How can an untreated broken toe lead to complications. What are the signs of a fractured toe. Why is it important to seek medical attention for a toe injury. How can osteoarthritis develop from an untreated toe fracture. What treatment options are available for a broken toe.

Signs and Symptoms of a Fractured Toe

Recognizing the signs of a fractured toe is crucial for proper treatment and prevention of complications. Common indicators include:

• Discoloration of the affected area
• Intense pain, especially when walking or applying pressure
• Swelling around the injured toe
• A snapping or popping sound at the time of injury
• Difficulty moving the toe

It’s important to note that these symptoms may not appear immediately after the injury. In some cases, it can take a few days for discoloration and swelling to become noticeable.

When to Seek Medical Attention

Is it necessary to see a doctor for a suspected toe fracture? While not considered a medical emergency, it’s highly recommended to have a professional assessment. Dr. Thomas Rambacher, a podiatrist at Podiatry Hotline Inc., emphasizes the importance of seeking treatment to ensure proper healing and prevent potential complications.

Potential Complications of Untreated Toe Fractures

Leaving a fractured toe untreated can lead to various complications, some of which can have long-lasting effects on your foot health and overall well-being.

Risk of Infection

How can a broken toe lead to infection? If the skin is broken or punctured during the injury, there’s a risk of bacteria entering the wound. This risk is particularly high for individuals with certain health conditions:

• Diabetes
• Rheumatoid arthritis
• Compromised immune system

Symptoms of a bone infection (osteomyelitis) in a fractured toe include:

• Fatigue
• Fever
• Persistent pain
• Warmth and redness around the affected area

If left untreated, a bone infection can lead to serious complications such as bone death, septic arthritis, and even an increased risk of skin cancer in the affected area.

Development of Osteoarthritis

Can a broken toe cause arthritis? While osteoarthritis typically develops over time due to wear and tear, walking on an untreated fractured toe can accelerate this process. Symptoms of osteoarthritis in the toe include:

• Pain and stiffness in the affected toe
• Swelling in the joint
• Difficulty walking or participating in sports
• Development of bone spurs

Bone spurs are bony protrusions that can cause additional pain, especially when wearing shoes. While it may take months or even years for arthritis to develop, the risk is significantly higher with an untreated fracture.

Toe Deformity

How can an untreated toe fracture lead to deformity? When a broken toe doesn’t heal properly, it can result in:

• Joint damage
• Chronic swelling
• Displacement of the broken bone

These conditions can cause the toe to heal in an abnormal position, leading to long-term deformity and potential mobility issues.

Diagnosis and Treatment Options for Toe Fractures

Proper diagnosis and treatment are essential for preventing complications and ensuring optimal healing of a fractured toe.

Diagnostic Procedures

How do doctors diagnose a broken toe? The diagnostic process typically involves:

• Physical examination of the affected toe
• Assessment of pain levels and mobility
• X-rays to confirm the fracture and determine its severity

Treatment Approaches

What are the treatment options for a fractured toe? The appropriate treatment depends on the severity of the fracture:

• For minor fractures:
  • Over-the-counter pain medication
  • Immobilization through “buddy taping” (taping the injured toe to an adjacent healthy toe)
• For more complex fractures:
  • Reduction (realignment of bone fragments under local anesthesia)
  • In rare cases, surgery using pins and plates to repair severe fractures

Dr. Rambacher emphasizes that a cast is usually not required for toe fractures, contrary to popular belief.

Importance of Professional Medical Care for Toe Injuries

Why is it crucial to seek professional medical care for a suspected toe fracture? There are several compelling reasons:

• Accurate diagnosis: X-rays can confirm the presence and severity of a fracture
• Proper treatment: A podiatrist can provide appropriate care based on the specific injury
• Prevention of complications: Early intervention reduces the risk of infection, arthritis, and deformity
• Pain management: Professional care can help alleviate discomfort and promote faster healing
• Expert guidance: A specialist can provide advice on proper care and rehabilitation

Remember, even if you’ve had a toe injury in the past that wasn’t treated, it’s never too late to consult with a podiatrist to address any ongoing issues or prevent future complications.

Common Misconceptions About Toe Fractures

There are several myths and misconceptions surrounding toe fractures that can lead to improper care and potential complications.

Myth: There’s No Treatment for Broken Toes

This is a widespread belief that Dr. Rambacher and other podiatrists frequently encounter. However, it’s entirely false. While treatment for a broken toe may not always require a cast or surgery, proper medical care is essential for optimal healing and prevention of long-term issues.

Myth: You Can’t Do Anything for a Broken Toe

Contrary to this belief, there are several treatment options available for fractured toes, ranging from buddy taping for minor fractures to surgical intervention for severe cases. The key is to seek professional medical advice to determine the most appropriate course of action.

Myth: Toe Fractures Always Heal on Their Own

While some minor toe fractures may heal without complications, assuming all toe injuries will resolve themselves can be dangerous. Without proper care, even a seemingly minor fracture can lead to long-term problems such as chronic pain, deformity, or arthritis.

Prevention and Care for Toe Injuries

While accidents can happen, there are steps you can take to reduce the risk of toe injuries and ensure proper care if an injury does occur.

Preventive Measures

• Wear properly fitting shoes that provide adequate protection for your toes
• Use protective gear when participating in sports or activities that pose a risk to your feet
• Be cautious when walking barefoot, especially on uneven surfaces
• Keep your living space free of clutter to reduce the risk of stubbing your toe

Immediate Care for Suspected Toe Fractures

If you suspect you’ve fractured your toe, take the following steps:

1. Apply ice to the affected area to reduce swelling
2. Elevate your foot to minimize blood flow to the injured toe
3. Avoid putting weight on the injured foot
4. Contact a podiatrist or foot and ankle specialist for an evaluation

Remember, proper care in the immediate aftermath of an injury can significantly impact the healing process and reduce the risk of complications.

Long-Term Management of Toe Fractures

Even after the initial treatment, proper management of a toe fracture is crucial for complete recovery and prevention of future issues.

Follow-Up Care

Your podiatrist will likely schedule follow-up appointments to monitor your healing progress. These visits may include:

• X-rays to ensure proper bone alignment
• Assessment of pain levels and mobility
• Adjustments to treatment if necessary

Rehabilitation and Physical Therapy

Depending on the severity of the fracture, your doctor may recommend rehabilitation exercises or physical therapy to:

• Restore full range of motion
• Strengthen the muscles supporting the toe
• Improve balance and coordination
• Prevent stiffness and promote flexibility

Long-Term Considerations

Even after your toe has healed, it’s important to be mindful of potential long-term effects:

• Pay attention to any persistent pain or stiffness
• Be aware of changes in your gait or balance
• Consider using orthotic devices if recommended by your podiatrist
• Continue to wear properly fitting, supportive footwear

By following your podiatrist’s recommendations and staying vigilant about your foot health, you can minimize the risk of long-term complications from a toe fracture and maintain optimal foot function.

When to Seek Emergency Care for Toe Injuries

While most toe injuries can be evaluated during regular office hours, there are situations where immediate medical attention is necessary.

Signs of Emergency

Seek emergency care if you experience any of the following:

• Severe pain that doesn’t respond to over-the-counter pain medication
• Open fracture where the bone is protruding through the skin
• Signs of infection such as fever, chills, or pus draining from the injury site
• Numbness or tingling in the toe that doesn’t subside
• Bluish or grayish color of the toe, indicating potential circulation issues

Emergency Treatment

In emergency situations, treatment may involve:

• Immediate pain management
• Cleaning and dressing of open wounds
• Administration of antibiotics if infection is suspected
• Emergency reduction of severely displaced fractures
• In rare cases, emergency surgery to address severe injuries or complications

Remember, while most toe fractures are not emergencies, it’s always better to err on the side of caution when it comes to your foot health. If you’re unsure about the severity of your injury, don’t hesitate to seek professional medical advice.

Think You Have a Fractured Toe? Here’s What Could Happen If You Don’t Get It Checked Out: Podiatry Hotline Foot & Ankle: Foot and Ankle Specialists

If you stubbed your toe and felt a snap, you may wonder if it’s broken, and you might think that the “wait and see” approach is the best course of action. However, a fracture that goes undetected and untreated can lead to complications.

While not an emergency, it is vital that you get your toe checked out. Dr. Thomas Rambacher and the team at Podiatry Hotline Inc. recommend seeking treatment of your toe injury to ensure a swift recovery and to prevent those potential problems.

When to suspect that your toe is fractured

Whether you’ve stubbed your toe or injured it playing sports, there are a few obvious signs that you’ve suffered a fracture. Look for discoloration, pain, and swelling. While it’s likely to hurt immediately, it can take a few days for the color to change and swelling to appear.

If you’re certain your toe is fractured or you simply want peace of mind, your Dr. Rambacher can provide a full assessment and order X-rays to make the right diagnosis.

A fractured toe that’s left untreated can lead to infection

When it comes to broken toes, infection risk usually happens if the skin on the affected toe is cut or punctured at the time of the injury. You’re at increased risk of developing a bone infection if you have diabetes, rheumatoid arthritis, or a compromised or weakened immune system.

Symptoms that suggest your toe has developed a bone infection include:

• Fatigue
• Fever
• Pain
• Warmth and redness of the toe

When dealt with quickly, a bone infection can be treated with antibiotics. If left too long, the infection can restrict blood circulation, leading to bone death of that toe, septic arthritis, and an increased risk of developing skin cancer.

Osteoarthritis can develop from an untreated toe fracture

Osteoarthritis typically develops from wear and tear of your joints over time, but walking on a fractured toe can speed up this process — although it may still take months, or even years, for arthritis to develop.

Symptoms of osteoarthritis — pain, and stiffness in the toe, swelling in the joint and problems walking or playing sports — can be difficult to live with. It’s not unusual for a bone spur to develop at the affected toe. This is a bony protrusion that can be painful, particularly when wearing shoes.

Treatment prevents complications

Once Dr. Rambacher has diagnosed your toe fracture, you have a few treatment options depending on the severity of the injury. Over-the-counter pain medication and immobilization of the toe is often sufficient for small toe breaks and simple fractures. Dr. Rambacher can immobilize the toe by carefully buddy taping it to the toe next to it. A cast usually is not required.

With more complex fractures, Dr. Rambacher may have to manipulate the pieces of bone back together again in a technique called reduction. This procedure is done under local anesthetic, so your toe is numb. In rare cases, surgery may be necessary to fix a severe fracture using pins and plates to repair the bone and position the toe with the correct alignment for healing.

If you suspect that you have a broken toe, or if you’ve fractured a toe previously and didn’t get it checked out, don’t hesitate to book a consultation with Dr. Rambacher today.

4 Common Complications of Untreated Toe Fractures

Year after year, I hear patients repeat the same refrain, “I’ve always been told there is no treatment for broken toes.” While this is a commonly held belief, it is actually completely false.

In fact, the American College of Foot and Ankle Surgeons warns, you should never underestimate an injured or broken toe.

Contrary to popular belief, if you think your toe is broken, the first step you should take is to make an appointment with your local foot and ankle specialist. They can help you to evaluate your level of pain, diagnose potential problems, and even take x-rays in the office to verify fractures.

Once a fracture is confirmed, the podiatrist can fit you with a splint, surgical shoe, or even a walking boot if the injury is quite serious. Whatever the treatment course, you will leave the office feeling a little better and rest a little easier knowing you won’t have to worry about potential long-term side effects of improperly treated toe fractures.

When broken toes aren’t properly treated complications can occur. The four most common are as follows:

1. Toe Deformity – An untreated toe fracture can lead to joint damage, chronic swelling, and a displacement of the broken bone. These conditions can cause a toe deformity. While a toe deformity may seem like a simple cosmetic nuisance it can also result in pain and make it difficult to wear shoes.
2. Osteoarthritis – If the fracture involved the joint, left untreated it can lead to osteoarthritis, resulting in chronic pain, swelling, and degenerative joint changes. If you’ve ever heard someone say their joints clue them into changing weather, they probably are suffering from osteoarthritis, and you don’t want to join their club.
3. Non-Healing Fracture – When a broken toe isn’t properly treated and is coupled with other medical issues like diabetes, poor circulation, and/or osteoporosis, the fracture can turn into a non-healing fracture. This means it stays in a persistently unstable state and will not heal. Once a fracture becomes non-healing it can be very difficult to treat and involves chronic pain, sometimes necessitating amputation.
4. Sausage Toe. – As you may be able to guess from the name, sausage toe is chronically red and swollen, chronically painful, and not so pleasing to look at.

The simplest way to prevent these complications is to seek early and adequate treatment of any injury involving your toes.

Your podiatrist can help get you on the road to recovery. Broken bones typically take about six weeks to heal. But stress fractures take less. With the help of a specialist, you’ll know what type of fracture you’re dealing with. Doctors sometimes refer to the first few days of bone healing as “the golden period” because they are so critical to recovery. This is why seeking medical attention as soon as possible is key. You don’t want to squander this important period. The first week or two after a toe fracture, immobilization (with “buddy taping,” splint, or surgical shoe) and elevation will kick off the healing process. However, the rest of the treatment plan can vary based on the nuances of your injury. Proving, not only is there a treatment for broken toes…there are many treatments.

If you or a loved one is experiencing toe pain that you believe may be the result of a fracture, please give us a call. Our foot and ankle doctors are board-certified by the American Board of Foot and Ankle Surgery. Call 208-855-5955 or request an appointment online.

Triad Foot & Ankle Center

Published on: January 3, 2018

It is a common misconception that broken toes can’t be treated and will heal on their own. The truth is, not treating a broken toe can result in complications that, not only make the healing process take longer, but can cause permanent damage.

When a broken toe isn’t stabilized, the bone can heal incorrectly, which can lead to limited mobility in that toe. In addition, your shoes may not fit comfortably, and your pattern of walking or gait may be altered. This can lead to other complications unrelated to the broken toe, such as ankle, knee and back problems.

Also, the broken halves of the bone could end up healing so poorly that surgery may be required. This invasive procedure can be avoided if a broken toe is treated properly.

In some cases, broken toes can create immediate and subsequent complications such as subungual hematomas or open/compound fractures, where the broken bone protrudes through the skin. Any sort of open wound, like a compound fracture, should be treated immediately to reduce the risk of infection.

The greatest risk in leaving broken toes untreated is the likelihood that it could lead to chronic arthritis. This common condition is the result of swollen and inflamed joints, and a poorly healed toe joint is an ideal place for arthritis to form. Chronic arthritis is a painful condition and can cause discomfort and stiffness, affecting activities of daily living, such as walking, for the rest of your life. While arthritic pain can be reduced with treatment, arthritis cannot be cured, so it’s important to prevent this condition by minimizing your risk of developing it.

When treated, broken toes take about six weeks to properly heal. Treatment varies depending on the severity of the break but may include stabilization of the toe, casting or splinting, as well as additional treatment for open fractures. Other remedies can be implemented at-home once treatment has been established, including plenty of rest and broken toeelevation of the injured foot.

Prognosis of a broken toe can be very good when treated. Simple fractures generally heal with no additional issues, while severe fractures can sometimes result in long-term, residual problems such as stiffness, deformity and chronic soreness or pain.

Remember, a broken toe may not always appear to be broken. This is why treating any type of foot injury by visiting a podiatrist is critical in reducing or preventing long-term damage.

Request an appointment with one of our podiatric specialists today for a foot exam by clicking here or call any of our convenient office locations in the Piedmont Triad.

Disclaimer: The information and other content provided in our blogs, videos, or in any other content or linked materials are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. For a full disclaimer, please click here.

