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Month: November 2016

Conditions General Hands

What is Kienbock’s Disease?

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What is Kienbock’s disease, and how is it treated? Those are the first questions patients may ask upon hearing this phrase.

Following are some of the basic facts about this hand condition.

What is Kienbock’s Disease, and What Causes It?

Also known as avascular necrosis of the lunate, Kienbock’s disease is a condition in which the blood supply feeding the lunate is somehow blocked. The lunate, which is one of the eight bones in the wrist, eventually dies and collapses. The condition, which usually involves only one wrist, is most common in young men.

Kienbock’s disease has multiple causes. It can be caused by such congenital defects like an abnormally short ulna. The radius and ulna are both forearm bones, and they share the force transferred from the hand to the forearm when the person grips something. An abnormally short ulna puts all of the pressure on the radius. The lunate, which is between the radius and the capitate bone, ends up absorbing excess pressure.

The disease can also be caused by injuries to the wrist, be they a single acute injury or chronic repetitive injuries that damage the blood vessels. Diseases that affect the blood vessels like sickle cell anemia can also cause Kienbock’s disease.

What are the Symptoms?

The chief symptoms of Kienbock’s disease are wrist pain coupled with limited mobility. The patient may also have trouble gripping items. During the early stages, the patient may feel only pain during or after actually using their wrist. As the disease progresses, the pain becomes constant.

A patient with this disease may also develop swelling in the wrist. The area around the lunate, the lower palm below the little and ring fingers, may become tender. The patient may also develop arthritis, but that symptom is associated with late-stage Kienbock’s disease, which takes years to develop.

How is the Disease Diagnosed?

During the early stages, the disease can be difficult to diagnose. Dr. Arora will likely begin by taking a medical history and examining the wrist. He will also order X-rays and MRIs. The X-rays can be used to determine how badly the lunate has deteriorated, while the MRI can be used to determine the damage to the blood vessels feeding the lunate. If necessary, the doctor may also order a CT scan of the bones.

What are the Treatments for Kienbock’s Disease?

There are several treatments for Kienbock’s disease. As the disease has several stages, the treatments vary accordingly. If our team catches the condition early, the wrist can be immobilized. This treatment is intended to let the damaged blood vessels and lunate heal on their own.

If the immobilization proves unsuccessful, or the patient has late-stage Kienbock’s disease, our doctor will recommend surgery. He may also recommend surgery if the Kienbock’s is caused by a birth defect, like an abnormally short ulna. In that situation, Dr. Arora can lengthen the ulna, shorten the radius or fuse certain bones so that the two bones meet the wrist bones above them properly.

The types of surgical procedures used will depend on how advanced the disease is. Wrist fusion, for example, is a procedure typically used for very late-stage Kienbock’s characterized by a wholly arthritic wrist.

Schedule a consultation at Arora Hand Surgery in West Bloomfield, Howell, Warren, or Macomb to have your condition evaluated and to learn more about what Kienbock’s disease is. Contact us today to book your appointment and get started with a treatment plan that can bring you relief.

General Wrists

Treating a Wrist Sprain with a Splint

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Wrist sprains are common injuries that can happen to people of all ages from a variety of causes. They can happen as sports injuries or from simple falls during normal daily activities. Whenever you fall, the natural reaction is to reach the hand out in an attempt to break the fall. This is what causes a tremendous amount of wrist sprains as the impact of the fall and the weight of the body are absorbed by the wrist, overextending it.

An injury to a ligament is known as a sprain. Ligaments are the connectors in the body that connect bone to bone as opposed to tendons, which connect muscle to bone. Sprains can vary in their severity to those that have only minor ligament damage and accompanying pain and swelling to the most severe, which is a complete tear of the ligament. When this happens, there is a loss of function in the affected joint.

A splint is commonly used as part of a treatment program for a sprain. Splints help to immobilize the joint in order to limit further irritation and to promote healing. Sometimes, people will use splints as a way of treating themselves when they suffer a sprain. However, splints used by individuals should only be used as a way to keep the injured joint immobile until professional medical help can be obtained.

Only through a professional evaluation can a sprain-type injury be properly diagnosed. One should seek medical care after an injury of this nature to rule out other injury types, such as fractures. If no fracture is involved, the sprain should be evaluated for severity. While most sprains will heal on their own, some of the most severe ones could require surgery.

