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Month: December 2015

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General Hands

Hand Fractures: Symptoms and Treatment

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Take a moment to imagine what life would be like without having the ability to use one of your hands? It would be difficult to drive, dress, shower, and complete all of the activities that you currently take for granted. However, hand fractures are more common than many believe. Whether you were in a car accident, a sporting accident, had your hand slammed in a car door, or anything else, the damage can be severe, and you need to know what to expect and how to treat these types of injuries.

What Happens With a Hand Fracture?

The term “hand fracture” encompasses many different bones. Each hand has 27 bones, and any of them could fracture and need treatment. Bones in the hand could break near the wrist, near the knuckle, or closer to the middle part of the bone. When a break occurs, you will feel pain and experience swelling. Some may also see a deformity in their hand based on the severity of the break and the amount of swelling. It will not be possible to move the fingers, at least not without a massive amount of pain. The knuckle may have an indented or depressed appearance and the affected finger could appear shorter than it should.

To determine the type of injury and the severity of the injury, the doctor will need to take an x-ray. This will give them an inside look at the fracture to determine the precise location and the type of fracture it is. Some patients will also undergo a test to ascertain the range of motion they have left in the hand, as well as a sensation test. The sensation test tries to determine if there is any nerve damage to the hand.

Types of Treatment

With many hand fractures, it will be possible for the doctor to move the bones and realign them without surgery so that they can heal properly. Once they have the bones in alignment, they will apply a brace, splint, or a cast, which will help to keep the bones in place until they can heal properly. After setting the hand, the doctor will want to take a second set of x-rays (generally about a week afterwards) to ensure they are set properly and healing. The length of time that you are in the cast will vary, but it is typically about three to four weeks.

Some types of hand fractures are much more severe though, and they will require surgery. If the hand has been crushed or the fracture causes pieces of the bone to protrude through the skin, surgery is in order. The hand surgeon will use a variety of techniques and implants, such as wires or plates, to help keep the bones aligned during the healing process. In some cases, they will remove the implants after the bone heals; other times, they will need to remain in the hand. After the surgery, you may need to do exercises and therapy to restore the mobility of your hand.

Hand fractures can be serious and those who feel they may have a broken bone in their hand should seek the advice of a medical professional as soon as possible.

Categories
General Wrists

Carpal Tunnel Syndrome Symptoms, Causes, and Treatments

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Many people do not even realize that they are beginning to get carpal tunnel, as it has a tendency to start slowly. It will often begin with a numb or tingling sensation that starts in the fingers. In the beginning, this is not permanent. Sometimes you will feel it and sometimes you will not. Most of the time, you will not feel it in your little finger, but you will feel this sensation in your thumb and the other fingers.

You may begin to feel this when you are gripping something, such as a phone or tablet, when you are reading, typing, or even driving. In some cases, it can even cause people to wake up at night. While most people will only feel it in their hands and fingers at first, it is possible to have the feeling spread up the forearm. As carpel tunnel worsens, these sensations become permanent quite often.

Many who have carpal tunnel will also find that they have weakness in their hands, making it more difficult to hold onto things with a good grip. Those who have these signs and symptoms should certainly consider speaking with a doctor about what they can do next and whether surgery will be necessary.

What Causes Carpal Tunnel?

When the median nerve in the wrist is compressed, it causes carpal tunnel syndrome. The nerve extends from the hand, through the carpal tunnel, and up through the forearm. It may be difficult to isolate the cause of the carpal tunnel. It is more prevalent in women than in men. Certain anatomical factors can be a cause as well. Those who have smaller carpal tunnels are at a higher likelihood of injury. Other causes can include diabetes and other conditions that damage the nerves, fluid retention, obesity, and of course, factors in the workplace. In any job where there is repetitive flexing of the wrist, there is a chance of people developing carpal tunnel syndrome.

Endoscopic Carpal Tunnel Surgery

Several different options are available for carpal tunnel treatment, and endoscopic surgery is one of the top choices for many. One of the benefits of getting endoscopic surgery is that the incisions tend to be small and the recovery time minimal for most types of surgery. This includes surgery to help people deal with their carpal tunnel syndrome. The surgeons will make a small incision in the hand, near the wrist, and then guide the endoscope into the hand to see the wrist. The tools utilized tend to be very small, which also go through the small incision.

During the surgery, the surgeon will cut the transverse carpal ligament as a means to help reduce the amount of pressure being placed on the median nerve. The goal is to help eliminate the symptoms that people with carpal tunnel suffer. While there are certainly benefits to the smaller incisions, endoscopic surgery may not be the right solution for everyone. You will need to speak with your hand surgery specialist about the best course of action for your own hands.