Dangers of Bone Fractures if Left Untreated: Mid Atlantic Orthopedic Associates, LLP: Orthopedic Surgery

If you break a bone, it’s imperative that you get it treated. Regardless of where the fracture took place in the body, the stress of a broken bone can be quite substantial, which means that you have to act sooner rather than later.

For the most part, bones are exceptionally good at healing. Unlike other parts of the body, when they are treated correctly, you can make a full recovery and have a bone that is as good as new. However, if left untreated, the problem can get worse and lead to complications and more pain and suffering.

Nonunion vs. Delayed Union

When a bone fracture is untreated, it can result in either a nonunion or a delayed union. In the former case, the bone doesn’t heal at all, which means that it will remain broken. As a result, swelling, tenderness, and pain will continue to worsen over time.

Delayed unions are bone fractures that take longer to heal than usual. In most cases, though, patients can make a full recovery, although there can also be complications, depending on how well the bone was set.

How Do Bones Heal?

When there is a fracture, that means that the bones have separated. A partial fracture means that some of the bone is still connected, whereas a total fracture implies a complete split.

In most cases, the doctor will set the bone so that the two sides can connect and heal. New tissue grows, new bone material fills in the gap, and you’re back to normal.

To ensure that this process happens smoothly, these conditions have to be met.

Stability –if the bones are misaligned, then they will connect unevenly. If that happens, it could impact the structural integrity of the tissue and lead to more pain and suffering.

Blood Supply –your bones heal thanks to the components of your blood. Thus, it’s imperative that the tissue gets adequate blood supplied to the site to facilitate rapid healing.

Nutrients –we all know that calcium helps build strong bones, so it’s extra vital to consume the right nutrients when they are healing.

Complications of Bone Healing

In some cases, even with the right treatment, your bones may not heal properly. Some of the risk factors that can lead to complications include-

• Old age
• Anemia
• Diabetes
• Tobacco use (smoking)
• Low vitamin D supply
• Some medications, including anti-inflammatories

Bottom Line –Stay Healthy and Get Treated

If you ever experience a bone fracture, it’s crucial that you seek medical attention as soon as possible. Once the bone is set, then you have to make sure that you’re helping your body heal as quickly as it can. If you have any of these risk factors, you want to talk to your doctor about how to mitigate them to facilitate faster healing.

Overall, a broken bone is a serious injury. Failing to get treatment can make things a lot worse.

In need of an orthopedic? Contact Mid Atlantic Orthopedic Associates today!

Your Guide On How to Recover From a Broken Toe

I remember exactly what happened the day I broke my toe. I was walking down my hallway barefoot when I stubbed my pinky toe so hard against a door frame that I saw stars. I hobbled back to my bedroom and refused to look at the damage for hours. If you’ve ever stubbed your toe too hard, you’ll know that the immediate, severe pain can bring you to your knees and make you wonder if it’s broken. In many cases, the injury is simply a sprain, but it can be hard to know the difference between a sprain and a broken toe without medical attention.  

When I broke my toe, I didn’t recognize the symptoms of it right away – I just knew that my pinky toe hurt a lot. But, learning to recognize the symptoms and treatment of a broken toe is important for your immediate next steps it needs to heal. If a broken toe is left untreated, it can lead to permanent issues that can affect how you walk and run. And, at the very least, unattended broken toes can leave you in a lot of avoidable pain.

I don’t want you to have to go through either of these scenarios, so follow along as I detail how to know if a toe is broken, what you can do to ensure a speedy recovery, and things to consider once it’s healed. 

How to Know If You Have a Broken Toe

Stubbing or dropping something heavy on a toe is very common and it never feels good, but most of these incidents are nothing more than a minor inconvenience. But, sometimes it goes well beyond that. The first clue that something is actually wrong with your toe is the immediate and severe pain that comes and stays for a prolonged period of time. Another, less common, clue that something is wrong is actually hearing the break happen. 

Other general symptoms of a broken toe are:

• Throbbing pain at a specific point of the toe
• Swelling
• Bruising
• Difficulty putting weight on the toe
• Toe resting at an unnatural angle
• Stiffness

If you’re experiencing any of these symptoms, it’s a good idea to pay a visit to your doctor or a local emergency room as soon as possible. Once a break happens, it’s going to immediately try to heal itself, which can cause even more problems down the road if it doesn’t heal properly. 

Once you’re at the hospital, the medical staff will perform initial diagnostic tests and get your medical history. Be sure to tell your doctor as many details as you can about the injury and your symptoms so they’ll have a clear picture of what they’re working with. Also, let them know if you’re experiencing a loss of feeling or a tingling sensation in your toe because it may be a sign of nerve damage.

After you’re admitted, the only way to really diagnose a broken toe is to get an x-ray taken of the afflicted digit. The technician will likely get multiple angles of your toe to make sure that they can see the damage from all sides. If there’s a chance the toe is broken, the doctor will be able to diagnose how severe the break is and recommend treatment options to you.

Healing and Treatment Options

So, I have good news and bad news. The good news is that, in most cases, broken toes are relatively clean breaks, which means that they won’t require surgery or extensive intervention to heal. Unfortunately, however, there’s not much a doctor can do in those cases. The best way to heal your broken toe is by keeping it stable and elevated while periodically applying ice to your toe for 10-20 minutes to help manage any swelling.

Splinting 

The typical treatment for a broken toe is called buddy taping. With buddy taping, you apply gauze around the broken toe, secure it carefully to the toe next to it with medical tape, and place a gauze pad in between the toes to prevent skin irritation. The non-broken toe helps keep the broken one stable as you walk around, giving it the support it needs to begin healing properly. 

Surgery and Additional Treatments

Some toe breaks aren’t as straight forward, and if you have bone fragments that need to heal, taping may not be enough. In these cases, you’ll need to wear a walking cast to ensure that your toe has extra stability while walking.

In very serious cases, you may need surgery to reset the broken bones. In this process, the surgeon will sometimes put a pin or a permanent screw into the bone to help it heal properly.

Recovering From a Broken Toe

As your toe heals, it’s likely going to be tender and swollen. Try to avoid activities such as running, playing sports, and walking long distances for a couple of months to ensure that your bone has the best chance to heal. Basically, just take it easy and continue to rest, elevate, and ice your toe. Recovery time can vary based on the location and severity of your injury, but you’ll generally be back on your feet (pun intended!) within six weeks.  

If the toe injury is severe enough, your doctor may recommend going to see a physical therapist, These specialists will then give you a series of exercises that will help strengthen your toe and maximize its range of motion.

Lasting Impact

Ultimately, broken toes aren’t that big of a deal, but they need to be taken seriously so you can fully heal. The key to a good outcome is following your doctor’s advice. After a couple of weeks, you can start to carefully put more pressure on your broken toe each day to see how it’s recovering. Take any slight improvements in pain and discomfort as signs that your injury is healing. 

Eventually, start to ease back into your activities. But, don’t forget to listen to your body and back off on your activity if something doesn’t feel right. After all, it’s better to take longer to recover than to rush back into your activities too quickly and injure yourself all over again. 

I hope my guide helped you! Have you ever broken your toe? If so, let me know your recovery process in the comments below! 

What Happens When a Broken Bone Does Not Heal Correctly?

A non-healing fracture, also called a nonunion, occurs when the pieces of a broken bone do not grow back together correctly. Usually, bones start rebuilding immediately after the bone fragments have been realigned and stabilized them into place. This process is called setting the bone.

During the following weeks or months, new bone tissue continues to form. As long as the bone fragments receive an adequate supply of blood and nutrients, the new tissue fuses the fragments together into a single bone.

In a nonhealing fracture, bones do not produce new tissue. A fracture in which the bone does produce new tissue but does so very slowly (over months instead of weeks) is called a delayed union. In some instances, the broken bone heals but may not be completely straight. This is called a malunited fracture.

A nonunion, delayed union, or malunited fracture may occur in any bone, but these conditions are most common in the humerus, or upper arm, and the tibia, or lower leg.

How Does a Bone Heal?

All broken bones go through the same healing process. This is true whether a bone has been cut as part of a surgical procedure or fractured through an injury.

The bone healing process has three overlapping stages: inflammation, bone production and bone remodeling.

The Inflammatory Stage

When a bone breaks, the body sends out signals for special cells to come to the injured area. The Inflammation Stage starts immediately after the bone is fractured and lasts for several days. When the bone is fractured, some of these special cells cause the injured area to become inflamed (red, swollen, and painful). This tells the body to stop using the injured part so it can heal and provides the initial structural stability and framework for producing new bone.

Other cells that come to the area during this stage form a hematoma (blood clot) around the broken bone. This is the first bridge between the pieces of the broken bone.

The Reparative Stage

The reparative stage starts within about a week of the injury. A soft callus (a type of soft bone) replaces the blood clot that formed in the inflammatory stage. As healing progresses, the soft callus is replaced with hard bone (known as hard callus), which is visible on x-rays several weeks after the fracture. Over the next few weeks, the soft callus becomes harder. By about 2–6 weeks, this hard callus is strong enough for the body part to be used.

The Remodeling Stage

The remodeling stage starts around 6 weeks after the injury and can last for several months.  In this final phase of bone healing, regular bone replaces the hard callus. In remodeling, bone continues to form and becomes compact, returning to its original shape. In addition, blood circulation in the area improves. Over the next few months, the bone is reshaped so that it goes back to looking the way it did before the injury.

How Long Does Bone Healing Take?

Depending on the severity of the fracture and how well a person follows their doctor’s recommendations, bone generally takes six to 12 weeks to heal to a significant degree. In general, children’s bones heal faster than those of adults. This will depend on the location and severity of the fracture, the type of surgical procedure performed and other considerations. People usually stop feeling pain long before the broken bone has healed and the limb is ready for regular activity.

Causes and Risk Factors

With modern treatment methods, most broken bones heal without any problems. After a fracture occurs, new bone tissue forms to connect the broken pieces. When the broken bone fails to heal it is called a “nonunion.” For bone healing to happen, the bone needs adequate stability and blood supply.

Nonunions happen when the bone lacks adequate stability and/or blood flow. Determining the cause of a nonunion is critical to determining the proper treatment. The most common causes of nonunion are:

• Use of tobacco or nicotine in any form. This includes smoking, chewing tobacco, and use of nicotine gum or patches.
• Older age
• Infection
• Diabetes
• Severe anemia
• Medications including anti-inflammatory drugs such as aspirin, ibuprofen, and prednisone.

Orthopedists at Ventura Orthopedics treat common bone healing complications, including:

• Bone infections (osteomyelitis). Infections can occur when bacteria enter the body during a trauma. Less commonly, infections can happen during surgery to set a bone.
• Inadequate blood flow to the bone: Healing bones get many factors delivered by the blood supply, including the cells that repair the broken area, growth factors, and oxygen. Some bones have a limited blood supply and in other cases, the supply is disrupted by the injury.
• Separation of the fractured ends of the bone: The bones may not have been set close enough for a union, or may have separated after stabilization.
• Inadequate stabilization of the fracture: Stabilization is one of the key parts of treating broken bones. If the fracture was not able to be set properly, a nonunion might result. Sometimes a cast is not sufficient, and the fracture must be stabilized with screws, rods, plates, and other fixation methods

Bone Complications: What to Look For

It is important to know the warning signs of a bone healing complication so you can alert your doctor. Receiving prompt care is critical to treating complications. Call your doctor if you notice any of the following signs:

• Chronic pain
• Fever
• Drainage from a wound
• Swelling
• Limping

Diagnosis/Treatment

• History and physical exam: Your doctor will obtain a history of your problem and perform an appropriate physical exam to find the exact area of concern.
• Imaging: Usually, imaging of the site in question begins with X-rays. If more information is needed, your doctor may order a CT Scan or an MRI.
• Surgery: The goal of treatment is to realign your bone in a position that improves the function of the upper extremity. Your surgeon may need to re-break the bone to realign the fracture. Depending on the type of malunion, some of the bone may need to be trimmed to allow for proper orientation of the fractured ends.

Prevention

The best thing a patient can do to prevent a nonunion is to avoid smoking. Other factors that will help prevent nonunions include eating well and adhering to your recommended treatment plan. Patients who are smokers, obese, have diabetes or have other medical conditions, may be at higher risk for developing a nonunion.

A Word From Ventura Orthopedic Today

Bone healing typically proceeds without much problem. However, there are situations where people have problems healing bone after fractures or surgery to fuse the bone together. In these situations, there may be steps to help stimulate the body to heal bone. If you are concerned about your bone health, our specialists are always willing to help you reach your optimal health.

The experienced and dedicated orthopedic surgeons at Ventura Orthopedics are here for you. We are committed to helping you through any procedure until optimum health, strength and mobility are restored. Call us today at 800-698-1280 to schedule an appointment.

Toe Injury

Is this your child’s symptom?

Types of Toe Injuries

• Cuts, Scrapes and Bruises. These are the most common injuries.
• Jammed Toe. The end of a straightened toe receives a blow. This is usually from stubbing the toe on an object. The energy is absorbed by the joint surface and the injury occurs there. This is called traumatic arthritis.
• Crushed or Smashed Toe. This is usually from something heavy falling on the toe. Sometimes, the nail can be damaged. Fractures are unusual, but are at risk for a bone infection (osteomyelitis).
• Toenail Injury. If the nailbed is cut, it may need sutures to prevent a permanently deformed nail. This is less important for toenails.
• Subungual Hematoma (Blood Clot under the Nail). Most often caused by a crush injury. It can be from a heavy object falling on the nailbed. Many are only mildly painful. Some are severely painful and throbbing. These need the pressure under the nail released. A doctor can put a small hole through the nail to release the blood. This can relieve the pain and prevent loss of the nail.
• Dislocations. The toe has been pushed out of its joint.
• Fractures. Toe has a broken bone. The treatment is the same whether the toe is broken or just bruised. Broken toes are not put in a cast.

Concerns About Missing a Broken Toe

• Most swollen, bruised and painful toes are not broken.
• X-rays are only needed for severe pain and severe injuries.
• If the big toe might be broken, it should be seen by a doctor. The other injured toes generally don’t need to be seen.
• A broken great toe is not urgent. It can be checked during office hours.
• The treatment is the same whether or not the toe is broken.
• The treatment of all broken toes is pain medicine and comfortable footwear.

Pain Scale

• Mild: Your child feels pain and tells you about it. But, the pain does not keep your child from any normal activities. School, play and sleep are not changed.
• Moderate: The pain keeps your child from doing some normal activities. It may wake him or her up from sleep.
• Severe: The pain is very bad. It keeps your child from doing all normal activities.

