banner providers01
 
November 03, 2017
dr sealey article

One of the injuries that I see increase in frequency during the winter months are foot and ankle fractures. Slippery conditions can trigger a fall, which is the usual cause of these injuries. Not only do falls occur during snowstorms or ice storms, but the snow or ice that gets left behind on sidewalks and parking lots will often result in twisting injuries around the foot and ankle that can lead to fractures. Winter sports such as skiing, snowboarding and ice skating also predispose patients to foot and ankle fractures. In fact, something called a "snowboarder's fracture" is a specific injury that occurs because of the position of the foot and ankle on a snowboard.

Foot and ankle fractures are some of the most debilitating injuries that we see in orthopedics. These injuries have both immediate and long-term effects. The majority of patients who sustain an ankle fracture will go on to develop ankle arthritis. The term arthritis means that there has been some damage or injury to the normal smooth cartilage in the joint. There are many conditions that can damage the joint surface, including an inflammatory problem (rheumatoid arthritis) or the long-term wear and tear of the joint (osteoarthritis). In the case of an ankle fracture, there is an acute and immediate traumatic event that leads to post-traumatic arthritis. This means that the patient will have some permanent mobility limitation and also some level of discomfort or achiness. While standing, the forces that ankles and feet experience can be up to 10 times the patient's body weight and this can lead to severe discomfort if arthritis develops in those joints.

There are many unique features about foot and ankle fractures that make them very different from fractures in other parts of the body. One very important thing to consider is which foot or ankle is fractured, because if it is your right side you will unable to drive for 2 to 3 months after the injury. Swelling can be a significant problem that may take up to a year to completely resolve. This not only leads to discomfort but may create some practical problems such as fitting into a normal shoe. Swelling can also lead to severe blisters that traumatize the skin around foot and ankle fractures. The blisters indicate that there has been severe injury to the skin, which can sometimes take several weeks to heal. Bruising is another feature that is very common around foot and ankle fractures—the result of bleeding from the bone that makes its way to the surface.

Seeing a specialist with experience in foot and ankle trauma is extremely important in order to have the best possible outcome after a serious injury. Any individual's treatment will depend on the severity and stability of their specific foot and ankle fracture. Most stable fractures are treated with a rigid cast, boot or shoe, and patients can begin walking immediately with some assistance. Some patients will need crutches, a walker or a cane first, until most of the pain resolves, and then, the treatment can continue in a fracture boot or shoe. Patients will usually benefit from physical therapy or a home exercise program after their fracture has healed since the period of immobilization will create atrophy.

If the fracture is unstable, however, it will require surgical treatment with orthopedic implants, such as plates and screws. A cast or splint will not be enough to keep an unstable fracture in the proper position for it to heal appropriately. Patients are often upset by the idea of surgery, but it will provide immediate stability to the bone and may allow for a more predictable recovery. Bones, on average, will take 6 to 8 weeks to heal; the timeframe for healing does not change with surgery but quicker movement is possible because of the stability provided by the hardware. Two emergencies that require surgery are an "open fracture" (in which there is an open wound or break in the skin near the site) and a joint that is dislocated along with a fracture. Open fractures lead to a high risk of infection and they need to be cleaned and stabilized immediately in the operating room. Patients also will need to take antibiotics to prevent infection. A dislocated joint must be put back in place, or "reduced," immediately and this is usually followed by surgery to keep the joint in position.

It is often important to wait for swelling to decrease before proceeding to foot and ankle surgery. It can be dangerous to operate on swollen tissues because this may lead to an infection around the incisions after surgery. It is not uncommon for a patient to have to wait 10 to 14 days after a fracture has occurred for the actual surgery to take place. Many times, x-rays are the only studies that we need before surgery, but occasionally a CT or MRI is necessary to plan the procedure.

Although foot and ankle fractures can have devastating implications on patients' immediate quality of life, it is possible to return to many of the activities they enjoyed once the injury is healed. There may be a "new normal" in terms of comfort level during weight-bearing activities, and it may be necessary to use an orthotic insert or an ankle brace for some activities.

There are some simple things that you can do to avoid foot and ankle fractures. Wearing appropriate footwear, such as winter boots with strong grip and ankle support, is a simple measure that can help you avoid injuries… avoiding unpaved walkways and surfaces without salt can also prevent slip-andfall events… and looking out for black ice during extremely cold temperatures is another step you can take to avoid injury.

