Injuries that increase in the summer are most commonly injuries to the neck, from people diving into shallow or turbulent water. Injuries also increase with more outdoor activity, people can have anything from a simple fall to injure their knee or wrist, to being struck by a car. Dr. Louis Rose, an orthopedic surgeon and assistant professor at Orthopedic Surgery New York Medical College talked to us about summer injuries and how people should seek appropriate medical attention.
Dr. Rose says people most certainly can break their neck and not know it, and that fracture can worsen and cause untold neurological damage very quickly. Once it has been ascertained that you have not suffered a fracture, it is then time to request a board-certified orthopedic surgeon to assess possible other injury or injuries.
Orthopedic surgeons treat all forms of skeletal and skeletal-related soft tissue (muscle, tendon, ligament) injuries and diseases, both surgically and non-surgically. Patients often get themselves into dangerous situations and delay or compromise healing when they self-diagnose and self-treat, particularly when it comes to appropriate medications, movement or its restrictions and physical therapy.
HOW DO YOU KNOW IF YOUR NECK INJURY IS SERIOUS?
Anytime you have injured your neck and have an altered sensation and have severe pain when you attempt to move your neck, generally a patient will know that something is seriously wrong. Or if the patient's neck moves on itself, their head gets stuck in one position and they think it's muscular but it could dislocate and go on to serious problems. So if you experience a neck injury, you should try not to move, or if you witness a neck injury, have the patient stay still, support their head, and call an ambulance to move the patient safely. In some cases you can have a fracture through the spine where you haven't injured the cord yet, and if you keep the patient from moving around, you can keep their neurological status. But the main thing is not to let the person move around. It's one of the dangerous areas. If you hurt your ankle, it's not going to be a devastating injury, we can fix that. The problem with injuries to the spine is, you can have a fracture and still be neurologically intact, but if it fractures and the spinal cord doesn't have the integrity of the bones around it, that could lead to paralysis.
WHAT ABOUT TREATING LESS SERIOUS INJURIES, LIKE SPRAINED ANKLES OR A HURT KNEE?
I think that common sense always prevails, whenever you have any injury to a joint, get off it as quickly as you can, elevate it above your heart. Stick to RICE: Rest, Ice, Compression, and Elevation. Those are the principals that everyone should abide by, be it your knee, ankle, or wrist. Use a loosely applied ace bandage, let the whole thing settle down. Obviously if there's a deformity around the bone, you should see a doctor. I broke my own ankle, and thought it was just a sprain and looked down and aw the bone had moved. If after 24 hours the swelling hasn't settled down, seek medical attention. You don't want to displace anything that hasn't been displaced; it may require surgery. One of the things about sprains, they should be immobilized. There are 3 grades of sprains from the simplest, to where it's stretched to where the ligament is ruptured. Depending on the degree of the sprain, it should be seen by someone knowledgeable. Because ligaments have no regenerability, if you don't immobilize and let scar tissue form, if the person's moving the ankle, and scar tissue forms in a stretched out manner, it heals in a bad manner and is more likely to be re-injured.
WHAT ABOUT KNEE AND SHOULDER INJURIES?
It's different for each joint. Around the shoulder, a common problem is dislocation. There's no question the person's going to know they have a serious problem because of the pain. You can dislocate a lesser joint, like if you fall off a bike. Those people don't go running to te ER so quickly because the pain is not as severe. As far as knee injuries go, they vary from simple sprains, to major ruptures of ligaments inside the knee. For a lesser sprain, it should be treated by an orthopedist to allow the ligament to start to heal. If you allow it to heal stretched out it doesn't get the appropriate support.
DO YOU NEED TO RUSH TO THE EMERGENCY ROOM FOR THESE INJURIES?
First use the RICE principles and 24-36 hours if things don't settle down then you should seek medical attention. The degree of pain is a good barometer. If you fall all of a sudden and you have wrist pain but no obvious deformity, you don't need to get immediate attention. If it improves over 24-36 hours, the likelihood of a fracture is small, but if pain persists, seek attention.
SHOULD PEOPLE TAKE PAIN MEDICATION TO TREAT SPRAINS?
Inflammation is at its peak between 48-72 hours. By using over-the-counter anti-inflammatory drugs you can decrease swelling. Generally it means 2 Advil every 4 to 6 hours. I caution patients who have other medical conditions, ulcer disease or are on other medication to talk to your doctor before taking pain relievers.
With kids, because they can't communicate to us, you're always better off erring on the side of being conservative, taking them for evaluation. If crying persists, or they're limping, or there's deformity, they should be seen by a trained medical person. But if he falls and cries for a second and goes about his business, don't worry. Bones are very plastic in young children and will deform easily. A lot of times they'll get hurt initially and try to go about business, but then won't use the wrist or elbow or walk on their ankle, those are signals you should bring the child to the doctor.
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