When to Call for Toe Injury

Call Doctor or Seek Care Now

• Skin is split open or gaping and may need stitches
• Large swelling is present
• Blood under a nail is causing more than mild pain
• Nail is torn
• Base of nail has popped out from under the skin fold
• Dirt in the wound is not gone after 15 minutes of scrubbing
• Severe pain and not better 2 hours after taking pain medicine
• Age less than 1 year old
• Age less than 2 years and toe tourniquet suspected. (Hair wrapped around toe, groove, swollen red or bluish toe)
• You think your child has a serious injury
• You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

• Broken toe suspected
• Toe injury that causes bad limp
• You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

• Dirty cut and no tetanus shot in more than 5 years
• Clean cut and no tetanus shot in more than 10 years
• Pain not better after 3 days
• Not using the toe normally after 2 weeks
• You have other questions or concerns

Self Care at Home

Seattle Children’s Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

Care Advice for Minor Toe Injuries

1. What You Should Know About Toe Injuries:
   • There are many ways that children can hurt their toes.
   • There are also many types of toe injuries.
   • You can treat minor toe injuries at home.
   • Here is some care advice that should help.
2. Pain Medicine:
   • To help with the pain, give an acetaminophen product (such as Tylenol).
   • Another choice is an ibuprofen product (such as Advil).
   • Use as needed.
3. Bruised/Swollen Toe:
   • Soak in cold water for 20 minutes.
   • Repeat as needed.
4. Small Cuts or Scratches:
   • For any bleeding, put direct pressure on the wound. Use a gauze pad or clean cloth. Press down firmly on the place that is bleeding for 10 minutes. This is the best way to stop bleeding. Keep using pressure until the bleeding stops.
   • Wash the wound with soap and water for 5 minutes.
   • For any dirt in the wound, scrub gently.
   • For any cuts, use an antibiotic ointment (such as Polysporin). No prescription is needed.
   • Cover it with a bandage (such as Band-Aid). Change daily.
5. Jammed Toe:
   • Caution: Be certain range of motion is normal. Your child should be able to bend and straighten each toe. If movement is limited, your doctor must check for a broken bone.
   • Soak the foot in cold water for 20 minutes.
   • If the pain is more than mild, “buddy-tape” it to the next toe.
6. Smashed or Crushed Toe:
   • Wash the toe with soap and water for 5 minutes.
   • For any cuts, use an antibiotic ointment (such as Polysporin). No prescription is needed.
   • Cover it with a bandage (such as Band-Aid). Change daily.
7. Torn Nail (from catching it on something):
   • For a cracked nail without rough edges, leave it alone.
   • For a large flap of nail that’s almost torn through, cut it off. Use a pair of scissors that have been cleaned. Cut along the line of the tear. Reason: Pieces of nail taped in place will catch on objects.
   • Soak the toe for 20 minutes in cold water for pain relief.
   • Use an antibiotic ointment (such as Polysporin). No prescription is needed. Then cover with a bandage (such as Band-Aid). Change daily.
   • After about 7 days, the nailbed should be covered by new skin. It should no longer hurt. A new nail will grow in over 6 to 8 weeks.
8. Remove Ring:
   • Remove any ring that is on an injured toe.
   • Reason: swelling may occur.
9. Shoes to Reduce Pain:
   • If regular shoes cause too much pain, make a change in footwear.
   • Wear a shoe with a firm sole to limit motion. Reason: Injured toes hurt when they bend (are flexed).
   • If the top of the shoe increases pain, wear an open-toe sandal. Another option is to use an old sneaker. Then cut out the part over the toe.
10. Buddy-taping:
    • Buddy-taping is taping the injured toe to the one next to it.
    • Method: Gauze padding must be placed between the toes before taping them together.
    • How long to buddy tape: Usually needed for 1 – 2 weeks. By then new bone formation will close the break. Then pain with movement will be reduced.
    • Usefulness: Buddy-taping is optional. Sometimes, it makes the pain worse. Wearing the right shoe is much more helpful.
11. Call Your Doctor If:
    • Pain becomes severe
    • Pain not better after 3 days
    • Toe not normal after 2 weeks
    • You think your child needs to be seen
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the ‘Call Your Doctor’ symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 05/30/2021

Last Revised: 03/11/2021

Copyright 2000-2021. Schmitt Pediatric Guidelines LLC.

90,000 Is everything already healed? Who needs rehabilitation and why – Chzhud Shi Clinic

Even if you are lucky and you have never broken anything, you or your loved ones must have pulled your back at least once, hurt yourself more than usual, or twisted your leg badly. We rarely take such injuries seriously. Just think, a broken finger, sprained ligaments or a slight concussion will heal before the wedding!

Unfortunately, very often it does not heal – even if it seems that everything is over. And many, after such injuries, suffer for years with pains, lumbago, clamps and edema – and do not know what they are associated with.It is really difficult to understand, because the consequences of untreated injuries often manifest themselves in completely different places.

It happens, for example, that a person breaks his leg. The fracture did not heal perfectly, and the leg eventually became a couple of millimeters shorter. Outwardly, this is imperceptible, but the straight position of the body when walking is disturbed, and because of this, over time, the sacrum and spine slightly tilt, the fingertips begin to go numb, and occasionally there are attacks of headaches or lumbago in the lower back.Naturally, it does not occur to anyone to associate this with a fracture of a leg six months ago, and the treatment does not go further than taking painkillers. Although only a couple of visits to an osteopath would easily solve the problem.

Another example happened in my practice just a month ago. A girl came to the appointment with a complaint that after the last phalanx of her little finger was broken, her fist did not fully clench, and it was terribly annoying to her. Doctors at another clinic suggested that the problem was in improperly fused tendons, and advised to do another operation. In reality, the fracture was simply not healed, and there was edema inside. After three sessions of acupuncture, the problem was solved without any surgery.

So if you or your loved ones have experienced trauma, even the most insignificant one, it makes sense to go to an appointment and check if rehabilitation is needed. Most doctors of conservative medicine consider the treatment to be completed at the moment the plaster or stitches are removed – but this is far from always the case.

How to understand that an injury is not healed?

If, even after a long time after the injury, you experience discomfort, pain, stiffness of movements, the injury is almost certainly not healed.If after an injury you have regular problems in other organs and systems (for example, pain, swelling, lumbago, numbness), it may very well be that the roots of the problem lie in the same injury, even if you broke your arm and your head hurts.

It is definitely worth dealing with such conditions – and the methods of oriental medicine cope with this task best of all. It is not for nothing that the same reflexology and osteopathy techniques are used by sports doctors all over the world, because they need to return the athlete to the field as soon as possible.

How does oriental medicine treat injuries?

If the injury is relatively recent, then at the initial stage we prescribe herbs and acupuncture sessions to the patient, which relieve swelling, inflammation and help tissues to recover faster (naturally, after: stitches, plaster cast, etc.)

When the acute condition has passed, we prescribe osteopathy sessions and continue acupuncture. This allows you to restore nutrition and lymphatic drainage of tissues (especially if a person has been in a cast for a long time), relieve tension and clamps, remove residual inflammation and imbalance in movements, due to which we have complications.

Of course, it is better to work with relatively recent injuries. Helping the body recover properly is always easier than removing the long-term effects of improper recovery.

Nevertheless, we also work with chronic injuries. In such cases, patients are recommended osteopathy sessions to restore movement balance and a course of massage that improves mobility, blood circulation and relieves muscle clamps.

And even if you have suffered from the consequences of the trauma for ten years, recovery, as a rule, goes quite quickly, and the changes are felt immediately.So do not tolerate pain, discomfort and stiffness of movements – come to Chzhud Shi, and we will tell you how we can help.

You can sign up for the first free consultation by phone 8 (495) 228-2808, in WhatsApp 8 (926) 880-5888 or online yourself.

90,000 Fracture is not a sentence. Get on your feet in a couple of days | HEALTH: Medicine | HEALTH

Today, with the help of the latest technologies, doctors work miracles and raise people to their feet in a few days. After the operation, retirees return to their usual way of life.

Oleg Ayupov, a traumatologist-orthopedist at the REAVIZ multidisciplinary clinic, said how it is possible. In a conversation with our correspondent, the doctor explained what the prevention of osteoporosis is, how to properly treat a fracture and avoid its dangerous complications.

Traumatologist-orthopedist of the REAVIZ multidisciplinary clinic Oleg Nazibovich Ayupov Photo: From the advertiser

– In winter, the number of injuries increases, especially among pensioners. What special care can these patients receive?

– Indeed, the most vulnerable category is the elderly.Due to demographic shifts, such patients are increasing. For example, if in 1990 there were 1 million 700 cases of hip and trochanteric fractures in the world, then in 2050, according to WHO forecasts, there will be 6 million 300. Every year there is an increase in the number of victims. Moreover, each elderly patient has from three to five comorbidities.

Women suffer more often. Today, with a hip fracture, age and concomitant diseases are not a sentence. The sooner medical attention is provided, the better.It is generally accepted that surgical treatment is more effective than conservative treatment, in which patients with such injuries die within the first year.

After the operation, people not only feel better, but also gradually return to their usual way of life.

In winter, the number of patients with ankle fractures also increases. Basically, they are treated conservatively: a plaster is applied to a person, after a few months it is removed. And the bones may not grow together. We have to start the treatment anew, to carry out an operation to connect the broken bones with metal fixators, and in some cases – replacement of the joint, and then rehabilitation.

– How long after the operation can the patient get on his feet and start moving on his own?

– You need to get out of bed in the first days after the operation. On the second day, we try to lift the patient so that he can walk first with the help of crutches and walkers.

– Give examples of difficult cases from your practice, when patients were helped thanks to modern methods.

– Typically difficult patients are hospitalized late.This happens for various reasons: either the relatives were unable to call an ambulance in time, or the patient does not attach importance to the injuries received. Ideally, the person will be operated on within the first two to three days after the fracture.

We had a case when one of the patients lay with a hip fracture in a regional hospital in a neighboring region for about two weeks. There, they could not help her for a number of reasons: somatic pathology, age more than 80 years. Relatives went to our clinic, we hospitalized her, examined her, treated her and performed an operation, put an endoprosthesis.Two or three days later, they raised me to my feet. And she was already moving around the ward on her own with the help of a walker.

– Have there been any patients with fractures in your practice who were initially incorrectly treated? Can the consequences be corrected?

– Bitter, but there is such a thing. These are cases with nonunited fractures and late treatment. There are patients with advanced coxarthrosis. The reasons are very different: the doctor’s lack of information about a certain pathology, ignorance of modern methods of examination and treatment.For this, doctors need to attend specialized conferences and symposia. The specialists of our clinic do it regularly. We study all the most promising methods of treatment and care for difficult patients. In the summer we were at the Eurasian Orthopedic Forum in Moscow, in the fall we attended the III International Congress of the Rheumatic Orthopedics Association.

One of the patients was treated for a long time by conservative methods in one of the hospitals. It is very painful and time-consuming. He was hospitalized in our clinic, performed an operation using modern technologies. Two months later, the man went to work. With a conservative method, he would have been treated three times longer. This is provided if the bones healed the first time.

-You have a multidisciplinary clinic. Is the patient fully examined before the operation?

– Of course, if there is evidence for this. We are talking about laboratory facilities, instrumental methods. We have a digital X-ray machine, a computed tomograph, an ultrasound scan, as well as all the so-called “narrow” specialists.All this helps to examine the patient as soon as possible.

– How can residents of neighboring regions apply to your clinic?

– Most often this is an appeal for paid services. We have a 24-hour emergency room, where you can apply for paid services and under the VHI policy. X-ray is available around the clock, traumatologists work, at any time of the day a comfortable inpatient department is open for admission, there are also single rooms available.

– What recommendations should fracture patients follow?

– The sooner a person returns to his usual rhythm of life, the better. There is no need to hope that in three or four months he will be helped to develop an arm or a leg. 70-80% recovery depends on the mood and efforts of the patient himself.

With regard to the prevention of osteoporosis, you need to lead an active lifestyle, exercise. The culture of a healthy lifestyle starts from childhood, from the family.Unfortunately, schoolchildren began to move less. There are many specialized sports schools in the region where you can send your child. I am glad that there are more and more cyclists on the streets.

Health depends on nutrition and habits that are formed from childhood. Fast food has a particularly negative effect, contributing to metabolic disorders and the formation of excess weight.

– Does being overweight increase the risk of injury?

– Unfortunately, yes. Under the influence of extra pounds, coordination of movements is impaired, bone density changes, and the risk of osteoporosis and concomitant diseases increases.

– Do I need to come for preventive examinations to a traumatologist?

– To avoid fractures, this must be done. The specialist will detect the initial stages of arthrosis. It will determine whether the joints are working in full, whether there is stiffness, contracture. According to the images, arthrosis of the hip or knee joint, the formation of local osteoporosis can be determined. Minimally invasive surgery will help to avoid complications. In the operated area, the blood supply improves, the bone becomes stronger and the risk of fractures decreases.This makes it possible to postpone the need for hip and knee prosthetics for several years. In our clinic, it is possible to individually select the necessary materials from the available stock. Unfortunately, many hospitals are deprived of this choice.

“Bells” for a visit to a traumatologist are joint swelling, their crunching, stiffness and restriction of movement in the morning, night pain in the joints.

– What advice would you give to readers on how to protect themselves from injury in winter?

-Most older people have osteoporosis.Therefore, they need to avoid falling as much as possible. Shoes should be comfortable, stable, on a low platform. It is better to use a cane, which, unfortunately, many are embarrassed to do.

Multidisciplinary clinic “REAVIZ” Samara, st. Soviet Army, 243.

Registration by phone (846) 3-21-21-21.

License LO-63-01-004916 issued by the Ministry of Health of the Samara region on 05.12.2018 Advertising

There are contraindications. Consult a specialist

Sick bone on the leg | Publications

The beauty of women has been of great importance at all times.Perhaps all modern men will agree with this, but what is there, even the classics of Russian literature mentioned this. However, it happens that the legs, or rather the feet, lose their beauty due to the “bone” protruding at the base of the big toe. It is important to understand how to deal with the thumb bone so as not to torment yourself with pain all your life.

A diseased “bone” (as deformity on the big toes is often called) is perhaps the most popular of the orthopedic problems, and mainly women are exposed to it.Statistics say that men are four times less susceptible to it. The cause of pain in the bone lies in the failure of the ligamentous apparatus – a congenital problem transmitted, mainly through the female line.

Why does the bone on the leg hurt?

We need to figure out what is the root cause of the diseased “bone”. This is, surprisingly, flat feet. In a healthy person, the foot is concave. There are two concavities in total: the longitudinal concavity is located inside the sole, the transverse one is located near the base of the toes.When the ligaments and tendons cannot withstand the load, the foot becomes flat.

In the case of transverse flat feet, the metatarsal bones, instead of going parallel to each other, begin to fan out, and the toes diverge after them. What’s wrong with that, you ask? This becomes the reason for the appearance of a protruding bone: the big toe does not move outward, but, unlike its metatarsal bone, turns inward. As a result, the head of the metatarsal bone of the big toe begins to protrude from the joint, and we see a “bump” at the very base of the big toe – this is a visual manifestation of the “bone”.

Further, the bone deformity progresses. Why does the bone on the leg start to hurt? The contact of the protruding joint lump with the shoes provokes chafing, which ultimately becomes inflamed, and the person feels pain in the very bone on the toe. Further, bone-cartilaginous growth appears, and the bone sticks out even more. After some time, his neighbors begin to suffer from the pressure of the deformed thumb. They bend in the wrong position, are fixed in it, eventually acquiring an unnatural curved shape, pain appears in them too.

This leg disease is a serious problem, especially for women. The heaviness and pain in the feet is constantly felt, the ability to wear shoes and other elegant shoes disappears.

What is the treatment for the leg bone?

What to do if the bones on the toes hurt?

Many have asked this question. Let’s deal with him.

There are many methods of dealing with deformity of the thumb, including folk:

• compresses,
• iodine nets,
• foot massage
• warm foot baths with herbal decoctions and sea salt.

and others.

These remedies can help relieve pain and reduce inflammation, but they cannot cure the disease itself. The joint remains deformed, and the pain in the foot eventually returns. Only qualified orthopedic surgeons can truly cure this disease, and the cardinal treatment is bone surgery.

The first practice of surgical treatment of a diseased leg bone

At the beginning of the operation, treating a diseased bone was terrible.The orthopedic surgeon simply removed the protruding part of the bone. After a while, the disease appeared again, and in a more aggravated form, and the pain became even stronger.

