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March 18, 2017

Fibula Fracture: Symptoms, Treatment, and Recovery


The fibula and tibia are the two long bones of the lower leg. The fibula, or calf bone, is a small bone located on the outside of the leg. The tibia, or shinbone, is the weight-bearing bone and is in the inside of the lower leg.

The fibula and the tibia join together at the knee and ankle joints. The two bones help to stabilize and support the ankle and lower leg muscles.

A fibula fracture is used to describe a break in the fibula bone. A forceful impact, such as landing after a high jump or any impact to the outer aspect of the leg, can cause a fracture. Even rolling or spraining an ankle puts stress on the fibula bone, which can lead to a fracture.

Types of fibula fracture

Fibula fractures can happen at any point on the bone and can vary in severity and type. Types of fibula fracture include the following:

leg bones
The fibula bone is the smaller of the two leg bones and is sometimes called the calf bone.
  • Lateral malleolus fractures occur when the fibula is fractured at the ankle
  • Fibular head fractures occur at the upper end of the fibula at the knee
  • Avulsion fractures happen when a small chunk of bone that is attached to a tendon or ligament is pulled away from the main part of the bone
  • Stress fractures describe a situation where the fibula is injured as the result of repetitive stress, such as running or hiking
  • Fibular shaft fractures occur in the mid-portion of the fibula after an injury such as a direct blow to the area

A fibula fracture can be due to many different injuries. It is commonly associated with a rolled ankle but can also be due to an awkward landing, a fall, or a direct blow to the outer lower leg or ankle.

Fibula fractures are common in sports, especially those that involve running, jumping, or quick changes of direction such as football, basketball, and soccer.

Symptoms

Pain, swelling, and tenderness are some of the most common signs and symptoms of a fractured fibula. Other signs and symptoms include:

  • Inability to bear weight on the injured leg
  • Bleeding and bruising in the leg
  • Visible deformity
  • Numbness and coldness in the foot
  • Tender to the touch

Diagnosis

People who have injured their leg and are experiencing any of the symptoms should consult a doctor for a diagnosis. The following steps occur during the diagnosis process:

  • Physical examination: A thorough examination will be conducted and the doctor will look for any noticeable deformities
  • X-ray: These are used to see the fracture and see if a bone has been displaced
  • Magnetic resonance imaging (MRI): This type of test provides a more detailed scan and can generate detailed pictures of the interior bones and soft tissues

Bone scans, computerized tomography (CT), and other tests may be ordered to make a more precise diagnosis and judge the severity of the fibula fracture.

Treatment

fractured fibula
Simple and compound fibula fractures are classified depending on whether the skin has been broken or the bone is exposed.

Treatment for a fibula fracture can vary and depends greatly on how severe the break is. A fracture is classified as open or closed.

Open fracture (compound fracture)

In an open fracture, either the bone pokes through the skin and can be seen or a deep wound exposes the bone through the skin.

Open fractures are often the result of a high-energy trauma or direct blow, such as a fall or motor vehicle collision. This type of fracture can also occur indirectly such as with a high-energy twisting type of injury.

The force required to cause these types of fractures means that patients will often receive additional injuries. Some injuries could be potentially life-threatening.

According to the American Academy of Orthopedic Surgeons, there is a 40 to 70 percent rate of associated trauma elsewhere within the body.

Doctors will treat open fibula fractures immediately and look for any other injuries. Antibiotics will be administered to prevent infection. A tetanus shot will also be given if necessary.

The wound will be cleaned thoroughly, examined, stabilized, and then covered so that it can heal. An open reduction and internal fixation with plate and screws may be necessary to stabilize the fracture. If the bones are not uniting, a bone graft may be necessary to promote healing.

Closed fracture (simple fracture)

In a closed fracture, the bone is broken, but the skin remains intact

The goal of treating closed fractures is to put the bone back in place, control the pain, give the fracture time to heal, prevent complications, and restore normal function. Treatment begins with the elevation of the leg. Ice is used to relieve the pain and reduce swelling.

If no surgery is needed, crutches are used for mobility and a brace, cast, or walking boot is recommended while healing takes place. Once the area has healed, individuals can stretch and strengthen weakened joints with the help of a physical therapist.

