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Doctor insights on: Congenital Vertical Talus

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Dr. Paul Velt Dr. Velt
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Please translate: comminuted left intertrochanteric hip fracture-avulsion of greater&lesser trochanters. Fracture lines evident. No callus formation?

Dr. Paul Velt Dr. Velt
2 doctors agreed:
Please translate: comminuted left intertrochanteric hip fracture-avulsion of greater&lesser trochanters. Fracture lines evident. No callus formation?

Not healing yet: This sounds like a complicated fracture. Callus is what we look for to show signs of healing. It varies in time before it becomes visible on an X-ray . Depending on when this happened would help explain the findings. As always talk to your orthopedist. Good luck ...Read more

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Is posterior cleft deformity of the sacrum also called spina bifida occulta?

Is posterior cleft deformity of the sacrum also called spina bifida occulta?

Spina bifida: Spina bifida refers to a deformity or defect within the lumbosacral spine and yes a posterior cleft deformity would be a form of spina bifida. ...Read more

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How to protect collapse of talus dome. Diagnosed with avn 6 month post injury. Undisplaced verticle talus body fracture. No joint involved. Ptb brace?

How to protect collapse of talus dome. Diagnosed with avn 6 month post injury. Undisplaced verticle talus body fracture. No joint involved. Ptb brace?

A cast might be : A better option than a brace...I would consider a window for a bone stimulator. I would encourage you to check your vitamin d levels. ...Read more

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Non displaced transverse fracture involving proximal diaphysis of the fifth proxmial phalanx what is non displaced transverse fracture involving proximal diaphysis of the fifth proxmial phalanx and what will happen woith treatment

Non displaced transverse fracture involving proximal diaphysis of the fifth proxmial phalanx what is non displaced transverse fracture involving proximal diaphysis of the fifth proxmial phalanx and what will happen woith treatment

There : There are three bones in the little ("pinky") toe (some folks only have two), and they are called phalanges (the pleural of "phalanx"). The one closest to the foot is the proximal phalanx, the one closest to the end of the toe is the distal phalanx, and the one in the middle is called.... Well, it's the middle phalanx. The diaphysis of a long bone (these are all considered "long" bones even though they're not really all that long) is the middle section of the bone. Transverse means sideways, and fracture means break. So to translate med-speak to english (google should think of doing something like this), you have a sideways fracture in the bone closest to the foot in your pinky toe in the middle of the bone. Non-displaced means the pieces are lined-up nicely, and there is no need to "reduce" it (put the pieces back in alignment). So this is really good news for you.... You don't need to have the thing put back in place, and the fracture is in the middle of the bone, so it doesn't cross or involve a joint, which means you're not gonna get arthritis in the toe later on (at least not from this fracture). Bone takes 6-8 weeks to heal, and since the 5th toe has it's own motion during the gait cycle, you really can't tape a 5th toe to a 4th toe. And there is no need to put a cast on for a toe fracture. So just keep your walking to a minimum for the next 2 months or so. Now's not the best time to do your christmas shopping... In case you have that planned for this weekend like i do... And you'll probably be more comfortable in a shoe with a stiff sole, because bending the toe with every step is going to cause that little piggy to go wee-wee-wee all the way home. How'd i do? ...Read more

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MRI -Marrow edema, chondral thinning, elongated osteochondral lesion (6x17mm) lateral talar dome.increased signal distal syndesmosis -- need surgery?

MRI -Marrow edema, chondral thinning, elongated osteochondral lesion (6x17mm) lateral talar dome.increased signal distal syndesmosis -- need surgery?

Talar Dome Lesion: Kolleen, you have a large lesion off soft bone inside your ankle. Surgery can be an option, but attempting to create a pain free environment (from boot to just activity restrictions), contrast bathing nightly to increase circulation, Exogen bone stimulator for 9 months, repeat MRI in 6 months to see if improvement is being made, and other treatments available may avoid surgery. Dr Blake ...Read more

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What does "left distal femoral osteotomy genu valgum" mean?

What does "left distal femoral osteotomy genu valgum" mean?

Surgery type: If you have a knee angular deformity, it can be corrected by cutting a bone (an osteotomy) near the knee joint to change the alignment of the knee. A knock-knee deformity is also called genu valgum, from the latin roots. The correction of a knock knee is usually done by cutting the end of the femur to make the correction. The term "distal" refers to end of the femur at the level of the knee. ...Read more

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Ct scan"comminuted fracture is seen within right medial cuniform bone with sliglhty displaced cortical bony fragment laterally" surgery or cast? Why .

Ct scan"comminuted fracture is seen within right medial cuniform bone with sliglhty displaced cortical bony fragment laterally"
surgery or cast? Why .

