

Wang Cheng Lin

About me
Having worked in orthopedic clinical practice for over ten years, he is a committee member for the Asia-Pacific Foot and Ankle Chinese District.
Proficient in diseases
Specializes in treating foot and ankle injuries and diseases.

Voices

How to treat an old fracture?
The concept of a bone fissure refers to a condition where the bone is not completely broken but is partially cracked, known as a fissure. The treatment for a bone fissure generally involves plaster fixation, typically for a duration of four to six weeks. However, an old injury refers to a chronic fissure that has been present for three weeks or more. If the fissure is three weeks old, it should continue to be immobilized with plaster, avoiding weight-bearing walking and activities. Plaster fixation can gradually allow the fracture ends to heal. If after four to six weeks, or even two months, the fracture ends have not healed, further surgical treatment may be required.

Post-syndrome of comminuted femoral fracture
The main sequelae of comminuted femoral fractures are as follows: The first is a delay in healing and nonunion of the fracture ends. Due to the comminuted nature of the fracture, local blood circulation has been damaged, and even with surgery, it is difficult to restore circulation. This can lead to delayed healing and nonunion of the fracture ends, generally requiring observation for around one year. If fracture lines are still clearly visible after a year, this confirms a nonunion, necessitating further surgery and bone grafting to restore the healing of the fracture. The second, in cases of nonunion, is the possibility of plate fracture. Many patients, unable to endure extended bed rest, need to start weight-bearing walking. If the fracture ends have not healed and weight-bearing occurs, the body's full weight concentrates on the plate, leading to stress fractures of the plate and screws. Should such stress fractures occur, immediate surgical intervention is needed to replace the internal fixation.

How should plantar fasciitis be treated?
For the treatment of plantar fasciitis, there are currently two approaches used in clinical practice: The first is conservative treatment, which mainly includes rest, local injections, electrotherapy, magnet therapy, and the use of topical non-steroidal anti-inflammatory and analgesic plasters, as well as plasters that activate blood circulation and remove blood stasis to alleviate pain in the sole of the foot. Additionally, foot muscle stretching exercises can be performed at home to help relieve the symptoms of plantar fascia pain. However, if conservative treatment is ineffective for over six months, or if the pain worsens progressively and severely affects your daily weight-bearing activities, then surgical treatment may be necessary. The goals of surgical treatment are to release the plantar fascia, reduce chronic inflammation in the area, and possibly remove heel spurs, thereby alleviating the pain in the sole of the foot.

Can you run with plantar fasciitis?
Patients with plantar fasciitis should absolutely avoid running, as running can increase the pressure on the sole of the foot, leading to a worsening of the symptoms of plantar fasciitis. If you want to exercise while suffering from plantar fasciitis, it is recommended to go swimming, as swimming does not put pressure on the feet. Additionally, swimming can provide proper stretching of the plantar fascia, which can help alleviate pain symptoms and aid in the treatment of plantar fasciitis. Currently, there are two main clinical treatments: the first is conservative treatment, such as rest, massage, acupuncture, and injection therapy to alleviate local pain. If these treatments are ineffective or if the pain gradually worsens, surgical treatment may be necessary. The goals of surgery are to release the plantar fascia and to remove bone spurs to help relieve pain.

Is moxibustion okay for osteoarthritis?
Moxibustion for osteoarthritis is feasible; it can alleviate local symptoms of pain and swelling in osteoarthritis. Currently, there are two methods of treatment for osteoarthritis: The first is conservative treatment, which includes physical therapy, rehabilitation, moxibustion, acupuncture, oral medication, and injections of sodium hyaluronate, all of which can relieve symptoms of joint pain, swelling, and discomfort during movement. The second method is surgical treatment, which is considered when conservative treatment is ineffective, or when symptoms worsen after conservative treatment. Presently, there are two approaches to surgical treatment: The first involves arthroscopic minimally invasive cleaning of the joint, followed by further cleaning of the meniscus and synovium; the second method is joint replacement, with total knee replacement being the most common.

The difference between osteoarthritis and rheumatoid arthritis.
Osteoarthritis and rheumatoid arthritis have distinct differences. Osteoarthritis commonly occurs in middle-aged and elderly women and is caused by the wear, degeneration, and rupture of joint cartilage, leading to swelling and pain due to friction during joint movement. On the other hand, rheumatoid arthritis is caused by bacterial infections leading to the proliferation of synovium in the joints, causing swelling and pain. Over time, this condition can damage the joint's cartilage and meniscus, severely affecting joint mobility. The treatments for these two diseases are different. Osteoarthritis can be alleviated through rest, oral medication, and physical therapy to ease local pain. If these methods are ineffective after more than six months, surgical treatment may be necessary, mainly total knee replacement. However, the treatment for rheumatoid arthritis primarily relies on medication to relieve local pain by removing rheumatism. (The use of medication should be under the guidance of a doctor.)

Symptoms of lumbar muscle strain
Lumbar muscle strain is mostly caused by excessive activity, overexertion, fatigue, and intense exercise, which leads to the continuous pulling of the lumbar muscle fibers beyond their load capacity, resulting in injury. After the injury, many patients may not have sufficient rest, causing the muscle fibers in the lumbar region to become scarred, which is referred to as lumbar muscle strain. The primary symptoms of lumbar muscle strain are pain and limited mobility in the lumbar region, especially after intense exercise or exertion, with the pain gradually worsening and possibly radiating to the buttocks on both sides. The main treatment involves rest, which is the most important. Additionally, treatments such as physiotherapy, rehabilitation, massage, acupuncture, and oral medication can be used to aid in the recovery and growth of lumbar muscles, with the main symptoms being pain in the lumbar area and restricted movement.

How is plantar fasciitis treated?
For the treatment of plantar fasciitis, there are currently two approaches clinically. The first is conservative treatment, which includes the following options: The first is rest, meaning to minimize weight-bearing walking and rest as much as possible. The second is to use heat application, such as applying a hot towel to the sole of the foot for 10-20 minutes each day, twice a day, which can help increase local blood circulation and alleviate pain. The third is the use of oral non-steroidal anti-inflammatory and pain-relief medications, as well as medications that promote blood circulation and remove blood stasis to relieve local pain. The fourth is extracorporeal shock wave therapy for relief. The fifth, and most commonly used, is injection therapy, but it is important to note that there are clear limits on the number of times injection therapy can be used. If conservative treatment does not work for over six months, or if the symptoms of plantar fasciitis progressively worsen, surgical treatment may be necessary.

Can you still exercise with plantar fasciitis?
Patients with plantar fasciitis can exercise, but there are definite restrictions on the type of exercise. For instance, it is best to avoid weight-bearing exercises such as running, weightlifting, or mountain climbing. For patients with plantar fasciitis, we recommend swimming because it involves limb, muscle, and fascia activities in a non-weight-bearing situation, which is greatly beneficial and not harmful to the fascia. Swimming is our recommended approach, as it can also appropriately stretch the plantar fascia during the process, thereby helping to alleviate foot pain.

How to treat a fracture?
Patients with bone fractures, due to the force applied causing partial fractures in the bone, do not necessarily represent a complete break and won’t exhibit noticeable symptoms of displacement or misalignment. Generally, patients with bone fractures only require a plaster cast for immobilization, typically for about four weeks. After a month, you can visit the hospital to get an X-ray to check for osseous union at the fracture ends. If the fracture ends have achieved osseous union, then normal activities and weight-bearing walking can be resumed. Thus, for bone fractures, simply applying a plaster cast for immobilization for four weeks is sufficient.