Who is Lisfranc? Better question is what…

Written by admin on October 17, 2012 – 3:20 am -

The NFL Injured Reserve has been awash with foot injuries the past two weeks. Cedric Benson, Ryan Kalil and Santonio Holmes all have sustained midfoot injuries, also known as a Lisfranc injury–much more serious than a simple sprain and sometimes requiring surgery.

A Lisfranc injury is an injury to the ligaments and/or bones of the midfoot. This injury can affect one or multiple joints of the midfoot and may include a fracture. Lisfranc injuries are named after Napoleon’s personal surgeon who first described the injury, then common in cavalry officers. The injury was typically sustained when the foot caught in the stirrup and twisted when the cavalryman was thrown from the saddle. Today, football and soccer players are more prone to these injuries because of the twisting and falling mechanisms that occur so frequently in competition.

Symptoms of a Lisfranc fracture include swelling over the top of the foot, bruising on the top and/or bottom of the foot, and pain with weight bearing. Athletes should seek medical attention from an Orthopaedic physician. An x-ray and sometimes an MRI or CT scan will be necessary to determine the alignment of the small bones and joints of the affected foot as well as the integrity of the ligaments.

Non-operative treatment of a Lisfranc injury includes non-weight bearing for 6 weeks in a cast, and progressing to a walking boot for an additional 2-6 weeks. An athlete would not be able to return to athletic competition until he is able to complete sport specific drills without pain.

If an operation is necessary, as it is for Kalil and Holmes, it can take up to six months for full recovery. With this corrective surgery, the bones are put back into place (reduced) and held by plates and screws, which may require removal at a later date.

Prevention of a Lisfranc injury is difficult especially in physically demanding sports like soccer and football, but it is helpful to wear well-fitting, properly designed and constructed footwear (avoid the Clearance bin). Cleats that are too flimsy and flexible may not be able to properly support the foot, increasing susceptibility to injury.

Dr. Mark Galland is a Board Certified Orthopaedic Surgeon specializing in sports medicine, practicing in Wake Forest and North Raleigh. He serves as team physician and Orthopaedic consultant to the Carolina Mudcats, High-A Affiliate of the Cleveland Indians of Major League Baseball, as well as several area high schools and colleges. Dr. Galland can be reached at (919) 562-9410 or by visiting www.orthonc.com or www.drmarkgalland.com or you can follow him on twitter: @drmarkgalland.

Kate Anderson, ATC/LAT is a post-graduate fellow at GOSM, Galland Orthopaedic and Sports Medicine. Follow her on twitter @kattethegreatt.


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Posted in Foot & Ankle, Sports Medicine | No Comments »

Dr. Mark Galland Named Medical Director Of Barton College Athletic Training Education Program

Written by admin on October 16, 2012 – 5:43 pm -

RALEIGH, N.C. – Dr. Mark Galland, a physician at Orthopaedic Specialists of North Carolina (www.orthonc.com/galland.html), has been named medical director of the Barton College Athletic Training Education Program, a Commission on Accreditation of Athletic Training Education (CAATE) accredited program. As medical director, Galland serves as a resource to the program’s students and faculty for questions, topics, lectures and courses related to musculoskeletal medicine. By partnering with Barton College, Galland’s wealth of knowledge and experience in orthopaedic surgery and sports medicine will be available to the program’s aspiring athletic trainers and future health care providers.

Barton College is a private liberal arts college in Wilson, N.C., with a student population of approximately 1,130. Its athletic training education program is a four-year curriculum and is nationally accredited by CAATE. Accredited programs prepare students with an interest in sports medicine to work in the growing allied health profession of athletic training, which focuses on prevention, emergency care, evaluation, treatment, and rehabilitation of injuries and conditions in physically active persons (not just athletes). Graduates of Barton’s program are qualified to sit for the national certification exam and must pass before being able to practice as an ATC (certified athletic trainer). You can find athletic trainers working on the sidelines of high school, college, recreational and professional sporting events, as well as teaching at all levels, researching, and working in the military, performing arts, industrial settings, hospitals, therapy clinics and doctors’ offices.