Categories
Conditions General

What Is a Ganglion Cyst and Does It Require Surgery?

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A ganglion cyst is a lump that people will develop on their hands and wrists. They are noncancerous, but they are full of fluid, which can cause pain if they are pressing on a nerve. The size of the cysts can vary greatly. Some are actually quite small, while others can be an inch or slightly larger in size. In some instances, the location of the cyst can make it difficult to move the joint.

The exact cause of ganglion cysts is unknown, and they will often disappear on their own. However, that is not always the case. Sometimes, you will need to have surgical treatment, which we will discuss further below.

What Are the Symptoms?

Most of the time, the cysts are painless. As mentioned though, if they are located close to a nerve, and they press on the nerve, this can cause a substantial amount of pain. Even a small cyst can cause problems, such as numbness and weakness in the muscle. The size of the cyst can change as well, depending on how often you use that joint. When you use the joint more often, the cyst could increase in size.

Whether you experience pain or loss of motion or not, you will want to make sure to head to a doctor so they can provide you with a proper diagnosis. You want to make sure it is a ganglion cyst and not anything more serious. The doctor will also be able to recommend treatment. As mentioned, many times, the cyst will go away without any type of treatment. Many doctors will want to see what happens with the cyst before providing treatment, as it might be unneeded.

Types of Treatment

When the doctor does decide that they need to treat the cyst, they have several options. First, they will likely want the patient to immobilize their wrist. This can help the cyst to shrink. For those cysts that do not go away, the doctor could aspirate the cyst. This involves using a needle, inserting it into the cyst, and then draining the fluid. Some doctors will then inject the area with steroids, which should help to keep the cyst from coming back. However, there is still the possibility of the cyst recurring.

Of course, there is a chance that the other treatments will not work. In those cases, the doctor will determine whether surgery is a good and viable option. The ganglion cyst surgery will remove not only the cyst, but also the connecting stalk that is attached to the tendon or the joint. While this is a good option for many, there is always the chance that the cyst could still return.

If you have a ganglion cyst, or a lump that you believe may be a cyst, you will want to get in touch with a medical professional who can examine you. You can talk to a specialist who performs hand surgery to determine whether removal is your best option to help get rid of the cyst.

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General

When Should You Talk With a Hand Specialist?

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Your hands are vital to all of the things that you do in your daily life. You use them to type, to use your phone, to get dressed, drive, eat, and so much more. Most people tend to take their hands and their wrists for granted. Take a moment to think about all of the normal things that you do each day. Now, try to imagine doing those things without the use of your hands. You will find that most of the things that you do would no longer be possible, at least they would not be as easy to do as they are now. You need to take good care of your hands, and that means you need to know when to talk with a hand specialist about issues you might be having.

Uncontrollable Swelling

Having swollen hands and wrists happens occasionally, and most of the time it goes away quickly and doesnt return. Other times, the swelling is persistent, and this could be a sign of trouble to come. In some cases, the swelling could be the result of arthritis. Other times, it might be due to an injury caused by repetitive motion. This could lead to carpal tunnel syndrome if it hasnt already – we will touch more on this later in the article. In some cases the swelling will affect not only the hands and wrist, but also the elbow. It is a smart idea to contact a hand specialist sooner rather than later so the problem does not get worse.

Trouble Moving the Hand

If you have issues moving your hand or your wrist, it could be a sign of a number of different problems. You may have arthritis, or you could even be suffering from a hairline fracture. Regardless of the cause, this type of pain in the joints means that you need to get in touch with a specialist to help determine the issue. When you are able to catch these types of problems early, it can help to make recovery much easier. In some cases, you may be able to make some changes that will help you avoid surgery. Other times, surgery might be the best option for you. A specialist will let you know what you should be doing to heal properly.

Numbness

If you experience a tingling sensation or numbness in your wrist and fingers, it could also be a sign that you are suffering from a hand injury that will only worsen over time. This could be one of the early signs of carpal tunnel syndrome, and catching it early can help you to eliminate the need for surgery later.

Whenever There Is a Concern

Ultimately, you will want to speak with a hand specialist whenever you feel any concern over the function, health, and safety of your hands, wrists, and elbows. Its always best to be cautious and to try to catch any potential problems early. Of course, if you suffer from a serious injury, such as a fracture, a serious burn, or a crushing injury, your first stop should be the emergency room. Then, you can get in touch with a hand specialist to determine how to proceed and get the right treatment.

