What are the common types of finger injuries. How can you recognize symptoms of finger sprains and nerve damage. What diagnostic methods are used for finger injuries. Which treatment options are available for different finger injury severities.

Understanding Finger Sprains: Causes and Symptoms

Finger sprains occur when ligaments in the finger are stretched or torn. These injuries differ from strains, which affect muscles or tendons. Common causes of finger sprains include:

• Hyperextension injuries during sports activities
• Falling on an outstretched hand
• Jamming the finger against objects or other players

Recognizing the symptoms of a sprained finger is crucial for proper treatment. Key indicators include:

• Pain in the finger joint during movement
• Stiffness and difficulty bending or straightening the finger
• Tenderness when touching the affected joint
• Swelling in the finger

It’s important to note that athletes often ignore these symptoms, which can lead to worsening of the injury if left untreated.

Diagnosing Finger Injuries: From Sprains to Nerve Damage

Proper diagnosis of finger injuries is essential for effective treatment. Healthcare professionals typically employ the following methods:

Physical Examination

A thorough physical exam is the first step in diagnosing finger injuries. The doctor will assess the range of motion, pain levels, and visible signs of injury.

Imaging Tests

X-rays are commonly used to rule out fractures and assess the extent of soft tissue damage. In some cases, an MRI may be ordered for a more detailed view of the ligaments and surrounding structures.

Grading Finger Sprains

Based on the severity of the injury, finger sprains are classified into three grades:

1. Grade 1: Mild stretching or microtearing of the ligament with stable joint
2. Grade 2: Partial ligament tear with mild joint instability
3. Grade 3: Severe or complete ligament tear with significant joint instability

Identifying Nerve Injuries

In cases of nerve damage, additional diagnostic procedures may be necessary. These can include nerve conduction studies and electromyography to assess nerve function and identify areas of injury.

Effective Treatment Strategies for Finger Sprains

Treatment for finger sprains varies depending on the severity of the injury. The primary goal is to manage symptoms and promote healing. Here are some common treatment approaches:

RICE Therapy

RICE therapy is a widely recommended initial treatment for finger sprains. It stands for:

• Rest: Avoid activities that exacerbate the injury
• Ice: Apply cold packs for 15 minutes at a time to reduce swelling
• Compression: Use an elastic bandage to provide support and minimize swelling
• Elevation: Keep the injured hand raised to reduce blood flow and swelling

Medication

Over-the-counter anti-inflammatory medications such as ibuprofen or naproxen can help manage pain and reduce inflammation.

Immobilization Techniques

For more severe sprains, immobilization may be necessary. This can involve:

• Finger splints to restrict movement and protect the injured ligament
• Buddy taping, where the injured finger is taped to an adjacent finger for support

When buddy taping, it’s crucial to pair the middle finger with the index finger and the ring finger with the pinky for optimal support and healing.

Surgical Intervention

In cases of complete ligament tears or when bone fragments are present, surgery may be required to repair the damage and restore proper finger function.

Advanced Treatment for Nerve Injuries in Fingers

Nerve injuries in fingers can be complex and often require specialized treatment. One such case involves the formation of painful neuromas after fingertip injuries.

Neuroma Excision and Nerve Relocation

When a digital nerve is injured and forms a neuroma (a tumor-like overgrowth), surgical intervention may be necessary. The procedure typically involves:

1. Identifying and isolating the affected nerve and neuroma
2. Carefully excising the neuroma from the healthy nerve tissue
3. Relocating the remaining healthy nerve to a less vulnerable position
4. Securing the nerve in its new location with sutures

This surgical approach aims to alleviate pain, restore normal sensation, and prevent neuroma recurrence.

Preventing Finger Injuries: Tips for Athletes and Active Individuals

While not all finger injuries can be prevented, there are steps you can take to reduce your risk, especially if you participate in sports or activities that put your hands at risk:

• Use proper protective equipment, such as gloves or tape, when engaging in high-risk activities
• Practice proper technique and form in sports that involve catching or handling balls
• Strengthen the muscles in your hands and forearms to improve stability
• Be aware of your surroundings and potential hazards that could lead to falls or impacts
• Warm up properly before engaging in physical activities

By implementing these preventive measures, you can significantly reduce your risk of experiencing finger injuries.

Rehabilitation and Recovery: Regaining Finger Function After Injury

Proper rehabilitation is crucial for regaining full function and strength in your finger after an injury. The rehabilitation process typically involves:

Range of Motion Exercises

Gentle exercises to improve flexibility and prevent stiffness are usually introduced as soon as pain allows. These may include:

• Finger bends and straightening
• Tendon glides
• Opposition exercises (touching the thumb to each fingertip)

Strengthening Exercises

As healing progresses, strengthening exercises are introduced to rebuild muscle and improve grip strength. These may include:

• Putty squeezes
• Finger extensions against resistance
• Grip strengthening exercises

Proprioception Training

Exercises to improve finger awareness and coordination are important, especially for athletes. These may involve:

• Fine motor skill activities
• Balance and control exercises
• Sport-specific drills

The duration and intensity of rehabilitation will vary depending on the severity of the injury and individual healing rates. It’s important to follow your healthcare provider’s guidance and not rush the recovery process to avoid re-injury.

Long-Term Considerations: Managing Chronic Finger Pain and Dysfunction

In some cases, finger injuries can lead to long-term complications or chronic pain. Understanding these potential issues and how to manage them is crucial for maintaining hand function and quality of life.

Osteoarthritis

Severe finger injuries, particularly those involving joint damage, can increase the risk of developing osteoarthritis later in life. Management strategies may include:

• Regular low-impact exercises to maintain joint flexibility
• Use of assistive devices to reduce strain on affected joints
• Pain management techniques, including medication and physical therapy

Chronic Regional Pain Syndrome (CRPS)

In rare cases, finger injuries can trigger CRPS, a condition characterized by persistent pain and sensitivity. Treatment approaches may include:

• Multimodal pain management strategies
• Cognitive behavioral therapy
• Specialized physical therapy techniques

Adaptive Strategies

For individuals with persistent finger dysfunction, learning adaptive strategies can help maintain independence and quality of life. This may involve:

• Using ergonomic tools and devices
• Modifying work or leisure activities
• Exploring alternative techniques for daily tasks

By addressing these long-term considerations, individuals can better manage the effects of finger injuries and maintain optimal hand function throughout their lives.

Emerging Treatments: Advancements in Finger Injury Care

The field of hand surgery and rehabilitation is constantly evolving, with new treatments and techniques being developed to improve outcomes for patients with finger injuries. Some promising areas of research and emerging treatments include:

Regenerative Medicine

Stem cell therapy and platelet-rich plasma (PRP) injections are being explored as potential treatments to enhance healing and reduce recovery time for ligament and tendon injuries in the fingers.

Minimally Invasive Surgical Techniques

Advancements in arthroscopic and endoscopic procedures are allowing for more precise and less invasive treatments of finger injuries, potentially reducing recovery time and improving outcomes.

3D Printing and Custom Orthotics

The use of 3D printing technology is enabling the creation of highly customized splints and orthotics for finger injuries, providing better support and potentially improving healing outcomes.

Virtual Reality in Rehabilitation

Virtual reality and gamification techniques are being incorporated into rehabilitation programs, making exercises more engaging and potentially improving patient compliance and outcomes.

Nerve Regeneration Techniques

Research into nerve growth factors and artificial nerve conduits is showing promise in improving outcomes for patients with severe nerve injuries in the fingers.

While many of these treatments are still in the experimental stages, they represent exciting possibilities for the future of finger injury care. As research progresses, we may see significant improvements in treatment options and outcomes for patients with a wide range of finger injuries.

Finger Sprains: Symptoms, Causes, Diagnosis, Treatment

A sprained finger is when you either stretch or tear one of the ligaments in your finger.  A ligament is a band of soft tissue. Most connect the outside surface of one bone to another bone.

