Nation assisting in following social distancing measures and maintaining the lockdown, some of them may have complications and may be hesitant to go to hospitals. Being at home, many may be new to take up the household chores. There are two types of complications that people may face in the lockdown, one is the most common foot and ankle related ailments and the other is the chronic morbidities and co-morbidities that may trigger these complications.

There are various types of foot and ankle problems that one may face during the lockdown, but when one should consider to visit hospital consult a specialist. One of the most common ailments that almost every one of us undergoes is ankle sprain.

1.Ankle sprain : Compared to western countries where ankle sprain is attributed as a sports injury, it is quite common in India due to bad pavements, footwear and improper movements. In almost 95% of the cases this sprain is a lateral one where the ligaments are stretched towards outside. While these injuries are manageable without surgical intervention, but we have to be careful about the severity and identify the grades of it in order to seek timely medical attention.

Grade 1 – If immediately after a sprain, if one is able to walk and there is no swelling until 24 hours, the sprain condition falls in the Grade 1 severity where only one ligament in the ankle is stretched. This is the most common grade and the most basic form of ankle sprain which can be treated with home remedial measures.

Grade 2 – 2^nd Grade severity causes more pain which is accompanied by limping, swelling and bruising. This can easily be identified if one needs immediate medical assistance through self examination. If the bony prominence in the ankle is painful upon touch then it is important to get X-ray done. But if the pain is scintillated around the bony prominence then it can be self managed at home itself.

Grade 3 – This stage is accompanied by immediate and heavy swelling and excruciating pain. Due to the damage in 2 or more ligaments the patient may need support while walking due to imbalance and feels as if the ankle is going to give way. Thus for timely action, radiological diagnosis like X-ray must be done immediately and the specialist may put plaster or ankle braces for support.

Most of the time any ankle sprain occurring while at home or doing any household chores are of Grade 1 or 2 which can be easily managed at home and no need to visit the hospital. But this should seldom be taken lightly as the ankles if sprained once causes ligaments to stretch and chances of getting another sprain is high known as Recurrent Ankle sprain which has very high chances of ligament, joint and cartilage damage arthritis.

Home Remedies: The simplest home remedy to treat ankle sprain is RICE technique.

1. Rest – Sufficient rest is required for quicker healing and depending upon the stages and severity of the sprain, duration of rest may vary. 5-6 days of rest may be sufficient in Grade 1, 1-2 weeks in grade 2 and around 3 weeks in grade 3. Rest here doesn’t signify to immobilize but walking on uneven surfaces should be prohibited.

2. Icing – Icing for 15-20 minutes three to four times a day may ease the pain and reduce swelling. This helps in reducing acute inflammation and swelling. This can be done in any comfortable way sought. Wrap ice in towel and apply for some time, but one must be careful as many people have complaints of skin burn due to excessive application of ice.

3. Compression – The affected area need to be compressed using a crepe band which can be put starting from toes and used while walking around and removed while resting. This will help in quicker healing, reduces swelling and bruises, and back to work will be faster.

4. Elevation – While lying down, keep your foot on two pillows and the swelling will go down. Do not worry if you see bruising as it will take 5 days to settle down.

2. Heel pain : It is the second most common type of foot and ankle ailments. There are two types of heel pain which people usually do not know to differentiate.

1.Plantar Fasciitis – 90% of us undergo heel pain at the bottom of the foot when the tissue from the heel bone joining with the toe is inflammated. This condition is known as Plantar Fasciitis. This type of heel pain can be easily identified as the pain is at its peak when the patient gets up in the morning or gets up after rest and then subsides after walking and settles down. It is most commonly found in middle aged population who are overweight, or undergo intense & impact exercise or does a lot of walking without proper stretching, warm up or cooling down.

Others having inflammatory disorders like Rheumatoid Arthritis, Psoriasis or Irritable Bowel Disease are also vulnerable. Most of the time Plantar Fasciitis can be easily managed by routine exercises like stretching of calf muscles, plantar fascia, and toe stretching accompanied by icing the foot as soon as you get up in the morning. This also eliminates the amount spend on physiotherapy and relieves the symptoms within 5-6 weeks time.

2. Stress Fracture – While the remaining 10% of the heel pain cases do not have typical symptoms as in case of plantar fasciitis. In this case the pain aggravates only after starting to walk, and can be triggered even with normal activities, and the reasons attributed include low levels of Vitamin D, Calcium and poor Bone Mineral Density (BMD). Other rare reasons may include tumor in the heel bone, pain due to infection, and compression in the backster nerve.

Dr Pradeep Moonot- Orthopaedic Surgeon & Podiatrist 

Mumbai Knee Foot and Ankle Clinic, Mumbai

The post Take care of your foot during the lockdown appeared first on Health Vision.

