Bruising of the metatarsal in the foot

In the second phase of fracture treatment, the main goal of therapy is to accelerate the resorption of dead cell elements and stimulate bone growth. In this phase, in addition to the application of physical means directly at the site of injury, general treatments such as transcranial electrical stimulation and electroses are used.

Physiotherapy and rehabilitation for fractures

A bone fracture is total or partial damage to the integrity of bone tissue, usually occurring over a short period of time, resulting in damage to adjacent muscles, tissues and nerves. The classification of fractures is broad, but we consider closed and open fractures.

With advances in technology, the number of fractures is also increasing rapidly. For example, the increasing number of cars also has other side effects in the form of more traffic accidents.

However, the most important biological property of bone tissue is its ability to heal. And the body's ability to heal itself is also very high with this type of injury.

Physiotherapy for fractures plays a concomitant but important role. It can be recommended both for treatment and for prevention. The speed and effectiveness of healing does not only depend on the bones. The overall condition of the central nervous system, endocrine system and mineral metabolism are also of great importance. Although physiotherapy does not directly affect bone regeneration, all of these systems and organs are affected as well.

stages Stages of bone tissue regeneration

Before we talk about physical therapy and rehabilitation methods and approaches, it is important to have a basic understanding of bone repair in general. It takes place in 3 phases. At each stage, rehabilitation has its own specific characteristics.

1. Phase 1 is the phase of traumatic inflammation. It begins at the time of injury, when the integrity of the bones is compromised and the soft tissues are crushed. If vessels are damaged, the process is accompanied by bleeding. This stage is accompanied by all the traumatic symptoms of a fracture - acute pain, inflammation. This stage lasts until day 10.
2. The second phase of the process begins around the 10th to 15th day. The patient's inflammatory response subsides, the pain subsides, the swelling goes down. At this stage, a primary callus forms.
3. The third phase is the phase of complete healing and formation of normal bone. This can be accompanied by an increase in mineral metabolism and an increase in the level of calcium in the blood.

The key to healing a fracture is repositioning the fracture and positioning it correctly. Physiotherapy begins on the 2nd to 3rd day of treatment after the fracture has been repositioned. The subject of physiotherapy is both the fracture area and the injured limb and the entire body. Physiotherapy also has a positive effect on the regeneration of bone tissue and the functioning of the limbs, as well as the normalization of the body in general.

Symptoms of a broken bone

There is an opinion that a fracture is more painful than a bruise. In truth this is not the case. The pain receptors are the same everywhere: in the muscles, the skin and the ligaments as well as in the periosteum. Therefore, a diagnosis based on the intensity of pain sensations does not make sense. Also, some fractures are not very painful, so a person may not initially realize the severity of the accident. This is e.g. This is the case, for example, with certain types of femoral neck fractures in the elderly.

The second symptom is the swelling of the tissues and the size of the hematoma (bruise). Fractures are usually associated with more massive trauma and thus with significant swelling and a large bruise. Also, the swelling and bruising can increase within hours of the fall or even the next day. But there are also exceptions. For example, bruises on parts of the body that have little fat but lots of blood vessels (chest, ankles, front shins, head and face). The injury site literally puffs up before your eyes, and then this huge bruise can even slide away under gravity, turning your skin purple and blue-green for a period of time. The consequences of these injuries look terrible, even if the bones are intact and there is no health risk. In contrast, with broken bones that are hidden under a thick layer of muscle, the swelling may be barely noticeable and there may be no bruising at all.

The third symptom is restricted movement of the injured body part. The broken bone loses strength and can therefore no longer fulfill its support function, so that movement is not possible. However, this principle does not work for subperiosteal fractures, bone fractures and embedded fractures.

Therefore, it is silly to say that in most cases it is just a bruise or a complete fracture. The chance that you are wrong is 50/50. The only way to accurately diagnose this is with an X-ray. Another question is: How dangerous are such fractures? Can they seriously harm your health if the symptoms are something like a simple bruise?

Should you see a doctor if you suspect a fracture?