Categories
General Hands

Most Common Ways to Injure the Hand

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The hand is one of the most impressive parts of the human body. Its a complex piece of biological machinery that lets people hold and manipulate items in ways that other creatures cant. If not for our hands, despite the power of the human brain, we may not have evolved to become the most dominant species on the planet. As important as our hands might be, they are also prone to injury. If you injure your hand, you will find that you cant do many of the things that you take for granted right now. For example, you would not be able to use your phone or tablet. Typing would be difficult, even driving and opening doors would be difficult if you do not have full use of your hands!

What Types of Injuries Affect the Hand?

The hand is exposed to many different types of injuries. Lacerations are quite common. Cutting your hand with a knife in the kitchen, for example, has happened to nearly everyone. Most of the time, cleanup and a bandage are all that you need. In severe cases though, there could be a deep cut that includes nerve damage. In those instances surgery would likely be necessary to restore full function of the hand.

Fractures and dislocations are common as well. These types of injuries could require the doctor to set the bone, and then splint or cast it so it can heal properly. In the event that the bones are not setting properly, it could require hand surgery. Other potential injuries from the hands come from burns, infections, crushing, soft tissue injuries, and amputations. Naturally, the symptoms for these different types of injuries vary.

Anyone who has a hand injury thats more than just a small cut or bruise may want to seek out a medical professional. Even with the small cuts, you will need to be careful to ensure that infection does not set in and cause more issues to the hand.

If there are any deep wounds, fractures, dislocations, bites, or burns (other than minor burns), contact a physician to get the proper care. Whenever there is any doubt as to whether it is a minor injury that can heal on its own or a more substantial injury, you should err on the side of caution and speak with a doctor.

Treating the Injuries

Because there are so many different types of hand injuries, the types of treatments necessary to repair the problem vary quite a bit. In some cases, simply resting the hand may be all that you need. For those who have a fracture, they will need to have the hand doctor set the bone and make sure it heals properly, as mentioned. Those who have burns will need a different course of treatment, and those who have amputated fingers will need a variety of treatments. In some instances, reattachment of a lost finger may be possible. However, regaining full function of the finger is not a guarantee.

Talk with your doctor about your injuries to determine the proper course of treatment, and with a hand surgeon for those issues that require surgery to correct properly. Its the best way to minimize your risks.

Categories
General

When Will a Doctor Report a Broken Bone?

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One of the most heartbreaking decisions a doctor has to make is whether or not to report a suspected case of domestic violence. Often, injuries to the wrist, forearm or elbow, especially if they are recurring, are a tip-off that something is very wrong in the home.

So, what are the signs of domestic abuse, and when will a doctor report suspected abuse?

The Research

US government research shows that every ten seconds, a report of child abuse is filed, and that five children die each and every day from abuse. Most are abused by their parents, or by someone who is known to the family, and most children who die from abuse are under the age of 3. Child abuse transcends all races, religions, and economic levels. Sadly, many instances of child abuse go unreported. This is because often the child loves the abuser and is reluctant to report the abuse. The child may even feel that he or she deserves the abuse. That is where the doctor comes in, and has to use his or her diagnostic skills to determine whether abuse has occurred.

Identifying Abuse

Sometimes, identifying abuse is easy, and doesnt even require determining the cause of an injury. It is easier with children than it is with adults. For instance, if a child presents with an injury that appears not to have occurred as a result of normal activity, and the child is also withdrawn, uncommunicative fearful of adults, and offers explanations that do not make sense (“a bad man came into my room”), abuse is easy to identify. Additionally, breaks and sprains do not usually occur in children who have not progressed beyond crawling. Wrist, arm and elbow injuries to infants are almost invariably due to abuse.

With adults (women, usually), it may be a little more difficult. It is generally a given that no one gets a black eye because “I walked into a door,” but in the absence of other evidence, it is hard to prove abuse. Often, even the most skilled, compassionate doctor cannot draw out the true cause of an injury from an abused adult.

Signs of Abuse

The signs of physical abuse can include:

  • Black eyes
  • Unexplained broken bones
  • Bruises that have a certain shape (“grab” marks, welts that appear to have been caused by a belt, etc.)
  • Ligature marks
  • Burn marks
  • Bite marks

Often, strange explanations may also be given for the injuries to the injured child or adult – “He was falling off the swing, so I grabbed his arm,” or “She was having a bad dream and fell out of bed.” Stairs also seem to play a significant role in domestic injuries.