 The outcomes for deformity correction in the knee foot and ankle injuries have drastically improved with the advent of 3 d printing technology. The technology offers a realistic option for even the most complicated deformity surgeries. 3D Printed models have been proving to be a boon not only for patients but also for the surgeons providing them with better and precise pre-operative planning, thereby saving time and correcting the deformity with accuracy.

More often it has been seen in cases where patients undergoing fractures in the foot and ankle usually have deformed structure post treatment. Such corrections may not have any severe impact on their quality of life, but once the deformity occurs, it seems to be an irreversible damage. Now with the revolutionizing technology, the deformities can be corrected with high accuracy and precision. Generating a pre-model of even the most complex structures, the surgeons can better analyze the anatomy through surgical simulation and plan their surgeries for better outcomes.

As the complete anatomy of the foot and ankle can be deeply studied, irrespective of the presence of patient, surgeons get ample time to predict the angle of deformity to be corrected with high accuracy. Being cost effective such technologies are gaining importance gradually across the country.

3D Printed models are highly useful for treating complex conditions like bow legs, knee deformities, deformities in the foot and ankle due to improper or misaligned joining of the bones, claw toes, plantar fasciitis among many other orthopedic complications which can be treated with high accuracy. With less time consumption the hospital stay is also reduced and the minimally invasive procedures used ensures complete safety and quicker recovery with better functional outcomes.

What is 3D Printing?

Three-dimensional (3D) printing is a manufacturing method in which objects are made by fusing or depositing materials—such as plastic, metal, ceramics, powders, liquids, or even living cells—in layers to produce a 3D object. 3D printing is expected to revolutionize medicine and other fields.

There are about two dozen 3D printing processes, which use varying printer technologies, speeds, and resolutions, and hundreds of materials. These technologies can build a 3D object in almost any shape imaginable as defined in a computer-aided design (CAD) file. It is important to note that two-dimensional (2D) radiographic images, such as x-rays, magnetic resonance imaging (MRI), or computerized tomography (CT) scans, can be converted to digital 3D print files, allowing the creation of complex, customized anatomical and medical structures

Diversity in 3D Printing:

3D printing has made a huge difference in the field of medical science. Usually this method is popular in planning of heart operation, spine and other orthopedic procedure. As this has nothing to do with the patient’s body during surgery there are no ill effects on them. Any organ or tissue can be made in nearly any imaginable geometry through the translation of x-ray, MRI, or CT scans into digital .stl 3D print files. In this way, 3D printing has been used successfully in the health care sector to make both standard and complex customized prosthetic limbs and surgical implants, sometimes within hours.

The ability to quickly produce custom implants and prostheses solves a clear and persistent problem in orthopedics, where standard implants are often not sufficient for some patients, particularly in complex cases. Previously, surgeons had to perform bone graft surgeries or use scalpels and drills to modify implants by shaving pieces of metal and plastic to a desired shape, size, and fit. Most often in cases where a patient has undergone knee foot or ankle fracture, their shape tend to deform. In such cases 3 D printing has revolutionized for correcting the deformity.

In the upcoming days, this itself will grow and develop with more advanced 3D models along with functional models where materials are more like the organs. Functional models along with organ like material could help us understand the diagnosis much better.

Advantages over traditional method:

3D bio printing offers additional important advantages beyond this traditional regenerative method

1. Customization and Personalization – The greatest advantage that 3D printers provide in medical applications is the freedom to produce custom-made medical products and equipment. Custom-made implants, fixtures, and surgical tools can have a positive impact in terms of the time required for surgery, patient recovery time, and the success of the surgery.
2. Increased Cost Efficiency -Another important benefit offered by 3D printing is the ability to produce items cheaply. The cost depends on the material used for printing, but it is cost efficient than other methods of treatment. Prior to this method, CT, MRI and X-rays on a plate were used which only portrayed 2 D model. Traditional manufacturing methods remain less expensive for large-scale production; however, the cost of 3D printing is becoming more and more competitive for small production runs. The cost to custom-print a 3D object is minimal, with the first item being as inexpensive as the last.  3D printing can also reduce manufacturing costs by decreasing the use of unnecessary resources.
3. Enhanced Productivity – Fast in 3D printing means that product can be made within hours. That makes 3D printing technology much faster than traditional methods of making items which require milling, forging, and a long delivery time. In addition to speed, other qualities, such as the resolution, accuracy, reliability, and repeatability of 3D printing technologies, are also improving.

Dr Pradeep Moonot,Orthopaedic Surgeon & Podiatrist 

Mumbai Knee Foot and Ankle Clinic, Bandra West, Mumbai- 400050

Mobile : +91 9869465597
Email : drmoonot@gmail.com

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