might be a candidate for total knee or hip replacement. Schedule an appointment for an evaluation by the nationally renowned sports medicine surgeons at Orthopedic Surgery San Diego to learn whether arthroplasty could be a solution for you.

Those suffering from knee pain caused by osteoarthritis may eventually need surgery to correct the problem. Procedures for knee osteoarthritis include arthroscopic surgery, partial knee replacement, and total knee arthroplasty (replacement). Arthroscopic surgery is a minimally invasive surgery where small cuts are made in the knee and a small camera is inserted to see and diagnose the extent of the damage. The doctor can then remove, repair, and smooth damaged tissue.

Partial knee replacements are often used for those with less damage to their knee, while total knee replacements are used for those with major osteoarthritic damage. While surgeries can help alleviate pain and increase mobility, it is important to understand and acknowledge there can be risks and serious complications, including death.

English investigators prompted a study to ascertain the risk of complications associated with knee replacement surgery. During that 9 year period, 467,779 knee replacements were performed with 1183 deaths occurring within 45 days of the surgery.  The incidence of death decreased to 37% in 2003 and to 20% in 2011. Findings show that mortality rates after unicompartmental knee replacement (partial knee replacement) was lower than with a total knee replacement. Causes of death were not related directly to surgery, as the patients suffered from comorbidities such as myocardial infarction, cerebrovascular accident, liver disease, or renal disease. The findings concluded that although early deaths have fallen drastically since 2003, more effort should be taken to reduce mortality in older patients with comorbidities.

A study was also done to compare adverse outcomes for those having total knee replacements (TKR) versus unicompartmental knee replacements (UKR) in England. The results showed that the failure rate for unicompartment (partial) replacement had a higher rate at 8years in comparison to total knee replacement.  However the risk of mortality was higher with total knee arthroplasty.

If you have been told that you have knee arthritis and are looking for treatment measures, it is in your best interest to seek treatment from a surgeon who has the skill set to tailor treatment to your specific condition instead of a ‘one size fits all’ approach.  Our nationally recognized sports medicine surgeons specialize in an individualized approach to alleviate your knee pain, whether by medication, injections, or surgery.

Hip pain after a falls is worrisome, as this often results in a hip fracture.  As the nation’s population ages, the number of injuries resulting from falls is reaching record levels.

More than 2.4 million patients older than 65 years of age required treatment at medical emergency facilities due to falling in 2012, the New York Times reported. Among older adults, falling is the leading cause of fractures, hospital admissions for trauma, loss of independence and injury-related deaths, according to the National Institutes of Health. From 2002-12, deaths of elderly Americans attributed to falls totaled 201,000.

In countless other cases, people suffered severe pain in their wrists, hips and other joints. A simple misstep can cause a person to lose balance and tumble to the floor.  It is so common that the concept has led to famous TV commercial slogan “I’ve fallen and I can’t get up”.  This may result in many types of injuries, including wrist and hip fractures. Seniors are particularly at risk, for a variety of reasons. They tend to have more balance issues, and less strength, than the young.  Most importantly, their bones may be vulnerable as a result osteopenia or osteoporosis.

“Balance is a complicated equation involving vision, muscle strength, proprioception (the body’s ability to know where it is in space), and attention. As people age, those elements deteriorate,” the Times explained.The newspaper noted that, according to geriatricians, “some older people possess an exaggerated sense of what they can still do, even as hazards (staircases, throw rugs, slick bathtubs, concrete bumpers in parking lots, tree roots, their own pets) lie in wait.”

About one-quarter of the time, a senior who fractures a hip in a fall dies within a year. Eighty percent of patients are in pain the rest of their lives, with severely limited mobility that costs them their independence and increases their reliance on others.

A recent study indicated that engaging in regular exercise can help anyone, especially the elderly, avoid falling. Those who work out, or at least take daily walks, have better strength and balance. Experts also advise keeping well hydrated to prevent dizziness. Medications for high blood pressure, psychotropic drugs and antidepressants are known to make patients dizzy, increasing the odds of falling.

Dr. Judy Stevens, an epidemiologist at the U.S. Centers for Disease Control and Prevention, told the Times: “Falls are a very difficult thing, because it’s such a scary idea. People don’t want to hear about it, and people affected don’t want to talk about it.”

Many older adults are afraid of falling, the National Institutes of Health noted, adding: “This fear becomes more common as people age, even among those who haven’t fallen. It may lead older people to avoid activities such as walking, shopping or taking part in social activities.”

Seniors limited by such fears are advised to consult their doctors or other health-care providers. Physical therapy can improve balance and promote confidence in walking ability. Relieving the anxiety allows a person to keep active, maintain health and prevent future falls, according to the NIH.

After falling, even if no injuries are apparent, it is a good idea to see a doctor. Many of the factors that cause falls can be treated or corrected. Falling may be a symptom of a medical issue like diabetes or improper blood pressure. Some people experience sharp drops in blood pressure when they stand up, which results in dizziness. Falls sometimes indicate problems with medications or vision. A doctor might prescribe eyeglasses, physical therapy or the use of walking supports like canes.

