Traumatic injuries to the lower extremity are very common. These injuries can result in long term consequences if not addressed adequately. At times the injury is so severe that regardless of acute intervention, long term pain and complications are unavoidable. See a small collection of our cases.
Fractures involving the joint violate the cartilage. Damage to this cartilage causes arthritis of the joints. Cartilage destruction by either biomechanical or biochemical forces results in abnormal repair of cartilage and increase in cartilage degradation. When degradation of cartilage exceeds attempts to repair cartilage, osteoarthritis occurs. This progressive loss of cartilage is usually accompanied by increased thickness of the subchondral plate, osteophytes, and subchondral bone cysts.
Symptoms include chronic pain, stiff joints, rigid and painful range of motion of the affected joint, joint swelling and joint deformity.
X-rays and CT scans are utilized to confirm the diagnosis. Loss of joint space and bone spurring is commonly seen. Initial treatment includes RICE, NSAIDS, supportive shoe gear, custom orthotics.
When conservative treatment fails, surgical treatment is considered. For some joints and certain patient types, joint replacement is an option. Arthrodesis for the affected joint is the other treatment option which at times is more viable, more predictable. The idea behind arthrodesis or fusion of joints is to eliminate pain by eliminating motion. Most often, patients have very limited motion at the affected joint but this motion is very painful. Thus fusing the arthritic joint eliminates the pain.
Midfoot fractures, calcaneal fractures, ankle fractures, pilon fractures are such examples in which patients may require arthrodesis of the involved joint.
Our Physicians and Surgeons have years of experience of address traumatic injuries. ER will refer to their employed hospital doctor; however, you have a choice on what doctor you would like to see. Once seen in the urgent care or ER, call us to help put the pieces together.