The next step in the treatment was the Vreden operation, which was named after the person who created it – the famous Russian surgeon R.R. Harmful. During this operation, the patient experienced less pain. The method consists in completely removing the inflamed metatarsal bone on the big toe. As a result, the big toe ceases to be associated with the foot and rests only on soft tissues.Oddly enough, when everything heals, people feel relatively well, the pain disappears, and the ability to walk and lead a normal life returns. This practice still exists. It would seem that there is no need to further develop the treatment of a diseased bone, but medicine continued to progress.

Modern methods of eliminating a diseased bone of the foot

In modern orthopedic operations, bone fragments are cut out and moved to remove the diseased bone and give the big toe the correct position.The finger is fixed with medical screws or knitting needles until the final fusion.

There is another treatment option – “closure” of the deformed joint. Orthopedic surgeons remove the cartilage completely and add the metatarsal bone to the first phalanx of the thumb in the correct position. As a result, the bone and pain disappear.

Considering the above, we can say that there has been a surgical revolution in the treatment of a diseased bone. The most important thing is that the attitude towards the problem and the very essence of the treatment have changed.If in the past deformity of the thumb was considered a defect of one joint and the bones included in it, today an integrated approach is used in the fight against the bone.

Nowadays, orthopedic surgeons, even taking into account the operation, can rehabilitate a patient in one day. The next day, people already begin to walk on their own, albeit with more support on the heel and the outer edge of the foot, but without plaster and crutches. After two weeks, the stitches are removed, and after 1-1.5 months the patient returns to his usual way of life, but already without pain in the foot.

It can be said that there are practically no shortcomings in modern operations. Unfortunately, they are not made everywhere. There is a shortage of highly qualified surgeons and special, high-quality and, therefore, expensive equipment. The situation is the same in other countries, but at a much higher cost of leg bone surgery.

Are there alternatives to operation

with a sore big toe bone?

Not all people when asked “what to do if the bones on the legs near the big toe hurt” want to hear about the need for surgery.There are methods for relieving foot pain. True, if the problem is not addressed, the foot disease will progress. Help reduce pain and improve general condition

• pain relievers,
• Silicone foot and toe liners,
• individual orthopedic insoles,
• Night orthoses for fixing one or more fingers in the correct position,
• selection of comfortable shoes with the help of an orthopedist.

It should be remembered that in this case the deformity remains and the pain in the bone is relieved only temporarily.

What is bunion surgery?

It is still not entirely clear what to do if the bones on the legs near the big toe hurt? Let’s consider in more detail the operation to remove the diseased bone. Surgical intervention on the thumb bone is expressed in the correction of the angle between the metatarsal bones and phalanges of the fingers.This allows you to return the big toe to its normal position, correct transverse flat feet, ultimately relieve pain and return the foot to its full function.

In each case, the operating plan may vary depending on the degree of leg deformity and associated changes in the other toes.

Preparation for bone surgery

At the initial consultation, the doctor will explain to you the surgical plan and tell you how to prepare your leg for surgery.

If the diseased bone on the leg is not too large, and there are no changes in the other toes that require intervention, the entire hospitalization will take only one day.

It is a good idea to prepare your home for the recovery period following surgery. You may want to rearrange the furniture to make it easier to walk. It is also advisable to stock up on food so that you do not have to go shopping, it will be uncomfortable given the pain in the finger.

Bone removal surgery to relieve thumb pain can be performed under local or general anesthesia. If the operation is performed under local anesthesia, after a few injections at the level of the ankle, you will no longer feel the feet. Also, the operation can be performed under spinal anesthesia, in which the sensitivity will be completely absent in both lower limbs, which means the patient will not feel pain.

Before any of these anesthesia, it is not recommended to eat for 6 hours before the planned operation.

Your surgeon will tell you what will happen before, during and after the operation. If you do not understand something, do not hesitate to ask. After you ask all your questions and receive an answer to them, you will be given a consent to carry out the operation on your leg.

What happens during bone removal surgery?

Surgery on a sore leg rarely lasts more than 1 hour, but still the duration depends on the degree of deformity.There are various options for the surgical treatment of the bone on the foot, using both open and percutaneous surgical techniques. With the closed method, artificial “fractures” called “osteotomies” are performed to restore the normal position of the bones of the foot. With the open method, an incision about 5-7 cm long is made along the inner surface of the foot, which allows you to accurately determine the required angle at which you need to operate and the degree of displacement of the bone fragments. If the surgeon is experienced, a closed osteotomy can be performed.These procedures do not leave large scars and postoperative pain is usually less. But sometimes in such cases there may be incomplete correction of the deformity, delayed consolidation of osteotomies. It is also possible to combine closed and open methods, for example, surgery on 1 metatarsal bone is performed openly, and closed on small rays and phalanges.

What follows the bone removal surgery?

Immediately after surgery on the bone of the foot, you will be in the ward until the anesthesia is completely gone.Further, within two weeks, it will be necessary to bandage the foot. In the case of an osteotomy, you will need to wear special shoes that relieve the forefoot for 6 weeks, until the bone fragments are completely healed. Such shoes are called “Baruk’s shoes”.

Diary of a broken leg | alexmak.net

No, I didn’t break my leg again, fortunately. It’s just that last week (March 14) was exactly one year since the day I had a bad skiing, and I decided that I needed to write a small update on how the leg recovery is going on.In the meantime, I decided to collect all my posts published last year on this topic on Medium, and put them out as a single blog post. (Yes, as one very witty reader wrote to me, it’s time to move the blog from the Apple tabs to the Health tabs).

Moreover, the story with the leg was only the first stage of my medical adventures last year, and for me this is a kind of closure of gestalts. So I exported all the posts from Medium, imported them into WordPress, put them together as one long read, tweaked the text a bit to make it more readable, and here’s my graphomaniac result.I hope you find it as interesting to re-read as it was to me.

By the way, you can read the notes of another equally lucky guy – Artyom (aka Yura) Rosnovsky, who in his Medium account talks about the same fracture and medical troubles with his leg in America.

Start
Once we went to France to ski … by the way, someone asked me “why France and not the States?” Oddly enough, but skiing in France is much cheaper than in the States, even taking into account more expensive air tickets.And everything is cheaper: accommodation, equipment rental, ski passes, food (it is also much better and tastier), and so on. Not to mention the fact that skiing in the Three Valleys is much more interesting and varied than, for example, in Vail, Colorado. Well, in general, this was our seventh time in Les Menuires, we are already used to it there and we all know. We usually arrive in Geneva and in 2.5 hours of absolutely charming surrounding beauties we reach the resort. In short, France as a whole rules.

Le Menuir’s main square (view from the balcony)

And on the third day of skiing (6 days were planned in total) I fell and broke my leg.

Big smile. I don’t know yet that I’ll break my leg in an hour.

I am falling completely out of stupidity, on a simple and flat section of the blue track – I wanted to stop and show the brother and wife who were following me which lift we had to get to next. So I started to turn around and slow down sideways … but then everything happened so quickly that I’m not sure if I remember the details correctly. It seems to me that some of the skis caught the snow with a piping, I stumbled, lost my balance and began to fall.Instinctively, even though I was driving sideways, I turned to face forward, and the ski remained across the track, and here, apparently, my leg could not stand it. In general, in theory, the ski should have unfastened (the right one was unfastened), but for some reason this did not happen, and as I fell I heard a crunch coming from my knee (damn it, I still have this crunch in my ears). Having already fallen and feeling the pain, I realized that this time everything is worse than in the previous falls, when I stretched my ligaments, but I did not want to believe in the worst yet.

With the help of my brother who drove up, I unfastened the second ski and somehow sat down on the slope. The leg, of course, hurt like hell, and it was difficult to bend it. But I continued to amuse myself with the hope that maybe everything will work out. I also remember that I thought, “Well, I shouldn’t have taken the knee corset, which I have left from the last time with ligaments.” After a minute of keeping the snow on my knee for cooling, an optimistic thought came to me: “ so, well, for today I have probably already skated ”. A couple of minutes later, focusing on the pain, I calibrated and thought “ and maybe I skated before the end of the vacation.”And after a couple of minutes I thought “ maybe, if I get up, it will somehow get better and I will be able to reach at least to the end of the slope”. When I tried to get up, I realized that I still needed transportation downward: my leg bent by itself and the pain was simply unbearable.

The wife went to the nearest ski lift to call the rescuers. About 5 minutes later, Uncle Tomas came downstairs with a stretcher, who asked questions, felt my leg and said that for a simple dislocation of pain it is too much, but the X-ray in the emergency room will tell me for sure.

In general, he, with the help of my brother, dragged me onto a stretcher and we rolled down. It was the most painful 10 minutes of sledding in my life, because every push gave me a sharp pain in my leg. He brought me to the emergency room, which was located on the -1 floor of the building in which we rented an apartment, and I managed to think “ well, now the plaster will be screwed on and I am hobbling up to the 10th floor in the elevator. I will sit all day on the balcony, drinking hot wine and sunbathing in the sun “.

In the emergency room, I was transferred from a sled to a gurney and immediately brought into a room with an X-ray machine. I had to take off my shoes, pants and thermal underwear, so for the next few minutes the emergency room was filled with my groans and screams “ fuuuuuuck ” … according to the results of the X-ray, the dude from the first-aid post dumbfounded me with the fact that a) my knee was broken (I already understood this), and b) to fix it, you need to go to the hospital and have an operation. In short, with this “successful” fall I deprived myself not only of skiing, but even sunbathing on the balcony with hot wine.Well, fuck …

An ambulance was ordered at the first-aid post to transport me to the hospital, and it was supposed to arrive in 1.5-2 hours. In the meantime, since I was still in great pain, they decided to give me a pain reliever. Since everything in my body is not very simple (I’ll tell you somehow what’s wrong there – upd As you understand, here I meant my story with the kidneys), then morphine acted as an anesthetic: a specially trained nurse came and put on an IV and sprinkled morphine there.Feelings, of course, yeaaaaa…. But, by the way, I just didn’t like these sensations and I would not want to repeat them, although this helped to reduce the pain.

Apparently, under the influence of adrenaline and drugs, I woke up with a desire to change everyone, so I tried to give out all sorts of valuable instructions to my relatives – call the insurance company, what should I bring to the hospital, etc. Fortunately, they mostly ignored my CU and did everything much more correctly and organized. They paid off with the emergency room for X-rays ( 150 euros ), with the nurse for morphine ( 120 euros ), and also sorted out the insurance guarantee for the payment of transporting the body from the slope ( 462 euros .I’m wondering, is it somehow considered “per meter” that such an exact amount is obtained?). In short, without them it would all be much more complicated, and I am very grateful for their help (and I am still tormented by remorse that I “broke their vacation with my foot.” My brother’s wife, for the first time, decided to try skiing on this trip, and it was we who persuaded her for a long time. She even managed to like it, so I hope that this minor incident will not scare her away).

X-ray at the first-aid post

In the meantime, an ambulance arrived.By the way, this seems to be just a commercial minibus that specializes in the delivery of injured people to hospitals. For about an hour and a half and 320 euros , two French handsome men, who practically do not speak English, not only took me to the hospital, but also managed to draw up the necessary papers and take my card to pay for the “delivery”. So I went to a hospital called Center Hospitalier de Bourg St Maurice . I was glad that almost all such cases are brought here from the nearest ski resorts, so their experience and specialization were understandable, and it would be difficult to find a better place to fix a leg in the district.

This is how I remember the mountains

I was unloaded in the corridor of the emergency room, and the nurses who periodically ran through, whenever possible, tried to ask me some questions and fill out the appropriate forms (by the way, the language barrier with the French did not float before me, but here I felt it in full measure). The leg was still painful, but I decided to refrain from painkillers as much as possible. In order not to lie in the corridor all the time, I used a technical trick – I said that I needed to go to the toilet, after which I was taken to a separate (temporary) ward with duck .An hour later, the doctor came, asked more questions, then after an hour and a half I reached the X-ray ultrasound (where they checked that the internal organs did not suffer during the fall – upd here I was just about what they were checking if everything was fine with the kidneys), and then they rolled another knee for CT. After these procedures, I was again returned to the same room with duck , but somewhere around 8 they said “so, we need a room, let’s go back to the emergency room”. After that I was left in the corner of the emergency room behind a special curtain while the documents were being processed.

In the hospital emergency room corridor

To help you understand the timeline better: I fell at approximately 12.30 . I was brought to the hospital at about 4.30 , and at about 8.30 I was taken to the “normal” ward in the surgical department. Considering the workload of the hospital with people with broken limbs, in principle, a good result. At the same time, no one could tell me exactly when my operation would be: Wednesday or Thursday, which resulted in an interesting mess on Wednesday.

In the ward where I was brought (in total, it is designed for two people), there was another neighbor who broke his hip while skiing. He had an operation with a joint replacement, and they promised that he could leave the hospital almost on the day of the operation. This neighbor, who spoke a little English, came in handy when he relayed various instructions in French to various nurses that had been given to me by doctors and other staff before. The ward itself is very comfortable, measuring 40 meters, with bedside tables, electrically adjustable loungers, TVs on the wall and regular nurses visiting you.Since at that time the time for dinner had passed, and I had not eaten for a long time (I fell just when I was driving to lunch), they warmed me some instant potatoes in the form of mashed potatoes, and gave it with a piece of ham. The staff was inclined to believe that the operation would be on Thursday, so they did not forbid eating, and the anesthesiologist generally insisted on drinking more. At night, the nurse came almost every hour and asked if I needed painkillers (I refused – I love to suffer). And then, at about 2 o’clock, apparently, a new shift came, and on the sly, while I was sleeping, I connected paracetamol to the dropper.

Such is the “dinner”

The next day (Wednesday) the French mess was taking its toll because the staff gave me conflicting instructions about food and drink. For breakfast they brought tea with crackers (although the neighbor had a bun, I saw it!), And then to the questions “ so can I eat or drink? “one staff said” yes, eat what you want! “, and the other” no, don’t eat, you have operation “. Since I wanted to finish the operation quickly, I thoughtfully decided not to eat.Around 12, a lashed-out anesthesiologist rushed into the ward, who had previously said “ drink more and eat what you want ” and asked “ did I eat something? “. He clearly sighed with relief when I said that apart from crackers, I had eaten nothing, and announced that the operation would be at 3 o’clock in the afternoon.

Preoperative breakfast

All sorts of orderlies and nurses ran around me, finally they took me out of the remnants of ski equipment, and then a sad orderly came, then all the time leaving somewhere and at the same time repeating the phrase “ ay kam back “.He said that I would need to wash and disinfect myself, and I had to do it myself somehow with the help of a basin of water, iodine and rags. (This orderly, by the way, looked a lot like Podrick Payne):

I somehow mastered this process, then the same sad orderly shaved my broken leg (it turns out, shaved legs are so beautiful! It’s no wonder that women do this to themselves all the time. Now I just can’t decide whether to shave the other leg – upd I decided to leave the natural cover anyway).The orderlies and nurses continued to run around, both to me and to a neighbor, at that time my family still came to visit me, and at the same time in the ward they first repaired a tap with hot water, and then a door lock, local Shpuntik . And all this 15–20 minutes before the operation; I hope this description conveys well the state of the madhouse around.

Preparing the leg for surgery

Exactly at 3 o’clock I was taken to the operating room.

