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Get to Know our Staff: Karla Farmer, Fracture Clinic

Get to Know our Staff: Karla Farmer, Fracture Clinic

by | Oct 7, 2024 | Spotlight

What is the most fulfilling part of your job?
I enjoy helping patients and their families get the care they need.

What makes Scottish Rite a special place to you?
Scottish Rite is special because of the compassionate, specialized care given to patients and families. The teamwork adds to the specialness.

What made you choose a career in health care?
I like to help people, and there are many options to do that in health care.

What is something unique you get to do in your position?
In my position, there is a lot of teamwork between providers, nurses, medical assistants and cast technicians to ensure patients receive what resources they need.

What’s your favorite thing to do outside of work?
I like to spend time with my family, as well as cheer on the Green Bay Packers.

Do you have any hidden talents?
When I went to college, I got my bachelor’s degree in music. I can play the piano, among other instruments.

Where are you from and what brought you to DFW?
I’m originally Wisconsin, and my family decided to relocate to the DFW area.

If you could travel to anywhere in the world, where would you go and why?
I would travel to Paris for the food, art and history.

If you had to pick one meal to eat for the rest of your life, what would it be and why?
I would choose to eat pizza, because there are so many choices!

What was the first concert you attended?
I saw the band Green Day.

Favorite DFW hidden gem?
The Dallas Arboretum.

If you were to have a movie based on your life, which actress/actor would you choose to play your character?
It would have to be Cameron Diaz.

What is some advice you would give your younger self OR what’s the best piece of advice you’ve received?
Take things one step at a time and try not to worry about what the future holds.

Wrist Complaints You Shouldn’t Ignore – Fracture Clinic Tips

Wrist Complaints You Shouldn’t Ignore – Fracture Clinic Tips

by | Aug 31, 2021 | Fractures

Falling onto an outstretched hand can often cause injuries to the ulna and/or radius, or the long bones in the arm. The most common injuries are called both bone forearm fractures (BBFA) or buckle fractures. Sometimes, the carpals, the smaller bones in the wrist, may be injured instead. When the hand is turned slightly inward during a fall, the scaphoid bone is most likely to be injured.

“In some cases, early X-rays of a painful wrist may not show an obvious fracture,” nurse practitioner in the Fracture Clinic Ray Kleposki, M.S.N., CPNP, says. “A detailed physical exam of the wrist is important to evaluate for a small fracture in the scaphoid or other bones.”

Scaphoid injuries tend to be slow to heal, so early intervention is important and can help to prevent future complications. Kleposki has helpful advice to parents about what to look for following a fall onto an outstretched hand. “If there is a concern for a scaphoid fracture, or if the wrist pain after a fall has not gotten better in more than a week, we recommend a specialized X-ray series to evaluate for a scaphoid fracture or other diagnosis,” Kleposki says.

Falling down and getting a few bruises comes naturally as kids play and learn new skills! Parents can rest easy knowing that experts at Scottish Rite for Children are here to help when a child breaks a bone or when a seemingly minor injury bothers a child longer than a few days.

Learn more about the multi-disciplinary care in our Fracture Clinic.

“Walk It Off, It’s Just an Ankle Sprain.”…. Or Is It? – Fracture Clinic Tips

“Walk It Off, It’s Just an Ankle Sprain.”…. Or Is It? – Fracture Clinic Tips

by | Aug 24, 2021 | Fractures

The ankle is one of the most commonly injured body parts in children of all ages. An ankle sprain usually occurs when the ligaments, which support the three ankle bones, are stretched beyond their normal limits. This often occurs when the ankle is twisted or rolled inwards. When this happens, the ligaments can stretch or even tear, and oftentimes a “pop” is reported to be heard or felt at the time of the injury. When a child or adolescent with open growth plates twists or rolls their ankle, it can actually result in a fracture of the growth plate rather than a sprain to the ligament.

Ray Kleposki M.S.N., CPNP, a Scottish Rite for Children Fracture Clinic Nurse Practitioner, tells us, “An evaluation by a pediatric orthopedic specialist can help to prevent potential complications. Usually X-rays are required to make a diagnosis and treatment will depend on multiple factors, including the specific type of injury and age of the patient.”

An ankle sprain is an injury to one or more of the ligaments which support the ankle joint. Ligaments connect bones and hold a joint together. Ankle sprains are one of the most common sports injuries but can happen anywhere.

How does it occur?

Any movement that causes the ligaments of the ankle to stretch farther than they naturally can, may cause an ankle sprain. Examples include:

  • Twisting or turning injury during a step or landing.
  • Fall or near fall on an uneven surface.
  • Unsteadiness from a sudden change in direction.

What are the symptoms?

  • Tenderness or pain
  • Limp or pain with walking
  • Aching
  • Swelling
  • Bruising or discoloration

How is it diagnosed?

An ankle sprain is best diagnosed by a health care provider. A detailed history and physical exam will be performed. In some cases, X-rays or other imaging may be ordered to evaluate for injuries to the bones or other tissues.

How long will this injury last?

Recovery time varies and depends on the child and the severity of the injury. A child may recover in a few days, weeks or months. Rehabilitation to strengthen and stabilize the ankle, and to reduce the risk of another injury, plays an important role during the recovery from an ankle sprain.

How is it treated?

To improve pain and swelling:

  • Limit activity since pain may increase with activity.
  • PRICE: Protect, Rest, Ice, Compression and Elevation.
  • Non-steroidal anti-inflammatory medications (NSAIDs) such as ibuprofen (Advil®, Motrin®) or naproxen sodium (Aleve®) may be taken as needed for pain.

