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Month: August 2016

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Fingers General

How Do I Treat A Broken Knuckle?

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How broken knuckles are treated will depend on a variety of factors, including the nature of the break, the age and occupation of the patient, and the level of function that is needed in the hand.

The most common type of treatment is known as “neighbor strapping.” As you might suspect, this treatment involves strapping, or taping, the finger with the broken knuckle to the one next to it. Once trapped, the strapping is kept in place for approximately three weeks. If strapping is impractical, then often a splint or plaster cast will be used, and again, it is left in place for usually about three weeks. If these treatments fail, or if the break is complex, surgery may be needed.

Types of Surgery

Various types of surgery can be considered for broken knuckles. One of the most common types of surgery involves the installation of thin metal rods, known as Kirschner wires, or K-wires. They are placed across the broken bones, in order to hold them in place until they heal (usually within three weeks). A bit of wire is left exposed outside the skin, and when the healing is complete, the wires are simply removed using a special type of pliers.

Interosseous wires are another way of holding the broken bones together. This type of wire is often permanently left in place.

Plate fixation involves the use of small plates made of metal, attached to the broken bones by means of small screws. They are also left permanently in the hand. This type of treatment is usually for metacarpal breaks in the palm area, rather than in the knuckles themselves.

Complex breaks may need external fixation. With this type of surgery, a thick pin is inserted through the skin and into the bone on both sides of the break. Then, a metal bar is placed between the pins in order to keep the bones still and any bone fragments in place while healing takes place.

Complications

Complications can occur with broken knuckles. The most common complication is stiffness. The break, along with the splinting needed to correct it, can often result in the affected finger not having the same flexibility of movement as it did before the break. Often, physiotherapy can help with stiffness, but in many cases a return to full functionality is not possible.

Pain can also be a complication. Usually it will not be severe, but patients often notice that the affected area aches during cold weather, or when heavy work is being performed.

Occasionally, there are problems with the healing process. Delayed union occurs when the break does not heal as quickly as it should. This is an inconvenience, but the bone will heal properly eventually. More problematic is non-union, which is when the bones fail to heal even after several weeks. When this happens, further procedures will be required. Mal-union is a condition where the bones heal in a bad position. This could be a non-issue, but if the function of the hand is affected, it may be necessary to perform further treatments on the knuckle.

Finally, as is the case with any type of surgery, there is a slight possibility of infection. When bone is infected, this is known as osteomyelitis. Sometimes a course of antibiotics, or additional surgery, can cure the infection. Sometimes, though, it will not clear. The worst case scenario is that the finger may need to be amputated.

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Fingers General

Signs, Symptoms, and Treatment of a Sprained Thumb

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Your thumb is an essential part of your hand. If you have a thumb injury, it means that grabbing things, holding items, and performing many normal daily tasks will be next to impossible. One of the most common types of injuries to the thumb is a sprain. Even though it might not sound serious, it can be. In fact, in some cases, it might even require surgery to repair.

What Is a Sprain?

A sprained thumb happens when you damage the ligament, which connects the thumb to the rest of the hand. The ligament is responsible for pinching and holding, and a sprain will weaken your ability to do these types of actions.

Sprains are often the result of falling. Most people will instinctively put their arms out in front of them when they fall, and they land on their outstretched and open hands. The impact can tear the ligament.

When the injury occurs, you might not realize that it is a sprain right away. Sometimes the pain comes quickly, but other times, it can take some time to set in. At that point, not only will you feel pain, but you will also find that your ability to move the thumb is greatly diminished. Often, you will notice swelling and bruising. The area around the thumb will also be tender when you touch it.

Should You See a Doctor?

For mild sprains, some people forego the doctor, but this could be a bad idea. Its often difficult for someone to determine just how bad a sprain might be. If you have more than a small tear in the ligament, it could cause instability and pain in the area for a long time. Its best to visit a doctor, who can then determine the extent of the injury and come up with a course of treatment.

When you visit the doctor, they will want to manipulate the thumb to see whether the ligament tear is complete or partial. They can move the thumb and test the stability, which will let them know how to proceed. Sometimes, they will also want to take an x-ray to determine if you have a fracture to any of the bones in the area.

For those who have partial tears, surgery will not be necessary. The doctor will usually recommend icing the sprain regularly, and may provide you with a splint or cast to keep the thumb in the proper position until it heals. They will likely want you to wear the cast for several weeks without removing it. After that point, you can remove the cast and do exercises to regain your strength and flexibility. When you are not exercising the thumb, you will still want to wear the splint for at least two to three weeks. Follow the doctors orders.

If the ligament is torn all the way, the doctor might recommend surgery to reconnect it to the bone. After the surgery, you will need to be in a cast for six to eight weeks as it heals.

If you have a sprain, or believe that you do, make sure you contact our hand surgeon’s office in West Bloomfield, Howell, St. Clair Shores, or Macomb to get in touch with a medical professional as soon as possible. Its the best way to minimize the risk of permanent injury.

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General Wrists

Wrist and Arm Fractures in Toddlers

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You have probably heard it said, and maybe even said it yourself, that when a child is hurt, it hurts the parent twice as much. Of course that is debatable, but indisputably it can be very hard on a parent seeing a toddler fall down and sustain a fracture.

That said, you are never going to prevent a toddler from ever falling down, and at some point it is very possible that a fracture will occur. Toddlers hardly ever incur a sprain – it is almost invariably a fracture. The good news is that even when a fracture does occur in a young child, it will usually heal quickly.

Identifying a Wrist or Arm Fracture in a Toddler

Toddlers are like the rest of us – when forward movement goes wrong, the natural reaction is to extend the hand in order to break the fall. Unfortunately, sometimes breaking the fall means breaking the wrist or the arm. Your first tip-off that a fracture may have occurred is obvious – the child will begin to cry. Do not assume, though, that just because the child can move the wrist or the arm, nothing is broken. You may not even be aware that a fracture has occurred unless the bone is obviously out of position. Generally speaking, if the child is in pain, and the pain does not ease quickly, a fracture is possible.

Types of Wrist and Arm Fractures in Toddlers

One of the most common fractures in toddlers occurs above the wrist, in the radius, which is the large bone in the forearm. In fact, nearly half of the broken bones in toddlers occur close to the end of the radius.

Another type of fracture is a “torus” fracture, where the bone collapses but does not break completely. This type of fracture usually heals well.

A greenstick fracture is another type of partial fracture that usually heals well. With a greenstick fracture, you may not notice symptoms – there could be very little bruising or swelling, but the child will be reluctant to use the arm, and the area may be tender. The joints will all still move.

See a Doctor

You probably know that doctors are required by law to report suspected cases of child abuse. Unfortunately, that knowledge sometimes makes good parents reluctant to seek medical assistance. Keep in mind that if the incident is isolated, and the child does not appear to have any other injuries, the doctor is very likely to accept your explanation that it was an accident. You should never be afraid to take your child to the doctor if you suspect a fracture.

Feel free to contact our hand surgeon’s office in West Bloomfield, Howell, St. Clair Shores, or Macomb to get in touch with a medical professional.

Most Toddler Fractures Heal Easily

Most of the time, when a toddler has had a fracture of the arm or wrist, he or she will want to begin using the arm right away. Frequently, this is not a problem, as toddlers heal very quickly and effectively. Sometimes, though, the doctor may recommend the use of a sling. Obviously, the arm or wrist should be handled more gently than usual as healing progresses.

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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.