Part 2
In the first part, I forgot to say what, in fact, I broke – the knee is a complicated mechanism.If I’m not confusing anything, this is a “tibial plateau fracture”, and this type of fracture even has its own Wikipedia page. Roughly speaking, this is when the femur, which is on top, crumbled a part of the lower (tibia) bone on impact with a twist. This is called “out of luck”. Also a warning: at the end of this part there is a photo from the #Unsead series, so be careful there!

Unfortunately, they are not allowed to enter the operating room, so the operation process will be without a photo.(Although, I must say, when I found out that the operation would be without full anesthesia, I wanted to arrange a live broadcast from the operating room). There I first lay in dressing room # 1, then another half hour – in dressing room # 2, where I was given anesthesia. Moreover, due to some peculiarities of my body (upd This, of course, is also about the kidneys), it was decided not to do the operation under full anesthesia, as was originally supposed, but under epidural (spinal) anesthesia – the doctor pronounced both of these terms, I don’t know which the term is more correct in this case.In short, some liquid was injected into my spine and after a certain time I stopped feeling the lower half of the body, but at the same time remained conscious and heard and felt everything that was happening.

It seems to me (here the feeling of the passage of time is rather blurred), after about 15–20 minutes the anesthesia worked, the surgeon came and began his action. This, by the way, is a very strange sensation, when you seem to feel touching your leg, and you understand that there is not just “touching”, but something is being cut, drilled, etc., but there is no pain.I “felt” well how the surgeon held the scalpel, opening the skin, I remember how the pins were inserted into the bone and how the last “threaded” bolt was screwed in, which secures the plate holding the crumbled bone. Towards the end of the operation, it seemed to me that pain began to appear, which I informed the staff about, and after that I don’t remember anything. Perhaps I finally fell asleep, or I was just hit on the head so as not to be distracted, but I did not hear how the cut on the skin was collected with paper clips, and I already woke up when they kicked me and said, “ well, what is it about? Go already, give “.No, in fact, they said, of course, not so rudely, but they informed me that now I will go to the intensive care unit (because I need additional supervision – upd, yes, of course, in connection with my history with the kidneys).

The intensive care unit is a department with 4 individual wards, which is assigned a team of nurses and nurses around the clock, as it seemed to me, in the amount of 4 people. They monitor the condition of patients, dispense medications, measure vital signs, ensure the circulation of ducks, etc.Since I had been drinking dinner that night in the operating room, the nurses had “muddied” me with the same “instant” dinner with mashed potatoes and ham, but by then I was again hungry enough to enjoy even this dinner. In bed, they hooked me up to a dropper, pulled a heart rate monitor on my finger, glued three sensors for monitoring the cardio system on my chest, and screwed a pressure monitor on my left arm (by the way, it turned on according to some algorithm every few hours, and on the first night I almost died several times from a heart attack, when this crap suddenly began to squeeze my hand and measure the pressure).

I am right after the operation. There were some problems with the Wi-Fi, so they connected me directly to the Internet with wires.

That night by 11 o’clock the anesthesia was finally released, my leg began to hurt, and the nurses immediately began to offer me morphine. I refused, agreeing to start with paracetamol. After an hour and a half, it became clear that paracetamol did not help much, and the nurses again began to offer morphine, but I continued to refuse, so they brought some kind of mixture in sugar.But she didn’t help either, so the leg was still covered with ice. At about 2 am I still gave up from the unabating pain and agreed to morphine, and the nurses happily injected me with it, so I managed to get some sleep. “A little” – because at 6 in the morning they had a shift, and the old shift had to take my blood for analysis, and the new one – to make sure that they were given a still relatively living body. By the way, about the body – after the operation, the leg was not enclosed in a plaster cast, but in a special corset that can be conveniently unbuttoned if necessary, but at the same time fixes the leg rigidly at all the rest of the time.

Corset

For breakfast there was traditionally tea (you can choose coffee), and a bun with jam. With breakfast, the nurse brought the pills and said that the operation went well overall. During the day, all the routine with measurements of vital signs continued, a change of bed (two nurses deftly do this right under the lying patient), and they also took me to an x-ray to see what was going on with my leg after the operation. Many saw this photo, I actively grabbed it on the Internet:

Obviously, they have no problems with screws

In profile it looks like this:

It’s funny, when they brought me for an x-ray, there was an old woman lying next to her on a cart, who had already been x-rayed, and now they had to take me to a CT scan.The old woman also went skiing successfully, but what was more interesting was that she was from Britain, and we exchanged a few phrases in English with her. At that moment, I experienced some incredible relief from the fact that at last I can speak with someone not in broken simple phrases, supplementing them with gestures, but in normal English, and, which is also important, the person understands me, and also answers so that I understand everything. Somehow, this feeling of the language barrier with the French covered me at this moment.

Lunch (it is served around 12.30) this time I caught it, so I was able to fully appreciate it:

Can he be called healthy? Not. But tasty – you definitely can!

Something, but feed for slaughter. That same day there was a dinner (around 6 pm):

It is hard to see, but a tomato cut in half with a thick cutlet is inserted in the rice, into which a thick cutlet is inserted

Sorry for the large amount of food photos, but what else to do in the hospital after surgery, when the fun is over and the recovery routine begins? On that day, there was another funny story when, apparently, the head of the hospital came and muttered something in French with the staff.From his gestures and intonation, I understood that he had asked something from the series “ and who is this? “, they answered something, and this manager was like this:” ahhhh, le American! “. I could not tolerate this, and I had heard that the French do not treat the Americans very well, so I hastened to assure him that “ but, but, ah um not American! Ah uh ukreinian! “. The doctor’s face really instantly brightened, and he asked me in English: “ So you are not Donald Trump? “. “ Of course, I’m not Donald Trump, yopta! ”, I assured him, and the manager, satisfied with this answer, left.

Even on that day, a physiotherapist came, who told me more about the injury itself, about the operation, about the recovery process, and also brought crutches and taught me how to use them. Actually, the most important thing about the process that I needed to know: at least 6 weeks of no weight on a broken leg, and after that, at least 6 more weeks – light loads. That is, crutches for the next 12 weeks are my best friends, so when we bought them (they were given a prescription and had to be bought at the nearest pharmacy), I called them “ Abbott and Kostyllo ”:

Typical forearm crutches, very inconvenient to use

Looking ahead, I want to say that when I arrived home, I ordered other crutches on Amazon, which turned out to be much more convenient.On the same day, a surgeon came to visit, who apparently operated on the leg, who said that “ operation is OK, the bones are weak, they need to be protected, no weight on the leg ” (upd Yes, the bones were weak due to kidney problems). By the evening, armed with crutches, I grew bolder and demanded to be escorted to the toilet (I had to push the IV after me). Two nurses said that they were not ready to take on such responsibility, and brought a special portable toilet chair into the ward.I said that I would not do anything in THIS, so the compromise was the decision in which they took me to the toilet in this chair.

The night passed more or less, and on Friday I was supposed to be discharged. Traditionally, at 6 in the morning, the night shift took blood from me, and the day shift began at 8, some of its regular procedures. Since I had to be discharged, after changing the bed I was told “ sit in the chair ”. A couple of strokes to the stupidity of the French:

1. They sat me down at the sink and told me to wash.The nurses changed their bed and rushed off with the words “ if you need anything – call ”. Everything is fine, but the washbasin did not have any button to call them. So after I washed, I sat for another 15 minutes and tried, waving my arms at the window opening in the door, to attract attention to myself, until they noticed me.
2. Then, when I was seated in a chair, I was also told “ if anything – call ”, not taking into account that the call button is actually on the other side of the bed, and I cannot reach it.It’s good that I didn’t have any urgent requests.

One of the most popular questions I got during the broadcast from the hospital: Who pays for this whole carnival? (in other words, do I have insurance?). I had insurance, specially bought for the trip – I needed to get a French visa, and there insurance is a mandatory document. The insurance was purchased online from Tokio Marine HCC, and we called them almost as soon as the incident occurred.Moreover, when it came to paying for “sledges” from the slope to the first-aid post, they faxed a payment guarantee for this amount (462 euros). Unfortunately, it was not so easy with the hospital. First, they sent the payment guarantee to the hospital by e-mail using the Cisco Secure Mail service, and the hospital administrators (not those who are IT, but those who are just responsible for working with patients) immediately exploded from this. There comes a link, which, in order to open, you still need to register, then confirm the registration and only then, having logged in, see the letter.Somehow I persuaded me to send a payment guarantee to my address, and I was able to get the letter itself from this system, after which I ran into another problem: although the letter was addressed to the hospital, for some reason all that the same coverage amount is 462 euros. Several calls to the insurance support service did not give me any results, they told me that the hospital should provide them with a detailed report on the procedures performed so that they can then review this report.

In short, we decided for ourselves that we would pay the amount of the bill from the hospital ourselves, and then submit for compensation to the insurance company for a refund (this is the second option, how to deal with the insurance company). So after several phone calls with insurance, I decided not to waste time on them that day. Moreover, they brought dinner:

I could not identify vegetables in fish garnish

At about 5 o’clock in the afternoon, a family arrived by car to pick me up from the hospital.A nurse from the intensive care unit brought a large envelope with various papers and more, among which were:

• X-rays of the leg after surgery
• post-operational report of a doctor, with information about what was operated on and how, with what anesthesia, etc.
• Recommendations for the further use of medications (in particular, pain relievers and blood anticoagulant injections)
• Prescriptions for necessary medicines
• Letter to the airline stating that I am allowed to fly on the plane
• exemption from work (“to lie for 6 days and not work for 3 months”.Obviously they can afford it in France)
• discs with X-ray images and with CT-recording (where in general there is a very cool 3D reconstruction of a destroyed knee)

Now the most interesting thing is the cost. What was done on the slope, I have already listed in the first part of the story. A hospital stay from Tuesday lunchtime to Friday lunchtime, including the operation, cost € 90,049 3255 90,050, and the operation itself cost € 90,049,700 90,050. In addition, the following was added to the expenses:

• crutches and leg corset ( 110 euros)
• prescribed medicines (90,049 67 90,050 euros)
• Well, there are all sorts of little things that patients buy – slippers, new pants to fit on the corset on the leg, oranges-apples.

So, having paid the bill from the hospital, we got all the documents in our hands, they gave us a chair to drive me to the car, I somehow climbed up there and we left somewhere around 6 pm (I just barely made it to dinner at the hospital, unfortunately!).
Then there was a very painful flight home and a new epic, this time with American doctors, but more about that some other time. Considering that I still sit at home and when I am not working, I freak out with boredom, there is no need to hope that my graphomaniac talent will suddenly subside.And nothing more interesting in my life still happens because of this leg, so I will, if possible, chronicle it.

PS. As a bonus, the photo might not be for the faint of heart. Today I went to the dressing, and finally saw how beautifully the braces hold the seam on the skin.

chpok-chpok-chpok 28 times

In short, take care of your legs when you are young, and then take care of it too. They will still be very useful to you. However, take care not only of your feet!

Part 3 – Transportation
I also decided to talk about how I got home from Europe (to America) with a broken leg – perhaps my advice will be even more useful than the previous two parts, where I mostly complained about life and told, how they fed in a French hospital.

Air travel is a topic that is not very pleasant, if you cannot afford to fly in business class and hang out in business lounges, and with a broken limb, a flight can even become quite a torment. We had a flight Geneva-Porto-Newark , with a total length of almost 10 hours, and we wanted to make it, if not comfortable, then at least not painful. (A separate part of the story was that my wife had completely different tickets for another day and with a different airline, so I had to strain and find tickets that allowed her to fly with us at least part of the way.Therefore, she got tickets Geneva-Lisbon-Porto-Newark , and already in Porto she joined us. As it turned out later, this was very correct on my part and made it possible to significantly alleviate my future suffering).

The flight from Geneva to Porto was operated by Swiss and from Porto by Tap Portugal. I don’t know how they divided tickets between themselves, but I communicated with both companies in parallel and could not get an intelligible answer from them about how I could upgrade my ticket.At some point, they rolled out something about 2 thousand dollars for a business class, but then a toad stepped on my throat – after all the hospitals and so on. I no longer wanted to throw money around. Theoretically, this money in the future could be knocked out of the insurance company later, but I was not sure of the success of this enterprise, so I did not want to risk my money. So I limited myself to two things:

1. I asked TAP in advance to arrange a wheelchair for me to get to the plane
2. When checking in online for the Porto Newark flight, I paid for seats with extended legroom

The wheelchair, by the way, was also not easy.I communicated with TAP support via Twitter (hanging on the phone while waiting for an operator through international roaming is still a pleasure comparable to the pain of a broken leg), and when I wrote to them “ help with chair ”, they first sent me to the page “ medical assistance ”on the airline’s website. There were listed various conditions in which a seat may or may not be provided, as well as a bundle of certificates that must be provided before the flight. I wrote to them “ dudes, you do not understand.I’m not dying, I just need a regular wheelchair from the check-in desk to take me to the plane, and then I’m myself, ”after which they confirmed to me that there would be such a chair. Also, being taught by the fact that Swiss and TAP are somehow not friends with each other, just in case, I asked Swiss support for a chair at the Geneva airport, too. The Swiss support answered me that “ and we see that our colleagues from TAP have already ordered for you,” and I relaxed. But, obviously, the synchronization between the companies still failed, so both at the Porto airport and at the Newark airport I was met not by one, but by two chairs.

Closer to the waste bins

Then everything was quite simple. In Geneva, I hobbled to the front desk on crutches and was checked in. During the registration process, the young lady asked a question that I did not pay much attention to: “ can I walk up the stairs? “. I honestly said that not very much. After that, she told me that I could get my seat (along with the accompanying person) in the “special assistance” department in half an hour. There was a waiting room where you could wait for a chair.There I showed my landing to a special registration aunt, and she immediately sat me down in a chair. After some time, a special man appeared who took my chair and took me to the plane. First, we went through the “for crew” security checkpoint, where the chair and me were contacted for dangerous items. There was no passport control as such, because the flight, in fact, is an internal one in Europe. Therefore, immediately after the security control, we went … to the airfield.

“ Wow ”, I thought, “ will he get me across the field to the plane now? “.

Everything turned out to be even more interesting. We drove up to a special truck that had a cab for transporting such “immovable” passengers. We got on the elevator platform and climbed into the back of the truck, sat down in the chairs in this cab and drove to the gate.

Real estate transportation

At the gate, the accompanying man took our passports and boarding passports with his son, and went inside the gate. There he apparently scanned us, returned and we drove further across the field, already to the plane.On the left side, a ladder was attached to the plane, so we approached the plane from the right side. The cockpit rose and “sucked” to a separate entrance on the right side, the escort knocked there, the door opened, and we were invited on board. It was very unusual to get on the plane this way.

Interior for the transport of real estate

The flight itself, although it was short, was accompanied by very unpleasant pains in the leg, and we must pay tribute to the Swiss staff, they helped to make this flight as comfortable as possible.The first two rows of the plane were allocated for “business class”, but there was only one passenger, and therefore, some time after takeoff, I was offered to transfer there. I was able to fully stretch my leg and put it on the seats, and this helped me a lot, since in the first days after the operation, the leg was very swollen. Too bad this flight was so short.

Swiss mimimi

When we arrived in Porto, after all the passengers had left, I was greeted by a burning man named Alberto, who happily sat me down in a chair and rolled through the terminal to the transfer point, occasionally patting me on the shoulder.We very quickly passed the border with him, and he drove us to the gate, where the next flight was supposed to be boarding. He left me in a chair and ran away on some important business, saying that when necessary, he would definitely return. Meanwhile, having flown in from Lisbon, my wife joined us.