In most cases, non-severe fractures will heal on their own without the need for an exam, a cast, or medical attention. It is sufficient if the point of impact is spared and immobilized. It is not uncommon for a trauma surgeon to x-ray a fresh fracture to find that there is a previously undiscovered fracture nearby. But these injuries are not always without consequences.

Example. A lifeguard was clearing the stairs of the ice, slipped and hit his chest painfully. The woman's intuition told her that it was better to rehab and call an ambulance. However, the paramedic who arrived at the scene of the accident suggested that the man should not have his first X-ray as no one would put a band-aid on his broken ribs anyway. He left everything as it was and drove away. In the morning, turning awkwardly, the man felt a stab in his chest and began to inflate like a balloon. After a few minutes, he found it difficult to breathe. Without the efficient work of another medical team, the bathhouse worker would have died of pneumothorax, a lung injury caused by a rib splitter that damaged soft tissues. The lifeguard was able to resume work after the operation in spring, when the steps no longer needed to be cleared of ice.

No less dangerous are embedded femoral neck fractures when falling on the side with a nosedive. The outward signs of an injury can be mild and the pain bearable, allowing you to continue walking or even running. But at some point, the bone fragments can shift, causing the condition to worsen significantly. First, surgery is required to reconnect them, and second, the femoral head can be completely destroyed by cutting off the blood supply. The result is a prosthesis or complete immobilization.

A compression fracture of the spine can lead to chronic low back pain, paresis and paralysis due to compression of the intervertebral nerves and even the spinal cord. A broken toe can later lead to a toe deformity. You can then no longer wear elegant shoes.

causes

Inflammation of one or more synovial capsules in the foot is most often caused by repeated trauma to the joint capsule. Predisposing factors increase the likelihood of developing the condition. This may include the following conditions:

• the presence of a foot deformity – most commonly a valgus big toe, heel spur, flatfoot or clubfoot;
• concomitant acquired diseases of the musculoskeletal system (plantar fasciitis);
• Repeated foot injuries, including those related to sports (long jump, athletics, etc.);
• Obesity, which increases the load on the joints and periarticular tissues;
• Biological aging, which provokes dystrophic processes in many tissues (bunions in women are often associated with the onset of menopause);
• thinning of the subcutaneous fatty tissue where the joint capsules are located under the skin;
• Deforming arthrosis of the medium and small joints of the lower limbs;
• Wearing compression shoes that have a mechanically unfavorable effect on the musculoskeletal system of the foot;
• Pathology of the spine, which increases the load on the feet;
• Metabolic and autoimmune disorders in the body.

Treatment

treatment of the fracture. Depending on the severity of the fracture, conservative or surgical treatment is chosen.

Treatment of a dislocation: closed or open (surgical) reduction of the dislocation, capsular augmentation, bone grafts, muscle and tendon grafts, use of grafts.

treatment of bruises. Immediately after the injury – cooling the bruised area and rest. In case of complications, surgical intervention is possible.

Treatment of sprains and strains. Conservative treatment depends on the severity of the injury - rigid (cast) or non-rigid immobilization of the injured area is recommended. In the case of surgical treatment, the torn ligament is sutured with lavsan and fixed at the point of attachment.

For all types of injuries, physiotherapy, physical therapy and massage are recommended during rehabilitation.

With every injury, you should not delay treatment and pay attention to and react to even the smallest changes and symptoms. By following the doctor's recommendations, you can restore your leg's function as much as possible.

Clinic of Medical High Technology NI Pirogov, Department of Traumatology and Surgery No. 2

Movalis or Xefocam: which is better?

Xefocam is a German medicine in the form of tablets and a solution for injection. The active substance of the drug is lornoxicam, which has a pronounced analgesic and anti-inflammatory effect. Unlike Movalis, it does not have an antipyretic effect and is contraindicated in children under 18 years of age.

The main advantage of Xefocam is its powerful analgesic effect, which is why it is used in the treatment of acute pain. Xefocam takes effect one hour after ingestion and lasts for 8 hours. In contrast, the effects of Movalis are visible after 5-6 hours and last throughout the day. Therefore, it is better to use Movalis for inflammation, and Xefocam for pain.

