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Clayton E Turner, MD
Casper Orthopaedic Associates
Casper, Wyoming
Frontiers in Wyoming Medicine 2014
Common Orthopedic Conditions
2
Common Orthopedic Conditions
1. Ankle Sprain
2. Plantar Fasciitis
3. Tennis Elbow
4. ACL Tear
6. Meniscus Tear
7. Rotator Cuff Tear
8. Carpal Tunnel Syndrome
9. Distal Radius Fracture
3
Ankle Sprain
 Ligament injury
 Ankle pain,
tenderness, swelling
One or more of these ligaments can
be torn or stretched.
Twisting
force
Illustration reproduced with permission from
The Body Almanac, Rosemont, IL American
Academy of Orthopaedic Surgeons, 2003
4
Ankle Sprain
5
Ankle Sprain
 R.I.C.E.
 Rehabilitation
 Anti-inflammatory
 Brace
 Recurring problem
 Adequate healing time
 Rehabilitation
 surgery Illustration reproduced with permission from
The Body Almanac, Rosemont, IL
American Academy of Orthopaedic Surgeons, 2003
6
Plantar Fasciitis
 Microtears of
plantar fascia
 Painful heel
 Unrelated to
“heel” spur on
xray
7
Plantar Fasciitis
 Tape heel, arch
 Customized orthotics
 Stretching
 Massage
 Exercises
8
Plantar Fasciitis - Treatment
 Warm up well before sports or activities
 Ice heel, 20-30 minutes after sports or
stretching (freeze Styrofoam cups)
 Anti-inflammatories
 Night splint
 Massage
9
Plantar Fasciitis
 Prepare before running
 Wear good, supportive shoes
 Arch support
 Keep feet strong
 Avoid activities that cause heel pain
 If pain persists
 Corticosteroid injection
 Surgical referral
10
Tennis Elbow
Lateral epicondyle
11
Tennis Elbow
 Pain just distal to bony ridge
 Extensor muscle origin
 Avoid with: warm up
 Avoid with: stretch before play
 Correct, well maintained
equipment
 Condition beforehand
 Evaluate cause
12
ACL Injury
 Direct blow to knee
 Non-contact injury,
with foot planted and an
attempted change in
direction – pivot or cut
 Landing on straight leg
 Making abrupt stops
13
ACL Tear
Normal anatomy Hyperextension
Femur
Anterior
cruciate
ligament
Anterior
cruciate
ligament
tears
Patella
Tibia
Fibula
Femur slips
Illustration reproduced with permission from The Body Almanac, Rosemont, IL
American Academy of Orthopaedic Surgeons, 2003
14
ACL Tear
 Treatment – aggressive rehab and potential
surgical reconstruction
 Incidence of ACL much higher among female
athletes
 Combination of causal factors
15
ACL Tear- Prevention
 Land safely from jumps
 Practice cutting
maneuvers
 Use little steps to stop
 Strengthening exercises
16
Meniscus Tear
 Helps knee joint carry
weight, glide, and turn
 Twisting injury
 Football and other
contact sports
 Subset of Degenerative
Tears occurring in MA
17
Meniscus Tear
 Pain
 Giving way
 Locking
 Clicking
 Swelling
18
Meniscus Tear
Normal meniscus Torn meniscus
19
Rotator Cuff Tear
20
Rotator Cuff Tear
 Shoulder pain
 Worse at night
 Weakness
 Catching
 Limited motion
21
Rotator Cuff Tear
 Treatment
 Rest
 Cold  heat
 Sling
 Physical Therapy
 NSAIDS
 Injection
 Surgery
22
Rotator Cuff Tear
Prevention
Avoid repetitive activities with the arm at
shoulder level or higher
23
Carpal Tunnel Syndrome
 Median nerve
 Transverse carpal
ligament
 Flexor tendons
 Compressive neuropathy
of the median nerve
 Common in:
 Pregnancy
 Diabetes
 Thyroid dysfunction
24
Numbness
Tingling Pain
Clumsiness
Carpal Tunnel Syndrome
25
Carpal Tunnel Syndrome
 Splint or brace at night (neutral position)
 Ergonomic/work evaluation
 Cortisone injections
 Anti-inflammatories
 Surgery to release ligament if unresponsive
26
Distal Radius Fracture
 Wrist fracture
 Fall onto outstretched
hand (FOOSH)
 Snowboarders,
skaters, elderly
 Nondisplaced - cast
 Displaced – reduction
possible surgery, ?
Intra- or extra-
articular
27
Normal Wrist
Normal wrist:
15’ radial
deviation
11’ volar or
palmar tilt
Radial
deviation Volar Tilt
28
Distal Radius Fracture
29
Wrist Fracture – Cast Care
 Keep it dry
 Don’t pull out the padding
 Don’t stick objects inside
 Keep dirt, sand  powder out
 Don’t break off or trim edges
30
Overuse Injuries
 Change
Intensity
Duration
Frequency
 Common issue in the
aging population
31
Training errors
Less-than-optimal
environment
Improper technique
Overuse Injuries  Boomeritis®
32
Acute vs. Overuse Injuries
 Acute - sudden trauma such as
sprains, strains, bruises, and
fractures
 Overuse - series of repeated small
injuries
33
Boomeritis®
Exercise - key, but . . .
Bike accidents prevail
Mortality  children
 50% wear helmets
34
tendinitis
bursitis
sprains
strains
Boomeritis®
35
Treatment
 R.I.C.E.
 Modify or stop sports activities
 90% of these issues can be addressed with
conservative/nonsurgical measures
 Physical therapy  medication
 Surgery may be warranted in rare
situations
36
Preventing Sports Injuries
 Know and abide by rules
 Wear appropriate protective gear
 Know how to use equipment
 Never “play through pain”
37
Preventing Sports Injuries
Warm up  stretching
are two separate
steps!
Dynamic stretch
Combine the 2 into
One activity
38
10% Rule
Don’t Increase Activity
by More Than 10% Per
Week
Overuse Injuries

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Common_Orthopedic_Conditions.pdf