2013年2月4日星期一

骨科骨科 - 全膝關節置術 (Total Hip replacement, Hong Kong)




全膝關節置術產生併發症的機會率並不高。嚴重的併發症如細菌感染,病發率約為2%,其餘的如心臟病或中風等,更為罕見。長期病患者患上併發症的機會較平常人為高。然而併發症雖不常見,一旦發生,它將拖慢復康進度,甚至影響手術的效果。

腿部靜脈栓塞是其中一種最常見的併發症,為防止它發生,你必須經常墊高下肢,進行腿部運動,使用壓力襪及有需要時使用抗凝血藥物。如對手術有任何疑問,最好在手術前向醫生瞭解清楚。
 



回家後的護理
手術的效果理想與否,很大程度取決於你有否跟隨骨科醫生及物理治療師的指示,在家中進行適當的護理。一般來說,傷口表面的縫線會在兩星期左右拆除。深層的縫線則不用拆除,它們會自動溶解。你應盡量避免沾濕傷口,直至它完全癒合。你可以用紗布覆蓋傷口,避免因衣服的磨擦而引起發炎。




運動方面
運動是家中護理不可或缺的一環,尤其是最初的數星期。通常在手術後的三至六星期後,你應可如常進行一般的日常活動。在這段期間,進行運動時和在晚間感到輕微膝痛是正常的,不用太擔心。你在家中的運動療程應包括以下數點:
  • 循序漸進式的步行運動以增強膝部活動能力,開始時在家中進行,漸漸地可移師到室外。
  • 一般日常的家居活動,如站立、步行及上落樓梯等。
  • 物理治療師會指導你在家中或物理治療中心,進行特定的針對性的膝部運動去強化膝部肌肉,及增加關節靈敏度。慢慢地你可自行在家操練。
當你的膝部可以屈曲至你可以舒服地坐在駕駛席的程度,加上腿部的肌肉有良好反應,令你可以從容地應付油門及煞車腳踏時,你便可以恢復駕駛汽車。一般來說,這需要約六星期。




以上所提供的資訊僅作為教育及參用途,如果你有任何醫療問題,
應向自己的骨科醫生查詢,而不應單倚賴
以上提供的資料。

2013年1月22日星期二

Spine Navigation Surgery (1)


Spine Navigation Surgery - minimally invasive and computer assisted surgery

Spine Navigation Surgery was introduced since year 2000 and adapted in Hong Kong for more than 5 years. Similar technology was widely used in daily activities like driving, computer games (like Wii),etc.. The image-based technology used in spinal surgery utilizes scans of the patient's bony anatomy and instruments that are tracked by the Navigation System's camera. Navigation can help orthopaedic surgeons to guide their instruments for precise screw placement and reduce X-ray exposure.





Spine navigation surgery - Applications

Orthopaedic doctors will undergo proper diagnosis and evaluation before recommendation of surgery. Generally, spine navigation surgery is applicable for common spinal disorders requiring screw placement and especially for areas requiring high surgical precision. For example,

  1. Revision spine surgery.
  2. Patients with osteoporotic bones.
  3. High risk areas like the cervical spine or areas with severe deformities.









Reference information: www.ispine.com.hk

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your personal physician.

2013年1月21日星期一

Degenerative scoliosis (2)


Treatment

In some cases, the symptoms can be relieved and activities of daily living can be maintained by appropriate pharmacologic treatment. For patients with their daily function severely affected despite of non-surgical treatment, surgical decompression and reconstruction can be considered after taking into the accounts the pros and cons in particular patient’s medical co-morbidities.





Surgery

The purpose of the surgery is to reduce pressure on the nerve, stabilize and improve the spine alignment by instrumentation and fusion. 3D computer navigation helps to reduce the difficulty and improve the precision of screw insertion in the deformed areas.












Reference information: www.ispine.com.hk

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your personal physician.


2013年1月18日星期五

Degenerative scoliosis (1)




Symptoms

Scoliosis means abnormal lateral curvature in the spine. There are different kinds of scoliosis. While the others kinds presents mainly in childhood and adolescent with purely deformity, the degenerative scoliosis mainly affects the elderly population by not only deformity but also neurological symptoms. It is regarded as the most severe stage of spine degeneration.




Clinical signs

Detailed clinical consultation, examination would identify the functional impairment and neurological deficit. Standing and dynamic x-ray examination measures the deformity and instability. MRI scan helps to precisely locate the area of nerve compression. Other examinations like CT scan and nerve root block may be necessary in some cases.




Exercise

Physiotherapy is an effective way to strengthen your muscles. The strong muscles can help to maintain a correct position of the spine. Low-impact activities can increase overall fitness without straining the back.











Reference information: www.ispine.com.hk

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your personal physician.

2013年1月14日星期一

Sciatica




Prolapsed intervertebral disc causing sciatica

Sciatica is a pain symptom radiating from the low back to the calf and foot. It is usually caused by prolapsed intervertebral disc most commonly occurred at 30-50 years old. At these age, our intervertebral discs, especially the lower lumbar, started to have tears of different extent, followed by dehydration and collapse. The may cause low back pain and it was reported that up to 80% of the population may have a least one episode of major low back pain during their working age. These tears cause pain but most of these are only transient. The pain may improve with time and the most important factor to improve the symptoms and prevent it from becoming chronic pain is to stay active, sometimes with the aid of appropriate pain medications and physiotherapy. In some of the individuals, the disc may protrude through the tear and cause compression on the lumbar nerve. This causes radiation pain down the leg, i.e. sciatica.


Physiotherapy

There are various modalities of physiotherapy help to relief pain and prevent prolonged bed rest which is found to be detrimental to functional recovery. More importantly, the physiotherapists help the patient to maintain proper posture and perform appropriate exercise to strengthening the back muscles. The strong muscles can help to maintain a correct position of the spine. Low-impact activities can increase overall fitness without straining the back.


Pharmacologic and surgical treatment

According to research and clinical experience, many patients can relieve their pain by maintaining regular and appropriate physical activities in several weeks. Six weeks of physiotherapy / pharmacologic treatments would be advised for general case. Orthopaedic doctors may employ nerve blockers for some serious cases. Generally, more then 80% of the patients would have their symptoms improved with these non-surgical treatments in a few weeks’ time. Surgical treatment is indicated for
Cauda equina syndrome-the lumbar and sacral nerve roots are severely compressed by the propapsed intervertebral disc. Apart from lower limb pain, the patient also has pain and numbness in in the buttocks and peranal area and bowel and uninary incontinence or retention. This condition needs emergent surgical treatment.
The disabling pain persist after 6 weeks of physiotherapy / pharmacologic treatments
Progressively worsening neurological deficit.
Orthopaedic doctors will undergo proper diagnosis and evaluation before recommendation for surgery. The main purpose of the surgery is to reduce pressure on the nerves.


















Reference information: www.ispine.com.hk

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your personal physician.