The Barton College Athletic Education Training Program has two components, a didactic portion, which is classroom-based, and a clinical education portion. The laboratory classes allow for hands-on practice of the theories learned in lecture classes where students utilize cognitive, psychomotor skill recognition. Faculty and staff ATCs serve as Approved Clinical Instructors (ACI’s) and supervise students during rotations. Students have the opportunity to work on clinical skills with an ACI during their clinical experience and are involved in the daily operation of athletic training in various settings during the field experience portion of their clinical rotations.

For more information, visit http://www.barton.edu/academics/ATEP/.

“I am honored to be named medical director of Barton College’s Athletic Training Education Program,” said Galland. “Students enrolled in the program have a strong passion for athletic training and are eager to learn how to be successful in the field. I am excited to share my expertise in orthopaedic surgery and sports medicine with the Barton College students.”


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Posted in Around the office, News Releases, Sports Medicine | No Comments »

Orthokine Therapy: Modern Day Fountain of Youth?

Written by admin on October 1, 2012 – 9:52 am -

Orthokine therapy is a new sports medicine treatment recently receiving widespread interest and acclaim. It was developed primarily for the treatment of osteoarthritis (OA) by German doctors, Dr. Peter Wheling and Julio Reinecke, PhD., of Dusseldorf, Germany. Little is known about this experimental technique, and there is scant data to support its efficacy, but anecdotal reports have been, high-profile and promising. Much like the mythical fountain of youth, the technique, its clinical mechanism, and its results are shrouded in mystery. Similar to Platelet Rich Plasma Therapy (PRP therapy), whose mechanism and effect has been discussed at great length, and is now widely-recognized in the public consciousness as the standard musculoskeletal rejuvenation therapy, Orthokine therapy is also an autologous treatment provided as an injection of the patient’s own blood. There are no foreign materials or substances used, so risk of adverse side effects is minimal, and the injections are well-tolerated.

In theory, proteins commonly found in patient’s blood –such as Interleukin – 1- Receptor – Antagonist (IL -1Ra) – possess inherent anti-inflammatory and analgesic properties that serve to protect and to preserve the cartilage in an arthritic joint against degradation by osteoarthritis.

During the Orthokine procedure, blood is obtained from the patient using a syringe containing beads that will enhance and/or release the production of these cartilage-protective proteins. The blood is stored at body temperature for up to 9hours, during which time, the concentration of the joint preserving proteins, have increased up to 100 times greater than normal. After the incubation period, the sample is centrifuged to isolate the enriched serum of proteins from the other elements of blood. It is then divided into numerous vials that may be used immediately or frozen for future treatments. The serum is then injected into the affected joint to decrease pain, increase range of motion, and decelerate the progression of degenerative joint disease, and (hopefully) improve the joints longevity. The practitioners report almost immediate improvement and symptom resolution for 2-4 years.

Orthokine therapy is being used throughout Europe but is not yet FDA approved for use in the United States. Professional athletes such as Kobe Bryant and Alex Rodriguez are among those who have traveled to Europe to receive the Orthokine therapy with the hopes of alleviating pain, enhancing their performance and extending their athletic careers.

It is unclear whether Othokine is the long-sought OA treatment (minimally invasive, long-lasting, relatively inexpensive to provide), the next innovation, or just the latest “snake oil” cure-all. It is certain, however, that despite the lack of clinical data, many more modern day Conquistadors will travel to Europe to imbibe this latter day fountain of youth, following the examples of the superstar “Ponce de Leon” that preceded them.–at least until it is “discovered” again somewhere else.