A sprain is different from a strain, which is an injury to one of your muscles or tendons, the cords of tissue that connect your muscles to your bones.

Sprained Finger Causes

Common causes of finger sprains include:

• An injury that causes your finger either to bend too far or bend in the wrong direction. If your finger bends backwards, it’s called “hyperextension.” For example, you might accidentally bend your finger in these ways during physical activities — especially in sports that involve using your hands, like basketball. You might accidentally jam your finger into a piece of equipment like the ball, or into another player, causing a sprain.
• Falling on your hand. You’re more likely to get a sprain if you have problems with balance or coordination, which makes you more likely to fall, or if you have weak ligaments.

Sprained Finger Symptoms

If your finger is sprained, you might have:

• Pain in one of your finger joints when you try to move or use it
• Stiffness in your finger or having a hard time straightening or bending it
• Tenderness in your joint when you touch the area
• Swelling in one of your finger joints

Sometimes athletes who get sprained fingers ignore the injury. But the pain can be severe, and left untreated, it could get worse.

Sprained Finger Diagnosis

Your doctor will do a physical exam of your finger. You may also get imaging tests like an X-ray, and, in less common cases, an MRI.

If you do have a finger sprain, your doctor will assign it a grade based on how severe it is:

Grade 1: Your joint is stable but you have some stretching or microtearing in your ligament.

Grade 2: You have some mild instability in your joint and partial tearing in your ligament.

Grade 3: There’s significant instability in your joint and you’ve either severely or completely torn your ligament.

Sprained Finger Treatment

There are different treatments to help you feel better.

RICE therapy

Your doctor may recommend RICE therapy to manage your symptoms. RICE stands for Rest, Ice, Compression, and Elevation:

Rest: If a specific sport or activity caused your sprain, take a break from it for a while to help your finger heal.

Ice: Within the first 24 hours of your injury, you should apply ice to the area for 15 minutes at a time. If your symptoms last longer than that, you can do this for several days after the injury, too. This will ease any swelling or inflammation in your joint, and help ease the pain. Don’t put the ice directly on your skin. Instead, put it in a plastic bag or a cloth.

Compression: Your doctor may recommend that you wear an elastic compression bandage around your finger to provide support and prevent swelling.

Elevation: During the first 24 hours after your injury, try to keep your injured hand elevated to reduce swelling.

Your doctor may also suggest:

• Anti-inflammatory medication (such as aspirin, ibuprofen, or naproxen) to help with your pain.
• A finger splint.
• Buddy taping, which is when you tape it to the finger next to it If you do buddy taping, make sure to tape your middle finger to your index finger and your ring finger to your pinky.
• Surgery, if your injury is severe, meaning your ligament is completely torn or a piece of your bone has broken off.

Missouri Plastic and Hand Surgery – Nerve Injuries

Below you will be provided with photographs and information from the surgeries of patients with NERVE INJURIES. 

SURGERY OF PATIENT I:

This patient presented to the office after allowing a fingertip injury that was quite significant to heal on its own. He presented with a very painful mass on the thumb side of his middle finger. Indicated by the ink on the tip of his finger, the painful mass is outlined.

In
the next image, one can see the digital nerve with the four individual dots of
ink on it in a straight line and then the neuroma is outlined with circular
dots. What has happened in this patient is the injured nerve has overgrown into
the scar producing a very sensitive fingertip. It is almost a tumor like
overgrowth.

In
the following photograph, one can see that the digital nerve and the neuroma together
have been freed up from its normal location. At this point, the overgrown nerve
tumor, called the neuroma, is removed from the nerve.
​

In
the last image, one can see that the nerve is buried in a tunnel up on the top
side, or the dorsal side, of the finger after having removed the neuroma. It is
secured there with a suture. The skin was closed and the patient has gone on to
heal without symptoms and he has full range of motion.

SURGERY OF PATIENT II:

The
reader will have a difficult time determining what is going on in the photograph below.
This person accidentally had lacerated his wrist, cutting the median nerve. I
took him to the operating room to repair the nerve and one can see the cut
nerve between the two gaps as indicated by the light gray piece of background
material underneath two cut ends of the nerve. I’m holding the one end of the
cut nerve with metal forceps on the left side of the frame.

In
the next photograph, one can see that this person, in
addition to lacerating the median nerve, had a congenital anomaly whereby an
artery, which was supposed to go away during the time of development in his
mother’s womb, persisted. This is called a persistent median artery which leads
to what is called a high division of the median nerve. Because this artery was
significant to the blood supply to the hand, we first repaired the nerve and
then repaired the artery with the use of the operating microscope. The blood
supply to the hand was restored as was his nerve supply and he did not lose
sensory or motor function long term.

Russell Wilson out after finger injury with Aaron Donald

Russell Wilson’s middle finger was dislocated on a weird play with Los Angeles Rams star Aaron Donald on Thursday night.

While the Seattle Seahawks quarterback returned to the game briefly, Wilson was sidelined in favor of backup Geno Smith in the fourth quarter of a 26-17 loss. His finger injury could be something that lingers for weeks.

Wilson was trying to throw a pass in the third quarter of their “Thursday Night Football” matchup with the Rams, and just barely got the pass off before Donald’s swinging right hand could block it.

Yet that came at a cost, as Wilson’s throwing hand collided directly with Donald’s — which sent his middle finger bending back wildly.

The images right after did not look good. At all.

Wilson spent the entire next drive from the Rams — who quickly marched 82 yards and took a 16-7 lead on a Tyler Higbee touchdown — trying to pop his finger back into place and get it taped up.

He returned to the field for the Seahawks’ next drive, but missed one pass and was sacked on third down before they had to punt it away.

Geno Smith nearly led the Seahawks to a wild comeback win on Thursday night. (Steph Chambers/Getty Images)

Geno Smith’s near comeback falls short

Smith entered the game to start the fourth quarter in place of Wilson, who was clearly struggling with his throwing hand.

The move turned out to be a good one. 

Smith — who hadn’t taken a snap all season — quickly marched downfield and put the Seahawks back within two points after connecting with D.K. Metcalf for a 23-yard touchdown. Smith went a perfect 5-of-5 for 72 yards on the drive. 

Story continues

The Seahawks defense gave him one final shot to mount a game-winning drive with just more than two minutes left, but Smith threw an interception on the first play, sealing the Rams’ win.

Smith ended the night 10 of 16 for 131 yards in his fourth-quarter run. 

Seahawks coach Pete Carroll said that Wilson was taken out of the game because he just couldn’t hold the football. He said that it’s like “a badly sprained finger,” but that they need further evaluation to determine how severe it is, via CBS Sports’ Jonathan Jones.

It’s unclear how severe Wilson’s finger injury is, but leaving the game in a crucial division matchup likely means it’s significant.

Hopefully you didn’t eat anything before seeing these closeups of Russell Wilson’s finger | This is the Loop

Between the double punt, two missed chip shots, a flukey pick and the fact Geno Smith played, Thursday night’s Rams-Seahawks game had all the batsh-t craziness we’ve gome to expect out of a Seahawks game. Unfortunately, it also featured a nasty injury to Seattle’s franchise player – Russell Wilson, hence Smith’s insertion into the game. 

But this wasn’t an injury of the season-ending variety, and Wilson even tried to play through it. It quickly became clear that he couldn’t, because the injury was to his throwing hand, rendering him unable to do what he does best. Rams defensive tackle Aaron Donald was at the center of it all, as is the case on just about every play. Watch as Wilson’s hand smashes in to Donald’s as Wilson follows through on a throw mid-way through the third quarter:

Ouch. You have to wonder, would Wilson trade this for just a plain old sack by the 6-foot-1, 285-pound mountain of a man that is Donald? Neither can feel good, but at least he can continue playing after the sack. This freak finger injury, though, is one that knocked him out of the game and could cause problems in the near future. Now at 2-3 on the season, that’s the absolute last thing Seattle needed. 

