Second Opinion on General Orthopedics

Orthopedics deals with conditions of the musculoskeletal system; that is, things that can happen to our muscles, bones and their adjacent tissues – tendons, ligaments, as well as nerves and vessels.

In terms of this second opinion service, general orthopedics shall cover any issue that does not fall into any of our specific consultation topics, i.e., hip, knee, or shoulder joint disorders.

Overview of some common orthopedic diseases

Problems that occur to our musculoskeletal system can be congenital or arise due to various reasons (injury, undue stress, or age), and be located in different parts of the body.

Inborn conditions

Congenital orthopedic disorders can be non-organ related (systemic) or affect certain organs. Examples of the latter include scoliosis (abnormal curvative of the spine), hip dysplasia, congenital knee dislocation, clubfoot, congenital pseudoarthrosis of the clavicle, radioulnar synostosis, and Madelung’s deformity.

Systemic issues may be of various nature: neuro-orthopedic (e.g. infantile cerebral palsy, spina bifida, congenital muscle disorders), genetic (e.g. osteogenesis imperfecta / brittle bone disease, achondroplasia), inflammatory (e.g. juvenile rheumatoid arthritis, septic arthritis, osteomyelitis), or abnormal cell growth (benign and malignant bone and soft tissue tumors).

In a lot of cases, management of congenital orthopedic diseases starts at an early age. Their therapy is primarily conservative; only in ten percent of patients surgery is an appropriate option. Typical surgical procedures include corrective osteotomies of the pelvis or proximal femur, temporary epiphysiodesis for axis correction, limb lengthening using a ring fixator, and soft tissue correction of tendons and muscles in clubfoot or spastic movement disorders.

Tennis elbow

Tennis elbow (lateral epicondylitis) is usually the result of one-sided or heavy strain - for example, during sports such as tennis or during manual labor. Typical of tennis elbow is pain on the outside of the elbow. However, it can also radiate into the entire arm.

Tennis elbow often requires just patience: the symptoms often take several months to disappear. Certain treatments can alleviate it somewhat or speed up the healing process. However, there are also many therapeutic methods available, whose benefits have not been proven.

Achilles tendon rupture

The Achilles tendon tear usually requires surgery; the exceptions when it can be avoided are very few. In any case, the patient is immobilized with a special orthopedic shoe or a special orthosis. Diagnosis is made by ultrasound or MRI.

Diseases of the great toe

Hallux valgus and hallux rigidus are both diseases that occur at the basal joint of the big toe. Complaints majorly occur on one side, but both big toes. Although they represent different conditions, mixed cases sometimes also occur.

Hallux valgus is also known as “crooked toe”. In simple terms, it is caused by an inward malposition of the metatarsal bone leading to an outward malposition of the big toes. On the inner side of the foot, a protruding bump usually forms as a result, which can cause pain. In addition, this can lead to inflammation of the affected joint (bursitis).

Hallux rigidus is actually joint wear (arthrosis) of the metatarsophalangeal joint of the big toe, and is distinct from hallux valgus. This is wear and tear of the joint surfaces, which can generally affect all other joints of the body.

To some degree, hallux valgus and hallux rigidus can be treated with orthoses and physical therapy, which may be combined with anti-inflammatory drugs (non-steroidal anti-inflammatory drugs such as ibuprofen or diclofenac) to relieve pain.

In some patients suffering from hallux rigidus, hyaluronic acid injections into the joint can relieve pain. This is a substance produced naturally in the body that acts as a kind of "lubricant" in the joint.

If the above-mentioned methods cannot bring freedom from symptoms, a number of surgery options may be suggested. All of them have both advantages and disadvantages, which should be a matter of discussion with a foot surgeon.

The benefits of an orthopedics second opinion

Despite the variety of general orthopedics issues, one thing the majority of them have in common is that they can be successfully assessed at a distance. The necessary imaging data will be delivered for expert review with the help of modern telecommunication tools, whereas the case history and clinical pattern details can be supplemented by an online video conference. As a result, patients will get high quality healthcare advise from the best specialists in the field.