Depending on the sprain, the health care provider may or may not advise formal rehabilitation immediately. Treatment goals for recovery and prevention are to restore these:

  1. Motion and flexibility
  2. Strength
  3. Balance, proprioception and stability

When can my child return to normal activities and sports?
This decision is made based on the severity of the injury, the child’s age and activity level. A gradual functional return to activity and sports can be made once:

  • cleared by provider.
  • pain and swelling are gone.
  • able to walk without pain or limp.
  • ankle has full motion, and strength is the same as on the other ankle.
  • balance is restored.

How can future ankle injuries be prevented?

Restoring and maintaining ankle strength and mobility are both vital in preventing repeat ankle injuries.
Here are several additional ways to protect the ankle:

  • Wear proper fitting shoes, tied correctly, for activities.
  • Learn and perform strength and neuromuscular exercises a few times a week.
  • Stretch before and after activity.
  • Focus on form and proper technique.
  • Work with a knowledgeable coach familiar with proper training for growing athletes.
  • Consider an ankle brace or ankle taping to provide support.

The Fracture Clinic in Frisco is open Monday – Friday from 7:30 a.m. to 4:30 p.m. The clinic accepts walk-in patients between 7:30 a.m. and 9:30 a.m.

Learn more about our Fracture Clinic.

Jump! Flop! Bounce! Break.

Jump! Flop! Bounce! Break.

by | Apr 20, 2021 | Fractures

As things get back to normal, we’re seeing an influx of orthopedic injuries from trampolines and bounce houses. We thought you would like some quick tips for making them as safe as possible.

  • Allow one child to jump at a time.
  • Separate the big kids from the younger kids.
  • Supervise at all times.
  • Consider the equipment:
    • Are there mats around the trampoline?
    • Is there a net?
    • Are the springs intact and covered?
  • Consider the environment:
    • Are there a lot of distractions for the supervising adult or the jumpers?
    • Are there safety protocols in place for all participants?

Most common injuries from these activities:

  • Fractured (broken) tibia, the lower leg bone.
    • Proximal tibia fractures occur at the top of the bone close to the knee.
    • Tibial shaft fractures occur in the middle of this long bone.
  • Buckle fracture of the forearm. Learn more here [link to blog].
  • Elbow fracture or dislocation.

Though kids are resilient and heal well from these injuries, we want to keep them safe. Kids under 5 are at a greater risk of injury and count on their parents to protect them in these environments.

Learn about our Fracture Clinic. It’s open weekdays and has morning walk-in hours.

Toddler’s Fracture: Important Things Parents Should Know

Toddler’s Fracture: Important Things Parents Should Know

by | Oct 8, 2020 | Fractures

Our team of pediatric orthopedic specialists in the Fracture Clinic understand that accidents happen. When your child gets injured, it can be scary, especially if the child is very young. It is important to understand common fractures, what to do and where to go if it happens to your child.

A fracture is a break in a bone. A toddler’s fracture is the name for a broken bone in the leg that typically occurs in children less than 3 years of age. A toddler’s fracture is a spiral fracture (break) in the tibia (the shin bone). It is considered a low energy break, and usually presents as a hairline (small) crack without significant damage to the bone or surrounding tissue.

As a nurse coordinator in the Scottish Rite for Children Fracture Clinic, Bonnie Ste. Marie, R.N., works closely with families when they come into the clinic. “We see this type of fracture often,” says Ste. Marie. “As a mom myself, I understand the concern of parents when this happens to their young child. It is important to me and the team to provide information every step of the way. This helps the child and parent feel comfortable and assured we provide the best care for each patient.”

How does a toddler’s fracture occur?
This type of fracture is the result of a twisting leg injury and typically occurs during a fall or going down a playground slide.

What are the signs and symptoms of a spiral tibia fracture?

  • One of the first symptoms is that your child will refuse to put weight on the injured leg and will withdraw the foot by bending at the knee with attempts to stand or weight bear.
  • Due to your child’s young age, it is difficult for them to communicate where the pain is coming from and they will often complain of pain in the entire lower leg or specifically point to the foot.
  • Mild swelling to the lower leg or foot is possible but rare in most cases.

 How is a toddler’s fracture diagnosed?

  • History – You will give a detailed description of the activity that caused the injury.
  • Physical Exam – A physical exam is performed, from the hips down to the feet. Typically, there is tenderness to touch in the tibia or shin bone area and pain with rotation of the lower leg. The hips and knees should be pain free and have full range of motion.
  • Imaging – X-rays may be taken of the lower leg.
    • In most cases, the fracture is very small, and the X-rays will show that the bone is still in place, or in normal alignment.
    • In some cases, X-rays will not show any obvious fracture. This is called an occult fracture and is diagnosed during a physical exam.

What is the treatment for a toddler’s fracture?
The majority of these fractures are stable injuries and treatment is aimed at providing comfort and modifying activities. A hard cast is rarely necessary. Evidence shows that a walking boot and allowing the child to continue to walk as tolerated produces similar results to wearing a cast or splint but with fewer risks of complications. Children will generally wear the walking boot for around four weeks.

The Fracture Clinic in Frisco is open Monday – Friday from 7:30 a.m. to 4:30 p.m. The clinic accepts walk-in patients between 7:30 a.m. and 9:30 a.m.

Learn more about the Fracture Clinic.