There are two main types of surgery if a patient requires them:

  • Closed reduction involves realigning the bone back to its original position without the need to make an incision at the fracture site
  • Open reduction and internal fixation realigns the fractured bone to its original position using hardware such as plates, screws, and rods

The ankle will be placed into a cast or fracture boot until the healing process is complete.

Rehab and physical therapy

After being in a cast or splint for several weeks, most people find that their leg is weak and their joints stiff. Most patients will require some physical rehabilitation to make sure their leg regains full strength and flexibility.

physical therapy
Some physical therapy may be required to regain full strength in a person’s leg.

A physical therapist will evaluate each person individually to determine the best treatment plan. The therapist may take several measurements to judge the individual’s condition. Measurements include:

  • Range of motion
  • Strength
  • Surgical scar tissue assessment
  • How the patient walks and bears weight
  • Pain

Physical therapy usually begins with ankle strengthening and mobility exercises. Once the patient is strong enough to put weight on the injured area, walking and stepping exercises are common. Balance is a vital part of regaining the ability to walk unassisted. Wobble board exercises are a great way to work on balance.

Many people are given exercises that they can do at home to further help with the healing process.

Long-term recovery

Proper treatment and rehabilitation supervised by a doctor increases the chance the person will regain full strength and motion. To prevent fibula fractures in the future, individuals who participate in high-risk sports should wear the appropriate safety equipment.

People can reduce their fracture risk by:

  • Wearing appropriate footwear
  • Following a diet full of calcium-rich foods such as milk, yogurt, and cheese to help build bone strength
  • Doing weight-bearing exercises to help strengthen bones

Possible complications

Fractured fibulas typically heal with no further problems, but the following complications are possible:

  • Degenerative or traumatic arthritis
  • Abnormal deformity or permanent disability of the ankle
  • Long-term pain
  • Permanent damage to the nerve and blood vessels around the ankle joint
  • Abnormal pressure buildup within the muscles around the ankle
  • Chronic swelling of the extremity

Most fractures of the fibula do not have any serious complications. Within a few weeks to several months, most patients make a full recovery and can continue their normal activities.

March 18, 2017

New study connects running motion to ground force, provides patterns for any runner

Researchers at Southern Methodist University in Dallas have developed a concise new explanation for the basic mechanics involved in human running.

The approach offers direct insight into the determinants of running performance and injuries, and could enable the use of individualized gait patterns to optimize the design of shoes, orthoses and prostheses according to biomechanics experts Kenneth Clark, Laurence Ryan and Peter Weyand, who authored the new study.

The ground force-time patterns determine the body’s motion coming out of each step and therefore directly determine running performance. The impact portion of the pattern is also believed to be a critical factor for running injuries.

“The human body is mechanically complex, but our new study indicates that the pattern of force on the ground can be accurately understood from the motion of just two body parts,” said Clark, first author on the study and currently an assistant professor in the Department of Kinesiology at West Chester University in West Chester, Pennsylvania.

“The foot and the lower leg stop abruptly upon impact, and the rest of the body above the knee moves in a characteristic way,” Clark said. “This new simplified approach makes it possible to predict the entire pattern of force on the ground – from impact to toe-off – with very basic motion data.”

This new “two-mass model” from the SMU investigators substantially reduces the complexity of existing scientific explanations of the physics of running.

Existing explanations have generally relied upon relatively elaborate “multi-mass spring models” to explain the physics of running, but this approach is known to have significant limitations. These complex models were developed to evaluate rear-foot impacts at jogging speeds and only predict the early portion of the force pattern. In addition, they are less clearly linked to the human body itself. They typically divide the body into four or more masses and include numerous other variables that are hard to link to the actual parts of a human body.

The SMU model offers new insight by providing concise, accurate predictions of the ground force vs. time patterns throughout each instant of the contact period. It does so regardless of limb mechanics, foot-strike type and running speed.

“Our model inputs are limited to contact time on the ground, time in the air, and the motion of the ankle or lower limb. From three basic stride variables we are able to predict the full pattern of ground-force application,” said Ryan, who is a physicist and research engineer at SMU’s Locomotor Performance Laboratory.

“The approach opens up inexpensive ways to predict the ground reaction forces and tissue loading rates. Runners and other athletes can know the answer to the critical functional question of how they are contacting and applying force to the ground.” added Ryan.

