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Month: February 2016

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General Treatments

How Does a Fractured Arm Heal? – Arora Hand Surgery

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Fractures are very common injuries, and the healing process is essentially the same for all fractures – it happens in stages, as new bone begins to form and fill in the area that was fractured. With severe fractures, healing may happen more slowly. A fractured arm heals in five stages:

  1. Inflammation

This is the stage where swelling occurs. It begins when you incur the fracture, and it is caused by bleeding from the bone and tissue. This stage typically lasts anywhere from 2-3 weeks.

  1. Soft Callus

Around the third or fourth week, the swelling will ease and the injury will become less painful. Stiffness will occur as the new bone begins to develop. This stage typically lasts between 4-8 weeks.

  1. Hard Callus

In 1-2 months, the fracture is bridged by the growth of new bone. Within 3 months, new bone should have filled in the fracture.

  1. Bone Remodeling

At the 3-4 month point, the site of the fracture begins to remodel itself. This is when deformities that may have occurred as a result of the injury begin to correct themselves. In adults, this will probably take the full 4 months. Children typically heal more quickly.

Complications

Most of the time, fractures will heal without complications. That said, though, most of the time fractures are also due to a severe injury, and sometimes that injury can result in swelling that is so bad that pressure is placed on the blood vessels, preventing blood from getting to the muscles surrounding the fracture. When this happens a condition known as “compartment syndrome” can result – the muscles begin to die, and long-term disability can result. In extreme cases, amputation of the affected limb may be necessary.

Other complications can include:

  • Infection – In cases of an open fracture, the bone ends are exposed to air and contaminants, and infection can result. In severe cases, infections due to arm fractures can lead to the need for intravenous antibiotics, and possibly several days in hospital.
  • Neurovascular Injury – This is a type of complication that can occur when the injury is so severe that the nerves and blood vessels around the injury are also harmed. Usually surgery is needed to repair the damage.
  • Growth Abnormality – This is a type of complication that occurs when a childs bone is fractured. One side of the arm bone, or even the entire bone, stops growing normally, and develops an abnormal angle. This can result in one arm ending up shorter than the other.
  • Post-Traumatic Arthritis – When a fracture extends into the joint, the bones can meet abnormally, and premature arthritis can result.

Most of the time, complications will not occur. Broken arms happen with great regularity, and generally speaking, they heal as they should. When the injury is severe, though, and complications result, medical professionals have a number of ways of dealing with them. Assuming that you follow your doctors directions, you can usually expect a full recovery, free of complications, from a broken arm.

Categories
Fingers General

Ligament Tears on the Thumb – Arora Hand Surgery

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Ligament tears on the thumb happen fairly often. The ulnar collateral ligament is a piece of tissue that extends from the thumbs middle joint to the joint near the web area of the thumb. Constant stretching and overextending the ligament can cause it to weaken and eventually develop tears. In addition, accidents that cause the thumb to suddenly pull away from the palm can cause severe damage to the ligaments as well. This can happen if you fall on your palms. The injury is actually common with skiers, as their falls can often place these ligaments in danger. In fact, it is prevalent enough that doctors have taken to calling this type of tear “skiers thumb”.

What Are the Symptoms?

The symptoms of this type of injury include pain and swelling. Those who have torn ligaments will feel that their thumb is weak, and they will have trouble gripping anything. In addition, it may cause bruising around the area. Because of the pain and the weakness, it can make it very difficult to take care of normal daily tasks.

Diagnosis and Treatment

When you go into the doctors office, he or she will examine both of your thumbs and talk with you about the injury and the symptoms you are suffering.

To understand exactly what is happening with your thumb, you will have to undergo imaging tests. These tests will help to get a look inside of your thumb. An x-ray will check to see if there are any fractures in the thumb. The x-ray may not provide a good look at the ligaments though, so other imaging will likely be needed. In addition, they may perform a valgus stress test after administering a local anesthetic. The test will manipulate your thumb into different positions. The doctor will then be able to ascertain the joints stability and will have a better idea of the extent of damage to the ligaments.

