American Medical Association Family Medical Guide - American Medical Association [691]
The healing time for a fracture depends on many factors, including the bone that is fractured, the number of bone fragments, the person’s age, and whether the fracture is open or closed. A child’s broken finger may heal completely in 2 weeks, while an adult’s tibia (the inner, thicker bone in the lower leg) may take 3 months or longer to heal.
Occasionally a fracture does not heal. In this case, a doctor may need to perform a bone graft to promote healing. In a bone graft, small pieces of bone are taken from a bone bank (a collection of bone donated for transplantation) or from the person’s body (often the pelvis) and packed around the break. In some cases, doctors use an artificial bone substitute for the graft. Electrical stimulation of the fracture with a weak electric current is sometimes used to accelerate bone healing.
Bunion
A bunion (which doctors call hallux valgus) is an enlargement of the bone at the base of the big toe. Bunions are common and tend to run in families.
Bunion
In the bone deformity known as a bunion, the bone at the base of the big toe is enlarged, causing the big toe to turn toward the other toes.
The persistent pressure of a shoe on a bunion often leads to painful inflammation of the bursa (a fluid-filled sac that acts as a cushion at pressure points on the body) at the base of the joint (bursitis; see page 1002). Shoes that are tight or that fit poorly, especially shoes with high heels and pointed toes, can make bursitis worse.
Symptoms and Diagnosis
A bunion causes the big toe to point toward the other toes and the bones at the base of the big toe to enlarge and protrude out. If inflammation (bursitis) develops, the area becomes red, warm, swollen, and painful. Bunions are diagnosed by their appearance.
Treatment
If you have a bunion, wear soft, wide, low-heeled shoes or use soft, cushioned, cotton-flannel bandages (which can be cut to size) to take pressure off the affected area. Taking aspirin or another nonsteroidal anti-inflammatory drug can help relieve pain and reduce swelling. If these treatments fail to relieve the pain or if walking is difficult, your doctor may refer you to an orthopedic surgeon. The surgeon may perform a procedure called a bunionectomy, in which the deformed bone is cut and straightened. After surgery, you may need to wear a cast or a special shoe for 3 to 6 weeks to protect the foot.
Osteoporosis
Bone is living tissue that undergoes constant change—breaking down and rebuilding. Its central core is a light, flexible, strong structure composed of vertical and horizontal links that resemble interlacing ladders. In osteoporosis, bone loses the horizontal rungs, making it thin, porous, weak, and prone to fracture. In healthy bone, the breakdown of bone tissue and the formation of new, replacement bone are balanced. In osteoporosis, the breakdown of bone tissue occurs faster than the formation of new replacement bone.
Risk Factors
Aging is the most common cause of osteoporosis in both men and women. Women are especially susceptible to osteoporosis after going through menopause (see page 851) because the female hormone estrogen, which declines substantially at menopause, plays a key role in helping bones absorb and retain calcium, which keeps them strong. Also, women tend to have smaller bones than men and, therefore, less bone to lose before problems develop. In addition to being older and being female, the following factors put you at increased risk of developing osteoporosis:
• Being thin, having a low body mass index (see page 11), or having small bones.
• Having a family history of osteoporosis.
• Being past menopause (either naturally or from having had your ovaries removed surgically) and not taking a bone-strengthening medication (see page 993).
• Being a younger woman whose periods have stopped abnormally from excessive exercise or excessive weight loss from an eating disorder (see page 725) such as