Orthopedic consult: Displaced cuneiform fractures often require an open reduction and internal fixation with screws. This is due to tarsometarsal joint instability. Additional important considerations include - intra-articular vs extra-articular and plane of the fracture. Isolated cuneiform fractures are rare and more likely to happen in association with metatarsal injuries. You need to consult an orthopedic surgeon! ...Read more

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Interval bony consolidation of the L5 pars fractures bilaterally. Coronal alignment is normal, exception of positional leaning to the left. explain?

Ok: So, you initially had fractures in an area of the spine knows as the pars interarticularis, consolidation suggests they have now healed. The alingnment if the spine when viewed from the back is normal. I would not hesitate to go through your study with the person that ordered it as well. ...Read more

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What causes horizontal vs vertical bone loss?

What causes horizontal vs vertical bone loss?

Can't answer: In general with osteoporosis bone loss you lose bone density in both the horizontal struts and the vertical trabeculae. The cause of the bone loss, the resorption canals are in all of the trabecular bones horizontal and vertical. Normal bone turnover does this also but in osteoporosis these resorption canals are increased in number and this leads to increased the bone loss. ...Read more

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C5/6residual rparacentral disc osteophyte complex mild flatening & indent anterior aspect of cord-surgery with anterior fixation&fusion 2fix-soreneck?

C5/6residual rparacentral disc osteophyte complex mild flatening & indent anterior aspect of cord-surgery with anterior fixation&fusion 2fix-soreneck?

Hard to say: The treatment options for someone with the MRI findings you are describing are based also on the degree of problem you have had with it and also with the understanding that many people can respond to nonoperative care. That being said, an anterior cervical discectomy and fusion is the time tested surgery for that condition and is reasonably safe and effective. Thank you for your question. ...Read more

Dr. Paul Velt Dr. Velt
2 doctors agreed:
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My ankle xray 8mm lucency in medial talar dome consistent with osteochondral lesion. Enthesophyte at posterior aspect of the calcaneus, means what?

Dr. Paul Velt Dr. Velt
2 doctors agreed:
My ankle xray 8mm lucency in medial talar dome consistent with osteochondral lesion. Enthesophyte at posterior aspect of the calcaneus, means what?

See orthopedist : Those findings especially at the dome of the talus was once osteochondritis dessicans. To try and avoid further aritic findings talk to your doctor. That talar finding is an "old" injury. So too is enthesophyte ( spur) ...Read more

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What does exostosis proximal tibia metaphysis?

What does exostosis proximal  tibia metaphysis?

Bone growth: Usually at the insertion of a tendon. If the cartlige cap is abnormal it is of concern. ...Read more

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Externally rotated tibia. Recurring compartment syndromes in leg/foot, gastroc contracture. Could proposed osteotomy help and why?

Externally rotated tibia. Recurring compartment syndromes in leg/foot, gastroc contracture. Could proposed osteotomy help and why?

No easy answer: This issue is to be addressed after a careful review of your history, physical exam and studies. There is no easy answer to this question. ...Read more

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Can congenital dislocated hip affect childhood development?

Can congenital dislocated hip affect childhood development?

Usually not: Developmental hip dysplasia, formerly called congenital hip dislocation, should not affect future development unless associated with another anomaly in major organ. ...Read more

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Does a distal humerus supracondylar fracture require surgery?

Does a distal humerus supracondylar fracture require surgery?

Displacement: If the fracture is not properly aligned, surgery is typically recommended for the best outcome. ...Read more

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What is the tx for a supra patellar joint effusion with a transverse, non-displaced, horizontal lower pole patella fracture?

What is the tx for a supra patellar joint effusion with a transverse, non-displaced, horizontal lower pole patella fracture?

Fracture first: Knee immobilizer for knee for fracture. Possible needle aspiration of blood in the joint. May need surgical fixation of fracture for quicker recovery and better long-term result, especially if fracture displaces in knee immobilizer. ...Read more

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Ok, xray results say acute transverse non-displaced horizontal lower pole patella fracture. What now?

See orthopedist: Treatment varies but if u are able to lift your leg up straight(slr), then more than likely u can be treated in a knee immobilizer, crutches.If the fracture is more towards the 'center' of the patella and shows signs that it may 'come apart' or displace than surgical fixation(orif)is indicated generally w/k wires or screws and 'tension-band' fixation.Se your ors.Good luck! ...Read more

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What is tibial derotation osteotomy along with femoral derotation osteotomy?

What is tibial derotation osteotomy along with femoral derotation osteotomy?

Good question: Osteotimy is a cut in the bone. In a derotational osteotimy, the bone is cut and then rotated to a better position and this corrected position is usually then held in place by a plate and screws. In this case, the surgery is done on the tibia and femur. The most common indication would be severe malalignment of the leg such as a severe case of "in- toeing." ...Read more