For those who only have a partially torn ligament, it is possible for the ligament to heal on its own, although it does take some time. Your doctor will make sure the thumb is immobile for between four to six weeks by placing it in a cast. Once you have the cast removed, you will then need to do some physical therapy to ensure you build up your strength and your flexibility.

In many cases, you will need to have surgery in order to repair your injury to a torn ligament, as it will not be able to heal itself entirely. Different types of surgery can work based on the extent of the injury. Suture repair requires that the hand surgeon open up the hand and repair the ligaments using stitches which will hold them in place so they can heal. In other cases, they may utilize fusion surgery instead, which will graft new tissue onto the ligaments. This could limit some of the mobility though.

If you have a torn ligament, you will want to speak with your surgeon about the options available to find the one that works best for your injury.

Categories
General Hands

Beware of the Text Claw! – Arora Hand Surgery

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This condition is not an official medical diagnosis just yet, but give it time. Text claw is also sometimes referred to as texters thumb, and anyone who uses their smartphone a lot knows the kind of workout that their thumbs get. Prolonged use can lead to cramping and soreness not just in the thumbs, but in the wrist, fingers and forearms.

This is because texting is what is known as “fine motor activity,” and it can lead to muscle or tendon pain. It may not even be due to texting – any type of fine motor activity, be it peeling vegetables, rolling a cigar, or doing needlepoint, can lead to this type of discomfort.

So Why Text Claw?

We perform fine motor activities every day. The problem is that in recent years, we have added smartphone use to our daily activities, thereby increasing the level and frequency of our fine motor activities. Essentially, we are overusing our hands, fingers and thumbs, and the evolutionary process has not yet caught up to the point where we are naturally adapted to that increased use. Because we are so welded to our smartphones, we run an increased risk of inflammation in the tendons that attach the muscles and bones in our hands.

But Im Using My Thumbs – Why Do My Hands Hurt?

Everything is connected. Your thumbs might seem as though theyre doing all the work, but because of the connection to the rest of your hand, the repetitive motions cause pain throughout. Keep it up, and eventually your muscles can become scarred and fibrotic. This leads to loss of strength, reduced mobility, and pain. Your thumbs and fingers may even begin to turn inward, hence the term “text claw.”

Treatment

If you are determined that you simply cant live without your smartphone for any length of time, here are five things that you can do to reduce the pain and improve flexibility.

  1. Apply Heat – Using a hot towel or heating pad can help to ease the pain and relax your muscles.
  2. Stretch – Hold your arm outward with the hand extending backward, and reach forward. This will stretch your tendons and muscles.
  3. Massage – As you stretch, look for tight areas. See if there are any nodules in your forearm. They will feel like little balls. Rub gently, pressing downward. This eases the tension. Make sure you dont overdo it, though, and dont press too hard on or near your thumb. This is because there is a large nerve in that area, and it can hurt if you press too hard.
  4. Pray – Not literally, unless you feel so inclined. But hold your hands together in a prayer-like position, and hold for several seconds. Repeat 6-8 times.
  5. Flex – With your palm up and your wrist turned down, pull your fingers gently toward your body. Next, turn your wrist up and press your fingers gently away from your body. Repeat 6-8 times.

Take a Break

If it is obvious that your pain is due to texting, you really should take it easy. Consider downloading a voice app so that you dont have to use your hands quite so much.

Categories
Fingers General

Children and Finger Crush Injuries – Arora Hand Surgery

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Sometimes it seems like its a wonder that children get through their early years, given the abuse that their fingers take. Crush injuries to the hand or fingers are incredibly common among toddlers and young children, usually occurring when a heavy object falls on the hand, or the hand is slammed in a door.

Often, these childhood injuries do not require an emergency room visit, although it is usually a good idea to see your doctor as soon as you can, just to make sure that everything is all right. There are things that you can do at home while you are waiting for the doctors regular office hours.

