Category: G

The Gustilo-Anderson classification for open fractures

Posted on August 12, 2023 by Steve - Classification systems, Fractures, G

The Gustilo-Anderson Classification is a widely used and respected system for categorizing open fractures based on their severity and the extent of soft tissue damage. This classification system was developed by orthopedic surgeons Ramón Gustilo and John Anderson and has become a fundamental tool for guiding treatment decisions and predicting outcomes for open fractures.

The classification is divided into three main types, each with subcategories, to describe the nature of the wound and the associated soft tissue injury:

Type I: Type I open fractures involve a clean wound with minimal soft tissue damage. The wound is typically small, and there is minimal contamination or damage to surrounding tissues.

Type II: Type II fractures are characterized by a larger wound without extensive soft tissue damage. There may be moderate contamination, but the soft tissue injury is generally manageable. Type II fractures are further subdivided into three categories:

Type II A: The wound is larger and may have moderate contamination, but it is still manageable.
Type II B: There is significant soft tissue damage, including periosteal stripping and a larger wound size.
Type II C: These fractures involve extensive soft tissue damage requiring flaps, grafts, or other soft tissue procedures to manage.

Type III: Type III open fractures are the most severe and involve extensive soft tissue damage, often with high-energy trauma. The wound is typically large and contaminated, and there may be significant crushing of the surrounding tissues. Type III fractures are also subdivided into three categories:

Type III A: Despite the severity of the wound, there is adequate soft tissue coverage over the fracture site.
Type III B: These fractures have extensive soft tissue loss and require significant reconstructive procedures.
Type III C: These fractures involve arterial injury, necessitating prompt vascular repair.

The Gustilo-Anderson Classification is crucial for determining the appropriate treatment approach for open fractures. It helps guide decisions ranging from wound management and antibiotic administration to fracture reduction, stabilization, and soft tissue reconstruction.

Gastrocnemius recession (calf release)

Posted on March 29, 2023 by Steve - G, Lower leg, Surgical, Uncategorised

A gastrocnemius recession, also known as gastrocnemius lengthening or calf muscle release, is a surgical procedure in which the gastrocnemius muscle is partially cut to relieve tension and tightness in the calf. This procedure is typically performed to treat a condition called equinus deformity, which is characterized by limited ankle dorsiflexion (the ability to pull the foot upward toward the shin).

During the procedure, a small incision is made in the skin over the gastrocnemius muscle, and the muscle is partially cut or released from its attachment to the heel bone (calcaneus). This allows the muscle to stretch more easily and reduces tension on the Achilles tendon and plantar fascia.

Gastrocnemius recession is often performed in combination with other procedures, such as Achilles tendon lengthening or plantar fascia release, to address the underlying cause of equinus deformity. Recovery from the procedure typically involves a period of immobilization and physical therapy to regain strength and flexibility in the affected leg. As with any surgery, there are risks and potential complications associated with gastrocnemius recession, and it is important to discuss these with a qualified healthcare professional before undergoing the procedure.

Gout

Posted on March 8, 2023 by Steve - G, Rheumatology

Gout is a type of arthritis caused by a buildup of uric acid crystals in the joints. It often affects the big toe joint, but can also occur in other joints in the foot and ankle. The symptoms of gout include sudden and intense pain, redness, swelling, and warmth in the affected joint.

Gout is typically managed with a combination of lifestyle changes and medications. Lifestyle changes may include a low-purine diet, limiting alcohol consumption, and staying hydrated. Medications may include non-steroidal anti-inflammatory drugs (NSAIDs) to relieve pain and reduce inflammation, colchicine to reduce inflammation and pain during gout attacks, and urate-lowering therapy to reduce the production of uric acid.

To prevent gout attacks, it is important to maintain a healthy weight, avoid foods high in purines (such as red meat, seafood, and alcohol), and stay hydrated. If you experience symptoms of gout, it is important to see a healthcare provider for an accurate diagnosis and appropriate treatment.

Golf injuries of the foot & ankle

Posted on March 8, 2023 by Steve - G, Sports

Golf is a low-impact sport that typically doesn’t cause many injuries, but the foot and ankle are still vulnerable to injury. Some common golf injuries to the foot and ankle include:

Plantar fasciitis: This is an inflammation of the plantar fascia, a thick band of tissue that runs along the bottom of the foot. It can cause heel pain and stiffness.
Achilles tendonitis: This is an inflammation of the Achilles tendon, which connects the calf muscle to the heel bone. It can cause pain, swelling, and stiffness in the back of the ankle.
Stress fractures: Repetitive stress on the foot and ankle can cause small cracks in the bones, known as stress fractures. They can cause pain, swelling, and tenderness.
Ankle sprains: Golfers can twist their ankles while swinging or walking on uneven terrain, which can result in an ankle sprain. It can cause pain, swelling, and difficulty walking.
Turf toe: This is a sprain of the big toe joint, caused by jamming the toe or repeatedly pushing off the ground. It can cause pain, swelling, and difficulty walking.

Prevention of golf injuries to the foot and ankle includes proper warm-up exercises before playing, wearing proper golf shoes with good support, and using a golf cart instead of walking on uneven terrain. It is important to seek medical attention if you experience any foot or ankle pain or discomfort during or after playing golf.

Gangrene

Posted on March 8, 2023 by Steve - G

Foot gangrene is a serious condition that occurs when the tissues in the foot die due to a lack of blood flow. It is most commonly caused by underlying conditions such as diabetes, peripheral artery disease, and atherosclerosis. Foot gangrene is a medical emergency and requires immediate treatment.

Symptoms of foot gangrene may include:

Pain or discomfort in the affected foot
Discolouration of the skin, ranging from red or purple to black
Numbness or tingling in the affected foot
Sores or ulcers on the skin that do not heal
Foul odour from the affected foot
Shiny or tight-looking skin over the affected area

If you suspect you have foot gangrene, it is important to seek emergency medical attention. Treatment may include:

Debridement: The affected tissue may need to be surgically removed to prevent the spread of infection.
Antibiotics: If an infection is present, antibiotics may be prescribed to treat the infection.
Hyperbaric oxygen therapy: In some cases, hyperbaric oxygen therapy may be used to improve blood flow and promote healing.
Amputation: In severe cases, amputation of the affected foot or toe may be necessary.

Preventing foot gangrene involves managing underlying conditions such as diabetes and peripheral artery disease, and practicing good foot hygiene. It is important to seek prompt medical attention for foot gangrene to prevent further complications and ensure proper treatment.

Ganglion

Posted on March 8, 2023 by Steve - G, Pathology, Rheumatology, Tumours

A ganglion cyst is a fluid-filled sac that often appears as a bump on or around joints and tendons, commonly occurring in the wrist and hand. However, ganglion cysts can also develop in the foot, usually at the top of the foot or at the ankle. The cyst is typically round or oval-shaped, and may be soft or firm to the touch. In some cases, the cyst may cause discomfort or pain, especially if it presses against a nearby nerve or tendon. Treatment options for a ganglion cyst include observation, aspiration (draining the fluid with a needle), or surgical removal. However, ganglion cysts may recur after treatment. It’s best to consult a healthcare professional for diagnosis and management of ganglion cysts.