Dr. Mark Galland is a Board Certified Orthopaedic Surgeon specializing in sports medicine, practicing in Wake Forest and North Raleigh. He serves as team physician and Orthopaedic consultant to the Carolina Mudcats, High-A Affiliate of the Cleveland Indians of Major League Baseball, as well as several area high schools and colleges. Dr. Galland can be reached at (919) 562-9410 or by visiting www.orthonc.com or www.drmarkgalland.com.

Caitlin Davis, ATC/LAT is a post graduate fellow at GOSM… For more information, visit us at www.atcfellowship.com

References
Wehling, P. D. P. (2012). Molecular orthopaedics. Retrieved from http://www.wehling-hartmann.de/en/wir-ueber-uns/
Wheling, P. D. P. (2007). Osteoarthritis: The individual osteoarthritis therapy. Retrieved from http://alfa-arthro.com/dokumenti/BookletOA_Pat_05062007.pdf


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See What You Hit

Written by admin on September 24, 2012 – 9:41 am -

Football is one of the most dangerous and violent sports. Though it has been considered the classic “contact sport,” it is more accurate to say it is the ultimate “collision sport.” While concussions currently garner the media spotlight, injuries to the neck and spine are ignored– until disaster strikes. Recently, defensive backs at Catawba and Tulane Universities both suffered severe cervical spine injuries. Last season, at Rutgers University, Eric LeGrand was injured while making a tackle, and he remains paralyzed from the neck down.

The cervical spine is comprised of the first 7 spinal vertebrae. The nerves that exit the cervical spine are vital to both basic and sophisticated body functions including respiration and movement. Cervical spine injuries typically result from an axial load, which is a force that originates at the top of the head and continues longitudinally down the spine. “Spearing” is the term used for a tackle in which the player leads with the head, and the top of the head makes initial contact with the opponent. This type of tackle has been banned in the NFL to ensure the safety of NFL athletes as well as the young players that emulate them. Roger Goodell, commissioner of the NFL, has said that football needs a “culture change” in order to become a safer sport at all levels. Rules changes are welcome, but to decrease the prevalence of these injuries, It is perhaps more important that coaches, parents, and players be educated in proper tackling technique. The NFL has joined with USA Football, the governing body of youth football, to form the “Heads Up Football” initiative to teach proper tackling technique and increase awareness of head and neck injuries. According to Heads Up “The right way of tackling begins with ‘the breakdown’: feet set, hands sunken, the arc of the back straight and the knees bent. The head is up at all times.” A player must always be able to “see what you hit.” If you can’t, your technique is incorrect.

Given the inherent danger of participation in football, it is important to have a well-coordinated medical team present at every game. These medical professionals include the athletic trainers, first responders, team doctors and EMS. Fortunately, these teams were present on the sidelines at Catawba, Tulane, and Rutgers, their skilled, rapid, and coordinated efforts were essential in achieving the best outcomes.

Dr. Mark Galland is a Board Certified Orthopaedic Surgeon specializing in sports medicine, practicing in Wake Forest and North Raleigh. He serves as team physician and Orthopaedic consultant to the Carolina Mudcats, High-A Affiliate of the Cleveland Indians of Major League Baseball, as well as several area high schools and colleges. Dr. Galland can be reached at (919) 562-9410 or by visiting www.orthonc.com or www.drmarkgalland.com or you can follow him on twitter: @drmarkgalland.

Kate Anderson, ATC/LAT is a post-graduate fellow at GOSM, Galland Orthopaedic and Sports Medicine. Follow her on twitter @kattethegreatt.


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Posted in Spine (Neck & Back), Sports Medicine | No Comments »

Dr. Mark Galland Releases Podcast On Double Bundle ACL Reconstruction Procedure

Written by admin on September 6, 2012 – 11:33 am -

RALEIGH, N.C. – Dr. Mark Galland, a physician at Orthopaedic Specialists of North Carolina (www.orthonc.com/galland.html), has announced the release of a podcast discussing the double bundle, or anatomic, ACL reconstruction procedure. In the podcast, Galland discusses what the procedure entails, what types of injuries require the surgery, candidates for the surgery and the proper patient treatment after the procedure. Galland serves as the team physician and orthopaedic consultant to the Carolina Mudcats, as medical director and orthopaedic consultant to the Louisburg College athletic program and as the team physician and orthopaedic consultant to several local high schools. The podcast can be found at: http://bit.ly/PoN4AM.

