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General

Hand Therapy and Rehabilitation – Arora Hand Surgery

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If you have had an injury to your hand, some type of disorder, or you required surgery, then you may also need occupational or physical therapy on your hand to ensure that you are able to use it properly in the years to come. Hand therapy can actually even be used for preventative measures and to help control chronic pain. Hand therapy will be provided by someone who is licensed and educated to provide the best service in order to get your hand back to full usefulness as soon as possible.

When Is Hand Therapy Used?

As mentioned, there are numerous different times when hand therapy can be used to deal with problems and situations:

  • Therapy can be used for management of chronic pain.
  • It can be used to desensitize the hands and nerves after there has been a nerve injury.
  • It can also be used to reintroduce senses to the hand after a nerve injury.
  • It can teach patients how to use exercises at home after an injury or surgery.
  • Therapy can be used to help retrain the patient to use their hand for normal, everyday activities.
  • It can be used to recondition the hand before a patient needs to return to work.

In the case of hand surgery, therapy has a number of other uses as well, such as assisting in the healing open wounds, controlling swollen or sensitive scars, reducing swelling during the healing process, and providing patients with at-home exercises for the hand.

People need hand therapy in a variety of situations, including injury directly to the hand, surgery, trauma, severe burns, scars, amputations, carpal tunnel syndrome, tennis elbow, arthritis, and much more. In addition, patients who have problems after a stroke may need hand therapy to use their extremities properly.

Splinting and Protection

Often, after a hand injury or surgery, the hand will need to be immobilized in a certain position. This is another job of the therapist. Often, they will create or choose a certain splint or brace to ensure the hand stays in one position while it is still healing.

When you go to a hand therapist, you can rest assured that this is a professional who specializes in the hand or arm only. They will not be general therapists who may have to get information on how to offer therapies for your hand specifically. You can even find out more about hand therapists by visiting the American Society of Hand Therapists at www.asht.org. You can even search for therapists in your area by looking up your city and state. This will tell you more information and get you on the right track to choosing the best therapist for your needs.

Hand therapy is a very important part of the healing process, and it should not be ignored. Instead, if you have to have surgery or you have an injury to your hand, be sure to follow your doctors orders and get the therapy you will need in the wake of your situation.

Resources:

http://www.asht.org/

Categories
Conditions General Hands

Understanding Hand Tumors

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People hear the word tumor and immediately think that this refers to cancer. However, thats not the case. In fact, a tumor is the name for any mass, lump, or bump hat may appear on or in the body. Most tumors are nonmalignant, which means they are not cancerous. On one hand, most tumors grow close to the surface. They may grow on the skin or directly under it. Of course, since you have all types of tissue in your hands, like tendons, muscles, skin, nerves, etc, then there are many different types of tumors that may occur. Instead of going over every type of hand tumor that is possible, lets discuss the most commonly seen.

Ganglion Cysts

Ganglion cysts are completely benign and they occur near or on a joint, especially on the fingers and the wrist. They are filled with a clear liquid and can grow or shrink from day to day. Sometimes, thy completely disappear all on their own. Usually, they do not cause any problems, but if they become painful or they get in the way of normal use of the hand, then surgical removal is possible. Ganglion cysts are the most common of all hand tumors.

Giant Cell Tumor on Tendon

This is the second most common and it occurs when a solid mass develops on the sheath protecting a tendon in the hand. They can occur anywhere a tendon is present, so anywhere in the hand. They grow very slowly and they are benign. It is unclear what may cause them, but some doctors feel there is a link between tumors and trauma or injury that affects the growth of the tendon sheath.

Epidermal Inclusion Cyst

Epidermal inclusion cysts are also very common and they are benign too, Essentially, they grow on the underside of your skin in the hand. Often, they form where the hand has been cut or otherwise wounded and they are made of keratin. As skin cells get trapped under the skin, keratin grows and continues reproducing.

Other, not so common types of hand tumors, include fibromas, glomus tumors, and bone spurs. In almost every situation, they are benign. If a foreign body, like a splinter gets stuck deep in the hand, then the skin may form a tumor around it as well.

Hand Cancer

As mentioned, most types of tumors are benign, but any lump or bump should be evaluated by a physician. Most of the time, hand cancer comes in the form of squamous cell carcinoma, melanoma, or basal cell carcinoma – all of which are skin cancers. It is important to get cancer in the hand diagnosed because it can spread to other parts of the body, especially the bones, breast, and lungs.

