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Orthopaedic Related Articles
The search algorithm handles phrases and strings of words quite well, so for example if you want words that are related to lol and rofl you can type in lol rofl and it should give you a pile of related slang terms. Or you might try boyfriend or girlfriend to get words that can mean either one of these e. People find different ways to limit the discomfort.
We have specific names for many of them. A coxalgic gait, for example, is a particular response to hip pain. When you see someone walking normally, there should be a natural, balanced rhythm to their gait. For analysis, we tend to break that rhythm up into smaller segments, focusing on how each leg moves through each stage of the cycle and how it adapts to the pain of weight bearing or the limitations caused by stiffness. Walking involves two phases: the stance phase, where the foot on that leg is in contact with the ground; and the swing phase, where the foot is raised and not in contact with the ground.
People with a painful limp will shorten the stance phase on the side that hurts. They want to minimize the discomfort caused by weight-bearing. Take knee stiffness, which is probably the easiest to spot. Imagine someone who suffers from extreme knee stiffness, where the knee is kept, or may even be stuck, in a single position. Normally, the knee would extend, just before the foot strikes the ground.
It would be relatively straight throughout the stand phase and then, as you get to the swing phase, that knee would flex when the foot comes off the ground to make room for the leg to pass over it again. A stiff hip is a little harder to notice because the hip—unlike the leg—may rely more on rotation of the pelvis. One way to get your leg out in front of you is to rotate your pelvis around your spine.
A gait with a very stiff ankle is also easy to spot. Most patients will externally rotate that foot, or the whole leg, so that the foot swings wide and points out to one side. That way they can roll over the inside of the foot rather than have to bend the ankle. Yes, the third cause of limping in the elderly is muscle weakness. Once again, this can be subtle and offers multiple versions, often combined with pain.
One common example is someone who has hip pain caused by inflammation of the fluid-filled sac, the bursa , on the side of the hip. This is accompanied with weakness in the gluteus medius muscle.
This can cause what we call the Trendelenberg lurch, named after the German surgeon Friedrich Trendelenburg. So the pelvis will dip when the patient tries to stand on the weaker leg. We also see elderly patients with significant overall deconditioning, a loss of muscle strength, often combined with late-stage diabetes.
They may be weak in a lot of areas: from the hips to the ankles. Those all result in a characteristic limp. There is indeed. Nerve damage, such as peripheral neuropathy , balance problems and loss of coordination can disrupt a normal gait. Damage to the perineal nerve can prevent them from pulling the front of the foot up. Those people have an unusual limp, characterized by lifting the leg higher in the air than normal. We call that a neuropathic, or steppage, gait. This was first described in people with secondary syphilis.
It became a generic term for any venereal disease.
The best thing is to prevent them, primarily through strength and balance training. We also have many ways to reduce pain, especially the wear and tear of arthritis. Non-painful limps can be investigated and treated more gradually. Modest stiffness can improve with stretching, physical therapy and manipulation. Physical therapy and weight training exercises also can help with moderate weakness.
Weakness from a neurological injury, on the other hand, is not something we can correct with exercise.
Instead, we would consider ankle braces or a custom-designed shoe that could support the foot in a functional position. It could cause the ankle to be stiff, but we prefer stiffness over weakness. We have new and better joint replacements and we can now perform the operations using the surgical robot, which has much smaller incisions. This can reduce discomfort and speed recovery. We have a vast array of new hip and knee replacements. We can replace just one side of the knee, as well as the standard total knee replacements.
We have done almost of those. We have the largest center and the only training center in the Midwest. More recently, we have brought robotic assistance to spine surgery, a significant addition to our robust spine program. Instead of making a long incision along the spine and spreading the spinal muscles aside to see and reach it, the robot lets us work through little incisions and tubes at each level of the spine.
That means no big incision, just a series of small incisions and entry through tubes.
What Causes a Child to Limp?
Douglas R. Dirschl, MD, is a highly accomplished surgeon and an expert in orthopaedics. He specializes in caring for patients with musculoskeletal trauma and fractures, as well as other injuries and diseases of the bones, joints and muscles.
When injury or illness affects the musculoskeletal system, the experienced and skilled orthopaedic team at the University of Chicago Medicine offers the full spectrum of nonsurgical and surgical care. UChicago Medicine offers primary and specialty care at over 40 locations throughout Illinois and Indiana. UChicago Medicine and Ingalls Memorial offer a broad range of challenging clinical and non-clinical career opportunities doing work that really matters.
Close MyChart MyChart is not for medical emergencies. If you have a medical emergency, call If you need help with MyChart, call us at Share with facebook Share with twitter Share with linkedin. Forefront Orthopaedics. Why do so many older people limp? Call Us At How common are gait abnormalities? Why is limping so common, especially in the elderly? How about stiffness?