Infection Within the Bone

Osteomyelitis is an infection involving the bone caused by various microorganisms such as bacteria and/or fungus. This disorder affects about 2 out of every 10,000 people.

Osteomyelitis can affect both adults and children. The bacteria or fungus that can cause osteomyelitis, differs among age groups as does the location of infection. In adults, osteomyelitis often affects the vertebrae and the pelvis. In children, osteomyelitis usually affects the adjacent ends of long bones. Long bones are large, dense bones that provide strength, structure, and mobility. These include the femur and tibia in the legs.

Osteomyelitis does not occur more commonly in a particular race or gender. However, some people are more at risk for developing the disease. These include: Patients with diabetes, weakened immune system, sickle cell or receiving hemodialysis, IV drug drug abusers or elderly patients.

Symptoms of osteomyeltis, may include:

• Pain and/or tenderness in the infected area
• Swelling and warmth in the infected area
• Fever
• Nausea, secondarily from being ill with infection
• General discomfort, uneasiness, or ill feeling
• Drainage of pus through the skin

There are many ways that infecting bacteria find their way to bone, resulting in the development of osteomyelitis. These include:

• An open injury to the bone or a soft tissue infection

• An infection from elsewhere in the body, such as pneumonia or a urinary tract infection, that has spread to the bone through the blood stream.
• Minor trauma, which can lead to a blood clot around the bone and then a secondary infection from seeding of bacteria.
• Bacteria in the bloodstream, which is deposited in a localized area of the bone.

The objective of treating osteomyelitis is to eliminate the infection and prevent the development of chronic infection. Chronic osteomyelitis can lead to permanent deformity, possible loss of limb, or life and other health issues, so it is important to treat the disease as soon as possible. If you or someone you know is suffering from this condition please contact our office for consultation, 440-946-5858 to prevent the complications noted above.

Shin Pain?

With the beginning of fall, means the beginning of many fall sports and possibility of new aches and pains for our athletes. One common complaint is pain to the front of the shin. Pain in this area is referred to as "shin splints."

“Shin splints” is a term used to describe pain and swelling to the front of the lower legs. The pain usually appears after and is aggravated by repetitive activities such as running or walking. Contributing causes are flat feet, calf tightness, improper training techniques, worn out or improper shoes/sneakers, as well as running or walking on uneven surfaces. The inflammation in the shin results from the repeated pull of a muscle in the leg from the shin bone (tibia).

This condition usually occurs bilaterally (both legs) and can be alleviated by rest, use of non steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, icing, a change in training habits, stretching exercises, and properly fitted shoes.

If you or someone you know is suffering please given our office a call, 440-946-5858, to allow us to properly treat the condition, recommend proper shoe gear and evaluate whether orthotics are needed. If not treated, shin splints may eventually result in a stress fracture of the shin bone.

Broken Toes

The structure of your foot is complex, consisting of bones, muscles, tendons, and other soft tissues. Of the 26 bones in your foot, 19 are toe bones (phalanges) and metatarsal bones (the long bones in the midfoot). Fractures of the toe and metatarsal bones (broken toes) are common and require evaluation by a specialist.

A fracture is a break in the bone. Fractures can be divided into two categories.

Category 1 of fractures is traumatic fractures, also called acute fractures. Traumatic fractures are caused by a direct blow or impact, like seriously stubbing your toe. These types of fractures can be displaced or non-displaced. If the fracture is displaced, the bone is broken in such a way that it has changed in position (dislocated). Treatment of a traumatic fracture depends on the location and extent of the break and whether it is displaced. Surgery is sometimes required. Signs and symptoms of a traumatic fracture may include a popping sound, pin-point pain, deviation (mis-shapen or abnormal appearance of the toe) or brusing and swelling to the affected area.

Category 2 of fractures is stress fractures. Stress fractures are tiny, hairline breaks that are usually caused by repetitive stress. Stress fractures often afflict athletes who, for example, too rapidly increase their running mileage. Or they may be caused by an abnormal foot structure, deformities, osteoporosis or improper footwear. Symptoms of stress fractures include pain with or after normal activity, pin point pain, swelling, but no bruising and pain that goes away when resting and then returns when standing or during activity.

Fractures of the toe bones are almost always traumatic fractures. Treatment for traumatic fractures depends on the break itself and may include these options: Rest, rigid or stiff-soled shoe and splinting or "buddy" taping the affected toe. If the break is badly displaced or if the joint is affected, surgery may be necessary. Surgery often involves the use of fixation devices, such as pins or screws.

Treatment of metatarsal fractures depends on the type and extent of the fracture, and may include rest, immobilization (casting or rigid shoe) and avoidance of offending activity. If the break is badly displaced or if the joint is affected, surgery may be necessary. Surgery often involves the use of fixation devices, such as pins or screws.

It is not true that if you can walk on it, it is not broken. Evaluation by a physician is recommended, therefore please call our office to schedule an appointment, 440-946-5858.