After almost no additional control (which is usually present before American flights) and some incomprehensible delay in the beginning of landing by about 40 minutes, we were brought up the sleeve to the plane, and from there I was already digging to my seat 11A.It was that same extended legroom seat, the first row just behind the business class, with really increased legroom. Since I bought these places for all of us at the last moment, I had 11A , my son 11D , and my wife 11G , but after certain “spots” with replacing neighbors (a complicating factor was a young Hasid, whose dad was not against him somewhere and transplant, but an important condition was that a woman could not sit next to him), we were able to sit down so that my wife and I sat in places 11A and 11B , that is, next to each other.This, probably, helped me to survive on this flight.

Me and my friends

The problem was that this extended legroom was just a tiny bit lacking. That is, in a normal situation, with healthy legs, it would not be critical, but in a situation where I needed to keep my left leg as extended as possible, but at the same time so that it did not rest against the wall, I was missing a couple of inches. Therefore, I had to keep my leg slightly diagonally (putting a backpack and bags with pillows and blankets under it from below), but this was not enough for a comfortable sitting.It was then that the wife sitting next to me came in handy (she came in handy before, with support and all that), but in a situation with chairs and a lack of legroom, I especially appreciated the opportunity to change places with her and keep my foot diagonally under the other angle. These replacements plus the pain reliever helped me to survive the 7.5 hour flight (although if the plane flew not at 700 km / h, but 900 km / h, then the flight could also have been much shorter). To enhance the discomfort during the flight, you can also add the fact that the toilet closest to me broke down during the flight, and I had to waddle further, which, of course, did not make my life easier for me in my situation.

On arrival, we were also greeted with a seat, which could be accessed after all the passengers had left the plane. But we passed the border without queuing, because we were taken in a chair to a special counter with a border guard, reserved for crews and real estate like me. Then the accompanying man helped to find the luggage (thanks to the Swiss, who stuck “Priority” tickets on it back in Geneva) and took us to the exit. Then the family rushed to get a car from the parking lot, and I waited for them at the exit until they arrived and took me away.Getting in with a sore and stiff leg, even in a compartment with its long doors, turned out to be even more fun, but I was so close to home that I almost didn’t care.

In any case, during the flight, I did not regret at all that I had agreed with the airlines about wheelchairs in advance, which significantly helped speed up and facilitate travel around the airports, and still a little regretted that I had saved on the upgrade to business class in TAP. which could possibly reduce the amount of suffering on the flight.It is surprising that all these additional services with seats and deliveries to the plane cost nothing to the passenger. BUT! I want to say that although it is pleasant to go around the line at the border and go through it quickly, because “you are in the chair”, but when choosing “in a chair out of line” or “standing with a whole leg in the queue”, I would not hesitate to choose the latter …

Part 4 – 2 weeks
Today I went to the local orthopedist for another examination, where he announced a clearer timeline of the process:

• Until May 10 – crutches and no weight per leg
• Until the end of May – still crutches and gradual small loads on the leg.

From such injustice, my graphomaniac talent experienced another attack of hard work and demanded to write something else about the leg. And since I still sit at home most of the time (and, in fact, I will continue to sit until the end of May), then to sublimate me into texts is not to re-sublimate.

Do you know what is the hardest thing in this situation with the leg for me? Loss of mobility. Moreover, as a local one – even walking around the house on crutches is quite difficult for now; and “global” – the lack of the opportunity to get into the car and go on business or even just somewhere, wherever the eyes are, simply infuriates.Yes, the family happily (for now) takes me wherever it is necessary – to donate blood there, for x-rays or to a doctor, but it is precisely the inability to control my own movement, and the need to synchronize it with others terribly enrages.

In the first two weeks I was ready to give anything for the opportunity to sleep on my side; I usually like to sleep on my side, but here I had to sleep on my back all the time. Now that the leg has begun to heal, you can contrive and lie on your side for a while. Therefore, in the first place came this desire to sit down and just go somewhere, without any goal.Drive, squeeze the clutch and enjoy the road. But it seems that this will not shine for me yet.

PS this morning we went to donate blood. I took out my phone … I thought, and hid it back: since for me the opportunity to get out into the “outside world” is now not common, I decided to just enjoy the views around. And I got such pleasure from this seemingly trifle …

Part 5 – 3 weeks

In addition to the loss of mobility, with a broken leg you still lose a lot of independence (although, probably, the same loss of mobility can be classified as “independence” as well).But this is manifested in so many daily examples that I wanted to tell you separately.

No, fortunately, I can go to the toilet myself. It’s not as convenient as without crutches, of course, but you can get used to it. True, with a broken leg it turned out to be more convenient to do everything while sitting, because when you try to pee while standing, it turns into some kind of selective yoga: since you are standing on one leg, then all the muscles in the lower body are tense, but in fact, just certain muscles it would be nice to relax at this moment.

Washing-shaving-brushing teeth is also quite successful independently, but taking a shower already requires additional help. For this business, I bought a special stool that is placed in the bathroom, then I need to sit on this stool (which, as it turned out, is not so easy to do with one leg over the side in the bathroom), remove the corset from my leg, and then pull it on my leg special protective cover. I also bought this on Amazon, such a special “condom” for the leg, with a tight elastic band in the hole, it stretches to the middle of the thigh and closes the wound and dressing with high quality.Moreover, it is impossible to pull this “sock” on the heel by yourself, you have to attract outside help. Well, then, while sitting, you wash from the hose as it happens.

Speaking of leg pulling. Since the left leg does not bend well and because of the pain it is also impossible to bend over to it, pulling clothes on to your feet is also a quest. In principle, I somehow mastered the “throwing” a net on my leg, and then somehow pull it higher (talking about the fish), but with the left toe so far I have to ask for help.The same, by the way, applies to shoes on the left leg, it is very difficult to pull it on your own leg, although, it should be noted, now it at least fits: in the first week and a half, the leg was swollen and was almost as thick as a ski boot.

Food is a separate topic altogether. It would seem a trifle: take something from the refrigerator and put it in the microwave to heat it (there is no talk of cooking food yet). But, when your hands are busy with crutches, you can’t jump from the refrigerator to the microwave with a saucepan in your hands.Therefore, when someone is at home, I usually ask for help with food, and when I stay on my own, I have to get out. Unscrewing basically consists in using a trolley on wheels, where you put food from the refrigerator, then push it where necessary, there, for example, you put it on a plate, heat it in the microwave, then take it back, and then you have to take it back to the table on a trolley.

Sitting, by the way, is also quite difficult for now, and this applies not only while eating, but also, for example, work: it is very difficult to maintain a leg in one position for more than half an hour.You begin to shift it back and forth, but after another half an hour or an hour it finally gets tired and you crawl onto the sofa to lie down a little and relax. But you still have to work, so you drag your laptop with you. But you can’t carry it in your hands – crutches, so the same cart comes to the rescue as for food – you put a computer on it and push it in front of you to the place of bedding.
Not to mention such an important part of everyday life as combing the hair of cats. I used to put cats in the bathroom and scratch them there, now, because of my legs, I can’t do that.I entrusted this task to my son, but it seems to me that neither he nor the cats have the patience for such a thorough process, as I had, so the wool at home has become even more, and I blame myself for this too.
But not by single losses, of course. I feel that the vestibular apparatus, with the need to often balance on one leg, has been pumped very well. Perhaps this will help avoid other falls in the future.

Part 6 – 4 weeks
Last week the doctor removed the second batch of braces from the incision (I promise, this time without a photo!) And we can say that the most boring period of recovery of a broken knee has begun.The pain, as before, seems to be almost nonexistent, except for some particularly careless movements with a turn of the leg, but it is still impossible to transfer weight to the leg, so you have to move only on crutches (and so on for a month and a half, until the end of May ). In general, I have learned to overcome some distances on crutches, although it does not bring me pleasure. But sitting at home is also not fun, the awl in the priest affects:

I also took off the bandages and bandages from my leg, now in the mornings and evenings this is a good reason to look at the scar and groan, feeling sorry for myself and my leg.I can’t wait for the warming so that you can walk in shorts and scare others with a scar.

The most unpleasant part is the loss of flexibility in the knee and muscle atrophy in the leg. Therefore, for the next many weeks, physical therapy is shining for me, with the development of the joint and the restoration of muscles. (Although, of course, with the mechanics in the car, I have to regain some of the muscles quickly enough when I can drive. You can even go to New York on Friday to speed up the process and knock about in traffic).

I do all sorts of exercises for contraction and stretching of muscles, it is not painful and not difficult, but with the knee it is worse, bending the leg causes quite painful sensations.To simplify the process, the doctor gave me a special device, which I call an “exoskeleton”: you insert your leg there, and the device tries to bend it at the specified speed to the specified angle. Formally, the thing is called OptiFlex-K1 Knee CPM, where CPM stands for Continuous Passive Motion.

In short, about once every 25-30 seconds, this thing bends the leg, and then unbends; you can specify the starting angle and the angle to which to bend. (Here you can watch an almost entertaining video on how it works).I started from 55 degrees, now I have brought it to 73. My wife jokes that by the end of the warm-up I will be able to participate as a dancer in River Dance:

Well, the muscles are weakened, you can feel it in simple tasks such as rearranging a leg, for example. Also, I am still afraid to walk up stairs with crutches. I seem to have learned to climb upward more or less without losing my balance, but going down still scares me, since the loss of balance is fraught with a fall on the injured leg, and I would like to avoid this. And at night, even under crutches, cats love to get confused, they have long passed the phase of fear of these sticks and they love to rub against them.

Since I almost stopped using the leg brace and started developing leg flexion, the big progress for me is that I can now fit with my leg in the front seat of the car. I think another week of recovery and it will be possible to try to steer on an automatic transmission – I really miss the ability to drive myself.

But the global conclusion is still the same: to be able to walk is good, to break legs is bad. Take care of your feet and more!

Part 7 – 5 weeks
As I wrote last time, the most boring period of leg recovery has begun, when nothing much happens except for the gradual restoration of leg function.Recovery consists of the exercises that I do, plus the passive flexion of the leg on a typewriter, which I also wrote about last time. There is some progress there: if I started with a 55-degree knee bend, now I have already brought it to 93 degrees. By the next visit to the doctor (April 27), I expect to bend my knee at least 270 degrees Fahrenheit.

I no longer use the corset, but I still cannot step on my foot and it will be impossible for a long time. The leg is still swollen in both the knee and the foot, but I read on the Internet that this is normal and with such injuries the swelling can last from three to six months (FML!).But by improving the bendability of the leg, I have already mastered the independent pulling of socks and shoes, which is good news.

But the most important breakthrough for me happened yesterday, when I was finally able to fit behind the wheel of a car and drive from the store to the house (10 kilometers). I felt like some kind of drive addict, I got such pleasure from the process. In fact, such a charge of pleasure passed through the body that it reminded me of the sensations from the injection of morphine, which I was given in the emergency room, only without the unpleasant “blow” of the injection.Climbing into the driver’s seat still requires a little patience, because the leg must be bent more than it allows without unpleasant sensations, but when you are already sitting behind the wheel, everything is very comfortable and, in general, the thrill of driving. Yes, so far only a machine gun, the mechanics still have to suffer, but it’s still great. 4.5 weeks of abstinence without a rudder – it was very difficult for me. Well, and a separate bonus is the return of at least a partial independent “mobility”.

Yesterday we still went to visit, and since yesterday we had a sudden heat (+ 30C), we had to put on shorts.It turned out that the scar was already in a fairly decent condition and none of those present fainted from the sight of it. The holes around the scar are, of course, funny, but the incision itself heals perfectly, thanks to the doctors. I hate crutches anyway, but there is still no way to get away from them. But until May 10, as an intermediate deadline, there is already relatively little left, and there it will definitely get even better, which is what I wish for you!

Part 8 – 6 weeks
Basically, when I was discharged from the hospital, they said that there was no weight on my leg for 6 weeks, so I could already slowly start to step on my foot.But my local orthopedist believes that you need to play it safe, and therefore insists that you need to additionally save your leg from weight for another two weeks. Well, okay, he, of course, knows better.

But I got bored and exported Health data from iPhone. After some manipulation of the data in Excel, it turned out to count about 87.5 thousand steps and 40 miles of distance traveled since March 15. I don’t know how correct a watch with a phone is in general counting steps-distance when you move on crutches, but for a one-legged (or three-legged?) Not a bad result, given that I don’t like to walk at all.

two observations: 1. it is interesting that skiing is somehow converted into steps, and 2. I don’t understand where 300 steps on the day of the operation (March 15) came from.

After reaching an angle of 105º on a knee-flexing machine, I realized that passive flexion was not enough for me anymore, and I needed to switch to active (muscles from passive flexion are not worked out at the required level). So I scored on a typewriter and just every day I try to bend my leg as much as I can (well, I do other exercises too), so in general, the leg is gradually being developed.At least for me, the progress is noticeable in that now, in order to climb into the driver’s seat, I do not need to move it completely back.

By the way, about the driver’s seats. Yesterday, for the first time in a long time, I climbed to sit in the Camaro. Climbed (it turned out to be easier than in Makan), started the car, sighed at the sound of a normal engine. I tried my left foot for the grip, but realized that it was too early: the grip is very tight, to squeeze it out, the foot movement is not enough, you need to move your whole leg and apply a solid effort for this.And this means weight on the leg, well, plus this requires the rectus femoris muscle, and it seems to have atrophied the most in the left leg. So you need to wait another two weeks for the doctor’s signal, and in general, consult with him how much you can / need to rush with such a foot movement, and then start developing the muscle back.
On the good news – the insurance company from which I bought travel insurance has finally blown up. They immediately said – “a month to consider an application for an insured event,” and I submitted the papers on March 24th.Today a letter came from them that they did not receive part of the bills that I poured into the system, but at least the most important bill – for hospital stay and surgery – they received and approved its payment, so this amount is sent check me. For the rest of the positions, they asked me to send them invoices, which I did, so we’ll see.
In short, it all fits together a little bit. I want it to be faster, but this is not really my case, so in addition to the muscles of my left leg, I develop patience, this is also a useful quality.

Part 9 – 10.5 weeks
Hooray, finally real progress! Approximately 2.5 weeks ago, the doctor allowed to transfer partial weight to the leg, and yesterday, after looking at a fresh X-ray, he said that it is possible to start transferring the full weight to the leg. True, so far I’m still with crutches, on the sly, but it’s 3-4 days until I get used to it. Then you can switch to a cane instead of crutches, and in a week you can even try to walk at home without a cane! I wanted, of course, on this occasion to buy some kind of cane, where there is more gold and with some kind of snake’s head, but nevertheless common sense won out.

So in 3–4 weeks, it may be possible to completely get rid of the walking aids. Even carrying a lot of weight on the leg is still scary, not to mention walking without crutches – in 10 weeks the body has completely forgotten how to do this. Yes, and purely psychologically, it is simply scary to step on the foot, because it seems to heal, but “what if what moves?”. So you need to change something in your head first.
But this is only part of the progress.Also, the doctor finally allowed me to ride a mechanical box. So far, I have recommended a little bit, to avoid sudden acceleration and deceleration, to avoid the highway and rush hour, but generally allowed! Soon, soon I will be fully enjoying my V8 again!

And I also went to rehabilitation therapy, this week I have already been twice. The therapy includes a whole bunch of different exercises, mainly with your own leg weight, but there are a couple of slightly more difficult ones. There was also a whole 5 minutes of the bike, during which I understood well where I still lack flexibility in my leg.Well, one of the exercises is electrical muscle stimulation with electric current to accelerate recovery. However, I am not complaining, because I really want to recover as soon as possible and start walking normally. And in July I’ll start, perhaps, a swimming pool.

