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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
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.
What causes plantar fasciitis?
Plantar fasciitis is mostly caused by prolonged standing, such as wearing high heels or leather shoes for extended periods. The fascia remains tense under these conditions, leading to tenderness in the sole's fascia upon examination. Pain tends to intensify while walking or bearing weight and alleviates when resting as the fascia relaxes. It is best to diagnose and treat this condition early. Applying heat, reducing the movement of the affected limb, and avoiding tension in the fascia are advisable. Consuming medications that invigorate blood circulation and relieve pain can also help, generally improving symptoms within 7 to 10 days. Recovery might be slow in some cases due to fascial damage. Furthermore, repeated pulling or tension from standing and working can lead to recurrent episodes. Rest is recommended for such individuals, and wearing softer sports shoes during activities can be beneficial. Resting and taking blood-invigorating medications usually lead to gradual recovery. For severe cases ineffective with conservative treatment, surgical cutting of the fascia may be performed to relieve pain. (Please use medication under the guidance of a professional physician.)
Why does tendonitis recur?
Tendonitis, if not well-rested, can easily recur. It mostly occurs during activities, work, or exercise, presenting with pain, swelling, and limited mobility. Tendonitis primarily involves the tendons, which are very hard connective tissues connecting bones and muscles. Tendonitis is mainly caused by the excessive use of muscle fibers and repetitive strain leading to degenerative changes in tendon collagen fibers. This accumulation of degeneration in tendon collagen fibers is commonly referred to as tendinopathy. Examples include common types such as Achilles tendonitis, patellar tendonitis, quadriceps tendonitis, or injuries to the rotator cuff, and lateral epicondylitis of the humerus. Long-term repetitive friction and fatigue can easily cause repeated episodes in these areas. Strict immobilization, along with physical therapy, massage, electric stimulation, and heat application can help alleviate symptoms. Additionally, taking blood-activating and pain-relieving medications, and when necessary, undergoing injective treatments can effectively prevent recurrences and promote relief, reducing symptoms.
Symptoms of knee ligament injury
The ligaments in the knee joint are quite complex, often resulting from trauma, strain injuries, or lateral impacts. Symptoms such as reluctance to move the knee, pain, and worsened pain after movement usually necessitate a hospital examination. Lateral stress tests examine the medial and lateral collateral ligaments, drawer tests check the anterior and posterior cruciate ligaments, and pivot shift tests or squat walking tests assess the meniscus. If necessary, an MRI is performed for diagnosis. Early detection and treatment are crucial. If trauma is frequent, or instability after injury occurs, one should seek hospital examination. Ligament damage often heals slowly, typically taking around a month to fully recover.
How long should I take off work for a lumbar muscle strain?
Lumbar muscle strain often occurs when engaging in heavy physical labor. For instance, swinging a heavy hammer or bending over for strenuous tasks, as is common for carpenters and roofers. Such occupations involve considerable effort from the lumbar region with frequent movements, and prolonged work can easily lead to local muscle congestion and exudation, stimulating surrounding nerves and blood vessels leading to strain. Generally, after finishing such activities, one may experience lumbar discomfort and stiffness the next morning, where the lumbar region feels stiff like a board, making movement painful. Movement can alleviate the pain somewhat, which is a typical symptom. Lumbar muscle strain usually requires strict bed rest, ideally for about a week, and it is best to take a leave of absence for about seven to ten days. Treatment often involves medications that promote blood circulation and relieve pain, combined with heat application, massage, and physical therapy, all of which can help alleviate symptoms. If it is possible and the workplace allows, it is recommended to rest for about seven to ten days.