About Dr. Randolph Sealey

Dr. Randolph Sealey, who is fluent in Spanish, specializes in the field of foot and ankle surgery and is the only fellowship-trained orthopedic foot and ankle subspecialist in the greater Danbury area. He completed his fellowship training and gained his ankle reconstructive surgery expertise at the world-renowned Institute for Foot and Ankle Reconstruction at Mercy Medical Center in Baltimore, Maryland. In 2008, he became the recipient of the prestigious Roger A. Mann Award, the highest clinical research honor given by the American Orthopaedic Foot and Ankle Society. He is Board-certified by the American Board of Orthopedic Surgery.

About OrthoConnecticut | Danbury Orthopedics

OrthoConnecticut I Danbury Orthopedics is the premier provider of orthopedic care in the region. Thirty-one fellowship-trained, Board-certified physicians provide care in nine office locations. The goal of the practice is to help patients regain mobility, lead active lives and attain optimal health. Offices are located in Danbury, Darien, New Canaan, New Milford, Norwalk, Ridgefield, Sharon, Southbury and Westport. To schedule an appointment with Dr. Sealey, or any of the physicians at OrthoConnecticut, please visit myorthoct.com or call (203) 797-1500.


Download article as pdf:

pdf(English) Keeping You Moving: Foot & Ankle Fractures

pdf(Español) Manteniendo su Movimiento: Fracturas de Pie y Tobillo

pdf(Português) Mantendo-se em Movimento: Fraturas nos Pés e Tornozelos

November 02, 2017

See and hear about our new Westport Office and OrthoConnecticut | Coastal Orthopedics services.

October 01, 2017

Southbury 5 DocsDanbury CT – OrthoConnecticut/Danbury Orthopedics is pleased to welcome five new physicians to the practice. The new team members include Board-eligible orthopedic surgeons Justin C. Paul, MD, PhD and Paul M. Tomaszewski, MS, MD, Board-certified orthopedic surgeon James W. Depuy, MD; and Board-certified pain management specialists Jesse T. Hochkeppel, MD, and David S. Kloth, MD.

Dr. Justin Paul, an orthopedic surgeon and spine surgery specialist, received his BS degree in Biology from Johns Hopkins University, and his PhD in Neurobiology from The Rockefeller University. He received his medical degree from Weill Cornell Medical College and his spine residency at the NYU Hospital for Joint Diseases.  He trained in minimally invasive spine surgery at Rush University and has published numerous scientific articles on avoiding complications in spine surgery.

Dr. Paul Tomaszewski, an orthopedic surgeon and sports medicine specialist, graduated from Boston College with a degree in Biochemistry and graduated cum laude from Georgetown University School of Medicine.  Dr. Tomaszewski completed his orthopedic surgery residency at Yale New Haven Hospital, followed by fellowship training in sports medicine and arthroscopy at Medstar Union Memorial Hospital in Baltimore, Maryland.  Dr. Tomaszewski has sports team coverage experience at the collegiate and professional levels, with teams including the Baltimore Ravens and the Washington Wizards, and universities such as Towson and Loyola. 

Dr. James Depuy, a well-known orthopedic surgeon in the greater Danbury community for more than 28 years, is best known for his expertise in knee and shoulder reconstruction, which he perfected during his Sports Medicine Fellowship Program at the New England Baptist Hospital in Boston. He completed his orthopedic surgical residency at Yale University, where he published several papers having to do with diseases of skeletal development and pathology of the wrist. He is a member of the State and County Medical Societies and maintains operating privileges at Danbury Hospital, the Danbury Surgical Center, and the Western Connecticut Orthopedic Surgical Center.
Dr. Jesse Hochkeppel is a board certified interventional pain management specialist.  He completed his fellowship training at Stanford University, where he specialized in multidisciplinary management of a wide variety of sub-acute and chronic pain conditions.  Dr. Hochkeppel combines holistic care with leading edge treatment modalities to help his patients improve the function and quality of their lives. He currently serves on the executive board for the Residents & Fellows Section of the North American Neuromodulation Society (NANS). Throughout his career, he has performed extensive educational research resulting in multiple publications, participation on expert panels, and speaking internationally at multiple conferences including the Bioethics Consortium in Oxford, England.