In short, definitely good news, which is what I wish for you!

Part 10 – 11.5 weeks
On Monday I started walking with a cane. I was looking forward to this moment, thinking about how I would throw off my crutches and flutter freely, waving my cane … but it didn’t work, it turned out to be much more difficult than I expected, and not even in the place where I expected.

First, the leg was not physically ready for such loads; It’s one thing to jump on crutches, moving my legs and even thinking that I transfer most of the weight to my leg, and quite another, when there are no crutches – the leg is not yet ready for such loads. Secondly, the psychological moment turned out to be even stronger than the physical one: the fear of transferring weight to the leg, as it happens during normal walking, turned out to be very strong: “What if something can’t stand there? Well, you never know. ” And thirdly, the most painful thing when walking was in the ankle.Not only did she do nothing for 11 weeks and did not experience any stress, she also does not really bend the knee when walking, and the load on the ankle increases significantly. Well, in general, when walking with a stick, I feel some kind of unnatural distortion, and I’m sure this only increases the pain in the ankle.

On the first day it really upset me: I thought how fun I would ride on three limbs instead of four. (Well, it hurt like hell.) But since I am very motivated to start walking normally as soon as possible, I force myself, overcoming the pain, to continue walking and, if possible, correctly rearrange my left leg when walking.This seems to help, as yesterday I was able to walk much more and with less pain than before. Plus, during physiotherapy, they knead my muscles with electric current and align the joint (by pressing on it, it’s also quite painful), so it gets better a little.
It’s funny that no matter how the ankle hurts while walking, this does not affect the sensations when driving mechanics. The quadriceps in the leg revived a little and this, apparently, is enough to squeeze out the grip without pain.However, getting in and out of the car with a cane, all the time I feel like Biff from Back to the Future 2, where he was walking with a cane, and then, getting out of DeLorean, he lost the knob from the cane:

In general, traditionally: take care of your feet and not only your feet! Head too!

Part 11 – 13 weeks
Today “turns” 3 months (or 13 weeks) since the day I broke my leg while skiing. Well, but I finally went!

It seems quite recently only I finally threw off my hooves crutches and switched to a cane, but less than a week later I realized that walking without it is even more comfortable for me than with it.Yes, I limp thoroughly, from time to time something crunches in my knee, I walk much slower than I walked before (or, for example, I walked on crutches), there are still a lot of painful sensations in my ankle, but I can already walk on my own, without aids … It is very difficult to describe how much delight this causes: when your hands are finally freed and you can do something with them, instead of, for example, holding onto crutches, it’s just a thrill. It would seem that such a completely simple and inconspicuous little thing, but it radically changes the quality of life for you.

I continue to do physical therapy – all kinds of exercises aimed at returning to normal “range of motion”, that is, the maximum indicators of flexion and extension of the leg. So far, there is still room to improve these indicators, but riding a stationary bike almost does not cause pain. The most interesting thing about physiotherapy is “torture with electricity”, that is, electrotherapy of muscles, and the most painful thing is “alignment” of the leg, when the physiotherapist presses on the leg from above, trying to give it an angle as close to 180º as possible.At first I asked them what kind of exercise it was, in which they again tried to break my leg, but then I got used to it. And I also uncovered the bicycle that was stored in the garage and began to wind a little circles around the house: in general, I do not like a bicycle, but now the circumstances are such that I have to. It’s funny that I found that with a broken (or, more precisely, healing after a fracture) leg, I often walk more per day than I walked before the fracture, and even stand-goal per day in Apple Watch I do much more often.

And it turns out to drive the car quite well. The quadriceps femoris has already recovered enough that even the tight Camaro clutch pedal can be squeezed out without problems, so that “car mobility” is almost completely restored. “Almost” – because in order to get in and out of the car you still sometimes have to grunt, especially if the long door cannot be fully opened in the parking lot or garage, but you can already drive without any discomfort.

As soon as I “moved” my legs, I immediately wanted adventure and even go skiing! Although I understand perfectly well that this will not shine for me for several years: first, everything needs to heal well (one and a half to two years), and then, if I am really going to ski again, I will still have to remove the plate and pins, and again wait until everything heals there (although the recovery after the removal is, as the doctor says, much faster and not as painful as after the fracture).Therefore, for now, there will be adventures of a different plan. Since I wrote that I already feel confident with the clutch, I signed up for the track day in July, since I no longer have the strength to hold on. Pocono Raceway, here I come!

I think that with this post it will be possible to close the topic of regular updates of the “diary of a broken leg”, because it is unlikely that something interesting will happen in the near future. Rather, it is simply a gradual improvement in walking quality, along with a “straightening out” of the leg.Thank you for reading my whining and complaints, I hope I convinced you with their help that you need to take care of your feet (and not just your feet).

Part 12, aka A Year Later, aka Epilogue
So, if you’ve read this far, then, first of all, you’re a great fellow! (However, if you’ve read all this before, and just scrolled the article to this point, then you are great too).
Those who regularly read my blog know about my kidney story, when I first had my kidneys removed and then had a kidney transplant from a donor.This story greatly affected the leg, both before and after the fracture. Firstly, if it were not for my diseased kidneys, then, most likely, the leg would not have broken, but there is no need to regret it now (although the nephrologist hinted before the ski trip that you need to be careful with the bones). And secondly, because of the operations in September and October, and the recovery period after them, I was generally not up to the leg and its recovery, so now, a year later, I can say that the leg has not fully recovered. In terms of regaining muscle strength, I would say that recovery was somewhere around 90 percent, and ellipsoid and bicycle exercises are actively helping me in this recovery.

The situation is worse with flexibility. If the broken leg is similar to the right leg in extension, but in flexion, I would say, recovery has occurred by 80 percent. This is expressed in the inability to fully bend the leg 180 degrees (for example, so that, sitting on the mat, the thigh touches the lower leg). More precisely, now I almost can, but so far it is very painful. When I started developing the flexibility of this joint a month and a half ago, there was an angle of 45 degrees between the lower leg and thigh, so there is definitely progress, I just try to do it without unnecessary haste.Now it’s almost possible to sit on bent legs, so I’m pleased with the progress. Feels like, as I understand it, the main problem is in the tendon of the quadriceps muscle and the patellar ligament, which have stagnated a little during the period of inactivity. Nothing, we can handle them!

I still don’t dare to run, and, by the way, I don’t want to, but I am very good at walking. True, in the knee sometimes while walking there is a crackling-crunching sound, but I hope that as the flexibility improves and the load on the muscles increases, this will go away.I continue to load the muscles on the ellipsoid and (when the weather permits) on the bike. Suddenly I really liked the bike, so I plan to actively pump this skill when the normal spring finally arrives.

Sometimes the place where the plate is installed aches, and I wonder if I ever want to get rid of it. In any case, I am not in a hurry with this question yet, because I do not want to return to the hospital in the near future, operations, recovery, that’s all. Plus, some of the medications I take after kidney transplant have a side effect like weakening of the bones, so it may be for the best if the plate remains.Although I hope that perhaps medicine has a way to check the condition of the bones without drilling, for example, a sample from it, and this can be found out without unnecessary intervention. And even then I will think about it (although I will not hide it, I would have gone skiing already!)

You can’t scare people with a scar, if you dissect them in shorts – the scar is quite well tightened up and is almost invisible under the layer of vegetation. This, by the way, gives me hope that the scars from abdominal operations will also heal well and will be less noticeable.

This is such a leg (the original photo from March was lost, so I had to remove a new one in November 2018)

Summing up … But what is there to summarize? Breaking your legs is bad, recovering them after that is not easy, but if you treat it as a temporary difficulty and an adventure, it helps to cope with difficulties. In addition to optimism, family and friends help us to cope with difficulties, for which I am very grateful to them. Take care of yourself!

90,000 If an elderly person has a hip fracture

Answers to the most common questions that arise from relatives are given by the traumatologist of the hospital No. 17 in Solntsevo Sergey Viktorovich Novikov.

How is hip fracture treated?

The patient should be taken to the traumatology department as soon as possible, where he should undergo an operation to replace the broken joint with an artificial one as soon as possible. Today, endoprosthetics surgeries for patients with a hip fracture are carried out free of charge under the compulsory medical insurance policy in the capital’s hospitals, including in our hospital.

The oldest patient I have seen after endoprosthetics was about 90 years old.The joints differ in the principle of planting – it can be cement (more often in the elderly) or cementless. Rehabilitation after surgery is the same in both situations.

What kind of pain relief is given to the patient during the operation? How long does the surgery take? How big is the suture left after surgery?

The operation is performed under spinal epidural anesthesia. A needle is punctured into the spinal space at the level of the lower thoracic or upper lumbar vertebrae and a catheter is inserted.It is fixed on the patient’s back and shoulder. During the operation, the patient receives anesthetic through the catheter. The operation takes an hour and a half. All this time, the patient lies on a healthy side. The incision required for endoprosthetics is only 10-12 cm, after the operation it is sutured with a cosmetic suture.

What is the most important thing in caring for a hip replacement patient?

It is important to follow safety precautions for 90 days after the operation so that your patient does not dislocate the operated joint.There is a rule of 90 degrees: such movements with the leg are prohibited, in which the angle between the body and the hip is less than a straight line. A person can lie in bed both on his back and on his healthy side, but in order not to dislocate the joint, a roller must be placed between the legs. Use a large, thick pillow to keep your legs from closing. The ward can sit with the leg extended forward, because in this case the angle is greater than 90 degrees. It is also necessary to limit turns with the operated leg inward or outward.Look at the foot, imagine that it is inscribed on the dial. When the toes are at the top, the foot is looking at 12 o’clock. So, you cannot translate it to 3 o’clock and 9, that is, rotation of the femur must be avoided. After 90 days, these movements will be possible and completely safe.

On what day after the operation is it time for the patient to learn to walk?

The patient is put in bed on the first day after the operation, and the patient is raised and put on his feet with support on a walker – on the second. This recommendation is respected regardless of age, which can be quite respectable.The sooner the patient gets to his feet, the less likely he is to get pressure sores and pneumonia. How fast to activate leg work and increase the range of motion in the operated joint should be suggested by the doctor. The usual recommendation is to walk for 2 months with a walker or with canadian crutches, which provide support under the elbows and do not rub the armpits. Then you can try walking with a cane.

How to help the operated patient to cope with pain, swelling, hematoma?

Pain is relieved by drugs prescribed by a doctor.

Immediately after the operation, ice, wrapped in a towel and applied to the joint site, helps. Recently, special adhesive tape dressings – tapes – are often used. They not only play the role of a fixing and compression bandage, but also activate blood and lymph flow at the site of attachment. Massage will help with edema. You can do it yourself – with smooth painless movements from the toes towards the center of the ward’s body, as if driving the swelling up.

How to avoid blood clots in blood vessels?

Usually, the patient is prescribed drugs that prevent the formation of blood clots – anticoagulants in tablets for a month after the operation.It is not necessary to control blood clotting by special studies. You must wear type 2 compression garments or bandage your legs (both sick and healthy) with elastic bandages for 2 months after the operation. It is supposed to put on underwear or bandage your legs in the morning. The ward cannot cope without your help, otherwise he will have to break the 90-degree rule. At first, the patient even sleeps in compression underwear. You can refuse it later. If swelling forms on the leg, it becomes cold, a violation of the blood supply can be suspected.We urgently need to show the patient to the doctor.

The ward cannot put on socks by himself or lift an object from the floor. How can these problems be resolved?

A special sock wearer can be purchased at the pharmacy or ordered online. This is such a plastic cone, a sock is pulled over it. The ward throws the cone (ropes are attached to it) on the floor, puts his foot into the cone – and immediately puts on a sock. Shoes should not be with laces, but with Velcro, zippers. There is a simple trick to pick up objects from the floor while sitting.Sit on a chair or stool so that the sore joint hangs down, and, bending over, take the sore leg back. In this case, the angle in the hip joint remains correct, and the hand reaches the object. But older people are better off exercising in your presence.

What should be changed in the apartment after the operation?

Raise the bed, because it is contraindicated for the ward to sit down and lie down on a low bed. You don’t have to buy new furniture.
It is enough to put bricks or tomes of encyclopedias under the legs of the bed.Or buy an extra thick mattress for your bed. A special plastic nozzle is installed on the toilet, which can be found at the pharmacy or on the Internet. It raises the seat level by 7 cm. It comes with 3 types of attachments, so the nozzle will fit any type of toilet. It is easy to move the patient into the bathtub using a special seat or an ordinary board placed on the sides, which will allow the ward not to move the injured leg inadmissible to him. Or you can just put the ward on the edge of the bathtub and help him to throw the first healthy, and then the operated leg, making sure that the person bends back a little and does not break the 90-degree rule.The bathtub must have a rubber anti-slip mat and handrail.

How to transport a patient?

It is not necessary to call an ambulance or order a special transport. The operated person can be transported in an ordinary car. Put the ward on the front passenger seat of the car, having previously reclined the seat deep enough.

What mistakes are made when caring for a operated patient?

Give more independence in movements to the ward, even if he is a very elderly person.It is clear that the relatives are afraid that the operated person will fall down again. To prevent this from happening again, examine the ward. The loss of balance was probably due to dizziness caused by high blood pressure, an irregular heart rhythm, and a problem with the cerebellum. The doctor will prescribe the right drugs and the risk of falling will be reduced. By the way, according to medical statistics, after 55 years, ordinary healthy people fall 3 times a year.
You probably need to develop a safety strategy for your charge.You can follow the example of older Europeans with joint problems. They move along the streets with walkers and rollators (three- or four-wheeled trolleys with a locking brake). And the risk of a new fall is reduced many times over.

–
Svetlana Chechilova

90,000 symptoms, signs, treatment, how much heals and whether plaster cast is worn

Fractures of the toes are a pathological condition in which there is a violation of the integrity of the bone tissue. Because of the similarity of clinical manifestations, fractures are often difficult to distinguish from bruises.This violation requires complex treatment.

Without targeted therapy and further rehabilitation, the likelihood of severe complications in the future is high. Often, fractures of the bones and joints of the toes cause the development of arthrosis and other degenerative-dystrophic diseases, which can adversely affect the ability to lead a full-fledged lifestyle.

Main causes of fracture

If a person breaks the bones of the toes, the most likely cause is a blow or other mechanical impact.The degree of damage to the bones of the leg in most cases depends on the intensity of the effect on the tissues. Less often, the cause of the problem lies in the twisting of the finger. It is extremely rare that a bone fracture is the result of its damage by a pathological process that weakens the structure of tissues and predisposes to further disruption of integrity. Such factors contributing to the appearance of a fracture of the bones of the feet include:

• infection of tissues with mycobacterium tuberculosis;
• osteoporosis;
• immunodeficiency;
• hyperparathyroidism;
• hereditary bone pathologies;
• osteomyelitis.

It is extremely rare that a finger fracture is the result of bone tissue damage by metastasis that occurs during the growth of a malignant tumor.

Injury classification

There are many parameters by which the marginal fracture of the phalanges of the fingers is classified.

Open

An open fracture in almost 100% of cases is the result of traumatic tissue damage. With an open fracture in the area of ​​the broken finger, there is a pronounced violation of the integrity of the skin, muscle layers and ligamentous apparatus.

Closed fracture

With a closed fracture of the toes, there are no pronounced signs of a violation of the integrity of the skin and other soft tissues. Moreover, this form of pathology is always accompanied by pronounced edema and the formation of a severe hematoma.

