Subscribe
34
Guan Yu Hua
Orthopedic Surgery
About me
Graduated from Yanbian University, with a postgraduate degree, engaged in orthopedic work. Has rich experience in joint replacement, common limb fractures, and joint dislocations. Has performed over 500 surgeries of different sizes in a year.
Proficient in diseases
Common fractures of the limbs, joint dislocation, hip and knee joint replacement, skin flap transfer, nerve and vessel anastomosis, limb reattachment.
Voices
Causes of recurrence of wrist tenosynovitis
Tendinitis is most commonly seen in the wrist or metacarpophalangeal joints. Typically, patients will experience redness, swelling, heat, and tenderness in the wrist, along with limited joint mobility. It is usually recommended that patients rest and avoid overexertion. Due to repeated friction caused by overexertion, swelling of the annular ligament or tendon sheath can occur. This leads to insufficient circulation of synovial fluid within the joints, and excessive friction can cause damage to the tendons and tendon sheaths, resulting in chronic inflammation and swelling. This is how tendinitis develops. Repetitive tasks, such as flipping a spoon at the wrist or cooking, can cause pain, with the most common being de Quervain's tenosynovitis, which can be confirmed by physical examination. Activities like wringing a towel or cooking can lead to pain. When necessary, treatments such as injections or small needle knife therapy may be required. Rest can relieve most symptoms, but there is a high chance of recurrence. Attention should be paid to wearing wrist braces and applying local heat can help.
What does osteosarcoma feel like to the touch?
Osteosarcoma is a malignant tumor that consumes bone and typically shows no symptoms in its early stages. By the time symptoms are recognized, it is usually in the mid to late stages. There might be localized masses; upon discovery of such masses, a visit to the hospital for diagnostic imaging is needed. Radiological examinations reveal characteristic signs such as sunburst appearance and Codman's triangle on X-rays. Further investigation with MRI or CT scans is necessary, followed by a biopsy for confirmation. During physical examination for this type of osteosarcoma, a localized mass may be found typically around the proximal tibia or distal femur, mainly around the metaphyseal ends. The mass may be accompanied by localized heat and pain, with nocturnal pain being more pronounced. Additionally, patients might show varying degrees of weight loss. Generally, osteosarcoma can be diagnosed through physical examination and radiological findings, followed by a confirmatory biopsy. Early stages require surgical intervention. Furthermore, osteosarcomas have a high rate of early pulmonary metastasis. Using extensive chemotherapy can improve patient survival time. With rapid advancements in chemotherapy, the five-year survival rate can reach about 50%.
Contraindications of Lumbar Disc Herniation
Patients with lumbar disc herniation mainly exhibit symptoms such as discomfort in the lower back, numbness in the lower limbs, and pain. These are primarily symptoms of sciatica, such as numbness and pain along the back and outer sides of the thighs, calves, and dorsum of the foot. Patients may find it difficult to put on shoes and socks in the morning, and sometimes they may feel as if their tendons are short when walking. It is generally recommended that patients strictly rest on a hard bed and warm up the lumbar region. They can also take some blood-activating and pain-relieving medications. The main precautions include avoiding bending over to lift heavy objects, carrying heavy items, and bearing heavy loads. Patients should avoid sitting or squatting for long periods and should try to lie flat or walk upright instead. If conservative treatment for lumbar disc herniation is ineffective, interventional surgical treatment may be sought.
Can late-stage osteosarcoma be cured?
For osteosarcoma in its late stages, it often metastasizes to other organs, with the majority of cases involving lung metastasis. In such cases, conservative treatment can be applied. However, if surgery is an option, it is the best approach as it can be complemented with postoperative chemotherapy and radiotherapy to extend the patient’s survival time. If there is distant metastasis and the body is in poor condition, unable to withstand surgery, then only conservative treatment and nutritional support are viable, along with the use of painkillers. In late stages, when the patient cannot tolerate surgery, only conservative treatment is available with no other alternatives. Typically, the conditions are divided into three stages. By stage three, there is usually lung metastasis. This stage often involves T which signifies intracompartmental or extracompartmental growth—T2 indicating extracompartmental, typically a marker of an aggressive tumor. Then M represents metastasis, with 0 for none and 1 for presence. So, in cases where distant metastasis occurs, it generally corresponds to stage three, phase B, which involves extracompartmental invasive metastasis. In such cases, even surgery provides poor outcomes. Early detection and treatment are best. If it progresses to later or final stages, treatment is often deemed unnecessary, limited to conservative management, as surgical outcomes are poor, and metastasis may occur elsewhere.
How to supplement the diet for osteoarthritis?
For osteoarthritis, it is best to eat more foods rich in protein, such as milk, egg whites, and fish, which have abundant protein and can help alleviate the condition. Furthermore, consume foods high in calcium and take calcium supplements. Osteoarthritis is mostly a chronic bone and joint disease, primarily affecting joint cartilage and leading to degenerative changes. It generally occurs more often in middle-aged and elderly people, and is more common in women than in men. In the early stages, the main lesions occur in the bone cartilage, with the joint cartilage being commonly affected. The cartilage surface may undergo erosion, exposing the underlying bone, and eating foods high in protein can help relieve symptoms. Moreover, collagen fibers can be supplemented by consuming broth made from large bones or pig's feet, which, combined with the use of calcium supplements, can better aid recovery. Regularly drinking milk is also very beneficial.