If you have a bump or lump on your hand, then be sure to visit a doctor. A diagnosis will be made and if the bump is causing you problems, then it can be removed surgically. This resolves the problems in most cases. Some people choose to leave the tumor alone if it is benign and it is not causing pain or discomfort.

Resources:

http://www.massgeneral.org/ortho/assets/pdfs/hand_conditions/HandTumors.pdf

Categories
Conditions General

What Is Kienbock’s Disease?

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There are numerous different diseases and problems that can affect the hand specifically. In the case of Kienbocks disease, one of the small bones in the wrist is effected specifically. This bone is called the lunate and it is closer to the fingers than the forearm.

Kienbocks disease occurs when the lunate bone goes without the blood supply it needs.

There is no specific cause to the disease, and there are a number of different factors that can lead to it, including: the arteries, the bones themselves, and the veins that take blood away. If any one of these things is not quite right, it can cause this disease to develop. Many times, people with certain conditions are more prone to the disease. These conditions associated with Kienbocks disease include sickle cell anemia, cerebral palsy, and gout.

Sometimes, certain types of trauma and injury can also lead to a lack of blood supply to the bone. Certain occupations put it at risk especially.

Diagnosing the Disease

The most common symptom of Kienbocks disease is pain in the wrist that continues over an extended period of time. Additionally, you will feel tenderness when touched right where the lunate bone is situated. Generally, the disease is diagnosed through a combination of a physical exam and x0rays. Sometimes MRIs, CT scans, and bones scans are used to pinpoint the disease.

It is impossible to determine how the disease will progress. Some people may experience the same level of discomfort for a very long time. However, x-rays will be used to track progression. Over time, if the disease is not treated, then fractures will occur throughout the lunate bone. Eventually, it will completely collapse and change the way the wrist works altogether. If not treated, then Kienbocks disease can be debilitating.

Treatment

Treatment of the disease will be determined based on the severity of the condition. Sometimes, the disease will simply be tracked and observed. Other times, the hand may be immobilized with a splint. Some more serious treatments include:

  • Surgery to fuse the bones
  • Hand therapy to ease pain and restore hand functionality
  • Hand surgery to lengthen or strengthen the bone

There is no one specific treatment for this condition and your doctor will decide what to do strictly based on your condition and how the disease will progress. Since there is no sure way to determine progression either, then the condition will need to be closely observed. Otherwise, it may progress quicker than expected and cause serious problems much sooner. If Kienbocks has progressed to severity, then surgery will have to be considered in order to save the bone.

If you have wrist pain, then you should visit a doctor as soon as possible to determine whether or not you have Kienbocks disease. There are other conditions that could result in wrist pain as well. So, make sure you get diagnosed. If you have the disease, then you will need to discuss your options with your doctor and determine how it will be handled going forward.

Resources:

http://orthoinfo.aaos.org/topic.cfm?topic=a00017

Categories
Fingers General

Understanding Mallet Finger and Treatment Options

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There are tendons located in your hand and fingers that are designed to straighten those digits. These tendons, called extensors, connect to muscles on each end so that you can have full control of your hands. If the extensor tendon becomes damaged, then it cannot properly do its job and may even be torn away from the bone and muscle. If this happens, you could develop mallet finger, which is often also referred to as baseball finger.

The common manner in which this injury occurs is if the finger is straightening and then forcibly hit by an object such as a ball, a hammer, or something similar.

The main symptom of mallet finger is a dropping fingertip that cannot straighten out. There could be other symptoms associated with the injury, including pain, swelling, and bruising. If the finger bone was fractured at the same time, more swelling and pain will be evident.

Diagnosing the Condition

Generally, the doctor will look at the finger first and then order x-rays. When the tendon was damaged, it may have forced a fracture and pulled a piece of the finger bone loose. It will be important to diagnose this properly so that the bone can be repaired.

Treatment of Mallet Finger

There are essentially two paths for treatment of this condition: surgical and nonsurgical. If the damage was only partial and no bones were broken, then the tendon may heal on its own. To help this happen, you will need to wear a splint for at least eight weeks. This will allow the tendon time to heal without experiencing any stress.

In many cases, the finger will go back to normal after it has been given healing time. However, some patients find that they are never able to fully extend their finger after such an injury. To help avoid this, your doctor or surgeon will go over therapy exercises you can do to regain full use of your finger and fingertip.

