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18
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
Can sciatica patients walk?
Sciatica can be managed with activities like walking, brisk walking, or jogging. It is best to walk or even walk backwards. It is important to avoid sitting for long periods, bending over, or carrying heavy objects. When the spine is bent, it can increase the pressure on the intervertebral discs, potentially worsening the nucleus pulposus, rupturing the annulus fibrosus, and causing a series of symptoms related to nerve root compression. This compression can cause local swelling, which can press on the nerves to varying degrees. It is recommended to strictly rest on a hard bed, and generally, with about ten days to two weeks of warming up the lower back, recovery is usually achievable. Gradual relief and disappearance of symptoms can occur, and it is advisable to avoid sitting for long periods, bending, or carrying heavy loads. Moderate walking is suitable.
Difference between arthritis and rheumatoid arthritis
Arthritis is typically osteoarthritis, a chronic inflammation characterized primarily by degenerative changes in joint cartilage, followed by bone proliferation, making it a chronic disease. Early pathological changes include alterations in joint cartilage, such as subchondral bone extrusion, followed by changes in the muscles surrounding the periosteum and joint capsule. Early radiographic examinations can provide a definitive diagnosis. Its symptoms primarily manifest as pain. For rheumatoid arthritis, it generally presents as morning stiffness and joint swelling and pain more severe than in the surrounding area, which can essentially confirm a diagnosis. It usually affects large joints such as the knee, shoulder, or wrist joints, typically presenting as migratory pain. A definitive diagnosis can usually be made by testing for rheumatoid factor, with an anti-O level exceeding 500 units. Additionally, there may be a slight increase in white blood cells, accelerated erythrocyte sedimentation rate, and elevated C-reactive protein. Examination of the synovial fluid shows increased white blood cells and neutrophils. In such cases, using anti-rheumatic drugs might suffice, but it’s also crucial to ensure rest and local heat application. These two types of arthritis fundamentally differ.
Characteristics of Osteosarcoma
Osteosarcoma is a malignant tumor of the bone that primarily occurs in adolescents and young adults, commonly found at the metaphyseal ends of long bones. For example, it may occur at the distal end of the tibia, the distal end of the femur, or the metaphyseal end of the humerus. Clinically, the main symptom is pain, which is persistent and more noticeable at night, accompanied by a local mass, limited movement, increased local skin temperature, distended veins, and general symptoms such as weight loss and even cachexia. Some patients may experience pathological fractures. Often, there are no symptoms in the early stages, and by the time it is detected, it is usually in an intermediate or advanced stage. Radiographic examination typically shows a Codman's triangle or sunburst pattern. Early detection and treatment are crucial. The usual treatment choice is surgical, such as deactivation and reimplantation, or limb-salvage surgery with prosthetic implantation. Additionally, amputation followed by extensive chemotherapy is another option. With recent advances in chemotherapy, there has been significant improvement in life extension.
How long should one stay in bed with a rib fracture?
Rib fractures are mostly caused by trauma, such as direct or indirect force. Radiographic examination can basically confirm the diagnosis. A single rib fracture generally requires no intervention or special treatment, just immobilization is sufficient. However, strict bed rest is necessary. Typically, immobilization for about four weeks is needed until callus formation occurs. During this period, you should avoid deep breathing, heavy breathing, or coughing, and stay away from cooking fumes and smokers. Such irritative coughing might cause pain. A rib fracture will likely also result in intercostal neuralgia, which can be very troublesome and prolong the pain. However, fractures generally fully heal within eight to ten months. They can gradually heal without issues, but it is best to rest in bed for a month.
What are the symptoms of lumbar muscle strain?
Lumbar muscle strain, also known as functional back pain, chronic lumbar injury, and lumbar-gluteal fasciitis, etc., is actually chronic inflammation of the lumbar muscles and their attachment points, such as the fascia or periosteum. It is one of the most common causes of back pain. The main symptoms include swelling and soreness in the lumbar and sacral regions, recurring pain, which is often related to the weather, such as feeling cold. Factors such as daytime fatigue can aggravate it, rest can alleviate it, and the intensity of pain can vary. Sometimes, it is severe and other times it is mild. For instance, some people feel stiff as a board in the morning upon waking up and are afraid to move; this is a typical manifestation. Physical examination can confirm the condition, and some diagnostic tests like lumbar disc CT or MRI can help differentiate if there is any lumbar disc herniation. Additionally, it is also important to distinguish from conditions like piriformis syndrome, which generally involves sciatica, and symptoms like numbness and pain in the lower limbs. Once diagnosed, the first step is strict bed rest, and appropriate blood-activating and pain-relieving medication can be administered. Local heat application, massage, and electrotherapy are some of the physical treatments available. It is advisable to avoid lifting or moving heavy objects routinely, as these activities can impose significant strain on the back and are not conducive to the recovery from back ailments.
What is the basis for the diagnosis of osteosarcoma?