Current methods for assessing patterns of ground force application require expensive in-ground force platforms or force treadmills. Additionally, the links between the motions of an athlete’s body parts and ground forces have previously been difficult to reduce to basic and accurate explanations.

The researchers describe their new two-mass model of the physics of running in the article, “A general relationship links gait mechanics and running ground reaction forces,” published in the Journal of Experimental Biology.

“From both a running performance and injury risk standpoint, many investigations over the last 15 years have focused on the link between limb motion and force application,” said Weyand, who is the director of SMU’s Locomotor Performance Laboratory. “We’re excited that this research can shed light on this basic relationship.”

Overall force-time pattern is the sum of two parts

Traditional scientific explanations of foot-ground forces have utilized different types of spring and mass models ranging from complex to very simple. However, the existing models have not been able to fully account for all of the variation present in the force-time patterns of different runners – particularly at speeds faster than jogging. Consequently, a comprehensive basis for assessing performance differences, injury risks and general running mechanics has not been previously available.

The SMU researchers explain that the basic concept of the new approach is relatively simple – a runner’s pattern of force application on the ground is due to the motion of two parts of the body: the lower portion of the leg that is contacting the ground, and the sum total of the rest of the body.

The force contributions of the two body parts are each predicted from their largely independent, respective motions during the foot-ground contact period. The two force contributions are then combined to predict the overall pattern. The final prediction relies only upon classical physics and a characteristic link between the force and motion for the two body parts.

New approach can be applied accurately and inexpensively

The application of the two-mass approach is direct and immediate.

“Scientists, clinicians and performance specialists can directly apply the new information using the predictive approach provided in the manuscript,” Clark said. “The new science is well-suited to assessing patterns of ground-force application by athletes on running tracks and in performance training centers.”

These capabilities have not been possible previously, much less in the inexpensive and accurate manner that the new approach allows for with existing technology.

“The only requirement is a quality high-speed camera or decent motion sensor and our force-motion algorithms,” Clark said. “It’s conceivable that even shoe stores would benefit by implementing basic treadmill assessments to guide footwear selection from customer’s gait mechanics using the approach.”

A critical breakthrough for the SMU researchers was recognition that the mass contribution of the lower leg did not vary for heel vs. forefoot strikes and was directly quantifiable. Their efforts lead them to recognize the initial force contribution results from the quick stopping of the lower part of the leg — the shin, ankle and foot — which all come down and stop together when the foot hits the ground.

Olympic sprinters were a clue to discovery

The SMU team discovered a general way to quantify the impact forces from the large impacts observed from Olympic-caliber sprinters. Like heel strikers, the patterns of Olympic sprinters exhibit a sharp rising edge peak that results from an abrupt deceleration of the foot and lower leg. However, sprinters accomplish this with forefoot impacts rather than the heel-first landing that most joggers use.

“The world-class sprinters gave us a big signal to figure out the critical determinants of the shape of the waveform,” said Weyand. “Without their big impact forces, we would probably have not been able to recognize that the ground-force patterns of all runners, regardless of their foot-strike mechanics and running speed, have two basic parts.”

When the researchers first began to analyze the seemingly complicated force waveform signals, they found that they were actually composed of two very simple overlapping waveforms, Ryan said.

“Our computer generated the best pattern predictions when the timing of the first waveform coincided with the high-speed video of the ankle stopping on impact. This was true to within a millisecond, every single time. And we did it hundreds of times,” he said. “So we knew we had a direct physical relationship between force and motion that provided a critical insight.”


New approach has potential to diagnose injury, rehab

The SMU team’s new concise waveforms potentially have diagnostic possibilities, Weyand said.

For example, a runner’s pre-injury waveforms could be compared to their post-injury and post-rehab waveforms.

“You could potentially identify the asymmetries of runners with tibial stress fractures, Achilles tendonitis or other injuries by comparing the force patterns of their injured and healthy legs,” he said.

And while medical images could suggest the injury has healed, their waveforms might tell a different story.

“The waveform patterns might show the athlete continues to run with less force on the injured limb. So it may offer an inexpensive diagnostic tool that was not previously available,” Weyand said.

Article: A general relationship links gait mechanics and running ground reaction forces, Kenneth P. Clark, Laurence J. Ryan, Peter G. Weyand, Journal of Experimental Biology, doi: 10.1242/jeb.138057, published online 18 January 2017.

