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When our patients have something nice to say about us, we like to brag about it!

Please enjoy some of the highlights from TSAOG's April 2013 Customer Survey:

• “Dr. Schroder was personable and thorough. He took the time to explain my injury and treatment.”
• “It is a very comfortable and welcoming environment. Everything there is designed with the patient in mind. Love it”
• “Ortho Now is an awesome service. I love their efficiency and the way they take care of everything for you.”
• “Dr. Balldin has awesome bed side manners. He made my kids feel so comfortable and explained everything to them about their condition and everything to expect during the healing process. I will completely recommend him and the clinic to all the parents on my kids’ team.”
• “great locations nice comfortable waiting areas, friendly staff, imaging on site, outpatient procedures on site, i have had more than one of your staff go out of their way to make me comfortable during my visits. I am suffering from sciatica and i am usually in extreme pain by the time i have ridden in the car to get to an appt. They notice and get me pillows or find an empty room so i can lie down. this seems like nothing but it is a big deal to me. thank you!”
• “Dr Bergfeld and Mayra went out of their way to squeeze me in for severe pain from my back injury!”
• “Vanessa & Dr Hennessy are the best”
• “I was confident in Dr. Woodbury performing my hand surgery and I am happy with the outcome.”
• “Dr. Randall Marx is the best physician I have ever had in my entire life. He's polite, but stern (as needed to get a point across), very sincere and makes me feel that he cares for me as a patient.”
• “I was very impressed with the physical therapist, Mr. Trueman, who did my evaluation. He was not at all rushed and was very thorough and had useful and practical advice that I can begin using right away.”
• “What really stands out for me about TSAOG is that the staff is extremely friendly and pleasant while still being professionally. From the time I arrived, the person who checked me in, the nurse, the doctor and the person who checked me out were all extremely pleasant. So much so that I almost felt like asking for an office manager before I left to tell them so. Thank you.”
• “Dr. Brenman has helped me and given me hope and a new life. He cares about helping me and he does an outstanding job doing what he does best. Yall have a winner working for yall.”
• “I couldn't ask for a better Doctor than Dr. Bell”
• “Dr. Ursone took the time listen to me explain the history of my injury vs. having a staff member do so. He did a good job in explaining my treatment options. He is calm natured and expressed an interest in resolving my knee problems.”
• “I have a lot of confidence in the providers. They did not rush into surgery and ensured realistic expectations on my part.”
• “Dr Taber has the unique, very specific knowledge required to fix my hip problem.”
• “My wife is treated as a person with a problem and not a patient with a chart.” (Dr. Ochoa)
• “OrthoNow allowed me to be seen immediately rather than wait a week to schedule an appt. I feel like I will get well faster knowing why I was in so much pain.”
• “I was nervous about surgery but the staff took care of me like family”
• “All of your staff, but especially Dr. Viroslav, are attentive and do their best to please.”
• “Very friendly and ACCESSIBLE staff. Doctors don't hide behind nursing staff.” (Dr. Tolin)
• “I can always be seen without delay. There are so many sub-specialists and I feel that my issues are appropriately addressed.” (Dr. Rowland)
• “The wait time is always very short and my plan of treatment is always explained thoroughly. My questions and concerns are address quickly and thoroughly.” (Dr. Pace)
• “Superb professionalism - they take their work seriously.”
• “I have been treated by Dr. John Hinchey in the past and have used this group since 1956.”
• “I call it the one stop shopping for my fix it shop. I have had foot surgery shoulder surgery and knee surgery there.”
• “Dr Bryan Kaiser has treated both my daughter and husband. I have complete confidence in his recommendation of treatment.”
• “Dr. Jacobs is very thorough, Informative and caring”
• “Liked the DR. Very much. Great attitude and manner.” (Dr. Hibberd)
• “What a blessing to have Dr. Gonzalez on my team!”
• “it was fast, clean and doctor was very clear” (Dr. Garcia)
• “All appointments have been wonderful. Very little wait time. Desk Staff very courteous and professional” (Dr. Galindo)
• “I wish you could teach all my Physicians how people should be treated.”
• “Dr. Drukker is awesome! He has helped me so much. I am very grateful to him.”
• “Dr. Connor and his staff are topnotch. I always get the best of treatment during my office visits.”
• “Dr. Burkhart and PA Haley will always occupy a special place in my heart/life. Thanks to them I have a shoulder that's like new. Will highly recommend them to friends and/or others for top-quality, premium service/care.”
• “[I like] the individual care and attention that Dr Brown and his NP provide to their patients.”

We encourage you to review and rate your experience with TSAOG.  The next time you visit us, please take the time to fill out our customer survey and you may see one of your comments online the next month!

Please note: Spelling and punctuation errors may have been corrected for readability.