Experts suggest making a home safer by getting rid of loose rugs, installing handrails on stairways and in hallways, and providing adequate lighting.If you suffer from hip pain or wrist discomfort contact us at Orthopedic Surgery San Diego for an evaluation.

Getting regular exercise is a key to preventing falls; the risk of falls as we mature is that it can result in hip and wrist fractures.

Many people, particularly the elderly, suffer hip and wrist pain due to falls. Avoiding such accidents “isn’t simply a matter of being more careful,” according to the New York Times’ Katie Hafner. She reported that experts advise people to adopt exercise regimens, as a way of making them less vulnerable to falling.

“If you’re in better physical condition, you’re less likely to be injured,” said Judy A. Stevens, an epidemiologist at the U.S. Centers for Disease Control and Prevention.

One option is to sign up for an exercise class that features balancing drills, in which a person stands on one leg; and workouts with Bosu balls. Many have found tai chi effective in promoting better balance. The practice involves making slow movements accompanied by coordinated breathing.

Hafner noted that a nursing home near San Francisco offers a 12-week tai chi program twice a year. The facility reports significant improvement in participants’ mobility, as measured by their ability to get out of chairs without using their arms.

“If only we could put tai chi in a pill,” said Dr. Lewis A. Lipsitz, a professor of medicine at Harvard University who observed programs at two facilities operated by Hebrew SeniorLife.

“Integrating balance and strength work into daily life (standing on one foot while brushing your teeth, for instance, or simply putting one foot in front of the other) can help, as well,” Hafner wrote.

She pointed out that studies have confirmed the power of Vitamin D to improve muscle strength and balance, which lessen the risk of falling. It also is important to stay hydrated to prevent dizziness.

Among those who are most vulnerable to accidents are patients taking multiple medications. Psychotropic drugs such as antidepressants, antipsychotics and benzodiazepines “are most clearly implicated in falls,” according to Hafner.

Dr. Mary Tinetti, a geriatrician at Yale University, told the reporter that antidepressants “can directly affect your balance.”

Medication prescribed to treat high blood pressure also can cause the sort of dizziness that leads to falls. According to a study published by JAMA Internal Medicine, the danger of sustaining serious injuries from falling is much greater for people on hypertension drugs.

That is why Dorothy Baker, a research scientist at the Yale School of Medicine, advises taking reduced doses of such medication, if possible.

Patricia Quigley, a fall-prevention expert at the James A. Haley Veterans Affairs hospital in Tampa, Fla., offered this recommendation: “Instead of taking sleeping pills, drink warm milk, or listen to talking books or soft music.”

Patients on diuretics for high blood pressure or heart failure should take their drugs during the day instead of the evening, to reduce the number of times they need to walk to the bathroom during the night, Quigley said.

Homes can be made safer by removing trip hazards from floors and stairways. Loose rugs are a common cause of falls. Good vision also is important. People need to learn how to properly use bifocals, as studies have shown they can cause missteps, Hafner noted.

Tinetti told the Times it can be counterproductive to be overly careful when walking.

“People who are more cautious cut down on their activity, which makes their balance worse, their strength worse, and reflexes that prevent falls worse,” she said.

If you have progressive weakness or balance problems contact our specialists at Orthopedic Surgery San Diego to schedule an appointment.

Shoulder Pain

From time to time, local news outlets tackle the topic of shoulder pain, digging into the causes and treatments for this common condition. One recent video offered a nice overview of the different ailments that commonly strike the shoulder, and a look at some common orthopedic surgery procedures we have at our disposal.

As the article states, we have come a long way in our treatment and management of shoulder symptoms. Today some of the best shoulder surgeons can return patients to full function in a matter of months:

Now, with minimally invasive arthroscopy techniques, orthopedic surgeons are able to reattach the tendon to the bone, with the goal of restoring strength and function to the shoulder. . . . Fortunately, due to the advancements in shoulder replacement surgery, surgeons are able to relieve patients’ pain, remove bone spurs and restore their function.

To learn more about how you can treat and manage shoulder pain with shoulder surgery here in San Diego, please contact my offices today.

Hip pain is extraordinarily common among cyclists, runners, and dancers, and a variety of other types of athletes.  Although hip pain is difficult to endure, athletes that sustain an injury resulting in groin pain should be particularly cautious, as that may be a sign of bigger injuries to come.  Labral tears and femoral stress fractures seen amongst triathletes in San Diego is of particular concern.

Fred Jackson has been one of the most underrated players in the NFL for quite some time now. He is consistently productive despite being considered “too old” to be successful at the running back position. He is the oldest running back on any active roster and he was having another solid year for the Buffalo Bills. Unfortunately Jackson suffered an injury to the groin area and is expected to miss a month of football.