If the tendon is completely torn, or if bone is broken, then surgery will be needed in order to repair the injury. Pins and wires may be used to repair the bone fragments and get everything aligned back in place. Surgery on the tendon may be used to stitch it together. Additionally, the tissues may need to be fused in order to regain use of the finger. Your surgeon will go over the options you have when you are diagnosed with mallet finger.

Mallet finger is often called baseball finger simply because it is a common injury associated with this sport. If a player attempts to catch a ball and the ball hits the back of outstretched fingers, then this could cause the injury. However, it is not limited to the diamond. There are numerous different ways someone could injure the extensor tendons in their hand. If you suffered an injury and you have trouble extending your finger or it droops, then it is important that you visit a doctor as soon as possible. In fact, to avoid further complications, it is best to see a doctor within a week of the injury.

Resources:

http://orthoinfo.aaos.org/topic.cfm?topic=a00018

Categories
Elbows General

Cubital Tunnel Syndrome

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cubital-tunnel-syndrome-figWhat many people call the “funny bone” really is a nerve. This ulnar nerve runs behind a bone in the elbow through a space called the “cubital tunnel” (Figure 1). Although “banging the funny bone” usually causes temporary symptoms, chronic pressure on or stretching of the nerve can affect the blood supply to the ulnar nerve, causing numbness or tingling in the ring and small fingers, pain in the forearm, and/or weakness in the hand. This is called “cubital tunnel syndrome.”

Causes

There are a few causes of this ulnar nerve problem. These include:

Pressure. Because the nerve runs through that “funny bone” groove and has little padding over it, direct pressure (like leaning your arm on an arm rest) can compress the nerve, causing your arm and hand—especially the ring and small fingers—to “fall asleep.”

Stretch. Keeping the elbow bent for a long time can stretch the nerve behind the elbow. This usually happens during sleep.

Anatomy. Sometimes, the ulnar nerve does not stay in its place and snaps back and forth over a bony bump as the elbow is moved. Repetitive snapping can irritate the nerve. Sometimes, the soft tissues over the nerve become thicker or there is an “extra” muscle over the nerve that can keep the nerve from working correctly.

Signs and Symptoms

Cubital tunnel syndrome can cause pain, loss of sensation, and/or tingling. “Pins and needles” usually are felt in the ring and small fingers. These symptoms are often felt when the elbow is kept bent for a long time, such as while holding a phone or while sleeping. Some people feel weak or clumsy. Loss of sensation and loss of strength or muscle in the hand is serious.

Diagnosis

Your doctor will be able to tell a lot by asking you about your symptoms and examining you. S/he might test you for other medical problems like diabetes or thyroid disease. A test called electromyography (EMG) and/or nerve conduction study (NCS) might be needed to see how much the nerve and muscle are being affected. This test also checks for other problems like a pinched nerve in the neck, which can cause similar symptoms.

Treatment

The first treatment is to avoid actions that cause symptoms. Wrapping a pillow or towel around the elbow or wearing a splint at night to keep the elbow from bending during sleep can help. Avoiding leaning on the “funny bone” part of the elbow can help also. A hand therapist can help you learn ways to avoid pressure on the nerve. When symptoms are severe or not getting better, surgery may be needed to relieve the pressure on the nerve.

This can involve releasing the nerve, moving the nerve to the front of the elbow, and/or removing a part of the bone. Your surgeon will talk to you about what is the right option for you and guide your care. Therapy sometimes is needed after surgery, and the time it takes to recover varies. Numbness and tingling may improve quickly or slowly, and it may take many months for the strength in your hand to improve. Cubital tunnel symptoms may not totally go away after surgery, especially if symptoms are severe.

View our Cubital Tunnel Syndrome PDF 

Categories
General

Kevin Martin Broken Wrist – Arora Hand Surgery

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Professional Athlete, Kevin Martin, Shooting Guard of the Minnesota Timberwolves, suffers a Broken Wrist

Kevin Martin broken wrist is a big blow to the Minnesota Timberwolves.

The Wolves are now also missing Ricky Rubio, Nikola Pekovic, and Thaddeus Young.

Martin has been integral to the team, averaging 20.4 points.

Apparently Martin was sick that day, requiring IV fluids for an illness that he was battling. Playing under less-than-optimal health conditions seems to have cost him dearly as he is now out indefinitely. ally a game-time decision that night after needing IV fluids while battling an illness for most of the day.