When a splint is used as part of treatment, our doctor’s recommendations should be followed regarding when and for how long to wear it. If you wear the splint for too long, you could be putting yourself at risk for additional joint stiffness and muscle weakness. Depending on your particular injury, our doctor may recommend some strengthening and stretching exercises.

If you have suffered a fall or some type of joint injury and you are experiencing symptoms like pain, swelling and tenderness, you should seek an evaluation from our team at Arora Hand Surgery. Our medical professionals can conduct whatever tests are necessary for an accurate diagnosis and develop a treatment plan accordingly. We have offices in West Bloomfield, Howell, Warren, and Macomb. Contact us today to schedule a consultation.

Fingers General

Symptoms of Trigger Finger

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Trigger finger, more formally known as stenosing tenosynovitis, is a condition in which a finger or the thumb gets locked in a bent position. The condition is more common in women than in men.

What are the Symptoms?

The affected finger may suddenly snap straight, like a trigger being pulled and released. Alternatively, the patient may not be able to straighten their finger at all. The patient may also feel discomfort or a lump at the base of the finger. Other symptoms can include limited mobility of the affected digit, a clicking or popping noise when the finger does move and pain.

What Causes Trigger Finger?

The fingers and thumbs have tendons that pass through sheaths or pulleys that keep the tendon close to the finger bone. If the sheath gets inflamed or irritated, it swells and thickens, which prevents the tendon from moving normally. If the condition isn’t treated, the sheath develops scars and nodules that make the sheath even more abnormally thick. This impairs the finger’s mobility even more.

Trigger finger is more common in people with certain health problems, such as diabetes or rheumatoid arthritis. Occupations and activities that require repeated strong gripping can increase the chances of developing trigger finger. For example, anybody who uses a screwdriver a lot might develop trigger finger.

How is Trigger Finger Treated?

There are many possible treatments for trigger finger. In a lot of cases, Dr. Arora will start by simply recommending that the patient rest the affected hand for at least four weeks. He may also recommend anti-inflammatory medication.

Our doctor may also splint the patient’s finger to keep it straight. In some cases, the patient will wear the splint only at night to avoid curling their fingers into a fist while sleeping. The patient may wear the splint for up to six weeks. Dr. Arora may also recommend gentle stretching exercises to improve the finger’s mobility.

If none of these methods prove helpful, our doctor may recommend a steroid injection near or directly into the affected sheath to reduce swelling and let the finger move freely again. Steroid injections are the most common treatment for trigger finger, and they work for about 90 percent of non-diabetic patients. The injection works for about 50 percent of the patients with diabetes.

An outpatient procedure in which the doctor breaks apart the constriction is often necessary if non-surgical treatments have failed. In severe or stubborn cases, our doctor may perform surgery on the affected tendon sheath.

Learn More During a Consultation

There is no one-size-fits-all treatment for trigger finger, as the best treatment option will depend on the unique situation. Make an appointment at Arora Hand Surgery in West Bloomfield, Howell, Warren, or Macomb so that our team can assess your condition and come up with a treatment plan for relieving you of your symptoms. Contact us today to schedule a consultation.

Conditions General

What Causes Carpal Tunnel Syndrome?

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Surrounded by bones and ligaments, the carpel tunnel is the narrow space located on the palm side of your wrist. The main nerve and tendons that control the movement of your hand and fingers run through this tunnel. Affecting one or both hands, carpal tunnel syndrome causes pain and burning sensations that travel up your arm from the wrist. The symptoms typically affect the thumb, index finger and middle finger.

Women are more likely to be diagnosed with this condition, which is often more troublesome at night. The symptoms typically present themselves between the ages of 30 and 60. A number of factors can cause a pinched median nerve in your wrist.

Running from your forearm, the median nerve provides the sense of touch for your thumb and first three fingers. The numbness and tingling symptoms of carpel tunnel syndrome occur when the nerve is compressed. Chronic inflammation associated with an underlying medical condition is the most common reason for the swelling and compression.

Ailments typically related to the condition include diabetes, thyroid dysfunction and autoimmune diseases like rheumatoid arthritis. High blood pressure and fluid retention associated with pregnancy or menopause can also cause inflammation in your wrist. Fractures or other trauma can cause carpal tunnel syndrome as well. Detrimental lifestyle choices like smoking, an increased body mass index and a high salt intake may increase the risk for developing carpal tunnel syndrome.