Getting Help

There are counseling and support groups for abusers and victims. There are also government agencies that are mandated to protect children under the age of 18. Systems vary from state to state, but usually involve family court. When children are involved, usually there is every effort made to reunite families. Abused adults also have access to safe environments and counseling. Doctors are required to report broken bones when abuse is suspected.

Categories
General Wrists

Is My Wrist Broken or Sprained? – Arora Hand Surgery

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How can you tell if your wrist is sprained or broken? Essentially, it goes without saying that if you suspect either a sprain or a break, you should see your doctor or visit the emergency room in order to obtain an effective diagnosis. Sprains and breaks are both painful, and both can cause damage to the structure of the wrist. Interestingly, though, patients who have experienced both often report that a sprain is the more painful of the two injuries. It is also interesting to note that breaks are often more easily treated, whereas sprains can sometimes be more devastating, and if not treated promptly an effectively, can lead to complications like arthritis later on.

If you are determined to self-diagnose, and wait for treatment, or if you are providing first aid to an injured person, you need to know how to determine the difference between a sprain and a fracture. You also need to remember that a sprain is not a minor injury. It can involve serious tears to the ligaments that hold the wrist bones together.

How Did the Injury Happen?

This is the first thing that you need to consider when attempting to answer the questions, “Is it a break or a sprain?” If someone uses their hand to break a short fall, it could be a break, but the smart money is on a sprain. On the other hand, if someone falls off a roof and lands on their hand, a break is more likely.

What Can You See?

If a bone is protruding through the skin, the diagnosis is obvious – it is a break. Additionally, if there appears to be a great deal of swelling or bruising, a break is likely. If the swelling and pain doesnt go away in a day or two, suspect a break, but if it goes away relatively quickly, suspect a sprain.

What Can You Hear?

If moving the wrist results in a grinding or crunching sound, accompanied by excruciating pain, it is almost certainly a break.

What Should You Do?

Immediately following the injury, you or the person you are treating should immediately stop moving the wrist. Elevate it and apply cold packs. If stopping movement seems to be problematic, apply a wrist splint.

Exceptions

Although a break will usually hurt for a long time, and a sprain will stop hurting in a few days, there are exceptions. One is a scaphoid bone fracture. The scaphoid is a small wrist bone that, if broken, could feel painful for a day or two and then stop hurting. In this way, it imitates a sprain, and can be easily misdiagnosed. If untreated, it can lead to arthritis. Additionally, if certain wrist ligaments are sprained, that can also lead to arthritis, because the bones that those ligaments were intended to hold together move abnormally. This can also cause arthritis.

The Final Word

Any wrist pain that has not gone away within 3-5 days after an injury should be checked out. You may need surgery.

Categories
Conditions General Hands

How to Deal With Skin Cancer of the Hand – Arora Hand Surgery

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Cancer is a condition that ranges widely and which can appear in almost any part of the body. It does occur on the extremities, including the hands and arms, and it is best treated quickly and by a qualified hand surgeon or expert.

Naturally, it may be difficult to recognize when skin cancer of the hand is present. Interestingly enough, it is the skin that is the organ most commonly affected by cancer, and on the hands the most common types of cancer to appear are:

  • Squamous cell carcinoma
  • Basal cell carcinoma
  • Melanoma

There are other rare forms of skin cancer of the hand, as well, and it takes a medical professional to perform any diagnosis. However, you can know if you are at greater risk for developing it. The following list of factors tend to apply:

  • Chronic sun exposure
  • Immune suppression
  • Fair or light complexion
  • Exposure to chemicals and/or radiation
  • If you have pre-malignant lesions in the past
  • Family tendency to melanoma
  • Genetic conditions relating to skin cancer

And while there are many online resources with photographs of various forms of skin cancer of the hand or upper extremity, the best way to get diagnosed is through a visit to a hand expert. Though there are some very clear indicators that can be used to visually identify potential carcinomas and melanomas (such as discolored nodules appearing on the skin, cutaneous horns forming in odd locations, and areas that wont heal), the expert opinion is the best.

Diagnosis and Treatment

You hand doctor will do a visual inspection and take a biopsy or sample of the tissue in question. This is sent to a lab that assesses it and determines if the tissue is indeed cancerous or pre-cancerous. In some cases a larger sample may be required to make a definitive diagnosis.

If cancer is present, the next step is often to examine the lymph nodes to be sure that the cancer has not metastasized (or expanded to another area of the body). This is done through biopsy or through a range of different scans, such as a CT scan.