Could he possibly gut it out? You tell me: 

Not ideal for a quarterback, some would say. With the Steelers, Saints, Packers and Cardinals all on Seattle’s upcoming schedule, Wilson is their only chance at salvaging the season. The Seahawks defense is not winning them a game any time soon, and unless something has drastically changed with Geno Smith (it hasn’t), he’s not winning you many games either. This team was a collapse at home against the Titans from starting 2-0, and now they’re in deep trouble. The NFL remains a cruel, cruel place. 

Accident Photos – SAFTENG

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Update On Russell Wilson’s Finger Injury From Seahawks Coach Pete Carroll

Carroll said it was too soon to have any details when asked specifics on the injury: “I don’t have anything for you at all… I really don’t know enough about it. I know it was pretty darn sore.”

Asked specifically if Wilson might need surgery, Carroll said, “I don’t know that. I don’t have any idea about that right now.”

Carroll said ultimately Wilson and trainers realized he couldn’t finish the game because he couldn’t properly grip the ball heading into a fourth quarter in which the Seahawks, who were trailing, were going to need to throw the ball a lot.

“He wasn’t able to hold onto the football the way he needed to throw it, because we needed to throw it all over the place, and we didn’t know what he would be able to do, he was just unsure,” Carroll said. “I trust him. If he could have, he would have.”

“Russ knows his body. He knows what he can do… He knew that this wouldn’t help us tonight.”

If there was any silver lining in Wilson’s injury, it was that it gave Geno Smith his first chance to play meaningful regular-season snaps in three seasons as Wilson’s backup, and Smith played well, leading the Seahawks on two scoring drives, including a 98-yard drive immediately after taking the field on which he was 7-for-7 for 72 yards, including a 23-yard touchdown pass to DK Metcalf. If Wilson does miss any time going forward, the Seahawks will be confident in Smith’s ability to help lead the offense.

“He did great, he really looked good,” Carroll said. “He’s been working for that. He’s a talented football player, he knows our system. If Geno’s going to play for us some as Russ comes back, he showed that we’re in good hands.”

As for Wilson, Carroll is putting nothing by his quarterback, who has been one of the NFL’s most durable players over the past decade.

“He’s been just remarkably durable, but the marvelous part about it is his attitude about how he approaches it,” Carroll said. “He is going to heal; he is going to heal himself. He is the epitome of the mentality of taking control of how your body functions. He makes stuff happen and does marvelous things.”

90,000 diagnostics and treatment – all about running on Get.run

The big toe plays a critical role in generating leverage to generate forward momentum while running, and because of this, it is susceptible to several types of repetitive motion injuries.

Big toe injuries are not common among runners. According to one study, these injuries account for less than 5% of all running injuries.

In another study published in 2002, researchers found that none of the injuries affecting the big toe were in the top 10 most common running injuries.

Regardless, a big toe injury can cause you to stop jogging for weeks or even months if you don’t diagnose it and take action to treat it.

Despite its modest size, the big toe contains several anatomical components, each of which is susceptible to various types of damage.

Features of the thumb joint

The big toe is more than just a joint between two bones. Since this finger bears a fairly large load during walking and running, its joint is well suited to create additional mechanical stress.

One of these mechanisms of adaptation to stress is the presence of tiny bones called sesamoid (from the word “sesame”, that is, “sesame seed”, because these bones are so small).

These bones function like the kneecap. They create a mechanical advantage to increase force. However, the disadvantage of this is that the sesamoid bones, along with the ligaments and tendons that surround them, are susceptible to injury.

Due in part to the rarity of injuries to the big toe, there is a lot we don’t know about risk factors for injury or which runners get them.

Based on the basic principles of biomechanics, it can be assumed that those who land on the forefoot, as well as middle-distance runners, may be more likely to injure the big toe due to the increased stress on the toe while running.

Elderly runners may also be at greater risk of injury to the big toe because some of the damage is associated with chronic degenerative changes in the joint that accumulate over the years.

How is a big toe injury diagnosed and treated in runners?

When big toe pain interferes with jogging, the first step is to accurately diagnose the injury.Big toe pain is not like Achilles tendon pain, in which case it is quite obvious what the problem is.

There are many possible causes of big toe pain. This can be arthrosis of the metatarsophalangeal joint, joint inflammation from running on artificial turf, sesamoiditis or tendonitis of the long flexor of the thumb tendon. All of these can cause severe pain while running.

• Hallux rigidus is a type of degenerative arthritis of the metatarsophalangeal joint of the big toe.One of the hallmarks of this condition is the stiffness of the thumb joint. Your range of motion will be limited, and walking barefoot is likely to be more painful than walking with shoes. The finger may swell a little, but there will be no bruising. Fortunately, a doctor can easily diagnose Hallux rigidus and assess the severity of the condition with a simple X-ray. The disadvantage is that since it is a degenerative condition, treatment mainly focuses on reducing the stress on the joint by wearing orthopedic insoles or shoes and using anti-inflammatory drugs to reduce swelling.In more complex cases, surgery is sometimes required to remove the bony growths that develop in the joint when the cartilage wears out.
• Hallux valgus is the medical term for hallux valgus, which is perhaps the easiest injury to diagnose. If you have pain on the side of the big toe and the toe deviates inward, you almost certainly have Hallux valgus. If the angle at which your thumb tilts inward is not too great, a small modification to the shoe may help.Some runners simply take a razor blade and cut a cut in the side of the shoe to relieve pressure on the side of the thumb, but buying a shoe with more toe room can also work.
• Joint inflammation from running on artificial turf is one of the most common causes of big toe pain in athletes. While this occurs most commonly in soccer players, it also affects runners. Overextension of the joint causes damage to the ligaments that surround the thumb, resulting in severe swelling, bruising, and severe pain when you try to walk.Ligaments need time to heal, so to treat this injury, you need to apply cold, rest your leg, and use a splint to immobilize the joint while it heals. It is a good idea to see your doctor for this because many medical professionals recommend locking the thumb joint in a specific position to ensure that the ligaments are not stretched too much.

Excessive overextension of the big toe, like the one shown in the photo, can cause inflammation of the big toe joint.

As you gradually return to running from this kind of injury, you can use a special turf toe taping technique to reduce the strain on your thumb area. Taping limits your thumb’s ability to overextend, so it’s a good precaution when you start running again.

What is sesamoiditis?

Sesamoiditis is an inflammation of the sesamoid bones. It is characterized by pain that is concentrated directly behind the ball of the foot.Pain is associated with direct pressure on the ball of the foot rather than flexion or extension of the big toe.

You can usually cause pain simply by pressing on the ball of your foot with your thumb. Sesamoiditis will cause more pain when walking barefoot, especially on a hard surface.

Treatment for sesamoiditis involves reducing the load on the pad, ideally to such an extent that the load the foot is subjected to while running does not exacerbate the damage.Resting can help, but you can also use standard orthopedic insoles, or order custom insoles with a notch for the ball of the foot.

Keep in mind that this will reduce the load on the pad but increase the load on the forefoot as a whole, so use this method wisely. Other than that, there is no special exercise or anything else you can do to heal the sesamoid bones; just rest your legs and apply cold.

Stress fracture of the sesamoid bone

In some cases, foot pain may be caused not only by sesamoiditis, but by a stress fracture of the sesamoid bone. The pain from a stress fracture will be more severe and may limit your ability to walk in general, especially barefoot. The best way to diagnose a stress fracture is with an MRI, although some doctors use conventional X-rays for diagnosis.

The latter can lead to a false positive diagnosis, since up to one third of the population have “dicotyledonous” sessamoid bones.This means that one or more of these bones are naturally divided into 2 parts, which can be mistaken for a sesamoid fracture.

Stress fractures of the sesamoid bones often do not heal well, so you need to wear an orthopedic shoe, splint, or custom insole for at least a few weeks to make sure the healing process is going well.