Keep an Eye On the Child

Realistically, a few hours will not make a difference. So before you rush off to the ER, just watch the child for a while. If he or she uses the hand, even a little, then chances are good that nothing is broken. For that matter, a small break, if left unattended for even several hours, will not cause any lasting harm. You can safely wait for the doctor.

Having said that, if the hand seems extremely swollen, or if fingers look like they are bent, a trip to the ER is warranted. You should expect some swelling with a crush injury, but unless it is severe or accompanied by disfigurement, it can wait.

If the crushing has occurred to the fingernails, you can expect to see nails bleeding or appearing bruised. Again, this does not necessarily mean that any bones are broken. If the nail appears to have been pulled out, either completely or partially, then you may wish to make a trip to the ER in order to have it sewn back in place. Sometimes, if this is not done, a new nail may not grow back in to replace it. If you decide not to go to the ER, apply an antibiotic ointment to the injured area and tape the nail down so that is protected from being pulled out accidentally.

Treating the Injury

You can reduce swelling, and ease the pain, by applying ice to the injury. Never apply ice directly – you can soak the childs hand in a bowl of water that contains some ice cubes, or use a medical cold pack. In a pinch, even a bag of frozen vegetables can work as a cold pack. You can also offer childrens ibuprofen or acetaminophen to ease the pain. Keep in mind, though, that children should not be given aspirin.

Conclusion

Hand and finger crush injuries are very common in young children. Most of the time the parent feels worse about it for longer than the child does. Also, most of the time these types of childhood injuries can be treated quite effectively at home with cold packs and over-the-counter pain killers. However, if swelling is excessive or the fingers appear bent out of shape, see your doctor or go to the emergency room.

Categories
General Hands Treatments

Is Hand Surgery Right for You? – Arora Hand Surgery

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Do you have issues with your hands? Are they painful and swollen much of the time, and does it cause you pain to do many of the things that youve always done and taken for granted, such as driving, holding a grandchild, or just typing? Have you had an injury to your hand, or have you developed a cyst or tumor on the hand? Many different things can go wrong with the hands, which are easily one of the most important, and often underappreciated, parts of the human body.

Determining the Right Course of Action

While some types of hand injuries can be remedied with medicine and rest, there are other injuries that could require surgical treatment. However, surgery is not the right option for all patients. Most of the time, doctors will want to avoid surgery unless it is the only or best option, and if other types of treatment have no effect.

You will need to speak with your hand specialist about whether surgery would work for your type of issue or not. In addition, you need to make sure that you are actually a good candidate for surgery.

You and the doctor will need to sit down and discuss the problems you are having with your hands (as they can vary so widely) and then come up with the best course of treatment. In some cases, they may want to move forward and consider surgery, but they need to make sure it you are actually a viable candidate. They will consider the type of condition and the severity, as well as whether you have exhausted other means of treatment. The doctor also wants to make sure you are healthy enough to have surgery, so they will ask a number of questions about your medical history and run tests.

In some cases, the patient may not be a good candidate. If they are smokers, are overweight or have other issues that could cause problems with the surgery, the doctors may request that they make some lifestyle changes first, to help make the surgery go more smoothly. Of course, this really depends on each individual case, and is something you can discuss with your hand specialist.

When you are speaking with the hand surgeon about the possibility of getting surgery, you should ask about the specific type of procedure being performed, the length of the procedure, how long it will take to heal, and what types of hand therapy might be necessary after the surgery. Getting answers to all of these questions in advance can help you determine whether it is the right option for you.

Emergency Surgeries

Of course, some types of surgery simply cant wait. A compound fracture, a crushing injury and the like will require immediate hand surgery in an attempt to repair damage and set the bones so the hand can heal. Emergencies are handled differently.

Find a Great Surgeon

When you are considering hand surgery, whether it is cosmetic surgery, surgery for arthritis, or any other issue, make sure you take the time to research and locate a respected hand surgeon in your area.

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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.