When a full diagnosis and assessment is done, the most common treatment is removal of the tissue by a qualified hand surgeon. The traditional approach is to remove all of the tissue infected with cancer cells along with tissue at the edges of the cancerous region. A surgeon will also perform all essential repairs at the same time, such as grafting healthy skin over the excised area.

In certain types of cancer, removal is followed by radiation or chemotherapy to be sure that all cancerous tissue has been eradicated. And in extreme cases there can be a need for amputation, but this is, as indicated, an extreme.

If you suspect that you are at risk for developing skin cancer of the hand or upper extremity, or have noticed a long-lasting change in the skin of one part of the hand, do not hesitate to visit a surgeon. As the experts say, the best treatment for skin cancer of any kind is prevention (SkinCancer.org, 2015). If you suspect something wrong, your next best treatment is early detection and rapid action in the care of a hand surgeon.

Categories
General Treatments

Tips for Recovering From a Broken Wrist or Hand

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You have 27 bones in your hand and wrist. The most common fractures for these bones include broken knuckles, fingertips, and thumbs from blunt force to the hand or falling on it. Whether youve broken your hand or wrist in a work related accident or while playing ball with your kids, its important to seek the proper medical attention from a qualified hand surgeon and then to follow your hand doctors orders as closely as possible to ensure you are recovering from a broken wrist, or hand in the most efficient way possible.

If you are unsure whether youve broken your wrist or not, dont diagnose yourself. Its better to go to the hand doctor, get an X-ray, and find out that youve only suffered a sprain or strain than to let the injury go untreated. If you have even the slightest suspicion that youve broken a bone, call the hand doctor immediately.

Take Your Medication On Time

Whether you are prescribed over-the-counter NSAIDs (non-steroid anti-inflammatory drugs like aspirin) or a stronger pain reliever and anti-inflammatory drug, you need to take your medication. You may think that this is not important if the pain has subsided and youre feeling better, but your anti-inflammatory medication will keep the injury from swelling, which will help it heal faster and more completely.

If you want to avoid being in pain any longer than is absolutely necessary, take your prescription and take it on time as prescribed. This is especially true if your doctor prescribes antibiotics. If the skin was broken in the injury or if you had to have surgery, you may be at risk for infection, and taking an incomplete dose of antibiotics or skipping them entirely could result in a serious infection.

Do Not Remove Your Splint or Cast

If your hand surgeon had to do an invasive procedure to set the bones in your hand or wrist, you may be curious about your stitches. Your splint or cast might itch and feel hot. In other words, you might be tempted to take it off, at least for a little while. Dont do this.

If your hand doctor splinted or put a cast on your hand or wrist, that means the bones need to be immobilized to heal properly. Taking it off could result in problems with your recovery.

Follow the RICE Method

You’ve probably heard it before, but it bears repeating: Rest, Ice, Compression, Elevation. The compression part of the RICE method is already taken care of by the splint or cast your hand surgeon put on your hand. The rest is up to you. Dont go doing any strenuous exercises or activities while youre recovering from a broken wrist, or hand. Keep ice on the injury whenever possible, and keep it elevated above your heart to reduce swelling. If you do these things and follow your doctors prescriptions and recommendations, youll be recovered and ready to take on the world again in just a few weeks. And if you have any questions or concerns about the recovery process, never hesitate to call your hand surgeon and ask their advice on recovering from a broken wrist or hand.

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Stories

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Dr. Aroras office from my first call to schedule my appointment was friendly. Walking in the first day, I felt like I was in a nice atmosphere. Dr. Arora was EXCELLENT in taking great care of my hand injury. He was gentle and very understanding to the concerns I had about my hand. His expertise was admirable and I would recommend anyone with an injury to their hand to his office to be under his care. Because of him, I have healed faster than expected and will make an 100% recovery! Thank you Dr.

Jackie S.

I first thought I was going to have to have painful injections or surgery, but Dr. Arora suggested physical therapy may do the trick. I was doubtful, but I agreed to do it. Now, my pain is gone, and with the help of an ergonomic keyboard at work to keep my hands in the correct position, I am virtually pain free. The therapy strengthened my wrists and shoulders, and built more flexibility into my wrists.

Jerry T.

My experience with this doctor was positive from the outset. Dr. Arora was kind and spent a great deal of time with me. Staff was friendly. The office was nice and bright.

Ariel G.

Very friendly and helpful Great staff!!! Doctor Arora was very professional and did great work. I was very happy with everything!

L B.