Tendonitis of the long flexor tendon of the big toe

Finally, big toe pain can be caused by long flexor tendon tendonitis.The long flexor is a muscle that helps bend your thumb downward and helps you push off the ground as you run. Because the tendon of the muscle runs under the sesamoid bones and attaches to the big toe, pain with tendonitis can be localized in the joint or spread to the arch of the foot.

In some cases, tendonitis of this tendon can be mistaken for plantar fasciitis. After all, tendonitis like this can cause pain that spreads to the arch of your foot and gets worse when you push your foot off the ground.

It should be noted that tendonitis of this tendon is rare and especially rarely affects the area of ​​the tendon that is located under the big toe. The good news is that tendon injuries heal well with stretching and strengthening exercises.

In 2005, Drs. James Michaelson and Laura Dunn proposed 3 stretching exercises to treat tendonitis of this tendon. Exercises should be performed several times a day for 10 seconds each.These 3 exercises are variations on the conventional calf stretch and create controlled stretching tension in the flexor longus tendon of the big toe.

The authors report good results in a large number of patients with this procedure alone, although some of them required surgery

3 calf stretches suggested by Michaelson and Dunn.Do them several times a day for 10 seconds each to treat extensor longissimus tendonitis.

In 2015, researchers in Japan and California suggested adding toes dangling toes dangling from a step to the above exercises.

The purpose of this movement is not to strengthen the long extensor of the big toe, but rather to relieve stress by training the body to use other muscles when pushing off the ground with the toe.

The study authors did not provide any specific guidance, but a good starting point would be 15 toe raises of one leg with toes dangling from a step, performed every day, with a gradual progression of training volume to 3 sets of 15 repetitions.

Modified one leg raises suggested by Rowley and colleagues. Do this exercise daily to treat extensor longissimus tendonitis.

How to diagnose and treat a big toe injury

Since there are so many possible causes of big toe pain in runners, and since some of the injuries require a long break from training, your # 1 priority should be figuring out the exact cause of your pain.

Degenerative arthritis, hallux valgus, joint inflammation, sesamoid or stress fracture of the sesamoid bone, and long flexor tendon tendonitis of the thumb are all possible candidates.

Determining exactly what the problem is can be difficult. Therefore, it makes sense to see a doctor, as you may need to get an X-ray or, in more rare cases, an MRI to diagnose the problem accurately.

The correct treatment will largely depend on the specific diagnosis. Unfortunately, most big toe injuries require prolonged abstinence from running, and in some cases even the use of a splint.

Orthopedic shoes or custom insoles can also be helpful if the goal is to reduce pressure on a specific area of ​​the foot, such as with hallux valgus or sesamoiditis.

For any injury to the big toe, the main treatments are to 1) allow the affected area to heal or reduce the degree of inflammation, and 2) reduce the stress on the big toe.

Returning to running will also depend on the specific injury causing the big toe pain, but unfortunately most injuries require weeks or even months of abstaining from training.

Check with your doctor or physical therapist if you’re not sure if you’re ready to start running again, as some serious big toe injuries, such as joint inflammation and stress fractures, need to be completely healed before you attempt a run.

“You cannot die from the loss of blood from the cut.” The doctor comments on the most severe injuries in MMA

Conor’s fracture, Donald Cerrone’s inflated hematoma, Antonio Silva’s gurgling dissection and Mike Perry’s collapsed nose – we showed it to the traumatologist.

Conor’s fracture, Donald Cerrone’s inflated hematoma, Antonio Silva’s gurgling dissection and Mike Perry’s collapsed nose – we showed it to the traumatologist.

Doctor Valentin Belyaevsky worked in the ambulance of Rostov-on-Don, in the football club “Rostov”, was a cutman and doctor at fighting tournaments and the chief doctor of the Chechen club “Berkut”. Now he has a private practice in Moscow, and his clients are still MMA fighters and football players.

Conor McGregor fights Dustin Poirier

Photo: © Jeff Bottari / Contributor / UFC / Gettyimages.ru

– As a rule, the tibia and fibula break here at the same time and equally. Such a fracture (with displacement) is more traumatic. The intervention that follows him on the operating table is also more traumatic. We need to do a reduction (insert bone fragments), more fixation points, use of plates. And for athletes who experience shock loads, we recommend removing these plates afterwards. Because bone has a certain degree of compression, and metal differs in rigidity from bone tissue.And metal with screws can migrate. We sometimes even see them move under the skin. Therefore, the plate must be removed.

I think it doesn’t really hurt at the moment of the fight. Most likely, he did not feel pain at all, because there is a high level of release of painkillers inside the body, a high level of endorphins, serotonin, and this is even more pronounced among the fighters. But after that, if he was not stuffed with painkillers, it hurts enough.

Belal Muhammad misses a poke in the eye in a fight with Leon Edwards

Photo: © Jeff Bottari / Contributor / Zuffa LLC / Getty Images Sport / Gettyimages.ru

– This is very dangerous for the health of the athlete, because when poking into the eye, intraocular pressure increases very much and such a thing as retinal detachment occurs. It can vary in degree, but at a certain level, an athlete may lose his sight if he is not urgently operated on. Such blows must be severely punished. In theory, something can be damaged around the eye, muscles, ligaments, blood vessels, oculomotor structures. It’s just that these injuries are more reversible than damage to the eyeball.

Kyle Roberson misses a jab from Roman Kopylov

Photo: © Jeff Bottari / Contributor / UFC / Gettyimages.ru

– There were no scary incidents in the UFC, but I know other leagues where fighters lost their sight in one eye due to a poke. In theory, after the edema subsides, there should be a good examination by an ophthalmologist and a decision. Basically, this is corrected by operational means.

– I don’t want to ask this question, but where does the finger fall in there?

– The eyeball itself can be deformed, compressed, and the cavity there is quite large, I think that the entire finger can fit there.

– Is it impossible to reach the brain?

– No, there is the back wall of the skull.

Eddie Alvarez gets a cut in a fight with Timofey Nastyukhin

https://www.instagram.com/p/BvwtZ3wn1yI/

– For the eyelid, this can become a problem only in terms of scar changes, plus a cosmetic defect, but there should be no problems for the eye.

The main tools here: atraumatic cylindrical needles are needed, which leave fewer marks, and special suture material (what you call threads), which is designed for seams on the front of the head.

In an unfortunate combination of circumstances, edema can interfere with eye function, a scar can subsequently interfere with blinking, nerve damage can cause neuritis.

Liana Jojua gets a cut from Miranda Maverick

that was a nasty elbow, but @lianajojua noes not broken and it’s stitched up pic.twitter.com/rsjJYROCb1

— danawhite (@danawhite) October 24, 2020

– In fact, the depth of the dissection in this place is about the same for everyone, because there is skin, a small layer of “subcutaneous” and bone. There are practically no muscles in this place. I would not continue the fight with such a cut, because the cut is large enough and it will bleed with subsequent blows, there may be a threat to the athlete’s health.Such a cut does not carry a life-threatening factor, but it gives a strong cosmetic defect in the future. And if this dissection happened with a fracture of the bones of the nose and a fragment or splinter penetrates somewhere or comes out of this section, this can become a problem.

As such, there are no regulations, rules, protocols at which cut it is necessary to stop the fight. There is just a subjective understanding of the doctor, whether this can further worsen any vital functions. Or it can pass without a trace and then it is better not to stop the fight.

Alistair Overeem missed a shot from Jairzinho Rosenstrike

Photo: © Jeff Bottari / Contributor / UFC / Gettyimages.ru

– There is a strong cut, which can be called a laceration. Here, there is a strong innervation, which means that in the future he may have some kind of mimic defect. Plus, a strong scar will remain, which can creep further. Therefore, the doctor and the referee made the right decision, and I would also have stopped the fight.