Injuries to the shoulder are common.  Injury of the Acromio-Clavicular (AC) joint (where the shoulder blade meets the collarbone) usually involves a fall directly onto the shoulder.  The common term for this type of injury is a “separated shoulder.”  

The main stabilizers of the AC joint are the AC joint capsule and the coraco-clavicular (CC) ligaments.  The AC joint capsule is more important for back and forth stability and the CC ligaments are more important for superior to inferior stability.  The CC ligaments are two separate structures that run from the front of the shoulder blade to the part of collarbone closer to shoulder.  

As with most bony fractures or dislocations, the orthopaedic community has a classification system for describing AC joint injuries.  There are six types:

• Type I - Sprain of the AC joint capsule with intact CC ligaments
• Type II - Tear of the AC joint capsule and partial injury of CC ligaments, with minimal elevation of the end of the collarbone 
• Type III - Complete injury of AC joint capsule and the CC ligaments, resulting in 100% displacement of the end of the clavicle above the AC joint
• Type IV - Posterior displacement of distal end of clavicle into the muscle layer surrounding the clavicle
• Type V - Gross displacement of the distal end of clavicle with >100% superior elevation and usually has a very visible deformity
• Type VI - Inferior displacement of distal end of clavicle below the acromion process which is a part of the shoulder blade below the clavicle (extremely uncommon) 

The good news is that most injuries involving the AC joint are types I, II and III and most of these injuries can be treated without surgery.  Types IV, V and VI are treated surgically.  There is some controversy regarding the preferred treatment of type III injuries, but most are treated conservatively.  However, if the patient is an overhead thrower/athlete/laborer, does not want have a bump on the clavicle with it being elevated, or continues to have pain after attempts at conservative treatment, then surgical intervention for a type III injury may be indicated. 

I perform the surgery using minimally invasive arthroscopic techniques to reconstruct the CC ligaments.  This is done as an outpatient procedure.  If the AC joint is arthritic from pre-existing conditions, then I often perform a distal clavicle excision (removal of the end part of the clavicle) at the same time in order to prevent further degeneration and pain after recovery from the surgery.

Recovery is quite long with a total rehabilitation process lasting close to 5 months.  Initially, the shoulder is kept quiet in a sling and only simple range of motion (ROM) exercises are performed.  This is followed by gradual increase of ROM and finally strengthening.  

Click here for additional information and graphics. 

Dr. B. Christian Balldin is an orthopaedic surgeon, fellowship trained in sports medicine.  He treats patients aged 3 years and up for all orthopaedic conditions with the exception of the spine and has a special interest in sports-related injuries and arthroscopic surgery.  If you would like to schedule an appointment with Dr. Balldin, please call 210.281.9595.

When our patients have something nice to say about us, we like to brag about it!

Please enjoy some of the highlights from TSAOG's March 2013 Customer Survey:

• “Dr. Schroder […] is extremely professional, courteous and through. He is an excellent addition to your physician staff. We also thought highly of Debra Mendiola. She was always helpful.”
• “Dr. Balldin was wonderful!! I would highly recommend him to my family and friends!!”
• “So glad to get the help for my back that I needed.” (Dr. Bergfeld)
• “This practice is the first practice that I've been to that is 100% perfect. From the front desk to the surgeons and all the techs and the physical therapist they are all great.”
• “Friendly staff and MDs who opt for the least traumatic therapies as first options.” (Dr. Hennessy)
• “Totally professional service from start to finish. I could not be more pleased with the entire experience. Thank you so much!”
• “Even though I live out of town, it is easy to get to and I always find a parking place. But, more importantly , the office staff and physicians are professional and cordial.” (OrthoNow Urgent Injury Clinic)
• “Dr Woodbury performed surgery on my son's hand. Even my husband (who is hard to please) was completely happy with everything.”
• “The staff in SAOG is wonderful and considering that we live 4 hrs away, we were able to be seen timely. But above all, i was very pleased that Dr. Randall Marx sees his patients from the beginning to the end of the appt., he isn’t one of those doctors that sees his patients and then passes them over to the PA or any other staff member. During our appointment, he seemed very confident in what he wanted to do during surgery and now that I've had my surgery, seeing Dr. Marx explain with total confidence on how the procedure went, gives us faith that we did make the right decision in leaving this surgery in Dr. Marx's hands. I will highly recommend Dr. Marx to all our friends and family!!!”
• “I enjoy coming to Dr. Brenman. He always answers my questions thoroughly and remembers information about me.”
• “Dr Bell is great. The best Ortho Dr I have had. Thanks for all. !!!!!!”
• “Thank you for taking such great care of our son! he even told me that he thought Dr. Ursone was a very nice doctor. If you know my son, that is a big deal, Doctors can be pretty scary for him ;)”
• “Dr. Taber is #1 in my book. He did a hip replacement surgery 9 mo ago and literally gave me my life back.”
• “Dr. Ochoa is very much a realist and he seems to care about my ideas. His knowledge of percentages of recovery and success were astonishing.”
• “I liked Dr. Viroslav and I feel he was very concerned about me and gave me his full attention and answered all of my questions.”
• “Good and truly professional physicians.” (Dr. Valdez)
• “Great Front desk and nursing staff and the physician is outstanding in terms of instilling confidence, diagnostics and follow up” (Dr. Tolin)
• “The Doctors and staff are very friendly, knowledgeable, and helpful. I like the convenience of having all necessary services within the group’s offices - xray, CT scan, surgery center, etc.” (Dr. Rowland)
• “Outstanding professional medical care.” (Dr. Pace)
• “Love your doctors!! They take care of me!!!”
• “The PT staff is the best!!! Phillip Trueman helped me through my first surgery and now and Keli Smith, Phillip, Tiffany are doing a great job for me!!!!!!!!! are helping me again”
• “Dr. Kaiser is top notch in my book. VERY SATISFIED WITH THE KNEE PROGRESS AT 8 WEEKS POST-SURGERY!!!!!!!!!!!”
• “Dr. Jacobs is great, willing to do whatever he can to help you.”
• “I have been with Dr. Hibberd from 2005 and from the start of our association have felt more safe and cared for than with any other physician.”
• “Dr. David Gonzalez and his staff always treat me incredible always answer my questions”
• “I have much confidence in Dr. Garcia.”
• “Dr. M.J. Galindo is a very good doctor he listens to everything you say and does not try to diagnose you fast just to clear the room for the next patient. I feel I am very cared for by Dr. Galindo and the staff. Above and beyond service compared to other doctors’ offices, urgent care, and hospitals I have been to.”
• “I liked everything. To be more specific I like that you do not have to wait too long in the waiting room. I like that you can see the appointments are on schedule. I like that the doctors see you very fast and you do not have to wait forever in a room. The care is specific to your needs and you are treated with a sense of urgency. Checking out is easy. I LOVE the patient portal it is very easy and makes updating medical records a breeze. Also I like the option of being able to pay online that is so AWESOME.”
• “Dr. Drukker was efficient, yet caring. My visit was quick & as painless as possible.”
• “I thank the Lord for my blessings, and for my good doctor. Dr. Connor should be encouraged for his good work.”
• “I hope the staff and Dr. Burkhart know how their help and kindness during this time means very much to the patient.”
• “The excellence of my doctor and the staff, as well as the impression that everyone enjoys working there.  Dr. Brown gives his patients the sense that he is totally focused on them when he is with them.  I never feel as though he is rushing my time, so I can accept the occasional wait.”

We encourage you to review and rate your experience with TSAOG.  The next time you visit us, please take the time to fill out our customer survey and you may see one of your comments online the next month!

Please note: Spelling and punctuation errors may have been corrected for readability.

The injury that Louisville’s Kevin Ware sustained is a gruesome one to watch.  An open tibia fracture is something that is much more common in higher energy type mechanisms such as motor vehicle collisions.  The fact that he sustained this injury simply from landing on his leg with some twisting makes me think that he almost certainly had a stress fracture in that area.  When he landed on that leg, his tibia was simply unable to withstand the forces due to the already weakened area and he completed the fracture.  Due to the twisting and force of the landing the bone, unfortunately, came through the skin thus coming in contact with the outside world.  This makes the situation worse not just because of its gruesome appearance but because of the now much higher chance for infection and potential for additional problems.  

Open tibial fractures (when bone breaks through the skin) are known for taking a long time to heal as they simply do not have the same blood supply and muscular envelope that other long bones have (i.e. the femur, radius and ulna).  They may take longer than a year to fully heal and occasionally they do not heal.  This is especially the case when infection sets in.  One of the more important points regarding open fractures is the need for antibiotics within a few hours of the injury in order to decrease the chance of infection.  An open tibia fracture requires urgent surgery to irrigate and debride the bone as well as stabilize the fracture.    

A tibia fracture that occurs in the middle of the bone is treated with an intramedullary nail (IMN).  This nail is usually a titanium rod with a few screws at the top of the bone near the knee and a few screws near the ankle.  It is a very stable construct and allows for immediate range of motion and often weight bearing very shortly after surgery.  The fibula (the other bone in the lower leg) often breaks along with the tibia but the vast majority of the time it is treated without any internal fixation and heals on its own.

Kevin Ware will be in the hospital for a couple of days for IV antibiotics and therapy but will hopefully have a speedy recovery and be back on the court before next season.

Read Dr. Balldin's interview with WOAI Radio's Jim Forsyth.

Dr. B. Christian Balldin is an orthopaedic surgeon, fellowship trained in sports medicine.  He treats patients aged 3 years and up and his special interests include sports injuries and fracture care.  To schedule an appointment with Dr. Balldin, please call 210.281.9595.