Kevin Martin broken wrist occurred with 6:48 to play in the first quarter when he was fouled while shooting a 3-pointer. He was actually able to continue play and go on to score 34 points and make six out of nine 3-point attempts. The Timberwolves were able to break a five-game losing streak.

There has been no mention of the need for surgery for Kevin Martin broken wrist. A tweet from Timberwolves PR on Twitter confirmed that an MRI was performed at Mayo Clinic Square on Martins right wrist, revealing the fracture.

Kevin Martin Broken Wrist - AroraHandSurgery.com

AP Photo/Jim Mone

Although the nature of the injury is unclear, what is clear is that even professional athletes can suffer injuries under what seem to be innocuous circumstances, such as a fall from a standing position. Bruising of the fingers, hand, or wrist could be indicative of a severe injury such as a fracture. Professional medical attention is recommended for these types of concerns and a Hand Surgeon is well-qualified to diagnosis and treat such injuries. Dr. Arora is one such qualified individual, a practicing Hand Surgery Specialist in Michigan.

Categories
General Hands

Greg Norman Hand Injury – Arora Hand Surgery

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Greg Norman hand injury highlights dangers of power tools. Another high profile individual is injured, this time using a chainsaw. This underscores the importance of safety while using powered tools, no matter what type or size. Greg incurred his injury at home while utilizing a chainsaw to cut down a tree. In a Tweet he stated “…he was a lucky man”, and “…when using a chainsaw ALWAYS be respectful of the unexpected.”

These injuries are commonly seen by Hand Surgeons. Dr. Arora has personally treated many patients who have suffered from injuries related to home use of power tools, including chainsaws, hedge clippers, and lawnmowers.

Such injuries can range from simple treatment involving repair of the skin only, to much more severe, involving repair of tendons, nerves, and blood vessels; occasionally skin or tissue grafting may be required. Recovery is dependent on the extent of the initial injury, but it is common for patients to require several weeks of occupational therapy after a severe injury. Unfortunately, severe injuries can lead to permanent impairment or loss of a digit or limb.

Dr. Aroras recommendation to all patients is that regardless of how minor you may think your injury is, or are told your injury is by a non-specialist, ALWAYS seek an EXPERT OPINION: what may seem innocuous at first-glance, can sometimes hide an underlying tendon injury that may become worse with time!

Greg Norman Hand Injury

[Greg Norman]
Categories
General Hands

Avoiding Lawnmower Hand Injuries

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Knowledge most certainly is power when it comes to using a lawnmower safely. So, you need to know the common ways these injuries occur and to whom so that they can be avoided.

Who Gets Hurt and How

There are two groups of people who are most likely going to be at risk for a hand injury. These two groups include:

  • Adults of both genders between the ages of 25 and 64 years of age
  • Children who are under the age of five

Lawnmower hand injuries are common, accounting for about 22% of emergency room cases. However, other injuries common to these accidents include foot, ankle, and toes. Of all the injuries that occur, about a quarter of them lead to a need for amputation of the foot or hand. Children who are under the age of six are at risk of death.

The majority of lawnmower injuries occur when the grass is wet. Thats because it can clog the blades and lead to an operator of the machine attempting to unclog by hand.

Other Types of Common Lawnmower Injuries

While hands getting injured when an operator tries to clear the lawnmower blades may be the most common accident, it is not the only one. Others include:

  • People allowing other adults or children to ride on the back of the mower or in a cart that is being pulled by the lawnmower. The person could fall off and be injured by the moving machine.
  • The mower being pulled back toward the operator and possibly running over the foot.
  • Trying to use a riding mower across a slope, resulting in a tilted machine that rolls over on the operator.
  • Trying to use a push mower up and down a slope, resulting in the mower rolling back on the operator.

All of these accidents can be avoided if you operate the lawnmower safely and correctly.

How to Avoid Injury

To avoid injuring your hand or foot and dealing with potentially permanent damage, there are certain safety steps you can take. They include:

  • Only mowing the lawn when the grass is dry
  • Wearing proper footwear during mowing (sandals or flip flops are never safe)
  • Cutting up and down the slope when using the riding mower
  • Cutting across the slope when using a push mower
  • Making sure the mower is completely turned off and the blades have stopped moving before unclogging grass from the blades
  • Using a stick or broomstick to unclog the blades when they have grass in them
  • Never drinking while cutting grass and operating the lawnmower
  • Never allowing passengers to ride on the back of the mower
  • Ensuring the mower has sharp blades at all times
  • Always wearing the proper clothing and safety gear
  • Never ever using the lawnmower when you are barefoot

The common injuries that occur to the hand or foot when operating a lawnmower require more than one surgery to completely rectify the injury. At times, the damage can be permanent. Thats because these injuries often result in skin, tissue, and bones being completely ripped and soil or grass coming in contact with the wounds. It creates a recipe for infection and serious injury.

