ottobock.

"In developed nations, stroke is the most frequent cause of long-term disabilities. Each year 150,000 people in the UK suffer from a stroke; with a dramatic increase expected over the next few years due to current demographic developments and the ageing of the so-called baby boomers." (http://tinyurl.com/cxv878r)

Otto Bock was a man who "founded a company to supply thousands of war veterans with prostheses and orthopaedic products" (http://tinyurl.com/bmxt89e). His company now have a huge range of products aimed at those affected by strokes and aiding in "reintegrating patients into their professional and social environments" (http://tinyurl.com/cxv878r).
 

Statistics from the Otto Bock website state that after suffering a stroke "one quarter of all people are still bound to a wheelchair; two thirds of all people have restriction of the ability to walk. Approximately one-third of all people complain of a total loss of arm functionality, and daily dexterity is significantly impaired in a further 50% of cases" (http://tinyurl.com/cxv878r). These statistics show the huge effects on daily life of a stroke, which is itself a life threatening medical condition.

"Like all organs, the brain needs the oxygen and nutrients provided by blood to function properly. If the supply of blood is restricted or stopped, brain cells begin to die. This can lead to brain damage and possibly death" (http://tinyurl.com/3py5b32). Strokes can be caused by a blood clot in the brain which leads to the blood supply being stopped and thus oxygen supply being reduced. This is known as "ischaemic (accounting for over 80% of all cases)" (http://tinyurl.com/3py5b32). The other main cause of a stroke is "haemorrhagic: a weakened blood vessel supplying the brain bursts and causes brain damage" (http://tinyurl.com/3py5b32).

"There is also a related condition known as a 'transient ischaemic attack' (TIA), where the supply of blood to the brain is temporarily interrupted, causing a 'mini-stroke'" (http://tinyurl.com/3py5b32).

Ischaemic strokes are caused by the build up of deposits, plaques, on the blood vessel walls causing an increased blood pressure, reduced space in the vessel and also stiffening of the walls. These factors later result in a blockage when a plaque breaks off and gets stuck in the blood vessel becoming fully blocked and causing a loss of blood supply and thus oxygen supply to the brain.

The risk of a stroke occurring can however be reduced "through a healthy lifestyle [such as] consuming a healthy diet, taking regular exercise, drinking alcohol in moderation and not smoking. Lowering high blood pressure and cholesterol levels with medication also lowers the risk of stroke substantially" (http://tinyurl.com/3py5b32).

Treatment of a stroke most often comes in the form of medical drugs for example in the case of ischaemic strokes "using a 'clot-busting' medicine called alteplase, dissolves blood clots. A regular dose of aspirin (an anti-platelet medication) [will also be administered] as this makes the cells in the platelets in the blood, less sticky, reducing the chances of further blood clots occurring" (http://tinyurl.com/d25mo6l). Other drugs are used, known as anticoagulants which also reduce the chances of blood clots by thinning the blood.

Blood cholesterol levels may also be an issue, if the LDL (low-density lipoprotein) cholesterol ('bad cholesterol') count is high then this could be part of the cause of the stroke as they stick to the blood vessel wall and form the plaques (restricting blood flow and reducing the elasticity of the blood vessel walls). "Statins reduce the level of cholesterol in your blood by blocking an enzyme (chemical) in the liver that produces cholesterol" (http://tinyurl.com/d25mo6l).

In terms of treatment for haemorrhagic strokes "emergency surgery is often needed to remove any blood from the brain and repair any burst blood vessels. This is usually done using a surgical procedure known as a craniotomy.

During a craniotomy, a small section of the skull is cut away to allow the surgeon access to the cause of the bleeding. The surgeon will repair any damaged blood vessels and ensure there are no blood clots present that may restrict the blood flow to the brain. After the bleeding has been stopped, the piece of bone removed from the skull is replaced.

Following a craniotomy, the patient may have to be placed on a ventilator. A ventilator is a machine that assists someone with their breathing. It gives the body time to recover by taking over its normal responsibilities, such as breathing, and it will help control any swelling in the brain.

The patient will also be given medicines, such as ACE inhibitors, to lower blood pressure and prevent further strokes from occurring." (http://tinyurl.com/d25mo6l).

This type of surgery is extremely dangerous and the risks and benefits to the patient must be assessed before any surgery takes place.

THIS IS A SURGICAL VIDEO
This video shows a procedure not for a craniotomy for stroke but for a tumour. (http://www.youtube.com/watch?v=CoDT9o01L08)

This brochure shows the product range for Otto Bock healthcare and displays the huge innovation in their products. http://www.ottobock.co.uk/cps/rde/xbcr/ob_uk_en/799_Stroke_Product_brochure_A4_FINALJAN.pdf

More information on stroke and the heart can be found at the websites in this post but also on the British Heart Foundation website at http://www.bhf.org.uk/#&panel1-2.





 

The Thumb

Reason for this bizarre topic.....?! I may have cracked/damaged the ligaments in my thumb and was wondering what could be the consequence of dislocated/breaking my thumb!

-Thumb Dislocation
"A dislocation is a separation of two bones where they meet at a joint. Joints are areas where two bones come together" (http://www.nlm.nih.gov/medlineplus/ency/article/000014.htm). In terms of the anatomy of the thumb, look below.



http://www.ski-injury.com/specific-injuries/thumb
 

Therefore a dislocation in the case of a thumb concerns the metacarpal bone and the bone below it or the metacarpal with the proximal phalanx. "In the case of a serious dislocation, the joint becomes unstable, and the function of the thumb is definitely altered. The joint of the thumb, between the metacarpal and the first phalanx, has two major ligaments (ulnar collateral ligament and dorsal collateral ligament) which may suffer from trauma and even rupture" (http://www.hand-clinic.com/pop_emergency/thumb_dislocation.htm).

-Treatment of a thumb dislocation.
Non-surgical treatment such as "orthopaedic treatment: immobilisation with a fixed plaster cast or resin to block the metacarpophalangeal joint of the thumb, with the wrist released. This immobilisation should be kept for three weeks. After removal of the immobilisation, the patient will gradually regain thumb motion, and should take care for two months. A few rehabilitation sessions [may] be needed" (http://tinyurl.com/btmf36n).

However surgical treatment may be necessary depending on the extent of damage;

As can be seen from the diagram above (http://tinyurl.com/btmf36n) an incision can be made (on the inside of the thumb in this case) and a screw can be put in place to hold the two bones together.



-Broken Thumbs (Fracture)
"Broken thumb injuries are highly debilitating and a common cause of thumb pain and hand swelling" (http://www.orthoped.org/broken-thumb-injury-symptoms-and-treatment.html).

"The thumb, being a vital part of the hand, dictates the necessity to achieve a nearly perfect reconstruction of a broken thumb" (http://tinyurl.com/d5eod44).  The options involve  "thumb joint replacement, and artificial thumb reconstruction" (http://tinyurl.com/d5eod44) or as we saw above, using 'orthopaedic bone screws'. The impact of this surgery can be seen in the patient below.



However "the common protocol, is to bring the broken ends of the bones or ligaments to their natural alignment as much as possible, with or without surgery. The next step is to keep them immobilised in this position until the fusion of the broken ends" (http://tinyurl.com/d5eod44).

I am very glad that I have neither of these but I do have the pain symptoms and swelling usually associated with both. the swelling is a "delayed symptom of thumb injury due to insufficient space in the thumb to accommodate the inflammatory fluids" (http://tinyurl.com/d5eod44).