Common symptoms of breast cancer

Many women think that a symptom of breast cancer is just a lump in the gland. In reality, this cancer can manifest itself in many different ways, depending on the stage.

Early breast cancer is painless, so it goes unnoticed for a long time. Common symptoms of breast cancer:

• A soft lump in the chest, resembling a fluid-filled blister;
• reddening and thickening of the skin for no apparent reason;
• An area of skin that looks like an 'orange peel';
• A 'stretched' piece of skin on the chest that makes movement difficult;
• Irregular nipple discharge – this is a symptom of fourth-stage breast cancer;
• a change in the shape of the nipple (e.g. pulling in) – this is also a late-stage symptom;
• a sudden change in the appearance of a breast (eg, change in size);
• Swelling or tenderness in nearby (axillary) lymph nodes.

Late symptoms of massive lymph node metastasis include swelling of the arms, pain when eating due to enlarged axillary lymph nodes, and symptoms due to distant metastasis, but this is already a very common cancer.

Breast cancer is not a punishment

'Breast cancer is not a punishment. If the disease is detected at an early stage, it is curable to 95 %. The probability that the disease will not be cured is about as high as the probability of a traffic accident. However, regular checkups and a healthy lifestyle are essential to keep the disease at bay.

Prevention is divided into primary and secondary prevention.

• Primary prevention includes a healthy lifestyle and physical activity. Exercising for half an hour twice a week cuts your risk of breast cancer by half, but you need to be active from a young age. It's important to maintain a normal body weight because postmenopausal women with a lot of body fat secrete a lot of estrogen, which promotes the growth of tumors. On the other hand, the ovaries stop producing progesterone, and estrogen alone significantly increases the risk of developing breast cancer.
• Secondary prevention is based on early detection of cancer. From the age of 20, women should carry out a self-examination every month on the 5th to 7th day of their cycle, ie shortly after the end of the menstrual period. For women who are not menstruating, it can be performed on any day. You should also have your gynecologist examine you during your check-up.

If you have problems with your breasts, such as B. high tenderness, pain, swelling, mastitis or menstrual syndrome, you should visit your mammologist regularly for an ultrasound examination. The examination can be carried out at the Diana Clinic in St. Gallen.

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diagnostic measures

In order for acute heel pain to be treated definitively and not turn into a chronic form, it is necessary to consult a doctor to take all measures to determine the factor that provoked the pain symptoms. The methods of examination depend on the age of the patient and the severity of the syndrome. If the appearance of the heel hurts, the following diagnostic measures are carried out:

• X-ray examination is a universal method that reveals all the factors that provoke pain when the heel strikes.
• Ultrasound examination of the heel and magnetic resonance imaging. Used to detect a tumor or other cancer.
• osteoscintigraphy. Performed to detect necrotic bone lesions and fistulas.
• densitometry. Used to determine the condition of the bone cavity.
• Puncture of the synovial capsule. The purpose of the examination is to detect an inflammatory process.
• puncture biopsy. Conducted to rule out tuberculosis.
• General and biochemical blood tests. The aim is to determine the uric acid content.

What to do with pain and how can you treat it?

If the heel of the left foot hurts, you should start treating this symptom. Do not treat the pain yourself, otherwise you can only aggravate the condition. Self-treatment can result in pain below the knee, in the hip, or in the lower back. The painful part of the foot can be treated with traditional medicines, surgical and orthopedic means. There are also popular folk remedies, but it is important to remember that you cannot permanently get rid of the syndrome using these methods. Alternative remedies can only alleviate the syndrome, not eliminate its cause.

treatment with medication

The choice of medication depends on the cause of the pain. If the feet hurt in the morning, after playing ball games, jogging or standing upright for a long time, the following drugs are most often prescribed

• Nonsteroidal anti-inflammatory drugs:
  • For internal use (ibuprofen);
  • Topical application for sore heels ('Fastum Gel', 'Diclofenac').
• Special lactic acid or salicylic acid patches.
• Drugs to lower uric acid.
• Medicines to fight infections and viruses.
• Medicines for tuberculosis.
• blocking drugs. Used when the heel is swollen. They relieve pain and improve blood flow to the affected part of the body.

surgical intervention

Surgical intervention is the most common treatment for heel spurs, which usually come with a dull ache and torn ligaments. This treatment method prevents chronic pain and permanently eliminates the cause of the symptom in the right or left extremity. The operation can be performed open or closed (endoscopic).