Offset

This form of pathology is the most dangerous. In this case, the structure of the fractured toe is displaced from its correct anatomical location.Such fractures by the type of displacement of bone elements can be characterized by:

• longitudinal engagement of the fractured bone element;
• longitudinal separation of debris;
• wedging;
• lateral shift;
• angular offset.

In this case, bone fragments can dig into the surrounding soft tissue. Often, this form of pathology is open, since areas of broken bone violate the integrity of muscles, ligaments and skin.With displaced fractures, there is a likelihood of developing severe complications, including osteomyelitis, i.e., bone infection, as well as fatty thromboembolism.

No offset

Fractures without displacement are much more common and have a more favorable course. With such injuries, the bone elements are not displaced from their correct anatomical place. Broken bones heal quickly. In addition, such injuries are rarely accompanied by the appearance of a complication.

Complete and incomplete

Complete fractures are accompanied by a complete violation of the integrity of the bone structure.Often such damage is characterized by displacement. With incomplete fractures in the bone tissue, cracks and fractures are revealed, but at the same time some integrity of the element is still preserved.

Simple

With a simple injury, the bone is broken only in one place. This is the most common toe fracture.

Difficult

In a complex type of fracture, there is a violation of the integrity of the bone in several places at once. Such damage to the bone elements that form the feet is extremely rare.

Intra-articular fracture of the finger

Intra-articular fracture of the finger is quite common. Similar damage occurs when a limb hits a hard surface. An intra-articular fracture is characterized by a violation of the integrity of the cartilaginous elements and surrounding soft tissues.

Types of damage

A defect such as a fracture can affect any bone in the phalanges of the fingers. However, some bones are affected more often than others.This is due to the peculiarities of their structure and size.

1 phalanx

The most common fracture of the main phalanx of the thumb. This is due to the fact that this bone has the entire load in blunt injuries. Less commonly, damage to the distal phalanx is observed. Such a violation is often associated with damage to the nail plate.

2

The defeat of the second toe is most often observed in patients in whom it is longer than the thumb. This leads to the fact that the load during the injury falls on this finger.In this case, damage to both the proximal and distal phalanx of the finger is possible.

3

The defeat of the proximal and distal phalanges, as well as the joint of the middle finger, is quite rare.

Most often, such damage occurs against the background of twisting the finger.

4

Fracture of the fourth, i.e. ring toe, often accompanied by deformation of the proximal phalanx and joints adjacent to this element.

5

In most cases, damage to the little finger occurs in the joint area between the middle and proximal phalanges. This place is most often injured by twisting a finger or mechanical stress.

Signs and symptoms of broken fingers

Fractures of the toes are considered painful and are accompanied by a number of characteristic manifestations. With such damage, it is difficult for the patient to step on the leg, since this action is accompanied by an increase in the pain syndrome.With some fractures, the victim can walk without deterioration, resting only on the heel.

Thus, the first signs of injury are much the same as with bruising. A leg with a closed fracture looks normal at first, and only severe pain syndrome indicates tissue damage. With an open fracture, fragments may stick out of the resulting wound.

In the future, the appearance of soft tissue edema is observed. The affected toe may become very enlarged.In addition, often when the integrity of small blood vessels is violated, a pronounced hematoma appears. The presence of damage is also indicated by an incorrect position of the finger in relation to others. Symptoms of a fracture usually worsen over several days.

First aid to the victim

What to do at home before taking the victim to the emergency room if there are signs of a fracture depends on the nature of the injury. First, it is worth examining the surface of the finger; if soft tissue ruptures are detected, be sure to rinse the wound surface with cool water and treat it with an antiseptic.If there is severe bleeding, a tourniquet may be needed to stop it. After this, the patient should be seated so that the injured limb is on a hill.

Considering that the injured person develops severe pain syndrome against the background of the trauma, it is advisable to give an anesthetic pill. If possible, an injection of an analgesic should be given, because this will reduce the discomfort faster.

If there is a suspicion that a displaced fracture has occurred, immobilization of the limb must be performed.To immobilize your finger, wrap the cloth around a pencil, ruler, or other suitable object. It is applied to the affected area and bandaged. If there is no suitable object for immobilization, it is allowed to bandage the injured finger to the adjacent healthy one. You cannot try to set your finger on your own.

To prevent the appearance of pronounced edema and hematoma, it is recommended to apply a cold compress to the injured area. Ice compresses should be applied for no more than 8-10 minutes, and then removed for 3-5 minutes.This will reduce the risk of frostbite.

It is best to wait for the ambulance doctors to ensure the most careful transportation of the victim to the medical facility. In case of urgent need, including if the injury was received in nature, it is recommended to independently deliver the victim to the emergency room.

Diagnostic methods

When the patient is admitted to the hospital, local or intra-articular anesthesia with Procaine is immediately performed.If necessary, procedures are performed to stop bleeding and disinfect the wound. After that, the traumatologist can start diagnosing the existing violation of the bone structure.

In most cases, light palpation and testing of limb joint mobility is performed first. After that, an X-ray is necessarily assigned. This is an extremely informative method for diagnosing fractures. The images show any changes in the integrity of the bone and the location of the existing debris.After that, treatment of the existing fracture can be prescribed.

Treatment

Fractures of fingers in most cases heal quickly if measures are taken to facilitate this process. A medical complex aimed at restoring a damaged bone element or joint is selected taking into account the nature of the existing fracture. Closed or open reduction can be shown. In addition, immobilization or a skeletal traction procedure is often required. To eliminate pain in the first days, it is recommended to take drugs belonging to the group of analgesics.

Non-steroidal anti-inflammatory drugs may be prescribed. They allow not only to reduce pain, but also to relieve inflammation and swelling of soft tissues. For displaced fractures, patients are often given injections of pain relievers. To accelerate the process of bone tissue fusion, calcium preparations, multivitamins and probiotics can be introduced into the drug treatment regimen.

To reduce the edema, the victim is advised to keep the leg in an elevated position.In case of emergency, diuretics are prescribed. Applying an ice pack can be of great benefit. In most cases, a plaster cast is applied or a retaining splint is put on.

The patient can move independently, but do not lean on his fingers. For fractures without displacement, a fixing tight bandage can be applied. After the severity of the swelling has subsided, a splint or bandage may begin to dangle after a few days. In this case, a repeated tight bandage is carried out over the old bandage.After the splinters have spliced, the patient needs rehabilitation.

Closed reduction

In the presence of a closed fracture, accompanied by displacement of fragments of the affected bone element, a closed single-chamber reduction is prescribed. This procedure is performed under local anesthesia.

After the analgesic effect is achieved, the doctor begins to slowly stretch the injured finger, returning the existing fragments to their correct anatomical place.After this, joint mobility is assessed. If the result is satisfactory, limb immobilization is performed.

Open

The open reduction procedure is a radical surgical intervention. This procedure is prescribed for multi-splintered and open fractures, as well as in the presence of complications that have arisen during therapy with other methods. Open reduction involves making an incision to gain access to the bone.

During visual inspection, a reliable fixation of the existing debris is carried out.Often, metal structures are used for this, incl. medical screws, knitting needles, wires and plates. After such an intervention, immobilization of the limb is carried out by means of a splint. The immobilization period is 4 to 8 weeks.

Skeletal traction

In some cases, if it is impossible to perform closed reduction, a broken finger should be treated using a skeletal traction procedure. This procedure involves performing manipulations aimed at pulling and supporting the final debris.Such manipulations prevent the separation of the broken bone sections.

The procedure is performed under local anesthesia. Skeletal traction involves the introduction of a special medical pin or nylon thread through the skin and nail of the phalanx, the ends of which are tied to form a ring.

In the future, a hook is attached to the plaster, on which the ring is put on in the position necessary for skeletal traction. After that, the patient needs to wear a cast for 2-3 weeks.At the same time, the existing punctures are processed daily with antiseptic solutions. After the end of this period, the pin or nylon thread is removed, and the finger is immobilized for another 2 weeks.

Do you always need to apply and how much to wear plaster?

The fracture heals faster in the plaster, since the device provides a greater degree of immobilization, however, splints, polymer materials, etc. can be used to fix the injured toe. With minor cracks in the bone, plaster may not be applied.

The use of plaster or other means for immobilization is justified until the damaged bone heals. How long the fracture heals depends on the individual characteristics and age of the patient. In children, complete fusion is often observed after 1.5-2 weeks. At the same time, in elderly patients, it often takes up to 3-4 weeks to restore the integrity of the bone. For open fractures, healing may take 5-6 weeks.

The use of folk remedies

To quickly heal a fracture, folk remedies can only be used as an auxiliary therapy and during the rehabilitation period.There are many good recipes that can promote tissue healing, elimination of puffiness and other manifestations.

To eliminate the inflammatory process and reduce the severity of pain, you can take a decoction based on herbal collection, including in equal proportions valerian, St. John’s wort and chamomile. To prepare a healing agent, you need about 1 tbsp. l. collection, pour 1 cup boiling water. The product needs to be boiled for 2-5 minutes, and then insisted for 20 minutes.The finished composition should be filtered and drunk throughout the day, divided into 3 doses.

To compensate for the lack of calcium, the intake of eggshell powder can be recommended. First, the shell must be dried, and then thoroughly crushed to a powder state. This powder should be added to food ½ tsp. 3 times a day.

Horsetail infusion can be used to eliminate edema. To prepare this product, you need to mix about 1 tbsp. l. chopped plant with 1 cup boiling water.It is necessary to infuse the product for 30 minutes, and then strain it. The finished infusion should be divided into 3 doses and drunk throughout the day.

After the fracture has healed, it is recommended to soar your feet in water with the addition of herbal decoctions and sea salt. It is advisable to perform such procedures daily.

Rehabilitation period

The affected bone can heal for several weeks, but after removal of the plaster, a rehabilitation course is required to restore the affected elements and the mobility of the foot.This will reduce the risk of delayed fracture effects. The recovery period after a fracture is 2 to 4 weeks, depending on the severity of the injury. Rehabilitation includes physiotherapy and massage.

Physiotherapy

Various physiotherapeutic procedures are used to improve soft tissue trophism and prevent future complications. Most often, UHF is prescribed during rehabilitation. These procedures involve exposure to ultra-high waves to warm up the damaged area.The procedure helps to accelerate regeneration and metabolic processes. In addition, such an effect helps to reduce the sensitivity of nerve fibers and relax muscles.

Ozokerite or hot salt applications may be recommended. Such procedures contribute to uniform heating of tissues and the normalization of local blood circulation. Calcium electrophoresis procedures are often recommended for patients with a fracture associated with osteoporosis. This effect helps to strengthen bone tissue.

Massage

The massage course allows you to speed up tissue recovery after fracture. You need to massage the limb, starting from the fingers and gradually moving to the ankle. It is imperative to massage the ankle muscles. This will improve blood circulation and promote the start of regeneration processes. When performing the massage, you need to ensure that the movements are light enough and do not cause pain or discomfort.

Remedial gymnastics

Therapeutic gymnastics should be aimed at developing the joints of the toes and restoring the elasticity of muscles and ligaments.First, all exercises should be performed under the supervision of an exercise therapy instructor. In the future, the patient can perform a complex of therapeutic exercises at home.

An exercise that involves picking up small objects with your fingers from the floor gives a good effect. It is recommended to perform this exercise for about 15-30 minutes, after which it is imperative to take a break. In addition, clenching and unclenching of the fingers may be recommended.

In a standing position, you must raise and lower your fingers.This exercise should be done 15-20 times in 1 approach. In the future, you can perform an exercise involving standing on tiptoes and returning to the starting position, on the entire surface of the foot. During this exercise, you can hold onto the back of the chair to maintain balance.

The instructor of exercise therapy can also recommend other exercises that allow you to develop the foot after prolonged immobilization during fracture treatment. It is advisable to perform a set of gymnastic exercises for at least 6 months.This will reduce the risk of arthrosis and other long-term effects of trauma.

Preventive measures

To reduce the risk of fracture, every precaution must be taken to avoid injury. It is advisable to wear comfortable shoes to avoid falling or twisting the foot. It is necessary to adhere to the rules of a healthy diet and take a multivitamin containing calcium. This will saturate the bones with the necessary connections, making them stronger.

Exercises to strengthen ligaments and muscles should be done regularly. This will reduce the risk of critical bone damage in the event of traumatic injury. As part of the prevention of fractures, it is necessary to promptly treat any pathologies that can cause weakening of bone tissue.

90,000 What to do with broken toes?

When should I see a doctor for broken toes?

An emergency room should be contacted if there are any of the following symptoms of a broken toe

• Any sign of a possible open fracture that includes open wounds, bleeding, or drainage near the broken leg
• Cold, numbness, tingling, or unusual sensations in the toes;
• Blue or gray skin surrounding the injury.
• Typical crunching (crepitus) when the affected area is compressed

Call your doctor if you have any of the following

• If the condition of the broken finger worsens or new pain persists with pain relievers
• Wounds, redness or open wounds on affected legs
• The ankle or lower leg is damaged or broken.

What should be the treatment for a broken toe?

Home care for a broken finger.A broken toe can be treated at home (provided there is no need to see a doctor or go to the emergency room for treatment). You can do the following to help reduce pain and swelling after a broken leg and help fractures heal faster.

Rest. Avoid strenuous exercise, long standing or walking. Crutches may be necessary, or you will need to wear special shoes when walking so as not to strain your leg and not put excess weight on it at the site of the fracture while it heals.

Ice compresses. Place ice in a plastic bag and apply it to the injury for 15-20 minutes every 1-2 hours for the first 1-2 days. Place a towel between your body and ice to protect your skin. Frozen peas or corn can also be used to ice compress a broken leg. Peas or corn can cure swelling and redness at the fracture site even better than ice.

Height. To reduce swelling and pain in a broken toe, keep your feet above your heart for as long as possible.Support on your leg should be as strong as possible (for example, using multiple pillows), especially when sleeping. Lounge reclining is also helpful.

Prospects for the treatment of broken toes

Depending on the location and severity of the toe fracture, the bones at the fracture site must be returned to their places. If the victim has an open wound, tetanus vaccination and antibiotic treatment may be necessary.

If there are open fractures of the leg, surgery and antibiotic treatment may be necessary in some cases.This type of fracture should be clearly visible to the doctor.

Medicines

Usually acetaminophen (Tylenol) or ibuprofen (Motrin) may be needed to relieve pain. To treat a severe fracture, your doctor may prescribe a pain reliever that is much stronger than the previous one.

If the toe at the fracture site displaces (the two ends of the broken leg bone do not converge) or twists (the toe points in the wrong direction), the doctor may need to shrink it or replace the broken toe.

Local anesthesia may sometimes be needed to numb the feet or toes before the bones are put back in place.

After pain relief, splints will be applied to the toes of the broken leg to hold them in place while they heal.

Plaster tape

If there are minor or minor cracks in the bone of one of the small toes, the doctor may require plaster tape on the injured leg to support it. This procedure is called plaster tape formation.

The tape, as a rule, does not make your foot safe for bathing, so you will have to take it off before swimming, so consult your doctor first.

How to work with plaster tape

Place a small piece of cotton wool or cheesecloth between your fingers, which close together. This prevents the skin between the toes from developing sores or blisters. Use some tape as needed to secure the broken finger and the finger next to it.If the fingers are deformed too much, it can cause additional swelling and pain. Operation

It is not usually required for a simple toe fracture. Shoes with hard soles should be worn, they are durable and will support the foot. The doctor may recommend special shoes for the patient if the feet or toes are very swollen.

Surgery may be necessary if the big toe is broken, and the fracture includes several small fractures of the legs, if the bone in the leg or the leg itself is broken.

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