advantage of surgery to fix the fractured bone

The concrete of our body which when heals from a fracture takes time.

During this time, the patient will have pain and loss of use of the part of the body.

This is acceptable to rest the building which is being repaired for few weeks before you start using it

But for us, pain remains partly even with plaster and rest.

Loss of function of the part of the body for few weeks was acceptable in those days, but people want to return to normality as quickly as possible

The drawback of not being able to use the leg or the arm is immense, understood by the person who has fractured it

Thus surgery helps to fix the bone and keep it still. This relieves the pain and helps to start using the arm or the leg and so on.

I will share some examples in the future blogs

Bye for now

Warm Regards

Chockalingam

the Reinforced concrete of our body, the bone has fractured, what to do

When the Reinforced Concrete of a building breaks, you want to repair it. until then you protect the building by not putting any force.

This is exactly what you do when the bone fractures. You stop putting any force acting across it. meaning you rest the part which is fractured.

Put some ice fomentation, and keep the body part still with bandage or splint with piece of wood.

Repair, the bone does it itself.

But while it repairs, it puts the concrete in the fluid form which then sets like the concrete mixture of water, cement and the sand.

This process in building can take days to weeks and you wait by not putting the stress.

In the bone also, you have to rest the part by immobilizing in a plaster cast or by surgery.

The body then puts blood at the fractured site which then becomes the concrete mix called callus which is soft bone.

This will then change to the hardened concrete which is hard bone.

The plaster cast is not applied directly to the bone unlike the RC in a building. hence the patient will have pain during the initial setting phase with movements.

This is why the fracture treatment has progressed for pain relief and early return to function by surgery.

We will see this in my next blog

Warm Regards

Chockalingam

RC of our body: bone, fracture, weakness and how to prevent

When the building breaks with the RC weakened with time or force, one has to repair it or reinforce it, or sometimes replace it

Bones also do break as the its RC can become weak with time or otherwise called age of the person. This is called Osteoporosis.

In some instances the building was not done with good standard RC, then the building collapses prematurely.

Bones also break when its RC is defective. This happens when the defect is in the collagen namely the steel. These happen in children when they break the bone repetitively and with unusually small falls or without any injury.

Bone break when the hydroxyapatite is not not good. as you know the hydroxyapatite is made of calcium and phosphate. this is commonly seen in Vitamin D deficiency.

How then to look after this side of the bone which breaks.

1.Please read my earlier blog on Sunshine vitamin which is Vitamin D. get at least half an hour of exposure of sunlight to your body.

Remember our old tradition of applying oil to our skin and our parents made us to stand in the sunlight on sundays, may be they knew the science behind this.

Eating vegetables is good for the calcium and milk and milk products for the vitamin and calcium

2. as your parent gets older, understand that they are prone for fractures. get them to walk at least half an hour to one hour of the day.

how does this help, please read the previous blog on RC

3. if your child breaks bones often , consult a paediatrician, but remember this is very rare. Often the fact is that your child is very active and falls often which is not a bad thing.

4. Vitamin C is important for the collagen, that is steel. Fresh fruits and juices give plenty of this vitamin and keep the bones healthy

5. Both young and old, exposure to natural sunlight is important for Vitamin D. Unfortunately children do not play outside as we used to, and there is no decent place for the elderly to walk either.

As a society we need to dwell on this further

Warm Regards

Chockalingam

bone the reinforced concrete of our body, but more unique and how to look after your bones!

My close friend and colleague , taught me about the bone of our body as being RC. RC meaning Reinforced Concrete.

The concrete in building can take loads but if you bend it with the force of the wind and nature, it will break.

Then Engineers then came up with this concept of reinforcing Concrete with Steel. The Steel has good ability to withstand bending moment but not good in compression.

Our bone needs both these strength of withstanding taking the load of weight. The human bone has Hydoroxyapatite which is calcium and Phosphate with a particular ratio.