Stages of treatment in the clinic

1. Consultation and diagnosis. Initial examination of the mouth to determine the presence of dental disease. Collection of anamnesis - presence of chronic diseases, type and duration of pain, presence of allergic reactions. If necessary, X-rays and laboratory tests are carried out.
2. oral hygiene. Oral preparation begins with professional hygiene. Adjacent areas are cleared of plaque and tartar. Sources of infection are treated.
3. The cause of the disease is treated. Treatment is carried out depending on the severity and complications:
   • In case of hypersensitivity – remineralization therapy or fluoridation of the tooth.
   • Chipped or cracked enamel is repaired with composite. A crown is used for larger damages.
   • Gingivitis is treated with anti-inflammatory drugs. Periodontal disease or abscesses are treated surgically.
   • With repeated treatments, the root canals are cleaned, filled and, if necessary, the root is removed.
   • Problems with the filling or crown are corrected by grinding or replacing the structure after the individual has been treated.

Medical therapy

Painkillers can reduce the intensity of symptoms. For example, Ketanov, Tempalgin, Nurofen are painkillers that work for 5 hours.

Inflammation can be relieved by rinsing the mouth with a saline and soda solution, decoctions of sage and chamomile. Medicinal anti-inflammatory solutions – Miramistin, Chlorhexidine, Furacilin. Do not heat the inflamed area or apply ointments. To avoid worsening the situation, do not take antibiotics without a doctor's recommendation.

You can try to get rid of the acute pain until your second visit to the doctor.

Treatment

To provide first aid to your child, you need to determine the location of the injury. If the anterior vascular areas are injured, the nose bleeds more. In this case, the bleeding stops after the first medical treatment or stops spontaneously.

If nosebleeds in children are severe, the large vascular structures in the back of the nose are damaged. This condition requires medical attention as it does not resolve spontaneously.

How To Stop Nosebleeds - Advice For Parents:

1. Place the child's upper body in an optimal position (sitting - with head tilted forward).

2. Remain calm so that your behavior does not incite fear; calm the child down.

3. Put a cold cloth or ice on the bridge of your nose.

Put vasoconstrictive drops in the nose.

5. If the above measures do not help, you can moisten cotton with 3%iger hydrogen peroxide and insert it into the nostril and press it against the nasal septum as high as possible.

6. If the manipulation is unsuccessful within 15-20 minutes, call an ambulance.

What not to do! Don't put the child on their back and don't tilt their head back. This causes the blood to flow down the throat and into the stomach, which soon leads to vomiting. If you can't stop the bleeding yourself, you absolutely must call an ambulance. If NCD occurs frequently, a visit to the otolaryngologist is indicated.

If your child has a nosebleed, contact RebenOK's ENT department. An online consultation service is also available.

Talk to your doctor to find out why your child is having a nosebleed. If tamponade does not help, surgical treatment with endoscopic electrocoagulation is indicated. The changed blood vessels in the nasal mucosa are 'closed' in order to prevent renewed bleeding. With local anesthesia, the procedure is performed with the help of electricity. The procedure can also be performed with medication.

prevention

Parents can prevent epistaxis from developing. Preventing nosebleeds in children includes good nasal hygiene, a favorable room climate and timely treatment of bleeding disorders.

For the treatment of nosebleeds, visit the Rebenok Clinic. Patients are treated by certified ENT doctors with extensive practical experience. The clinic is equipped with devices of the highest standard. The instruments and devices used are designed for pediatric patients.

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