When our patients have something nice to say about us, we like to brag about it!


Please enjoy some of the highlights from TSAOG's February 2013 Customer Survey:

• “I was VERY impressed with Dr. Brown! While maintaining a professional attitude, he was still very friendly, making me feel quite comfortable for a 1st visit.”
• “I feel that I am receiving attention from professionals who are skilled and up to date.”
• “I am able to see the best of the best shoulder specialist.” (Dr. Burkhart)
• “…Dr. Connor is a GREAT doctor. Dr. Connor is a kind and caring physician. Dr. Connor explains everything clearly and strongly cares about his patients and their needs. More doctors should care for patients and not treat them as the next $ figure.”
• “The entire experience, from check in to check out, was great. Everyone was very friendly, courteous and professional.”
• “I trust Dr. Drukker to make wise decisions and give good advice for my situation. That is huge! Some doctors give reason to be concerned with their judgment and abilities these days.”
• “…Visiting here for the winter months, I broke my ankle, and needed surgery. This is the first time I ever had surgery in my life. Not knowing any surgeons here in town, I lucked out and found you guys through the Web. As soon as I met with Dr. Galindo and he explained what had to be done with my ankle, I was not afraid to go into surgery. He is terrific. Many thanks also to Benny for the great cast, and Kym and Elizabeth for making the admin/financial process easy. The pre-surgery process was very efficient, and the staff was great. Surgery went well. Everything that was going to occur was explained clearly to me before it happened. Post-op process was smooth, and the staff very accommodating. The San Antonio Orthopaedic Group is very professional and efficient...and all staff very friendly and approachable. And you have wireless available in the waiting room! As a Web Developer, I love that! Your Patient Portal is excellent as well. Thank you all so very much for helping me. It is good to be on the mend.”
• “Dr. Hibberd was very professional yet friendly, felt at ease.”
• “Dr. Jacobs is a true professional. I enjoy the doctor-patient relationship.”
• “Dr. Kaiser did an outstanding job on my left knee replacement. Also, he or his staff made all arrangements for my follow-up home care and physical therapy with competent providers.”
• “Everyone was professional and efficient. When I felt light headed after my cortisone injection in my hand and wrist, two staff members had me lie down in a recliner and rest. Then, when I felt better, I was escorted to the elevator to ensure my readiness to leave safely. I greatly appreciate this type of caring” (Dr. Pace)
• “Convenient locations...great doctors”
• “Dr Rowland is excellent”
• “Dr. Tolin and his PA were exceptional! Very helpful and understanding...”
• “Well run organization with the premier docs in the area. On a previous surgery I experienced the cast staff and they are grrrreeeaat!!!!!!!”
• “Dr. Viroslav did a great job with me knee...I will highly recommend him to all my friends in the gym and co- workers.”
• “Always [a] pleasant experience” (Dr. Valdez)
• “Possibly the most professional and courteous medical facility we have worked with”
• “…My surgery and recovery went well just like the Doctor said. I was very satisfied with the attention and service the Doctor provided for me.” (Dr. Ochoa)
• “Dr. Taber listens and is prepared when I visit. I have had multiple health problems and he stays aware of how my current health can be affected.”
• “Dr. Ursone is the best Orthopod in the business”
• “Dr. Bell treated me for my own good and did not try to push me into anything. He gave the option to decide what I wanted done.”
• “So far, [I like the] professionalism and approachability of doctor and therapist. Nice office -- professional, attractive, clean, well equipped.” (Dr. Brenman)
• “The physicians LISTEN to their patients”
• “Courteous staff and caring doctor” (Dr. Marx)
• “Everyone is friendly, polite, and just plain wonderful. Tony, Josh, the secretarial staff and Dr. Woodbury have been fantastic. Even my physical therapists were great. I cannot thank you all enough for a VERY positive experience.”
• “Excellent care by Dr. Hennessy.”
• “I LIKE EVERYTHING” (Dr. Bergfeld)
• “You have several doctors, several locations, courteous staff, I liked that you have your own x/ray-CT-MRI office, I like the electronic portal medical records info. I like the e-mail type info on appointments and charges and I especially like the board that tells you if your Dr is on time or late to see you. Thank you for treating me with RESPECT and not just trying to take my money”
• “Convenient locations, OrthoNow saw me the same day.”
• “The level of professionalism displayed by the staff and the doctor gave me a great deal of confidence in getting my partial knee replacement done ASAP” (Dr. Schroder)
• “Quick professional service. Good doctor bed side manner.” (Dr. Balldin)

We encourage you to review and rate your experience with TSAOG.  The next time you visit us, please take the time to fill out our customer survey and you may see one of your comments online the next month!

Please note: Spelling and punctuation errors may have been corrected for readability.