We must understand that he will not die from this, he will not remain disabled, but walking with a scar on half his face is also wrong.This will have to be very difficult to sew up: put a lot of stitches, dock the edges of the wound. On the reverse side, you will have to sew the mucous membrane, on the front side with atraumatic needles, a special cosmetic suture.

Yoanna Ejeichik’s face after the fight with Wei Li Zhang

Photo: © Harry How / Staff / Getty Images Sport / Gettyimages.ru

– The hematoma is painful, because the zone is sufficiently well innervated, plus there are various venous sinuses that are compressed by this hematoma and impede venous outflow, causing severe headaches.This can be accompanied by local pain and headache in principle.

Why so big? A large vessel has burst, blood accumulates under the skin and can flow into various cases. The danger here can be only if there is a fracture of the bones of the skull. If there is, the danger is very serious. It happens that at the time of examination, there may be no signs of cerebral hemorrhage, but, as we know from boxing, the hematoma can grow over time and from the locker room the athlete can be taken to intensive care in a severe coma.Therefore, it is important here to quickly make a differential diagnosis and make a decision.

Jared Vandera gets cut while fighting Justin Tafa

Photo: © Chris Unger / Contributor / UFC / Gettyimages.ru

– And in this area there is even more blood supply, and therefore we see so much blood. But these are superficial vessels, of which, in principle, it is physiologically impossible to lose so much blood that it becomes life-threatening. Even if no measures are taken, blood loss cannot become critical here.

Listen, these pictures scare me a little. I had a case when I flew to the region with medical aviation. There, the surgeon told the woman who had the fracture to work out her arm. She worked, and her bone fragments damaged the brachial artery. And her hand literally began to swell. It was there that it could have reached amputation, and the blood loss was also completely different.

In the photo below, a hard dissection of the skin on the shin of Gabriel Benitez

Watch (or not)

– If there is no fracture of the tibia, then the wounds in this area cannot entail any serious consequences, except for cosmetic ones.Here, yes, indeed, in the depths of the wound, the edge of the tibia is visible, so I would stop the fight – the next blow there can injure the periosteum. Plus, we must not forget that the longer the wound remains open and untreated, the more infection occurs, which means that the consequences will be more severe.

Colby Covington’s jaw is broken in a fight with Kamaru Usman

Photo: © Jeff Bottari / Contributor / UFC / Gettyimages.ru

– Jaw fractures are one of the most severe and terrible injuries in percussion martial arts.They always take a heavy toll on the athlete. Firstly, these are painful fractures, secondly, it always happens with some kind of slight deformation in the temporomandibular joints, thirdly, it almost always happens together with a concussion, and fourthly, it has serious consequences. In case of serious fractures of the jaw, it may be such that it will not be possible to chew for 2-3 months, you will have to take food through a tube.

Nate Diaz is banned from fighting after the third round with Jorge Masvidal

Photo: © Josh Hedges / Contributor / Getty Images Sport / Gettyimages.ru

– If we allow this section to expand, bleeding will increase, there will be a greater traumatic effect and an even stronger cosmetic defect. At the same time, stopping a fight with a cut of this size is a moot point. You can give one more chance and see if the cut does not grow further, then continue the fight for a while. In boxing, they would probably have stopped, in MMA, they could have given a chance.

Kane Velasquez leaves a large cut to Antonio Silva after elbowing

Photo: © Josh Hedges / Contributor / UFC / Gettyimages.ru

– I heard such a version that from the cuts in this area (between the eyebrows and the bridge of the nose) there is always profuse bleeding, because there is generally not a vein that is damaged, but an artery.

– Veins are big in that place. Arteries, as a rule, lie deeper and are closed by some kind of passages or groove. It is quite difficult to injure an artery, it has a muscular wall, but in this area the veins also bleed very much. At the same time, it is possible to damage the artery with the elbow in battle, it is just necessary, most likely, to inflict several blows into the torn tissue.I myself saw how an artery was damaged after the battle – either in this area, or in the temporal region.

Donald Cerrone is prohibited from continuing to fight Tony Ferguson after hematoma has formed

Photo: © Rey Del Rio / Stringer / Getty Images Sport / Gettyimages.ru

– The most important thing here is whether the fighter sees with this eye or not. With bruises that cover the eye, this is the only score. If a fighter cannot see with his eye, he should not be allowed to continue the fight.

– Donald Cerrone got such a hematoma when he wanted to blow his nose.Does this sound like the truth?

– Yes, in case of injuries and fractures of the nose, it is precisely forbidden to blow your nose. They say this to all athletes, just not everyone understands it. This is called emphysema, the ethmoid bone is injured, the air goes into the subcutaneous space and is inflated somewhere else. In general, no matter how much you would like to blow your nose, it is better not to do this during the battle. In principle, when blood accumulates, it also performs an antiseptic function and, thrombosed, stops bleeding, and if we remove it, it will continue to flow.Even if it prevents you from breathing, blowing your nose will not change the situation. You will need to breathe through your mouth.

Mike Perry breaks his nose in a fight with Vicente Luke

Photo: © Alexandre Schneider / Zuffa LLC / Contributor / UFC / Gettyimages.ru

– Boris Akunin and people who “own the secret GRU technicians” write that you can break your nose like that, that the bones will enter the skull and the person will die. This is true?

– This is a myth. Because between the bones of the nose and the brain there is also an ethmoid bone. It is unlikely that shrapnel can pierce it and go somewhere deeper.

Specifically here, the problem may be that not only the nose is broken, but also, for example, the orbital bone.

Matthew Lopez and his big bruise on his leg after Rafael Assuncao’s low kicks

Photo: © Brandon Magnus / Contributor / UFC / Gettyimages.ru

– Such hematomas on the limbs can form even in the wrong place where they are beaten. For example, with knee injuries, swelling often occurs in the ankle area. And in fact, this does not mean that the person has some serious pain or that his leg was severely beaten off.Such a hematoma does not tell us about anything in essence. If desired, such a bruise can be done with cans … or massage.

Paul Craig twists Jamal Hill’s elbow

Photo: © Jeff Bottari / Contributor / UFC / Gettyimages.ru

– There is a dislocation of the elbow joint. Dislocations are different. There are dislocations, in which the capsule of the joint can break and it will be harder to repair than a fracture. Some dislocations are accompanied by avulsion of ligaments, detachment of ligaments with a bone fragment. But there may be a dislocation without consequences, when by some miracle nothing broke and the person returns to sports activities in a couple of weeks.

Such a dislocation, as in the photo, can be corrected if it is without complications. Or with both hands, if the patient is not very muscular, or with the help of an assistant and a table. One person fixes the hand in the wrist joint, and the second pulls and sets with a towel in the elbow area.

Read also:

90,000 Traumas of the past State Darwin Museum

October 10, 2020 – April 4, 2021

Location: Exhibition halls of the museum / 0 floor (basement) / Exhibition hall №1

An announcement with the author of the exhibition can be viewed here

Exhibition “Traumas of the Past” – about how people were treated
tens of thousands of years ago.We all remember the picture from the textbook: hunched over
Neanderthal man in skin with a club in his hand. People lived then for a very short time, in
an average of 27-30 years, but during this time on the hunt or in a skirmish with other tribes
got injured, broke bones. Excavations have shown that, even after receiving heavy
injuries, some survived. How do we know this?

Of course, from scientists, archaeologists and paleontologists. With time
even such specialization as paleopathology appeared. Paleopathologists on
bones of ancient people can determine their lifetime, gender, diet
nutrition, medical history, injuries sustained while hunting or in skirmishes with enemies,
suggest the cause of death and even say whether the person was right-handed or left-handed.By the way, while studying the ancient tools of the Neanderthals, one can easily see in the notches for
fingers in the choppers, for whom this chopper was intended. For left-handers or right-handers.