Back to School Shoe Shopping

The sounds of school bells, slamming locker doors and students clammering into classrooms are being heard once again. With the start of a new school year, parents are eagerly seeking a wide array of school supplies and new fashions for their children. One of the most important purchases on a parent’s back to school shopping list is a new pair of shoes. With the numerous styles and fashions of shoes, several important factors must be considered:

-Children’s feet change with age: Shoe and sock sizes may change every few months as a child’s feet grow.
-Never hand down foot wear: Just because a shoe size fits one child comfortably does not mean it will fill another the same way. Also, sharing shoes can spread athlete’s foot and nail fungus infections.
-Examine the heels of your child’s shoe. Children may wear through the heels of shoes quicker than out-growing shoes themselves. Uneven heel wear can indicate a foot problem that should be evaluated by a foot/ankle physician.
-Shoes that do not fit properly can aggravate the feet: Always measure a child’s feet before buying shoes and watch for signs of irritation.
-Always buy for the larger foot: Feet are seldom the same size.
-Buy shoes that do not need a “break-in” period: Shoes should be comfortable immediately. Also, make sure to have your child try on shoes with socks or tights, if that’s how they will be worn.

6 Tips to Protect Kids in Fall Sports

If your children are playing sports this fall, pay attention to six tips that could protect them from serious ankle injuries.

--Have old sprains checked by a doctor before the season starts. A medical check-up can reveal whether your child's previously injured ankle might be vulnerable to sprains, and could possibly benefit from wearing a supportive ankle brace during competition.

--Buy the right shoe for the sport. Different sports require different shoe gear.

--Children should start the season with new shoes. Old shoes can wear down like a car tire and become uneven on the bottom, causing the ankle to tilt because the foot can't lie flat.

--Check playing fields for dips, divots and holes. Most sports-related ankle sprains are caused by jumping and running on uneven surfaces. That's why some surgeons recommend parents walk the field, especially when children compete in non-professional settings like public parks, for spots that could catch a player's foot and throw them to the ground. Alert coaching officials to any irregularities.

--Encourage stretching and warm-up exercises. Calf stretches and light jogging before competition helps warm up ligaments and blood vessels, reducing the risk for ankle injuries.

If you would like more information please visit our website at www.drrobertrosenstein.com, or call our office at 440-946-5858 to set-up a consultation.

Sporting Activities and Big Toe Pain

Turf toe is a sprain of the big toe joint resulting from injury during sporting activities. This injury usually results from excessive upward bending of the big toe joint. The condition can be caused from either jamming the toe, or repetitive injury when pushing off repeatedly when running or jumping. Although this injury is most commonly reported in football players, participants in soccer, basketball, wrestling, gymnastics and dance also are at risk.

The name “turf toe” comes from the fact that this injury is especially common among athletes who play on artificial turf. When playing sports on artificial turf the foot can stick to the hard surface, resulting in jamming of the big toe joint.

The signs and symptoms of turf toe can include pain, swelling, and limited joint movement. If turf toe is caused by repetitive actions that cause injury, the signs and symptoms will usually begin slowly and gradually worsen. Turf toe can also be caused by a direct injury leading to damage of the bone beneath the cartilage. If direct injury is the cause, the signs and symptoms may begin suddenly and get worse over a 24-hour period.

Treatment of turf toe consists of controlling the inflammation of the joint capsule. The most important aspect of treatment is to rest the sore toe to allow the inflammation to subside and the joint capsule to heal. In addition to resting the toe, inflammation can be controlled by icing the area and elevating the foot, and anti-inflammatory medications.

Athletes diagnosed with turf toe should avoid their sport at least three weeks to allow the joint capsule to heal. Without doing so, the injury can progress, and can lead to an even longer recuperation. It is not uncommon for athletes to try to come back too soon, or to try to play through the injury. Unfortunately, this usually leads to a more chronic injury, and ultimately a longer recovery.

If you or someone you know is suffering from this condition, please contact our office for a consultation, 440-946-5858 or visit our website, www.drrobertrosenstein.com for additional information.

Surgeons Issue Warning on Dangers of Cosmetic Foot Surgery

"Foot facelifts” are a growing trend around the globe, a procedure that can help to narrow the feet so that they fit better in heels or smaller shoes. However, the American Orthopedic Foot and Ankle Society has issued a warning about these procedures, indicating that this type of surgery can cause extensive nerve damage and pain, and may lead to other problems.

Cosmetic foot surgery involves shortening the second toe so that it is not longer than the big toe. This makes it easier for the foot to accommodate high heels, and can reduce pain and discomfort when wearing heels for an extensive period of time. However, the procedure can cause a significant amount of pain and nerve damage in itself, and poses many risks. Complications of foot surgery include infection, corns, and chronic pain when walking. In some cases, the bones and tendons can become inflamed or may even shift, requiring more surgery.

The procedure is also known as restorative foot surgery, because it is designed primarily to enhance the physical appearance of the foot. Some procedures involve removing fat from the heels and around the sides of the foot, so that the foot looks better in high heels. Other procedures involve the injection of fat into the balls of the feet so that the individual has a more shapelier foot and feels more comfortable in heels. Some surgeons also perform bone restructuring procedures, or administer procedures that narrow the base or tip of the feet.

Please follow the Foot and Ankle Society’s recommendation and never have surgery performed to improve the appearance of the foot.