Groin injuries are actually one of the less common sports injuries as they only account for roughly 5% of all sports injuries. The groin area is very large and very anatomically complex, which can make diagnosing groin injuries a difficult task. To boot, it is pretty common to have two or more groin related injuries simultaneously. This can make the diagnostic process very frustrating for athletes. Luckily for Jackson, the Buffalo Bills’ orthopedic physicians were able to diagnose this rather quickly. Jackson has a torn adductor longus. The adductor longus is a muscle that connects to the femur and the superior pubic ramus. Jackson’s adductor longus was separated from the bone by about a centimeter causing the 33-year-old running back to be carted off the field.

The symptoms of a groin injury such as Jackson’s include severe stabbing pain, swelling, bruising, inability to move the leg across the body, loss of muscle strength, and muscle spasms. While this seems like a rather serious injury, rehabilitation can usually heal a torn adductor longus completely within 10 weeks. The likely course of action for Jackson is about a week or two of resting, ice, compression, and immobility. After that, he can begin doing stretching and strengthening exercises.

As I mentioned earlier, groin injuries are difficult to diagnose and I thought it would be appropriate to take a look at another common sports injury of the groin area: Torn hip labrum.

 Hip

The hip labrum is a ring of cartilage that sits between the ball and socket joint of the hip. This objective of the hip labrum is to securely hold the ball of the femur head into the socket of the pelvis. Unlike Jackson’s injury, the symptoms of a hip labrum tear can be acute and sometimes even unnoticeable. The symptoms that are reported are typically a locking, catching, clicking of the hip joint, as well as some pain, stiffness, and decreased range of motion. One particular case of this occurred last year to then Seattle Seahawks wide receiver Percy Harvin. Harvin actually ended up missing almost the entire season due to a slight tear of the hip labrum. Unlike the adductor longus tear Fred Jackson suffered, Harvin required surgery to repair his torn labrum. More and more orthopedic surgeons are opting for arthroscopic surgery to smooth off and repair a torn labrum. Once surgery is complete, patients often will need to stay on crutches for about one to two months until limp has completely subsided. At this point physical therapy is required to restore strength and mobility.

The onset of hip pain may be out of your control.  According to a recent study, babies with low birth weights and those born prematurely are at greater risk of developing hip pain, and eventually needing hip replacement surgery.

They are more likely to be diagnosed with conditions like hip arthritis, which can cause severe hip pain and decreased range of motion in the joint, Australian researchers found.

The study involved 3,604 patients, 116 of whom required knee replacement,  the New York Times reported in its “Well” blog. Seventy-five of the participants were osteoarthritis sufferers, older than 40, who underwent hip arthroplasty. The results were published in the online library “Arthritis Care & Research.”

The researchers took into account factors like age, gender, body-mass index, education level, hypertension, smoking and physical activity. They concluded that premature or preterm birth (defined as three weeks sooner than a normal 40-week pregnancy) doubled the odds of needing hip replacement as an adult. The risk for low birth-weight babies was 250% of the average patient. No link to knee replacement was determined.

“The reasons are unclear, but there is some evidence that prematurity and low birth weight can result in abnormal hip development or lower bone mineral density,” the Times reported. Nicholas Bakalar’s blog noted that the study marks the first time that premature birth has been associated with hip arthritis.

“There isn’t enough evidence now to change practice, but we know that congenital hip disease in children can proceed to osteoarthritis later,” the study’s senior author, Dr. Flavia M. Cicuttini of Monash University in Melbourne, told Bakalar. “It may be that eventually we will introduce simple interventions for all premature infants, like the double-diapering that is now recommended for much more serious congenital hip deformations.”

The conditions that are most often responsible for hip pain are:

1. Hip arthritis, which results from the deterioration of cartilage that covers the pelvic and femur bones that join to form the joint. This protective lining wears away, causing the inflammation that leads to osteoarthritis.

2. Hip bursitis, which occurs when bursa sacs that lubricate the hip joint and surrounding muscles become inflamed from injury or overuse.

3. Muscle strain, which can result from irritation or overuse of any of the three muscle groups that enable the hip to make its various movements.

4. Nerve irritation, such as sciatica, which features sharp pains in the back of the leg and outer thigh.

Other hip ailments include labral tears, ITB syndrome, femoral head avascular necrosis, hip impingement syndrome and snapping hip syndrome.

In most cases, hip pain and its causes are effectively treated with anti-inflammatory medication and physical therapy. When these methods are insufficient in relieving pain and restoring joint function, hip replacement may be warranted.

The surgery, also called hip arthroplasty, involves removing damaged bone and cartilage, then implanting prosthetic devices. While most hip-replacement patients are between the ages of 50 and 80, the procedure also helps juvenile arthritis victims and seniors with degenerative arthritis.

Indications that hip replacement could be needed include pain in the hip or groin that makes walking difficult, pain even while the hip is at rest, stiffness that limits range of motion, inability to easily climb stairs, and severely restricted walking distance without pain.