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Conditions & Treatments


Ligament Tears

Many of the problems orthopedists treat involve the joints, places in the body where two or more bones meet. Humans have three different kinds of joints: fibrous (in the skull), cartilaginous (in the spine) and synovial (the neck, shoulders, elbows, wrists, hands, hips, knees, ankles and feet).

These parts of our bodies can be damaged from a traumatic injury, disease, congenital disorder or the natural aging process. Commonly treated conditions include arthritis, back pain, carpal tunnel syndrome, bone fractures, sprains and strains, knee and shoulder problems, tendon and ligament tears, osteoporosis, sports injuries, and pediatric conditions such as club foot. Patients may be infants, adolescents, middle-aged or elderly.

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Fracture Care

A fracture is a break or crack in a bone that occur when the bone cannot withstand outside forces, often as a result of trauma or disease. Fracture, break and crack all refer to the same thing. Fractures can range from a small crack in the bone to complete separation. They are often caused by a fall, motor vehicle accident or sports injury. Normal activities can also cause fractures for people at a higher risk, including those with low bone density (osteoporosis), bone tumors, cancer or brittle bone disease (osteogenesis imperfecta).

Some of the different types of fractures include:

  • Stress Fracture - A stress fracture occurs as a result of overuse. Because of repeated use, the bone becomes weak and cannot absorb the shock that is put on it. It is common in the lower leg or foot and especially among athletes.
  • Compression Fracture - A compression fracture occurs as a result of old age. People with osteoporosis are at high risk for this type of fracture because their bones lose calcium. The weakened bones, usually in the spine, can crumple under the force of gravity.
  • Incomplete (Greenstick) Fracture - A greenstick fracture occurs when the bone bends but does not completely break. This occurs most often in children, who have high levels of calcium in their bones.
  • Comminuted Fracture - This occurs when the bone cracks into several fragments. It occurs as a result of high impact trauma or osteoporosis.

A bone fracture causes pain, swelling and sometimes bruising of the affected area. Applied weight or pressure causes even more severe pain. They are usually easy to diagnose, but treatment requires precision and care by experienced professionals.

At Sites Orthopaedics & Sports Medicine, we offer specialized knowledge and care for the treatment of fractures. Dr. Sites will treat your injury every step of the way until it is completely healed. Bone fractures can be diagnosed by physical examination and an X-ray or CT scan. Immobilizing the area is often helpful in relieving pain before proper treatment begins. Treatment for bone fractures depends on the location and type of fracture, as well as the patient's medical history. We take all of these factors into account when developing a treatment plan.

Mild fractures, including stress and greenstick fractures, usually only require the conservative treatment methods of ice, rest and anti-inflammatory medication. Moderate fractures may require splints or braces along with pain medication. The immobilization helps relieve pain and speed up recovery. More severe fractures may require surgical treatment, especially open fractures with wounds that need to be closed.

After the proper treatment is performed, the rehabilitation process begins. It is important to care for your fracture while it heals. Full healing can take several weeks to several months. Your doctor will advice you on how to care for your fracture and helpful measures you can take to ensure a speedy and healthy recovery.

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Instability Surgery

Shoulder instability is a condition that involves a loose shoulder joint that slides around too much in the socket after an injury. This can cause frequent slipping (subluxation), dislocation and may lead to arthritis. Shoulder instability can occur after a previous shoulder dislocation, and is also common in young athletes and double jointed people.

Treatment for shoulder instability usually begins with physical therapy and rehabilitation, but some people may need surgical treatment. Instability surgery varies depending on the cause of the condition, but usually aims to tighten the loose ligaments of the shoulder. The most common types of instability surgery include:

  • Bankart Repair - used for shoulders prone to dislocation and removes torn and degenerative tissue and any bone spurs that rub on the tendons of the shoulder. The torn ligaments are then reattached to the bone with suture anchors.
  • Capsular Shift - used to decrease and tighten the joint capsule, the lining of the joint, when it is too large.

Both of these surgeries can be performed through arthroscopy, which allows for minimally invasive procedures with smaller incisions and shorter recovery times.

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Carpal Tunnel

Carpal tunnel syndrome is a common condition involving numbness, pain, tingling and instability in the wrist, hand and fingers. It occurs when pressure is put on a nerve in the wrist called the median nerve, which controls motor function in the wrist and hand. This pressure, called impingement, is most often caused by bone spurs, rheumatoid arthritis, repetitive use or injury.

Carpal tunnel syndrome can be diagnosed with tests such as an electromyogram or a nerve conduction study. It can often be effectively treated with non-surgical therapies such as wrist splints, anti-inflammatory drugs or corticosteroids. In cases where pain and numbness persist, surgery (usually endoscopic surgery) may be necessary to relieve pressure on the nerve.

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Carpal Tunnel Release

Carpal tunnel release is an outpatient procedure performed to relieve pressure on the median nerve and reduce the symptoms of carpal tunnel syndrome. This procedure can help restore muscle strength and dexterity, and is typically performed on patients who have had persistent symptoms that do not respond to conservative treatment methods.

Carpal tunnel release can be performed endoscopically or through an open procedure. Both types offer different advantages to the doctor and patient, and should be considered after a thorough evaluation of the patient's individual condition. Open carpal tunnel release involves a two inch incision in the middle of the palm and gives the surgeon a better view of the treated area with less risk of accidentally damaging nerve tissue. Endoscopic carpal tunnel release involves two tiny incisions and offers patients less post-operative pain and the ability to return to work more quickly.

Patients can return home the same day, but may need prescription pain medication at first to manage the pain from the procedure. The hand may be kept in a splint for the first few weeks after surgery in order to protect the wrist while it heals. Although patients may continue to experience carpal tunnel symptoms after this procedure, most report that symptoms are significantly reduced after carpal tunnel release.

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