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CLASSIC LIST

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13/Nov/2018

Knee dislocation is when the bones that come together at the knee joint are thrust out of place with great force.  It is very painful and an orthopaedic emergency.

The dislocation usually occurs as the result of a car accident or sports injuries when the knee is bent in an awkward position or over extended.

The area hurts considerably, the leg is swollen and sometimes can look out of place.

During such an injury  it is possible to damage the blood vessels running behind the knee joint.  The most important one  to worry about is the Popliteal artery  taking blood to the leg.  If this is  badly damaged, there is no blood going to the leg and the leg becomes ischaemic and at risk of needing an amputation.

Sometimes the blood vessel is not actually avulsed or transected but the bending damages  its lining  and clot develops  within it having the same effect of reducing blood flow to the leg.

However, although this can occur, it is rare, occurring in about 3% of people who have a full dislocation of the knee.  It is far more common in men than ladies,  and in the age range 20-40 years old

Although the arteries can be damaged, in a lot of cases surgical intervention is not needed and the leg swelling only needs to be observed to ensure it remain fine.  Of those who do have arterial damage, about 13% will need some form of surgical intervention.

The orthopaedic surgeon therefore keeps a very close eye on the blood supply to the leg after such an injury and usually requests a vascular surgeons opinion.  There are a number of investigations which can be  undertaken  such as a Doppler  ultrasound, CT angiogram or MRI.

If vascular surgery is needed, a bypass operation around the damaged vessel  can be considered.  Sometimes it is possible just to tack down the torn area.  Only very rarely (<0/1%) does this result in an amputation at the knee.

If you would like any further information, please email me and I will be able to send you recent clinical papers on this.

www.sydneyinsurancebrokers.com.au/758-2/kneecap-injury-2/

Management of Acute Knee Dislocation before Surgical Intervention


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13/Nov/2018

Peripheral vascular disease or hardening of the leg arteries causes blockages in these vessels. This affects the quality of life of over two million people in the world.  The severity ranges from severe cramping on walking quickly to  leg ulcers and gangrene.

One of the ways to improve the quality of life and reduce the progression of any ulcers or gangrene is to get more blood down to the legs.  This can be done by doing a bypass operation or opening up the blood vessels with an angioplasty, passing a balloon through the narrowing and opening it up.  Unfortunately, often after an angioplasty the blood vessel thickening up and narrowing down again and the symptoms come back.  To stop this narrowing down happening, a stent or spring can be placed into the vessel. A more recent development has been to apply a chemical to the balloon that reduces the the re-narrowing occurring  (that is intimal hyperplasia).

There are now several studies that show that, if the angioplasty balloon is coated with a chemical that can reduce this happening, the lumen of the blood vessel remains open for much longer.  With this new development gradually being introduced into the  day-to-day management of peripheral vascular disease, there is great optimism that the millions of people who suffer from it will be able to walk further and are less likely to develop gangrene.  A nice review article on this has recently been published and can be obtained free by clicking here. Alternatively if you are concerned please consult a specialist.


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13/Nov/2018

Heart disease is one of the leading causes of death. It is vital we adopt healthy habits to keep our vascular system healthy to help protect our heart and keep it strong.

Some simple lifestyle changes can go a long way in maintaining good vascular health. Take a look at the following five ways to keep your vascular system healthy.

1- Get active

One of the most effective ways to improve our vascular systems is to take regular exercise. Make it your goal to get a minimum of 30 minutes of exercise most days of the week to get the blood circulating round the body and the heart pumping.

Regular exercise such as walking or jogging helps improve the circulation in your legs, promoting the growth of new blood vessels.

2- Have a healthy, well-balanced diet

Replace sugary or fatty snacks with healthier options like pieces of fruit. Opt for fresh food instead of processed meals that loaded with salt. Eat the recommended five portions of fruit and veg each day and regularly consume oily fish.

3- Stop smoking

It’s never too late to stop smoking, which is a major cause of cardiovascular disease and causes approximately one in every four deaths. Giving up smoking is one of the best things you can do to improve your vascular health and keep your circulatory system and heart healthy.

4- Maintain a healthy weight

Being overweight significantly increases your risk of stroke, diabetes and heart disease. Losing even a little weight and maintaining a healthy weight can greatly improve your vascular health, give your heart function a boost, improve metabolism and lower blood pressure.

5- Keep iron levels balanced

Iron is a vital mineral for our circulatory system as it is needed to make haemoglobin, a primary component of red blood cells, which is required to carry oxygen. Consuming foods that are rich in iron such as spinach and red meat, can help our bodies have the iron they need. However, it is important not to consume too much iron, which can have a negative impact on the cardiovascular system.

It is advisable to talk to a doctor before you start taking iron supplements or embark on an iron-rich diet.

If you have concerns about vein disorders and would like to talk to a specialist in vascular health, get in contact with the Vascular Consultancy.


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13/Nov/2018

The common surmise that it’s only older people who suffer from varicose veins and spider veins bares little truth. Granted, age is a factor in the onset of varicose veins but whilst the risk increases after the age of 50, young people can get varicose veins as well.

One of the principle causes of varicose veins is hereditary. When this common condition is caused by hereditary, it can affect young adults and even teenagers.

Pregnancy is another leading cause of varicose veins, as is the use of birth control pills, obesity and hormonal imbalances during puberty and the menopause.

With this unsightly condition affecting all ages, treatment for varicose veins is not confined to older people.

It could be argued that treating varicose veins in younger patients is more effective, as younger skin is less disposed to scarring than more mature skin and healing rates are increased with younger patients.

Like with any condition, the sooner varicose veins are treated, the better.

If you are worried about varicose veins regardless of your age, speak to a vascular expert about the different treatment options available to you and which treatment is likely to be the best for the severity of your varicose veins.

Effective treatment for varicose veins include:

* Varicose vein surgery

* Endovenous laser

* Radiofrequency ablation

* Varicose vein avulsions

* Non-surgical treatments including compression stockings and the use of horse chestnut extracts

Help prevent varicose veins

Whilst varicose veins caused by hereditary is usually unavoidable, there are several lifestyle changes people of all ages can make to help avoid the onset of this common condition. These steps include:

* Getting regular exercise

* Watching your weight

* Losing weight

* Avoid wearing high heels

* Elevating your legs

* Avoid standing or sitting for long periods

If you would like to discuss varicose veins and the different forms of treatment for the condition, get in touch with the Vascular Consultancy, specialists in vascular health and providing effective treatment for vascular conditions including varicose veins.


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Daryll Baker is a Consultant Vascular Surgeon at the Royal Free Hospital London and Clinical Lead for North Central Region Vascular Services.

He read Medicine at Oxford University and trained in Vascular Surgery in Nottingham, London and Edinburgh. He obtained his research PhD from the University of Wales.

Contact

Wellington Hospital
34 Circus Road
London
NW8 9SG

020 7722 7370

Copyright 2016 The Vascular Consultancy