QUOTES:

“I am happy to share my knowledge about ACL injuries and the current treatment methods,” said Galland. “ACL injuries are very common for athletes and need to be treated with the best procedure possible.”

ABOUT DR. MARK GALLAND:

Dr. Mark Galland is an orthopaedic surgeon, sports medicine specialist and physician at Orthopaedic Specialists of North Carolina. Galland received his medical degree from Tulane University’s School of Medicine and completed his residency in the university’s Department of Orthopaedic Surgery. He began his career in orthopaedic surgery and sports medicine while serving in the United States Navy at a naval hospital at Camp Lejeune, N.C. There, he served as chief of orthopaedic surgery and was the recipient of numerous awards for both leadership and excellence in treating injuries common to sailors and marines. Since beginning with Orthopaedic Specialists of North Carolina, Galland has continued to treat injured athletes. He currently serves as a team physician and orthopaedic consultant to the Carolina Mudcats, the AA affiliate of the Cincinnati Reds Major League Baseball team, and as medical director and orthopaedic consultant to the Louisburg College athletic program. He also serves as the team physician and orthopaedic consultant to several local high schools.


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Posted in Knee, News Releases, Podcast, Sports Medicine | No Comments »

Dr. Galland Interviewed By News 14’s Marti Skold

Written by admin on August 14, 2012 – 10:30 am -

Dr. Galland recently set down with News 14’s Marti Skold to discuss how high school athletes returning to their Fall sports can prevent injury and how to know when the injury requires seeing a physician. Check out the interview here.


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Article from Dr. Mark Galland Featured in Cary Citizen

Written by admin on August 8, 2012 – 11:13 am -

Dr. Galland recently had an article published in the Cary Citizen, titled, Top 4 Ways to Tell “Sore” from “Injured.” In the article, Dr. Galland provides advice for high school athletes who are returning to fall sports on how to know when an injury is serious. To view the article, click here.


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Dr. Mark Galland Releases Podcast On Tommy John Elbow Ligament Reconstruction

Written by admin on July 18, 2012 – 6:58 am -

RALEIGH, N.C. – Dr. Mark Galland, a physician at Orthopaedic Specialists of North Carolina (OSNC) (http://www.orthonc.com/galland.html), has announced the release of a podcast on Tommy John elbow ligament reconstruction, a frequently-discussed topic in the sports world. In the podcast, Galland discusses the type of injury that requires Tommy John elbow ligament reconstruction, what type of athletes typically undergo the surgery, how the surgery works and what to expect during the recovery process. Dr. Galland serves as the team physician and orthopaedic consultant to the Carolina Mudcats, as medical director and orthopaedic consultant to the Louisburg College athletic program and as the team physician and orthopaedic consultant to several local high schools. The podcast can be found at: http://drmarkgalland.com/?p=187&preview=true

QUOTES:

“Tommy John Elbow ligament reconstruction is a common procedure that athletes undergo, particularly throwing athletes,” said Galland. “We want to make information about this surgery easier to obtain, so that more people are aware of how it works and can take advantage of the procedure.