Human body more than a static building, needs more protection from bending moments. More in the sense that the body is in motion and the bone may not be vertical all the time.

Collagen is a structure which then acts as dynamic steel rearranged in different orientations. This is unlike a Reinforced concrete where the steel is in vertical orientation or horizontal most of the time.

Human bone  "which then has this collagen -steel and the Hydroxyapatite- the concrete" is quite dynamic. it can change the content and ratio depending on the amount of load you put in.

This is unlike the building where the ratio is already decided by the engineers.

How then to look after our bones. We need to give work for this steel and the concrete of our body to make it remain in good condition.

This will be in the form of weight bearing exercise like walking and bending exercise such as flexibility exercise such as yoga or pilate.


Hope this is useful

please free to post your comments

Warm Regards

Chockalingam

Seat Belt, what do i do when my family do not want to wear the seat belt

The common problem of family members not wanting to wear the seat belt needs to be tackled. Often the head of the family may even be a doctor who fully understands the importance of the seat belt. But he is not able to convince the family  members to wear the seat belt.

What does one do?

Switch off the ignition was the reply by one of my senior colleagues and i should agree with him.

What do you think?

If you care for someone, sometimes you have to be firm and tough, if need be, eh!!

Warm regards

S Chockalingam

Food for thought: National public toilet map: public toilets listing worldwide and need for one good software on the mobile platforms

A humble request to all the software developers for the mobile phones. please do a software for mobile phones where the nearest public toilet can be located. there are good ones in other countries such as

http://www.toiletmap.gov.au/map.aspx on the web

http://www.toiletmap.co.uk/ on most platforms of mobile phones

This will be the only way that we can get the public to access the nearest toilet or rest room rather than using the open space

this will also be the only way that the existing public toilets will get publicity [as you know that there are no public sign boards to direct you to one. there is no guarantee that these boards will remain in place if the govt decides to erect these]

this will also be the only way that the availability or the lack of it would be noticed widely if one wants to campaign of them

If countries such as Australia and UK can do it, i am sure India can also do it

If one wants to know where the nearest KFC by looking at the maps on the mobile phones, i am sure he or she would be keen to know of the whereabouts of the rest room to refresh thereafter



Best Wishes

Chockalingam

Ortho Questions Part 3: Patients queries answered

Please find some of the questions asked regarding the problems affecting the bones and joints [Ortho Problems]

 I will share few questions in each blog and i will be pleased to answer any if you have queries.

Disclaimer: This sharing is only to educate the public and not taken as an advice to your or someone else's present problem

Question # 11:


Can a low back ache person (L3~L5) practice swimming. If yes, what are the pre‐cautions to be taken?

Yes is the answer, avoid breast stroke if in acute pain. Otherwise need not worry.


Question # 12:
I was a regular runner and sports person right from my school days, was active till my college days. Later I continued
exercising in gym and run in almost all terrain surfaces ( Uphill, ground, beach, and tread mill) I had even participated in
Marathon running until 2010, later I developed pain in my knees which use to be acute with little swelling in between
knee bones. Without running or exercise the swelling and pain gets reduced and aggravates slowly when I continue. And
now without any treatment I haven’t got any pain for last few months. Kindly requesting clarity on what would have
been the cause for above said symptoms and any best way to deal with it to continue my running.

Answer: 
You have not mentioned your age. Osteo arthritis of knee is very common as one grows old; typically pain comes after
prolonged activity or rest. Consult an Ortho Surgeon who would be able to assess and give you an answer.
Question # 13:
My Sister, aged 30yrs. Is having Extra bone Growth at Feet (Heel). Doctors saying there is no cure. She is suffering from
severe pain. What is the Cure?
Please refer to the answer to question 2. Injection to the heel by a trained Ortho Surgeon can be considered if in severe
pain after following the treatment methods mentioned in the answer to question 2

Question # 14:

Attached herewith please find my Hinduja Hospital scanned copy Reports wherein I have done my Vitamin D & BMD
Tests. My Ortho Doctor  has prescribed the following medicines to be consumed:‐
1. Gemfos‐35, once a week, daily after breakfast for 4 weeks.
2. Bio‐D3 Mox to be taken once daily after breakfast for 10 days.
Kindly advise me the extent of Calcium level in my body & what treatment. Should I take for my calcium level to be
normal in my body/bones?