Sometimes bone research reveals surprising facts about our
ancestors. For example, 7,000 years ago
people knew how to perform craniotomy. It’s hard to imagine how
a sharpened stone could drill the skull of a living person!

At the exhibition you can see for yourself how the skulls look from
trepanations found in the southern regions of Russia.Scientists are still wondering
why people who lived in different parts of the world resorted to trepanation, and for
what this operation was intended for. It is believed that for the treatment of strong
headaches. For some peoples, trepanation was probably part of a ritual.
or initiation rite. At the same time, the operated “patient” often remained alive –
from several weeks to many years, which indicates a high level of skill
ancient “surgeons”.

According to studies already 13,000 years ago, our ancestors
suffered from caries, and treated their teeth with wax and bitumen with the addition of herbs and hair.According to the surviving remains of seeds in
burials, it is possible to determine what herbs were treated.

Ancient people took care of their wounded, sick and old people,
they had a lot of pathologies: cancer, dental problems;
in the elderly, as a rule, multiple traces of fractures and even
amputation of, for example, the hands or the entire arm. This suggests that they were treating
their fellow tribesmen and looked after them. After all, people with such injuries
just couldn’t survive on their own.

By the lifetime deformation of bones, archaeologists can determine
what this person was mainly doing, i.e.that is, his “specialization”. Hunting,
carrying heavy weights, digging or blacksmithing develop one side of the body better,
than the other. Such professions can be calculated when found relative to the whole
skeleton. Regular sewing, skin piercing, beading and other
fine work leaves characteristic abrasions on the phalanges of the fingers, which
persist for millennia.

How scientists study human bones, and what stories from
the lives of our ancestors can their remains tell? About this – a new exhibition
“Trauma of the Past” at the Darwin Museum.Rare bone samples provided for
exhibitions Institute of Archeology RAS.

Having got acquainted with the methods of studying bones at the exhibition, you can try on the role of a paleopathologist in the computer game “Clearing”: you need to find the skeleton of an ancient man and try to determine its gender, age, trauma and cause of death.

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Hand numb: the doctor described the case of a patient who aggravated the disease in the country

Some chronic injuries can significantly worsen the quality of life and at least ruin the summer cottage season.This happened with one of my age patients, whose story I want to tell today.

A 74-year-old woman came to see me last fall, just after the summer cottage season. Before that, in May, she slipped and fell on her hand. She went to the emergency room, where she underwent an X-ray and revealed a fracture of the beam in a typical place. The fracture was simple, no displacement, no reduction was required – it was enough to fix the bone in the desired position and give the hand a rest. She was given a plaster cast, and a month later they made another control X-ray before removing the bandage, and the doctor said that everything was in order.

In case of a fracture of the wrist joint, it is very important to find out how the fall occurred, which was not done by the doctor who examined her initially. In addition, an intermediate X-ray was not taken for her – after the splint was applied, it is necessary to track the changes in two weeks on an X-ray: how the bones grow together, whether there was any displacement. You should not be afraid of radiation exposure today: modern X-ray machines are absolutely safe from this point of view, which allows you to take an unlimited number of images throughout the year.

… The woman moved to the country house, where she spent the whole summer. But throughout the entire summer cottage, she remained swelling of the wrist joint. In fact, she could not fully load the arm, since the pain did not go away like that. But the patient believed that this was how it should be after the fracture, just that the arm needed to be developed better. In addition, she, like many in such situations, self-medicated: rubbed ointments, drew iodine nets on the affected area.

And now the second, third month has passed – and the edema still did not subside.Moreover: there was a limitation of movement in the joint. She could no longer lift light weights, the pain grew, and the swelling not only persisted, but also expanded. That is, all the symptoms of good inflammation appeared. Due to the inability to lift weights, the woman stopped many things in the country. And yet she did not dare to see a doctor for the entire summer season.

However, closer to autumn, it became obvious that medical assistance was indispensable. There was a pronounced limitation of movement not only in the wrist joint, but also in the fingers of the hand.The whole brush is swollen. She could not fully use her hand: dress, brush her teeth, eat.

She came to me with severe pain and bright swelling – the hand was half as healthy, the swelling spread to the area of ​​the fingers. And, since any edematous manifestations in the area of ​​the wrist joint are accompanied by neurology, by September numbness of the fingers was added to the symptoms. By which fingers go numb, one can indirectly determine which nerve is compressed. This patient had numbness in the little finger and half of the fourth finger – this is a characteristic innervation of the radial nerve, which is responsible for this area on the hand.

Photo: Natalia Gubernatorova

She brought her pictures, and I suspected from them that she either had slow consolidation or no bone fusion – in any case, after removing the splint, she started rehabilitation too early. I immediately sent her for an x-ray to rule out a non-fused fracture. It turned out that the consolidation took place without bias. But another problem came to light: a fracture missed by the doctor in another place of the wrist joint! When the ray is fractured in a typical place, the radius is also often broken.Therefore, it is so important to find out how a person fell. This lady had a fall with all her weight on the hand, and with such a fracture, the styloid process of the ulna often breaks. In this patient, too, a fracture of the radius was accompanied by a fracture of the styloid process of the ulna, which the doctor simply did not see either because of inattention or because the radiologist did not make the correct projection. In addition, the doctor did not track the situation with an intermediate picture. This is far from an isolated case of incorrect assessment of a ray fracture in a typical location by colleagues who do not always painstakingly collect the patient’s history, especially in terms of the mechanism of injury.

Due to the detachment of the styloid process, which dangled in the soft tissues, all the problems arose. But they could be avoided solely due to a longer plaster immobilization: a woman had to walk in a brace not for a month, but two, because at this age tissue regeneration is slowed down. And if in young people everything grows together in a month, then at her age, given the postmenopausal period with a high risk of osteoporosis, more time was needed. And although the lift was not roughly displaced, she activated her arm too early.In case of problems in this area of ​​the wrist joint, any movement leads to the fact that inflammation occurs.

It was useless to try to influence the brush with plaster in this situation: more than three months have passed. The correct anti-inflammatory measures were required. I fitted the patient with an orthosis that limited flexion and extension of the hand. Physiotherapy with drug support relieved the inflammation. Then it was taken up by the instructors of exercise therapy.

Photo: Natalia Gubernatorova

It is a pity that after three months at the dacha she has decently lost her range of motion in her fingers, and this is the biggest problem.While she cannot clench her fist completely, and there is a high risk that this will remain so. Her joint is all right, but problems with her hand remain. I recommended her special simulators, however, there is no panacea in such cases. After all, a month of inflammation is enough to lose movement in the fingers. In her situation, there is a chance that the situation is reversible, and we will return a large percentage of compression, but we will not restore the full volume.

Using her example, I want to say once again how important it is to consult a doctor in a timely manner and follow all recommendations, although often patients pay little attention to physical rehabilitation.When everything is fine with us, we do not think how important it is for the brushes to work correctly: thanks to them we can dress ourselves, wash ourselves, go to the toilet. Therefore, take care of yourself and your health!

The next material with the doctor’s advice will be released on Wednesday 23 April. And if you want to ask a question to the doctor, then we are waiting for your letters to the e-mail address of the editorial office [email protected].

90,000 Treatment of Morton’s Neuroma – Orthopedics Ruslan Sergienko

Morton’s neuroma is a benign enlargement of fibrous tissue on the foot in the area of ​​the plantar nerve of the foot.This disease is referred to as Morton’s metatarsalgia, Morton’s syndrome, Morton’s disease, interdigital neuroma, foot neuroma, perineural fibrosis, and Morton’s toe syndrome.

A pathological neoplasm develops mainly in the area of ​​the third intermetatarsal space (the area of ​​the base between the third and fourth toes on the foot). Basically, unilateral damage to the nerve is found, but bilateral damage is extremely rare.