If you or anyone is injured by a lawnmower, call 911 immediately. This is not the type of injury that can be treated at home. It will need immediate attention at a hospital and you do not even need to touch or try to clean the wound. You could do more damage this way. Whatever you do, never use your hands or feet to remove grass from the lawnmower blades and never allow children around an operating machine. This is the best way you can avoid serious injuries to you or someone else.

Avoiding Lawnmower Hand Injuries

[Lawnmower Hand Injuries]
Categories
General

Sports Injuries of the Hand and Wrist and Where to Get Treatment

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Sports injuries of the hand and wrist – There is not a single sport that doesnt require the use of your hands in some fashion or form. For this reason, there are numerous sports injuries of the hand and wrist every single year. Even very small injuries to the hand or wrist can turn into something serious and permanent if not treated properly. Thats why, if your hand or wrist has been injured you will need to visit an emergency room or hand surgeon.

The Types of Injuries

About 10% of sports injuries that lead to an emergency room visit are to the hand, including lacerations, fractures, infections, and serious bruises. Of course, most common sports injuries are from blunt force trauma. The hand can be crushed or bent backward and can take the brunt of the force if you fall during a sports game.

In addition to the sudden injuries that occur during a sports game, there is also the risk of overuse injuries. This can include inflammation or damage to ligaments and muscles. Generally, these occur when the player is required to make the same motion over and over again. Its commonly seen in sports like golf, baseball, and tennis. These repetitive motion injuries even have names: skiers thumb, Dr.Quervains tendonitis, basketball finger, and tendonitis.

Preventing Injuries

The first thing you should do is work to prevent these injuries if you play sports regularly or even if you only play on occasion. Steps you can take for prevention include:

  • Wear wrist guards and gloves as needed. Make sure the items you use for protection of the hands and wrists are high quality and designed to help dissolve impact on the small bones, ligaments, and tendons in the hand.
  • Always take breaks during sports activities to give your hands a chance to rest, especially if your sport requires repetitive motions.
  • Always use the proper posture and position any time you need to make repetitive motions. For example, know how to hold the bat or tennis racket properly before using it.

Even if you take these steps, there is a chance you could sustain an injury to your hand while playing sports.

When to Go to the Doctor

If you are injured, you will need to determine if the injury is minor or serious. Often, very minor things can be treated at home. However, if you experience any of the following, you need to visit the emergency room or hand surgeon:

  • You have a bleeding wound that has not stopped bleeding after 15 minutes of pressure.
  • You have severe pain and swelling in the hand.
  • You notice your hand or fingers turning gray or becoming discolored.
  • You see that your fingers are abnormally bent or twisted.
  • You can hear a clicking or grating sound whenever you move your fingers or hand.
  • Bruising and swelling does not get better after two weeks.

If you have any reason to believe that you have sustained a serious injury, it is better to be safe than sorry. When it comes to your hand, taking any chances can result in permanent damage. Always see a hand surgeon or go to the emergency room if you think your hand is hurt more than it seems at first.

The Treatments

There are different treatments used to deal with sports injuries of the hand. A simple contusion (bruise) can be managed with ice and medication. Some cuts require stitches. If any bones are broken or ligaments and tendons are damaged, then hand surgery may be required as opposed to simple casting. Thats because there is too much of a risk for permanent damage in the hand. In some cases, consecutive surgeries will be needed to fully repair the injury.

When you play sports, you are at risk of hand injuries, even if you take proper precautions. However, you should always use safety gear to protect your hands and wrists. Additionally, if you must make the same repetitive motions over and over again, then take breaks throughout the sport to allow your hand time to rest. If you have any sports related injury of the hand, go to a doctor or hand surgeon as soon as possible. The longer you wait, the more permanent the damage can become and there may not even be a solution to giving you back full use of your hand.

Sports Injuries of the Hand and Wrist

[Sports Injuries]

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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.