Can lumbar disc herniation be treated with an injection block?
Lumbar disc herniation can be treated with an injection, which mainly uses caudal epidural steroid injections. This approach has a certain therapeutic effect but is limited. For example, it may relieve the patient's pain for about a week, after which symptoms may gradually reappear. I believe that this treatment method is more about addressing the symptoms rather than the root cause. For ineffective conservative treatments, such as resting on a hard bed, applying local heat, minimizing prolonged sitting, and lying down as much as possible except for going to the toilet or eating, symptoms will generally gradually alleviate over about 10-14 days. This can be combined with drugs that promote blood circulation and relieve pain, and drugs that nourish the nerves, as well as some diuretic drugs to relieve the pressure on the intervertebral discs. This can alleviate the stimulation of the nerve roots by the nucleus pulposus of the intervertebral discs, affecting nerves from L4 to S3, which may cause numbness and pain in the back of the thighs, the dorsum of the calves, or feet. The symptoms vary depending on the stage of compression but the difference isn't significantly large. For cases where conservative treatment or injections are ineffective, we can consider interventional surgeries like ozone nucleolysis, which are currently performed skillfully with minimal damage and quick recovery. You can consult a hospital for more information.
Can osteosarcoma be treated with moxibustion?
Osteosarcoma is a malignant tumor of the bone, and the treatment effect of moxibustion is not very good. This disease develops quite rapidly, mostly occurring at the proximal end of the tibia, the distal end of the femur, the proximal end of the humerus, among others, typically at the metaphyseal ends. Clinically, the main symptoms include persistent pain, which becomes more pronounced at night, along with local swelling, restricted movement, increased local surface skin temperature, some may show prominent veins, and patients often appear emaciated, severely looking cachectic as the disease progresses with noticeable symptoms. Radiographic examination can reveal Codman's triangle or sunburst patterns. Early detection necessitates early treatment, including surgery such as inactivation reimplantation or prosthesis implantation to sustain operation. Additionally, amputation followed by extensive chemotherapy can effectively improve the patient’s survival time. Osteosarcoma has a high chance of early pulmonary metastasis, requiring systematic treatment at a hospital. Solely using moxibustion is not very effective and has limited usefulness, but it could still be worth a try if there are no better options available.
How many days to administer fluids after minimally invasive surgery for lumbar disc herniation?
With the development of medical technology, currently for the treatment of lumbar disc herniation, such as when conservative treatment is ineffective—including lying on a hard bed, pre-heating the waist, taking blood-activating and pain-relieving medication, or drugs that nourish the nerves—some interventional surgeries are chosen if these do not provide relief. The main ones commonly used include ozone ablation, collagenase nucleolysis, percutaneous disc removal, and foraminoscopic technology, etc., all of which carry very low risk. The most commonly used is ozone ablation, which involves instant oxidation of the degenerated protruded nucleus pulposus. This destroys the proteoglycans, thereby making the proteoglycans lose their function. The cells produce proteoglycans, reducing the osmotic pressure of the nucleus tissue, which cannot maintain normal moisture, leading to shrinkage and loss of tissue. This increases the space, thereby reducing the symptoms of nerve compression caused by disc herniation. Usually, antibiotics are used post-surgery to prevent infection, generally for about three days. After the medication is completed, considering discharge and returning home for recovery is possible, followed by oral medication. (Please use medications under the guidance of a physician.)
How long does conservative treatment for lumbar disc herniation take?
The main issue in lumbar disc herniation is that the nucleus pulposus ruptures through the annulus fibrosus, causing compression of the nerve roots. These nerve roots at lumbar 4 and sacral 3 form the sciatic nerve, leading to numbness and pain on the posterolateral side of the thigh and the dorsum of the foot. This is a distinctive manifestation of lumbar disc herniation, most commonly seen at the L4-5 and L5-S1 intervertebral spaces, accounting for over 95% of cases in outpatient settings. Conservative treatment primarily involves strict bed rest, local application of heat, sleeping on a firm mattress, pre-warming the lower back, and taking medications to promote blood circulation, relieve pain, and nourish nerves. Generally, symptoms will gradually abate and disappear within approximately 10 to 14 days, with noticeable symptom reduction after about 7 days. For cases where conservative treatment is ineffective and symptoms recur, interventional surgery such as ozone nucleolysis can be sought. Ozone therapy can help reduce the pressure on the intervertebral discs, increase their volume, and relieve nerve compression. Surgical trauma is relatively minor, the procedure is currently well-practiced, and the side effects are relatively low. It may be worthwhile to consult a local hospital for more information.
How big do osteosarcomas generally grow?
The size of osteosarcoma is generally difficult to measure. By undergoing radiographic examination, Codman's triangle and bone destruction can be observed in the patient's images, which can be diagnosed as osteosarcoma. Further biopsy is then required. Osteosarcoma typically presents as a mass approximately the size of a fist, and early stages may involve malignant pulmonary metastasis. By conducting a pulmonary CT scan, lesions and metastatic foci can be discovered, primarily indicating bone destruction and the presence of Codman's triangle. Such destruction can deform the normal bone structure, and abnormal masses may be palpable during physical examinations, presenting in irregular shapes. This condition is commonly seen and cannot be evaluated merely by the size of the osteosarcoma. Early stages may involve lung metastasis, progressing to advanced stages where the prognosis is poor and survival rates significantly decrease. Therefore, this disease generally requires early diagnosis and treatment.