Pathogenesis

The mechanism of development of Morton’s neuroma has not been sufficiently studied, however, a number of hypotheses have been proposed.When studying the morphological material, it was concluded that in this pathology, a thickening occurs on the intermetatarsal branch of the tibial nerve, while the researcher believed that this is not a true neuroma, but a pseudoneuroma, similar to the one that develops in the trunk of the median nerve above the place of its compression during carpal tunnel syndrome. Later, changes were described that ranged from thickening of the wall to complete obliteration of the lumen of the artery feeding the nerve and adjacent tissues in this part of the foot, a conclusion was made about the ischemic nature of the pathological process.

Currently, it is believed that the starting point is repeated, multiple microtrauma and compression of the nerve that passes between the 3rd and 4th metatarsal bones, as a result of which the transverse intermetatarsal ligament of the foot thickens, separates it into fibers and forms edema.

The so-called pathological intermetatarsal ligament of the foot leads to constant compression and displacement of the medial plantar nerve and its accompanying vessels, causing its ischemia. Modern studies have shown that the average size of a neuroma is 0.95–1.45 cm in length and 0.15–0.65 cm in width.That is, this is an elongated, spindle-shaped formation.

Clinic

Asymptomatic course of Morton’s metatarsalgia is possible if the size of the neuroma is less than 5 mm. The progression of the disease leads to the appearance of at first shooting, aching pains in the region of 3-4 toes, arising after physical exertion, in combination with sensory disorders. At night, discomfort in the foot practically does not appear. If the patient does not seek medical help in time, the symptoms of the disease increase.

Over time, the frequency and intensity of pain increases, the time interval from the start of the load to the onset of symptoms decreases. As a result, the pains acquire a sharp, burning character, begin to appear at rest, often a feeling of the presence of a foreign object in the shoe is formed, but no external changes in the foot are observed. On palpation, the pain sensations increase sharply. In parallel with the progression of pain syndrome, an increase in sensory disorders, up to anesthesia, is possible.

Diagnostics

Clinical diagnosis of this pathological condition is not difficult. First of all, it is based on the characteristic localization of the pain syndrome. With palpation compression of the 3rd intermetatarsal space for 30-60 s. the patient usually begins to experience numbness and a burning sensation. Movement disorders are uncommon. Sensory disturbances confirm neural involvement.

Speaking about instrumental studies of Morton’s metatarsalgia, it should be noted that magnetic resonance imaging, unfortunately, does not always confirm the clinical diagnosis and, in some cases, gives dubious results.Computed tomography of the foot rarely gives any information due to the absence of mineral deposits in this soft tissue formation. However, thanks to the methods of radiography, it is sometimes possible to determine the usuration of the bone at the site of compression by the neuroma.

Ultrasound examination is one of the leading methods for diagnosing the condition of the soft tissue structures of the foot. However, in our country, the use of ultrasound for the diagnosis of peripheral nerve diseases is not sufficiently developed.

Regression of pain after treatment and diagnostic blockade of the intermetatarsal nerve with a solution of local anesthetic is a convincing sign in favor of a neuroma.

Pain in the foot and toes is often observed in clinical practice, in most cases it is caused by deformity of the foot, noted in various pathological conditions, in particular with flat feet or chronic Achilles tendonitis. At the same time, with significant deformity of the feet, a pronounced pain syndrome does not always develop, as, for example, in patients with hereditary spastic paraplegia.

Differential diagnosis of Morton’s neuroma is carried out with diseases:

• synovitis of the metatarsophalangeal joint,
• Metatarsal stress fractures,
• arthritis of the metatarsophalangeal joints,
• osteonecrosis of the metatarsal heads,
• tumor lesions of the bone,
• Diseases of the lumbar spine with pain radiating to the intermetatarsal spaces.

Treatment

At the initial stages of the development of the disease, conservative treatment is carried out. The first recommendations of the attending physician are:

• unloading the feet,
• Intermittent use of metatarsal pads and lifters,
• Wearing shoes with retro-capital support.

The essence of these methods is to reduce the pressure on the nerve trunk. The use of custom-made orthopedic insoles increases the effectiveness of conservative treatment.With their help, it is possible, firstly, to reduce the load on the anterior region of the foot and to normalize the state of the transverse arch; secondly, to reduce the pressure of bones and ligaments on the damaged nerve, which makes it possible to stop the development of the disease; thirdly, to eliminate the inflammatory process in nerve fibers and tissues, which significantly reduces or completely eliminates pain; fourthly, to restore the structure of the foot, thereby ensuring the correct gait.

If the effect is insufficient, glucocorticosteroids are injected into the intermetatarsal space from the back of the foot under ultrasound guidance, which in half of the cases leads to an improvement in the course of the disease, and in a third of cases – to complete recovery.If the patient has deforming arthrosis, it is possible to prescribe preventive therapy with chondroprotectors.

In case of resistance to conservative methods of treatment, patients are offered surgical treatment. However, there are several different approaches to the surgical treatment of Morton’s syndrome

The most common operation performed under local anesthesia is to remove a neuroma. Since it is part of the nerve, the hypertrophied and inflamed part of it is excised.In most cases, this eliminates the pain syndrome, but, as a rule, a small area of ​​unexpressed numbness remains on the foot, which is almost always not felt until the patient touches it. The motor and support functions of the foot are not affected. The rehabilitation process is on average 2–4 weeks, during which the patient is recommended to reduce the load on the foot.

Some surgeons believe that excision of the inflamed part of the nerve as a primary surgical method is too radical.Surgery to cut (release) the transverse ligament between the metatarsal bones will relieve the compression of the nerve. One of the advantages of this method is the absence of sensory disturbances. In the event that this operation does not lead to success, excision of the neuroma is possible.

Osteotomy of the 4th metatarsal bone is the least used method of surgical treatment of this pathology. The essence of the intervention is to achieve decompression of the nerve due to the displacement of the head of the 4th metatarsal bone after osteotomy (artificial fracture).Such manipulation is performed under X-ray control through an incision or puncture of the skin, not exceeding 2 mm.

Analysis of the effectiveness of surgical treatment of Morton’s neuroma showed excellent results (complete absence of pain and other symptoms) in 45% of cases, good (significant reduction of pain syndrome and almost complete regression of neurological symptoms) – in 32%, in 15% of cases the outcomes were satisfactory (pain syndrome decreased slightly, neurological symptoms persist), in 8% – unsatisfactory (the operation did not bring any improvement).The low efficiency of surgical interventions is associated with the formation of a true amputation neuroma in the proximal part of the intermetatarsal nerve.

TRUST YOUR HEALTH CARE TO REAL PROFESSIONALS!

Center for Orthopedic Pathology and Rehabilitation of Trauma Consequences – activities of the department and specialists

Stabilometry: checking the musculoskeletal system of children in a playful way

Stabilometry is a method for studying body functions associated with maintaining balance.This diagnosis allows you to identify disorders of the musculoskeletal system and assess the degree of their severity.

What is stabilometry?

Today stabilometry is the most modern method for studying the functional capabilities of the musculoskeletal system. Experts from all over the world have recognized this survey technique as one of the most informative and objective. The stabilometry method is widespread in sports medicine and is the standard for in-depth medical examination of athletes.

Stabilometry is a global characteristic of body balance, provides additional opportunities for identifying:

• functional disorders in diseases of the spine, nervous system, vestibular and visual analyzer;

90,040 limb support;

• functional state of the ankle joints;

90,040 balance disorders in scoliosis, after injuries and operations.

Stabilometry is also used as a means of rehabilitation of violations of the motor function of a person, training his coordination.

How is the study going?

The study does not require the attachment of sensors to the body. Before it begins, the patient takes off his shoes and stands on the stabilization platform. Under the supervision of a specialist, he performs simple actions in a playful way. Information about the work of various body systems is immediately displayed on the monitor at the doctor. The use of modern equipment excludes the influence of the human factor and gives exclusively objective indications.