March 17, 2017

Skilled workers more prone to mistakes when interrupted

Expertise is clearly beneficial in the workplace, yet highly trained workers in some occupations could actually be at risk for making errors when interrupted, indicates a new study.

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March 17, 2017

Self-expanding TAVR as good as surgery in intermediate-risk patients

Two-year data reveal no difference in the combined rate of stroke and death from any cause when comparing the use of self-expanding transcatheter aortic valve replacement (TAVR) with standard open-heart surgery in intermediate risk patients with severe aortic stenosis, according to research.

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March 17, 2017

Flexibility is key in mechanism of biological self-assembly

A new study has modeled a crucial first step in the self-assembly of cellular structures such as drug receptors and other protein complexes, and found that the flexibility of the structures has a dramatic impact on how fast two such structures join together.

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March 17, 2017

More than half of college football athletes have inadequate levels of vitamin D

More than half of college football athletes participating in the NFL Combine had inadequate levels of vitamin D, and this left them more susceptible to muscle strains and ‘sports hernia,’ according to researchers.

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March 17, 2017

New toxic pathway identified for protein aggregates in neurodegenerative disease

Scientists have identified new processes that form protein “clumps” that are characteristic of amyotrophic lateral sclerosis (ALS) and frontotemporal lobar degeneration (FTLD). How these proteins, which can bind RNA in normal cells, stick together has remained elusive until recently, when scientists demonstrated that they demix from the watery substance inside cells, much like oil separates from water. The team sheds light onto the molecular interactions behind the process in patients with defects in the C9orf72 gene.

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October 28, 2016

How a NYC gait analysis lab can improve your health

You’ve probably heard of gait analysis and a gait analysis lab and have a rough idea of what they are. Maybe you think it’s mostly for serious runners wanting to fine tune their technique in order to avoid injury. Or perhaps you think it’s a sales device  of high-end running stores to help them sell expensive footwear.

 

While some of this may be true, gait analysis is a whole science which involves much more than this.

 

What is gait analysis?

In essence, gait analysis is the systematic and scientific study of motion, usually human. It requires intensive observation by both the human eye and by cameras to intelligently process kinetic and kinematic data. Gait analysis should effectively measure muscle activity, body mechanics and body movement. Importantly, it should also deliver findings and advice in a clear and understandable way, as we do at The Center.

 

How has gait analysis developed?

With the rapid pace of technological development, gait analysis as a field has enjoyed significant improvement. Gait analysis has come a long way since its origins concentrating on animals and the first scientific papers in the 1890s, looking at the bio-mechanics of human gait under loaded and unloaded conditions.

Today, thanks to major continuing developments in photography and cinematography technologies, there is unprecedented visual access and bio-mechanical intelligence in how our bodies move and how we record related data.

 

What happens during a visit to NYC gait analysis lab?

Most gait analysis labs have several cameras, including infrared cameras, placed around a treadmill and connected to computers. As a patient, you will have markers placed on various points of the body, enabling trajectories to be calculated and detailed evaluations given of each functioning joint. You will be given a series of physical tests for observations to be made and data to be collected.

 

But remember, every gait analysis is likely to be slightly different. There are many variables.

Gait Analysis NYC | Running Lab NYC where can i get a gait analysis?

 

RunningLab at Launchfit™ by Clinicube®

At our running lab and gait analysis in Manhattan, we have state-of-the-art technologies including the OptoJump Next. This is an innovative analysis and measurement system enabling the measurement of ‘flying’ and ground contact intervals.

 

Athlete performances can be evaluated and periodically monitored, building intricate databases to check progress or help develop rehabilitation plans. At The Center, our computer-assisted functional evaluation and training programs ensure accurate results.

 

Is gait analysis for you?

While it is commonly used to support athletes and runners, gait analysis can offer an effective insight for those undergoing rehabilitation after an accident or injury, or anyone with posture or movement issues.

 

Gait analysis is bigger than us

As a science, it’s worth remembering that gait analysis also has much wider and deeper applications for improving health and making findings. It can be used to inform a range of medical diagnostics: providing options for the treatment of conditions such as cerebral palsy; potentially helping a patient rediscover who they are, should they ever lose their memory; and offering us a greater understanding of movement outside our species).

 

If you’d like to discuss how gait analysis can improve your health today, contact us at Launchfit™ by Clinicube®for more information or sign up online right away by clicking here.