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Month: March 2021

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Fingers General

Dupuytren’s Contracture vs. Trigger Finger: What is the Difference?

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When it comes to Dupuytren’s contracture vs. trigger finger, the differences are not always clear. On the surface, they have similar effects on the fingers. When you look deeper, however, you will see that the reason why the fingers are functioning the way they do is different.

Facts about Dupuytren’s Contracture vs. Trigger Finger

It’s easy to see why people may confuse the two conditions. They are similar in some ways. First of all, both conditions can affect any finger. Another similarity is the appearance. The affected fingers are typically curved inward toward the palm, although in some cases they can be bent to the left or right.

Otherwise, they are very different conditions. Following is a breakdown of the differences in Dupuytren’s contracture vs. trigger finger.

What is Trigger Finger?

The technical name for trigger finger is stenosing tenosynovitis. Trigger finger is caused when an injury causes a finger to get stuck in a bent position. This occurs when inflammation narrows the sheath around the tendons, leading to the formation of a nodule. When you flex this finger, the nodule must slide through the narrow sheath, causing a snapping sensation.

Treatment for trigger finger may include:

  • The use of medications to relieve pain
  • Therapy that includes rest, stretching exercises, and the use of a splint
  • Steroid injections
  • A percutaneous release procedure, where the hand surgeon uses a needle to break apart the constriction that is blocking proper movement
  • Surgery to loosen the constricted area
Trigger finger is usually caused by an injury and is most common in the thumb, index finger, and middle finger.
Trigger finger is usually caused by an injury and is most common in the thumb, index finger, and middle finger.

What is Dupuytren’s Contracture?

Dupuytren’s contracture develops over time. It begins when tissue forms knots under the skin of the palm. As these knots form, they create a cord that pulls the fingers into a bent position. Everyday activities like gripping silverware can become difficult with this condition.

Similar to one of the trigger finger treatment options, Dupuytren’s contracture can be treated with the needling procedure to break the cord of tissue that is causing a finger to contract. Other treatment options include self-care, Xiaflex enzyme injections, and surgery.

Surgery for Dupuytren’s contracture entails removing all the tissue that is affected, including the skin. A skin graft may be required to repair the wound. Because this is a serious procedure with a lengthy recovery time, it is ideal only for those who have a diminished quality of life due to the condition.

Dupuytren’s contracture develops over time and stems from the tissue in the palm.
Dupuytren’s contracture develops over time and stems from the tissue in the palm.

Differences Between the Two Hand Conditions

Following are some of the primary differences in Dupuytren’s contracture vs. trigger finger.

  1. Trigger finger starts with the fingers while Dupuytren’s contracture stems from the palm.
  2. Dupuytren’s contracture involves the tissue, but trigger finger involves the tendons.
  3. Trigger finger is most common in the thumb, index finger, and middle finger. Dupuytren’s contracture is most likely to occur in the fourth finger and the pinky.
  4. Someone who has trigger finger can straighten the finger if they tried, but someone with Dupuytren’s contracture cannot.
  5. Whereas trigger finger is usually the result of an injury, the causes of Dupuytren’s contracture are not clear.

If you have experienced a recent injury that led to trigger finger or have been seeing the effects of Dupuytren’s contracture progress over a number of years, see our hand specialist in Macomb, Warren, West Bloomfield, or Howell for treatment. Make an appointment by calling our office or sending our hand surgery team a message online.

 

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Fingers General

Broken Knuckle Symptoms & Treatment Options in Southeast Michigan

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If you have a broken knuckle, it’s likely very painful, red, and swollen, and you probably won’t be able to move it for days or weeks. Despite this injury, many people mistakenly assume that it will heal on its own … and it might. But if you don’t seek broken knuckle treatment as soon as possible, the recovery process will take longer than necessary.

More importantly, the knuckle may heal incorrectly, leading to a deformity in the finger and possibly damaging the nerves around it. If that does happen, correcting the problem may require a surgical procedure, so it’s important to get the injury treated rather than face the effects indefinitely.

Signs and Symptoms of Broken Knuckles

The problem is that you can’t tell if a knuckle is broken or only bruised by looking at it. In order to determine the extent of the injury, make an appointment to see our hand specialist at a southeast Michigan office near you.

In the meantime, following are some of the signs that your knuckle may be broken, not only bruised.

  • Difficulty moving that particular finger
  • Swelling of the finger and hand, particularly in that area
  • Bruising
  • Redness
  • Pain
  • A visibly misshapen hand
  • Cut or pierced skin
  • Depressed knuckle
  • Popping or cracking sound when you try to move it

Many patients say that their hand began to swell about 10 minutes after the injury, but the bruising may become visible instantly.

Having a depressed knuckle is one of the clearest signs that the knuckle is broken rather than bruised. The length of time that it takes to recover is also a sign. A bruised knuckle generally heals within a few days without long-term effects. A broken knuckle may take several weeks to heal completely, and even then you may never get proper function back in that finger if you did not seek treatment right away.

Broken Knuckle Treatment Options

Known as metacarpal fractures, common causes of broken knuckles include punching something, getting your finger stuck in a door or window, getting injured while playing sports, and falling.

Broken knuckle treatment aims to alleviate pain and swelling in the short-term, as well as facilitate proper healing for later.

As a first aid treatment for a broken knuckle, start with applying a cold pack to the area to minimize pain and swelling. Try to keep your hand in an elevated position as well.

When you come in to see Dr. Arora for broken knuckle treatment, he will likely immobilize that finger so that the knuckle can heal. It may involve “buddy taping” that finger to the one beside it or using a splint or cast. The use of over-the-counter or prescription pain medication may help as well. If the injury involved a cut or wound, you may need antibiotics to prevent infection.

Surgical Treatment Options for Finger Injuries

Most of these injuries don’t require surgery, but that may be necessary if you have an open fracture, pieces of the bone are unstable, the tissues are damaged, or multiple fractures exist in the same area.

The type of surgery for broken knuckles depends on the severity and location of the injury. The possibilities include:

  • Internal fixation, which involves making an incision and realigning the knuckle
  • External fixation, which involves using pins to secure a metal frame around your finger or hand to keep the knuckle in place until it heals

After you have healed, you may need to work with a hand therapist to recover the functionality of your hand.

For broken knuckle treatment in southeast Michigan, make an appointment to see Dr. Arora in West Bloomfield, Howell, Warren, or Macomb Township.

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General

Physician Assistant Joins Arora Hand Surgery Team

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Arora Hand Surgery is proud to welcome its newest team member, Physician Assistant Ashley Delzer (PA-C).

Ashley has more than 10 years of experience as an orthopedic surgery physician assistant. As a physician assistant at our hand surgery practice, she will see patients in the clinic, administer injections, first-assist in the operating room, and manage the care of post-operative patients.

She has a Master of Physician Assistant Studies from the University of Findlay, and she earned her Bachelor of Science degree from Michigan State University after studying human biology.

Outside of work, Ashley enjoys spending time with her family and two young sons, horseback riding, traveling, and outdoor activities.

With the addition of Ashley as a physician assistant, the Arora Hand Surgery team now consists of:

  • Surgeon and Hand Specialist Dr. Avery Arora, M.D.
  • Lodia, occupational certified hand therapist (OT-CHT)
  • Crystal and Karlie, medical assistants
  • Sally, practice manager
  • Sonja, patient/surgical administrator
  • Korinn and Amanda, office assistants

Please join us in welcoming Ashley to our team!

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Patient

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.