More details about the stabilometry method we asked to tell traumatologist-orthopedist of the children’s polyclinic “UMMC-health”, candidate of medical sciences in the field of traumatology and orthopedics Olga Nikolaevna Khamidulina.

– Olga, what are the advantages of the method stabilometry?

stabilometry can be used both for diagnostic and therapeutic purposes. The survey is conducted for 5-15 minutes. According to the results the patient is issued a conclusion. Among other things, I would stabilometry safely considered as screening – quickly, conveniently and objectively. As a result, we get a clearer picture, allowing to decide which specialist to refer the patient further.
If we talk about treatment, the “Stabilan” device has simulators that we prescribe to patients with impaired balance function. Such classes are conducted in courses.

– Which specialist can be contacted with the results of examination on a stabilometer?

– The examination makes it possible to judge the pathology of one of three systems: nervous, muscular or bone and vestibular. Therefore, there are three specialized specialists: a neurologist, an orthopedist and an ENT.

– What is the treatment at Stabilan?

– Today, rehabilitation with the help of kinesiotherapy, that is, movement, exercise therapy, is recognized all over the world.Especially based on the principle of biofeedback. And “Stabilan” is used precisely as a biofeedback trainer. Everything is realized in a playful way. For example, a patient is given the task of flying an airplane, or catching butterflies, or collecting puzzle pictures. The patient, as in a game, needs to emit all this, doing it with the whole body. In this case, the higher nervous function, all the muscular and vestibular systems work.

– Is it possible to use stabilometry for the selection of orthopedic products?

– Certainly! The technique allows you to accurately determine which orthodontic device is suitable for the patient.

– Who is not allowed to undergo the procedure?

– There are no contraindications, but there are age restrictions. The examination can be assigned to the child after the completion of his support and walking processes, this happens after five years.

Kinesio taping as a method of conservative treatment of children with orthopedic pathology

What is kinesio taping?

Kinesio taping is a fairly young method of physiotherapeutic effect on the body.It was discovered by the Japanese chiropractor Kenzo Kase in the early 70s, and appeared in Europe 10-15 years ago. Today kinesio taping is widespread in sports, rehabilitation and among people leading an active lifestyle.

Clinical studies have shown that the use of physical tapes accelerates recovery from injuries, diseases of the joints and the neuromuscular apparatus. The effect of kinesio taping is associated with the theory of “pain blocking” and the theory of “pain blockers”, according to which mechanoreceptors (nerve endings responsible for carrying signals of physical impact) are stimulated, which interfere with the transmission of pain signals.

How are kinesio taping procedures performed?

Kinesio tapes are elastic tapes made of high quality cotton and coated with an acrylic-based hypoallergenic adhesive gel that activates at body temperature. The elastic properties of the tapes are close to the elastic parameters of the skin. The cotton base does not prevent the skin from breathing and evaporation from its surface.

Correct application of the tape tightens the skin, improves blood circulation and metabolism.Proprioceptive stimulation, which works in the opposite direction of muscle contraction, also helps to relax an overworked muscle. In the area where the tape is applied, the space between the skin and muscles is increased, which helps to improve lymphatic flow.

For whom is kinesio taping indicated?

Kinesio taping relieves pain and inflammation, normalizes muscle tone, is effective in fascia syndrome (prevents stretching, reduces overstrain of weakened muscles, relieves tension and overstretching of muscles), improves motor functions (incl.in children with cerebral palsy), reduces edema, accelerates the healing process, increases endurance during physical activity.

Medical indications for kinesio taping:

• Tension headaches
• Trigeminal neuralgia
• Cervical spondylitis
• Trauma SHOP
• Rotator cuff syndrome
• Shoulder-scapular dysfunction
• Instability of the shoulder joint
• Bursitis of the shoulder joint
• Injury of the clavicular-acromial joint
• Injuries to the sternoclavicular joint
• Scoliosis
• Fracture and contusion of ribs
• Spondylolysis, spondylolisthesis
• Myofascial lower back pain
• Hallux valgus
• Bursitis of the olecranon
• Epicondylitis of the humerus
• Carpal tunnel syndrome
• Lymphostasis of the upper limbs
• Injury to the hand
• Hammer toes
• Joint arthritis
• Inflammation of the iliotibial tract
• Sciatica
• Lymphadema of the lower leg
• Ligamentous tendonitis
• Patella subluxation
• Osgood-Schlatter Syndrome
• Injury of the ligaments of the knee
• Recurvation of knee joints
• Plantar fasceite
• Achilles tendosynovitis, ankle ligament injury
• Neuroma Mortana

Attention to the patient! The kinesio taping procedure is prescribed and performed by orthopedic traumatologists of the children’s polyclinic “UMMC-Health”

90,000 Main types of eye injuries

• Superficial damage to the cornea of ​​the eye. The most common eye injury is corneal abrasion, or traumatic erosion. Causes severe pain, eye redness and photophobia. Corneal damage makes the eye susceptible to infection, so the patient is most often prescribed antibacterial drops on the first day after the injury.

• Penetrating wounds , foreign objects in the eye . If you suspect a foreign body in the eye, if you cut your eye with any sharp object (glass shard, nail, wire, metal objects, etc.), as well as if your eyesight has deteriorated immediately after the injury, immediately consult a doctor.This situation requires the provision of urgent surgical care in an eye hospital.

• Chemical eye burns . Occurs when any chemically active substance enters the eye, usually household, garden or industrial chemicals. It must be remembered that burns with alkaline solutions are much more dangerous than with acids; try to quickly flush your eyes with plenty of clean cool water and see a doctor.

• Burns by ultraviolet radiation. Common sources of hazardous ultraviolet (UV) radiation are welding arcs, computer technology, and sunlight reflected from snow or water, especially at high altitudes in the mountains.

• Eyelid hematomas . With strong blows to the face, nose (more often in fights), large hematomas of the eyelids with pronounced edema may appear. Often, such injuries are accompanied by a fracture of the orbital bones. This is a common injury when practicing sports such as boxing, martial arts, baseball.

• Subconjunctival hemorrhage . Developed with mild eye contusions. This is the most harmless type of injury, although it looks intimidating. After a few weeks, the blood dissolves and the eye regains its normal appearance.

• Traumatic iridocyclitis and hyphema . Inflammatory process caused by damage to the choroid as a result of contusion or penetrating injury to the eye.In some cases, rupture of the iris and the appearance of blood in the anterior chamber are possible. Inpatient treatment and surgery are required.

• Hemophthalmos . With severe contusions of the eye, hemorrhage often occurs inside the eye, which is accompanied by loss of vision. In the absence of timely treatment, it can lead to the development of irreversible blindness. In the event of any severe impact to the eye, see a doctor as soon as possible to prevent serious injury.

• Traumatic cataract . With penetrating or blunt trauma to the eye, loss of transparency of the lens and the development of traumatic cataracts are possible.

Substances potentially hazardous to the eyes:

• Alkaline chemicals commonly found in fertilizers, detergents (ammonia), dish detergents (lye), and gypsum or cement mixtures (lime).

• Acids, food vinegar.

• Careless handling of light sources.

To the attention of housewives: a chemical burn of the eye can be obtained by simply mechanically scratching the eye with a dirty hand while cleaning using strong household chemicals. Always wear gloves and do not touch your face until you remove them.Store vials of household chemicals, fertilizers and other potentially hazardous chemicals tightly closed, out of the reach of children.

For Motorists: A car battery may explode and cause a sulfuric acid burn. This is one of the most common home acid burns.

Parents’ attention: Every year during the New Year holidays hundreds of people in Moscow suffer serious eye injuries from fireworks or firecrackers used without proper supervision and precautions.Your kids should never have easy access to fireworks.

Observe the following guidelines to reduce the risk of eye injury:

• Wear safety glasses when using power tools;

• Follow directions when working with chemicals or detergents;

• Do not let unsupervised children play with throwing toys or sharp objects such as scissors.