Dr. David Kloth, who has merged his well-established Connecticut Pain Care practice with OrthoConnecticut, earned his MD degree from New York University School of Medicine. He completed his residency in anesthesia with subspecialty training in pain management at the Hospital of the University of Pennsylvania. Dr. Kloth has been the president of multiple societies, including two national organizations—the American Society of Interventional Pain Physicians and The North American Neuromodulation Society—as well as the Connecticut Pain Society, which he helped found. Dr. Kloth specializes in the treatment of chronic spinal pain and the use of regenerative medicine therapies for musculoskeletal injuries. The addition of Dr. Kloth to the OrthoConnecticut team will expand the range of services offered in the new Musculoskeletal Center of Excellence at 2 Riverview Drive in the Berkshire Corporate Park. 

“We are excited to welcome these five new, talented physicians to our OrthoConnecticut team. Adding their expertise to OrthoConnecticut demonstrates our commitment to providing the highest level of comprehensive care to our patients and our community,” states Dr. Michael Brand, President of OrthoConnecticut.

About OrthoConnecticut

OrthoConnecticut is the new name of the combined practices of Danbury Orthopedics, New Milford Orthopedics, Coastal Orthopedics, and Connecticut Pain Care, where 31 fellowship-trained, Board-certified physicians provide care in nine office locations. The goal of the practice is to help patients regain mobility, lead active lives, and attain optimal health. Offices are located in Danbury, Darien, New Canaan, New Milford, Norwalk, Ridgefield, Sharon, Southbury, and Westport. To schedule an appointment with any of the physicians at OrthoConnecticut (Danbury Orthopedics/New Milford Orthopedics), please visit myorthoct.com or call 203.797.1500.

September 01, 2017

OrthoConnecticut | Coastal Orthopedics has announced it is moving its Westport office to a new facility that will occupy an entire floor at the Westport Center for Health. The Westport Center for Health is a 38,000-square-foot, Class-A medical office campus that provides a conveniently assembled array of medical services to Fairfield County. Located at 323 Riverside Avenue in Westport, C.T., the new office is located directly off I-95, less than one mile from downtown Westport, and offers serene outdoor spaces with sweeping views of the Saugatuck River. It also includes ample parking, including 77 garage spaces, for patients and staff.

“We’ve been part of the Westport community since 1963, and are pleased to expand our practice into a new, larger medical campus at the Westport Center for Health. We were attracted to the center’s impressive roster of medical practices and ideal waterfront location, and are excited to open this new facility,” said Dr. Michael Lynch, Co-President of OrthoConnecticut. “This new office allows us to provide improved convenience to our patients in a modern, upscale environment.”

The Westport Center for Health represents the largest collection of medical offices in Westport. The vision for the Westport Center for Health as a one-stop-shop for medical services is coming to fruition and enhances the town of Westport by delivering a premium venue for healthcare services. The campus has grown into an environment with a strong sense of community that will benefit both the facilities’ staff members and their patients.

The brand new Ortho Connecticut | Coastal Orthopedic’s 5,000 square foot facility will offer comprehensive orthopedic care as well as a walk-in urgent care facility including physician offices, digital X-ray, and physical therapy. OrthoConnecticut | Coastal Orthopedics’ new center at Riverside aims to become Westport’s destination of choice for all facets of musculoskeletal outpatient care.

Ortho Connecticut | Coastal Orthopedics is a leading orthopedic practice dedicated to the highest quality, patient-centered care and the promotion of medical excellence in the community. The practice has been providing outstanding and compassionate care to patients in lower Fairfield County since 1963 and has maintained an office in Westport since 1994 at the Willows Medical Center (known as “Fort Apache”). They also have offices conveniently located in Norwalk and Darien. In 2015, Coastal Orthopedics joined with Danbury Orthopedics and New Milford Orthopedics under the name of “Ortho Connecticut.” The merger allows the combined groups to serve a wider geographic region with access to world-class care, in state of the art facilities that are close to home.

For more information, please visit the Ortho Connecticut | Coastal Orthopedics website at myorthoct.com or call 203 845-2200.

About OrthoConnecticut

OrthoConnecticut is a multispecialty practice staffed by leaders in orthopedic and pain care, and is the united practice of Coastal Orthopedics, Danbury Orthopedics, New Milford Orthopedics and Connecticut Pain Care. The practice’s network of 31 fellowship trained, Board-certified physicians offer appointments and follow up care in 9 office locations. The goal of the practice is to help patients regain mobility, lead active lives, and attain optimal health. Offices in Danbury, Darien, New Canaan, New Milford, Norwalk, Ridgefield, Sharon, Southbury, and Westport.