Repeated motions of your wrist can contribute to inflammation and swelling. Regularly overextending your wrist can make the symptoms worse. This type of physical stress occurs in occupations like assembly line work, construction and professions requiring constant keyboarding.

If you are experiencing the symptoms of carpal tunnel syndrome, schedule an appointment at Arora Hand Surgery so that a comprehensive assessment can be conducted. Treatment options will depend on the severity of your condition. Typically, the earlier the syndrome is diagnosed and treated, the more favorable the outcome.

During a consultation at our office in West Bloomfield, Howell, Warren, or Macomb, our team may also provide information on helpful lifestyle changes. These measures can reduce the risk of developing carpal tunnel syndrome in the future or provide significant long-term improvement or elimination of symptoms if you are already afflicted with the disorder.

You do not have to live with the debilitating effects of carpal tunnel syndrome. With the right treatment options and lifestyle changes, you can experience a significant improvement in your quality of life with help from Avery Arora, MD and his team at Arora Hand Surgery. Contact us today to book your appointment.


The Best — Without the Boast

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“As long as I can remember, I have always wanted to be a physician,” says Dr. Avery Arora.

With that goal in mind — and a lot of hard work — this quiet, studious young man accomplished his dream. Now a board-certified shining star in his field, Dr. Arora was selected by local physicians as a Top Doc of 2013 in the field of Hand Surgery.

Practicing medicine since 2005, Dr. Arora’s medical journey started at the Medical College of Wisconsin. He completed his residency and internship in general surgery at William Beaumont Hospital in Royal Oak. During his residency, Dr. Arora had the good fortune to meet some surgeons who were pursuing hand surgery training. Exploring the specialty further, he knew this was the right path for his career. Technical and functional aspects of a hand surgery specialty suited him exceptionally well.

“I enjoyed the concrete, mechanical nature of the hand. Hands are an integral part of the body, and their form, function, and anatomy are interesting and challenging,” Dr. Arora explains.

He was accepted into fellowship training in the department of orthopaedics at the University of Colorado in Denver, where he honed his skills as a hand surgeon — treating a spectrum of hand problems associated with veterans, and children through adults. He excelled in advanced hand trauma, microsurgery, and common problems with the hand, wrist, and elbow.

Dr. Arora conveys that many of us take for granted how much we need our hands for the activities of daily living. When there is something wrong with your hand, there is a lot riding on the outcome — and, therefore, on whom you choose to help you recover. Because he has seen such a range of challenges associated with hands during his career, Dr. Arora is sensitive to a patient’s situation, and meticulous and vigilant with regard to procedures.

“I am not a salesperson,” Dr. Arora says. “I enjoy one-on-one interaction with my patients, learning about their lives, their work, their struggles, and what makes them tick. There’s always a uniquely personal aspect to each case.”

He conveys this with genuine sincerity. Introspective and respectful, this doctor and father of two young boys brings a big heart and impressive professional competence to bear when dealing with his patients.

There is no cookie-cutter routine to Dr. Arora’s method. He is adamant about practicing a patientcentered approach to his work, and involves his patients in all aspects of the decision-making process. He presents a menu of options as patients move forward with their care, and they are encouraged when he guides the process and helps them choose the clinical path that makes sense for them.

“Patient and surgeon must be on the same page,” Dr. Arora says. “I like to take the time to talk through all the options with patients — imaging, surgery, therapy, follow-up care; and educate them and make it easy for my patients to make decisions that suit them best for their circumstances.”

Practicing medicine is not the same today as it was a few decades ago. There are patients who are uninsured, and the risk of medical malpractice has increased tremendously. Unlike some in his field of expertise, Dr. Arora will take calls and see patients in the emergency room and hospital, as well as in his office. He enjoys the variety of patients and interesting cases, and this keeps his array of skills polished.

Dr. Arora maintains membership in a number of professional organizations, including the American Society for Surgery of the Hand, the American Association of Hand Surgery, the Arthroscopy Association of North America, and the American Board of Surgery. Emphasizing his work, Dr. Arora says, “I am grateful and happy, and although I might appear a little reserved to some, in truth I care very deeply about what I do and the outcome for my patients.”

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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.