MALLET (BASEBALL) FINGER

MALLET FINGER - Mallet finger is an injury to the thin tendon that straightens the end joint of a finger or thumb. Although it is also known as "baseball finger," this injury can happen to anyone when an unyielding object strikes the tip of a finger or thumb and forces it to bend further than it is intended to go. As a result, you are not able to straighten the tip of your finger or thumb on your own.
Tendons are tissues that connect muscles to bone. The muscles that move the fingers and thumb are located in the forearm. Long tendons extend from these muscles through the wrist and attach to the small bones of the fingers and thumb. The extensor tendons on the top of the hand straighten the fingers. The flexor tendons on the palm side of the hand bend the fingers.

In a mallet injury, when an object hits the tip of the finger or thumb, the force of the blow tears the extensor tendon. Occasionally, a minor force such as tucking in a bed sheet will cause a mallet finger.
The injury may rupture the tendon or pull the tendon away from the place where it attaches to the finger bone (distal phalanx). In some cases, a small piece of bone is pulled away along with the tendon. This is called an avulsion injury. The finger is usually painful, swollen, and bruised. The fingertip will droop noticeably and will straighten only if you push it up with your other hand.

Mallet finger can be caused by a blunt force on the DIP. Patients who are diagnosed with mallet finger have an inability to extend their finger and experience pain and numbness. Depending on how severe the injury is, the patient can be prescribed medication in order to prevent infection. Also, most mallet finger injuries can be treated without surgery.

LOW BACK PAIN

LOW BACK PAIN - Low back pain is a universal human experience -- almost everyone has it at some point. The lower back, which starts below the ribcage, is called the lumbar region. Pain here can be intense and is one of the top causes of missed work. Fortunately, low back pain often gets better on its own. When it doesn't, there are effective treatments. In most episodes of low back pain, a specific underlying cause is not identified or even looked for, with the pain believed to be due to mechanical problems such as joint strain. If the pain does not go away with conservative treatment or if it is accompanied by "red flags" such as unexplained weight loss, fever, or significant problems with feeling or movement, further testing may be needed to look for a serious problem.

Lower back pain can be caused by a variety of problems with any parts of the complex, interconnected network of spinal muscles, nerves, bones, discs or tendons in the lumbar spine. Typical sources of low back pain include:

• The large nerve roots in the low back that go to the legs may be irritated
• The smaller nerves that supply the low back may be irritated
• The large paired lower back muscles may be strained
• The bones, ligaments or joints may be damaged
• An intervertebral disc may be degenerating

Certain causes of lower back pain have a tendency to occur more often in younger individuals versus older adults:

• Younger adults (30 to 60 year olds) are more likely to experience back pain from the disc space itself or from a back muscle strain or other soft tissue strain.
• Older adults (over 60) are more likely to suffer from pain related to joint degeneration or from a compression fracture.    

TOTAL HIP REPLACEMENT

TOTAL HIP REPLACEMENT - A total hip replacement is a surgical procedure whereby the diseased cartilage and bone of the hip joint is surgically replaced with artificial materials. The normal hip joint is a ball and socket joint. The socket is a "cup-shaped" component of the pelvis called the acetabulum. The ball is the head of the thighbone. Total hip joint replacement involves surgical removal of the diseased ball and socket and replacing them with a metal ball and stem inserted into the femur bone and an artificial plastic cup socket. The metallic artificial ball and stem are referred to as the "femoral prosthesis" and the plastic cup socket is the "acetabular prosthesis." Upon inserting the prosthesis into the central core of the femur, it is fixed with a bony cement called methylmethacrylate. Alternatively, a "cementless" prosthesis is used that has microscopic pores which allow bony ingrowth from the normal femur into the prosthesis stem. This "cementless" hip is felt to have a longer duration and is considered especially for younger patients. Total hip replacement is also referred to as total hip arthroplasty.

Total hip replacements are performed most commonly because of progressively worsening of severe arthritis in the hip joint. The most common type of arthritis leading to total hip replacement is degenerative arthritis of the hip joint. This type of arthritis is generally seen with aging, congenital abnormality of the hip joint. The progressively intense chronic pain, together with impairment of daily function including walking climbing stairs, and even arising from a sitting position, eventually become reasons to consider a total hip replacement. Because replaced hip joints can fail with time, whether and when to perform total hip replacement are not easy decisions, especially in younger patients.

TOTAL KNEE REPLACEMENT

TOTAL KNEE REPLACEMENT - Patients with severe destruction of the knee joint associated with progressive pain and impaired function maybe candidates for total knee replacement. Osteoarthritis is the most common reason for knee replacement operation. Physical therapy is an essential part of rehabilitation after total knee replacement. A TKR is a complex procedure that requires an orthopedic surgeon to make precise measurements and skillfully remove the diseased portions of your bone, in order to shape the remaining bone to accommodate the knee implant. After knee replacement surgery, you are usually sent home or to a rehabilitation facility, depending on your condition at that time. If you are sent to a facility, the average rehabilitation stay is approximately seven to ten days.

After knee replacement surgery, you should not pivot or twist on the involved leg for at least six weeks. Also during this time, when lying in bed, you should keep the involved knee as straight as possible. Kneeling and squatting also should be avoided soon after knee joint replacement surgery. Stair climbing should be kept to a minimum. Make the necessary arrangements so that you will only have to go up and down the steps once or twice a day. A firm, straight-back chair is extremely helpful in adhering to these joint precautions. Recliners should not be used. To help avoid falls, all throw rugs should be removed from the floor and rooms should be kept free of unnecessary debris. Enthusiastic pets should be kept far away until you have healed.