Ankle injuries from page 29
Heel fractures Sixty percent of tarsal fractures involve the calcaneus, also known as the heel. Heel bone fractures are often severe and disabling, preventing many daily activities and most sports. Beyond confirming the fracture by x-ray, CT scans show the severity and other possible injuries, and help determine the most effective treatment plan. A cast or an immobilization device is used if the broken bones have not been displaced. Otherwise, surgery helps restores the normal position of the bone pieces and speeds healing. The AAOS notes that research for improving outcomes has focused on three areas: smaller incisions for fixing the fracture; defining which treatment method works best for which type of fracture and which type of patient—for example, smokers or people with diabetes; and inventing better plates and screws. Treatment advances According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, advances in diagnosing and treating injuries to the ankle and foot include: Arthroscopy. The biggest advance is using arthroscopy to view joint problems without major surgery. Tiny incisions mean less trauma, swelling, and scar tissue than with conventional surgery, as well as decreased hospitalization and rehabilitation. Because injuries often are addressed earlier, success is more likely. Tissue engineering. Unlike other tissues, injured joint cartilage
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MINNESOTA HEALTH CARE NEWS SEPTEMBER 2011
does not heal on its own. Techniques such as transplanting one’s own healthy cartilage or cells to improve healing are used today for small cartilage defects. Questions remain about the usefulness and cost of this treatment. Targeted pain relief. New pain-killing, medicated patches and gels can be applied directly to an injury site rather than be taken systemically, thereby limiting some of the potential side effects. Treatments on the horizon According to the institute, future developments likely will include: • Technical advances and new imaging methods for improved diagnosis and treatment • Improved rehabilitation techniques that may reduce the need for surgery • Treatment improvements based on the role of nutrition in healing • Musculoskeletal tissue engineering Most of the ankle injuries we see in our 24-hour urgent care are minor and heal relatively quickly with proper instructions and treatments begun promptly after the injury occurs. It’s good to know, however, that advances in the care of ankle and foot injuries are being made in a wide area of diagnostic and therapeutic options, enabling people to resume healthy and active lifestyles more quickly and completely. Sumner McAllister, MD, practices family medicine at Apple Valley Medical Clinic.