NEW MEDIA:

Dr. Mark Galland Blog

http://drmarkgalland.com

Dr. Mark Galland YouTube Channel

http://www.youtube.com/user/DrMarkGalland

ABOUT DR. MARK GALLAND:

Dr. Mark Galland is an orthopaedic surgeon, sports medicine specialist and physician at Orthopaedic Specialists of North Carolina. Galland received his medical degree from Tulane University’s School of Medicine and completed his residency in the university’s Department of Orthopaedic Surgery. He began his career in orthopaedic surgery and sports medicine while serving in the United States Navy at a naval hospital at Camp Lejeune, N.C. There, he served as chief of orthopaedic surgery and was the recipient of numerous awards for both leadership and excellence in treating injuries common to sailors and marines. Since beginning with Orthopaedic Specialists of North Carolina, Galland has continued to treat injured athletes. He currently serves as a team physician and orthopaedic consultant to the Carolina Mudcats, the High-A affiliate of the Cleveland Indians Major League Baseball team, and as medical director and orthopaedic consultant to the Louisburg College athletic program. He also serves as the team physician and orthopaedic consultant to several local high schools, as well as on the board of directors for the Trentini Foundation, a nonprofit scholarship organization. For more information, visit http://www.orthonc.com or http://drmarkgalland.com.


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Posted in Elbow, News Releases | No Comments »

Dr. Mark Galland Treats Cincinnati Reds Prospects In Dominican Republic

Written by admin on March 29, 2012 – 7:51 am -

RALEIGH, N.C. – Dr. Mark Galland, a physician at Orthopaedic Specialists of North Carolina (OSNC) (http://www.orthonc.com/galland.html), completed a weekend of examinations and treatment Jan.14-15 with 43 Cincinnati Reds Major League Baseball team prospects in Santo Domingo, Dominican Republic. Galland addressed the health status of the prospects, ranging from ages 16 to 24, and provided treatment recommendations regarding the players’ current injuries.

Galland regularly works with baseball pitchers and position players at all levels of the game. He serves as orthopaedic consultant to the Carolina Mudcats, High-A Affiliate of the Cleveland Indians Major League Baseball team and to several area college and high school athletic programs, treating youth and amateur players around the Triangle.

The Dominican Republic has grown a reputation for producing top-flight baseball talent to the Major Leagues. According to MLB.com, 28 of the 30 Major League baseball teams currently run academies in the country.

QUOTES:

“The Reds organization has a terrific group of young athletes in the Dominican Republic,” Galland said. “These prospects stand to make great contributions to the parent club and farm system, and I am very honored to be entrusted with their care and well-being. I look forward to watching them develop.”

NEW MEDIA CONTENT:

Dr. Mark Galland Blog

http://drmarkgalland.com

Dr. Mark Galland YouTube Channel

http://www.youtube.com/user/DrMarkGalland

ABOUT DR. MARK GALLAND:

Dr. Mark Galland is an orthopaedic surgeon, sports medicine specialist and physician at Orthopaedic Specialists of North Carolina. Galland received his medical degree from Tulane University’s School of Medicine and completed his residency in the university’s Department of Orthopaedic Surgery. He began his career in orthopaedic surgery and sports medicine while serving in the United States Navy at a naval hospital at Camp Lejeune, N.C. There, he served as chief of orthopaedic surgery and was the recipient of numerous awards for both leadership and excellence in treating injuries common to sailors and marines. Since beginning with Orthopaedic Specialists of North Carolina, Galland has continued to treat injured athletes. He currently serves as a team physician and orthopaedic consultant to the Carolina Mudcats, the High-A affiliate of the Cleveland Indians Major League Baseball team, and as medical director and orthopaedic consultant to the Louisburg College athletic program. He also serves as the team physician and orthopaedic consultant to several local high schools, as well as on the board of directors for the Trentini Foundation, a nonprofit scholarship organization. For more information, visit http://www.orthonc.com or http://drmarkgalland.com.


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Posted in Around the office, News Releases, Sports Medicine | 1 Comment »

Dr. Mark Galland discusses Kendall Marshall injury

Written by admin on March 20, 2012 – 1:05 pm -

Dr. Mark Galland spoke with Andrew Carter of the Raleigh News & Observer to discuss the scaphoid injury to the wrist of UNC point guard Kendall Marshall. Check out the article here.

News 14 Carolina aired a video segment featuring an interview with Dr. Galland regarding the scaphoid injury.


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Posted in Hand & Wrist, Sports Medicine | No Comments »