Answer:
Calcium is controlled strictly by vitamin D and hormones. Measurement of calcium is done in blood and will be normal in
most situations. However Calcium in the bone can be deficient due to vitamin D deficiency and you are already on
treatment for the same.
Table 2: Selected Food Sources of Calcium [2]
Food
Milligrams (mg)
per serving Percent DV*
Yogurt, plain, low fat, 8 ounces 415 42
Mozzarella, part skim, 1.5 ounces 333 33
Sardines, canned in oil, with bones, 3 ounces 325 33
Yogurt, fruit, low fat, 8 ounces 313–384 31–38
Cheddar cheese, 1.5 ounces 307 31
Milk, nonfat, 8 ounces** 299 30
Soymilk, calcium‐fortified, 8 ounces 299 30
Milk, reduced‐fat (2% milk fat), 8 ounces 293 29
Milk, buttermilk, low‐fat, 8 ounces 284 28
Milk, whole (3.25% milk fat), 8 ounces 276 28
Orange juice, calcium‐fortified, 6 ounces 261 26
Tofu, firm, made with calcium sulfate, ½ cup*** 253 25
Salmon, pink, canned, solids with bone, 3 ounces 181 18
Cottage cheese, 1% milk fat, 1 cup 138 14
Tofu, soft, made with calcium sulfate, ½ cup*** 138 14
Ready‐to‐eat cereal, calcium‐fortified, 1 cup 100–1,000 10–100
Frozen yogurt, vanilla, soft serve, ½ cup 103 10
Turnip greens, fresh, boiled, ½ cup 99 10
Kale, raw, chopped, 1 cup 100 10
Kale, fresh, cooked, 1 cup 94 9
Ice cream, vanilla, ½ cup 84 8
Chinese cabbage, bok choi, raw, shredded, 1 cup 74 7
Bread, white, 1 slice 73 7
Pudding, chocolate, ready to eat, refrigerated, 4 ounces 55 6
Tortilla, corn, ready‐to‐bake/fry, one 6" diameter 46 5
Tortilla, flour, ready‐to‐bake/fry, one 6" diameter 32 3
Sour cream, reduced fat, cultured, 2 tablespoons 31 3
Bread, whole‐wheat, 1 slice 30 3
Broccoli, raw, ½ cup 21 2
Cheese, cream, regular, 1 tablespoon 14 1
* DV = Daily Value.

Question # 15:
My father was suffering from knee pain since 2 years. 6 months back it was diagnosed that there was pus inside the
knee. Finally pus was removed by the doctor. But till this time he is not able to walk without support. He is diabetic.
What precaution he must take? Is it required, the knee replacement or there are any other ways for healing.
My mother is also suffering from the similar problem but she complains the stinging pain mostly in her legs and back. I
have consulted several doctors for my mother but they end up giving pain killers. The root cause of the problem is
not diagnosed. Please give me some idea what could be the real cause of the problem and what tests to make in order
to diagnose the problem.

Answer: 

Your father having pus in the joint is fairly uncommon. Pseudo gout with wear and tear of the knee can mimic pus in the
joint. If he indeed had infection in the knee joint, then total knee replacement is contraindicated. Hence please confirm
with the surgeon who treats your father on the exact diagnosis. Your mother, please consult a neurologist for the
shooting pain down the back and the legs. It may be sciatica and some medicines and some physiotherapy would help. If
the symptoms do not resolve, then further investigations such as MRI of the back may be indicated, then you need to
consult an ortho surgeon or a neurosurgeon who deals with spine.