Let's briefly describe osteosarcoma, which is a malignant tumor of the bone, most commonly found in adolescents and young adults, typically occurring near the proximal end of the tibia, the distal end of the femur, or the proximal end of the humerus, mainly growing at the epiphyseal ends. In the early stages, patients show no symptoms, with the most common symptom being pain, usually discovered in the middle to late stages. This pain tends to be persistent and is most pronounced at night. Some patients may also have a local mass. Osteosarcomas are highly prone to early lung metastases. Additionally, the surface skin temperature may increase, veins may become distended, and there may be a presence of cachexia as the disease progresses, leading to severe thinness and weakness in the body. The primary diagnostic basis is radiographic examination, which might show unique signs such as Codman’s triangle under sun-ray exposure, indicative of osteosarcoma. If the radiographic signs are not typical, further differentiation can be done using CT scans or MRI. The most crucial matter is surgical biopsy for a definitive diagnosis, mainly based on the postoperative pathology. Intraoperative measures like cryosurgery can be performed. Upon discovery, limb amputation is generally recommended, although limb-sparing surgeries can be considered, involving techniques like resection followed by reimplantation or prosthetic implantation. Overall, the prognosis is typically poor, but with the rapid advancement in chemotherapy, the five-year survival rate can improve somewhat, generally around 50%.
Is red, swollen, and itchy heel frostbite?
Let's talk about chilblains first, which can occur on various parts of the body. The most common cause is cold stimulation, such as redness and itching on the back of the heel, which may be due to occupational or other factors. The heel is often exposed and susceptible to cold, potentially leading to chilblains. This condition can be particularly troublesome but sometimes heals on its own as the weather warms up, though it is prone to recurrence. Treatment may require the use of vasodilators or traditional Chinese medicines that improve microcirculation and invigorate the blood. Regular physical exercise to boost immunity, avoiding cold exposure, and ensuring adequate warmth and dryness are important. Tight shoes and socks should be avoided, and it is not advisable to soak in hot water immediately after getting cold; instead, gradually increase the water temperature. If there is an open wound, appropriate ointments can be applied to promote healing, ensuring the area stays dry to prevent further chilblains. For example, soaking in water daily can be beneficial if there is no open wound, starting with water at 10°C, then increasing gradually to 20°C, and finally 30°C to gradually warm the area and improve blood circulation, aiding in recovery. Additionally, using ointments like chilblain cream can help improve the condition, but the area is still prone to reoccurrence if it gets cold again. Mainly, keeping the area warm and moist is crucial. For open wounds, regular disinfection with povidone-iodine and applying erythromycin ointment to prevent infection may be beneficial. (Please use medications under the guidance of a doctor to avoid inappropriate self-medication.)
Is spinal bifida prone to dementia?
Spina bifida is a common congenital malformation caused by incomplete closure of the vertebral canal during embryonic development. If the spina bifida is occult, it does not affect anything and does not cause dementia. If it is overt spina bifida, it can be diagnosed through physical examination, and confirmed with radiographic examination, CT, or MRI. Typically, the patient has a swelling along the midline of the back, which grows as they age. The cystic tension increases when the child cries, and may be accompanied by varying degrees of flaccid paralysis of the lower limbs and incontinence. Occult spina bifida generally has no symptoms and does not require intervention. However, overt spina bifida is best treated surgically, or if the occult spina bifida is accompanied by spinal cord tethering, then surgical treatment is recommended as it would be for all cases of overt spina bifida. In cases where the cyst wall is very thin and ruptured, emergency surgery is necessary and can be curative. For other cases, surgery within one to three months is optimal to prevent aggravation of the condition due to cyst rupture. Generally, adult patients with stable conditions in recent years may not need surgery.
What should I do if plantar fasciitis is very painful?
Plantar fasciitis is mainly characterized by worsened symptoms after activity, with pain at the bottom of the foot, which tends to ease during rest. Typically, the most intense pain occurs when stepping down for the first time in the morning or when the affected foot bears weight painfully, possibly due to tension in the plantar fascia. This condition frequently arises in individuals who wear leather shoes or high heels for extended periods, stand for long durations, or walk on cobblestone pathways in flat shoes. Pain occurs when the plantar fascia is tense and gradually worsens, but rapidly alleviates when the fascia relaxes upon resting. Local heat application is recommended as it promotes dilation of the surrounding vessels, effectively stimulating blood circulation and thereby easing the symptoms. Additionally, it is suggested to reduce the amount of time standing and the frequency of activities, and to rest as much as possible in bed. Recovery is typically slow, generally improving gradually over about 3-4 weeks. For significant pain, medications that promote blood circulation and alleviate pain may be taken. If necessary, encapsulation therapy can be performed. In cases where repeated treatment is ineffective, fasciotomy might be considered, which can impact the function of the foot to various extents, yet the benefits outweigh the downsides and might be the last treatment option chosen. Many patients find that rest, along with medications that promote blood circulation and alleviate pain, physiotherapy, heat application, electric baking, massage, and others, help in alleviating the symptoms.
Is rib pain gallblitis?
The gallbladder is located in the upper right abdomen, at the intersection of the midpoint of the right costal margin and the costal arch, near the midclavicular line. If there is tenderness in this area, it indicates a positive Murphy's sign. Usually, an ultrasound can reveal whether there is gallbladder wall thickening or a rough surface. Additionally, the ultrasound can detect gallstones or bile duct stones. Furthermore, a complete blood count should be performed to check for elevated white blood cells, which could indicate acute suppurative cholangitis. This condition may present with fever, positive Murphy's sign, Charcot's triad or pentad, and all require ultrasound for differentiation. Rib pain is mostly related to trauma, strain, or localized pressure during sleep, such as from a pillow corner, ashtray, or remote control. It can also be associated with costochondritis or intercostal neuralgia, and breathing heavily or coughing may cause pain. To confirm a diagnosis of cholecystitis, an ultrasound and a complete blood count should be performed.