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Conditions General

Syndactyly Causes and Treatment

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Everyone has a little web of flesh between their thumb and their forefinger. If there are fleshy webs between your fingers as well, though, you may have a condition known as syndactyly.

What Is Syndactyly?

Simply stated, syndactyly is a condition in which adjacent fingers have grown together and appear webbed. If the fingers are completely joined, the condition is known as “complete syndactyly.” If only part of the fingers are involved, this is “incomplete syndactyly.” If both the flesh and the skin are involved, the condition is referred to as “simple syndactyly,” although sufferers would probably argue that there is nothing simple about it. Complete syndactyly is a joining of the bones. Fingers may also be joined at the tips, but have separate bones. This is complete simple syndactyly.

Causes

Syndactyly is a birth defect. The condition is sometimes genetic, passed down from one generation to the next. Other times, it occurs for no apparent reason. What is known, though, is that syndactyly has nothing to do with anything the mother may have done or neglected to do throughout her pregnancy. There is no need for a mother to feel guilty if her child is born with syndactyly.

Treatment

If it appears that syndactyly may interfere with function, it can be surgically corrected. Otherwise, parents can make the decision based on aesthetics. Most cases of syndactyly actually will not impair function. If surgery is done, though, therapy will be required post-surgery. Usually this involves wearing spacers between the fingers while the child is sleeping, in order to prevent the fingers from growing together again. The hand will also need to be bandaged for some time – perhaps even months. There may also be a need for follow-up surgery in years to come.

Success of Treatment

The goal of the surgery for syndactyly is to improve appearance, and also prevent the deformity from progressing. Usually, this is successful, although the appearance of the hand may not be completely what we would consider to be “normal.” It is important to remember that unless the appearance of the hand is extremely abnormal, what most people notice about the hand is not how it looks, but how it works. As long as a person is using their hand in a natural manner, deformities will usually be overlooked by the casual observer.

Refusing Treatment

If you have a child who has syndactyly, treatment is generally optional. Syndactyly does not usually present a health risk unless the fingers are joined toward the tips – in that case, they will bend in undesirable directions over the course of time. In such situations, surgery should be performed in the early years so the child can adapt to the changes in his or her hand. If delayed beyond the early childhood years, the results of syndactyly surgery are usually less than satisfactory.

If the condition is likely to result only in aesthetic issues, then surgery can be foregone without fear of complications down the road.

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Conditions General

A Look at Gamer’s Thumb – Arora Hand Surgery

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Video games are designed for human beings, but human beings are not designed to play video games. Our hands are simply not constructed to manipulate game controllers for hours on end. Most video game controllers require the thumbs to take the brunt of the activity, and that often leads to a condition known, appropriately enough, as Gamers Thumb. This is a type of repetitive stress injury affecting not only the thumb, but the wrist as well.

Symptoms

People afflicted with Gamers thumb will often notice that they dont have the strength in their hands that they once did, or the range of motion. They may also notice a popping sound, or a feeling of snapping, on the outer part of the thumb where it joins the wrist.

The Mechanics

The thumb is designed to move inward toward the wrist, and its overall anatomy makes this possible. This action, the movement of opposable thumbs, is what distinguishes us from animals, enabling us to pick up objects and use tools. The thumb is made to grip, but not to complete complex motions that can put stress on the joint as wells as the tendons and muscles that are attached to it. When non-gripping movements are performed over and over, inflammation in the tendons and in the tenosynovium (a membrane that helps the tendons to slide through the wrist) can occur. The ability to grip is then reduced, and swelling can occur in the thumb, the wrist, and even the forearm. This, at its essence, is Gamers Thumb.

The Pain

Usually, Gamers Thumb pain occurs when the wrist is flexed, or when the sufferer grabs something or makes a fist. It occurs in gamers who play for long periods of time, usually every day. If left untreated, the inflammation can worsen, and the synovial sheaths that protect the tendons can thicken and even deteriorate. In the long term, this can lead to a loss of range of motion, loss of strength, and even permanent damage accompanied by constant pain. Not only will you have trouble performing ordinary activities, your gaming career is going to be over.

Treatment

If Gamers Thumb has not progressed significantly, it can be treated. Treatment is much the same as for other injuries to the hand and wrist. Most importantly, you need to rest, so whether your passion is Minecraft, Call of Duty, vintage games like Super Mario and Tetris, or maybe just Facebook games like Candy Crush or Bejeweled Blitz, you need to take a bit of time out. Watch a movie, read a book, go for a walk – whatever gets you away from your games.

You can get relief from the pain by applying cold packs to your hand and wrist, and taking over-the-counter pain remedies. Keeping your hand elevated can also ease the discomfort.

Keep in mind that if you have noticeable symptoms, you cant “scale back.” You have to stop for a while. But if you do, youll be back at your gaming console soon, none the worse for the wear.

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Conditions General Treatments

Signs, Symptoms, and Treatment for Arthritis Sufferers

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One of the most common afflictions among people in the United States is arthritis. There are more than 100 different types of arthritis, and while many of them have the same types of signs and symptoms, there are some differences that are important to note.

Osteoarthritis

Symptoms can include pain in the joints. Sufferers can feel pain in the joint during movement as well as after movement. The affected area may also be tender to the touch, even if there is only a minimal amount of pressure applied to the joint. Many sufferers also complain that they feel stiff when they wake up in the morning. They also lose a substantial amount of flexibility in their hands (and other joints). The joint could also develop bone spurs. This occurs due to the wearing away of the cartilage at the end of the joints.

This type of arthritis can affect many people, and there are a variety of different risk factors that come into play. Those who are older are at risk, as the cartilage in the joints tends to wear down with age. Women are more likely to develop osteoarthritis than men. Those who have suffered from joint injuries in the past could be at a higher risk as well. In addition, workplace factors (jobs that have repetitive motions), genetics, and other diseases can increase the risk of developing osteoarthritis.

Rheumatoid Arthritis

RA is another common type of arthritis, and this can be more dangerous than other forms of arthritis as it can affect the organs in the body. It can be difficult to detect RA, but there are some symptoms to consider. Those who have RA tend to have injuries that will be difficult to heal. They may also feel a tingling or numb sensation in their hands. This can sound similar to carpal tunnel. RA can also cause eye problems, foot problems, and aching joints. If you go to the doctor, make sure you tell him or her about all of your symptoms so you receive a proper diagnosis.

What Treatments Are Available?

Fortunately, there are a number of ways to treat arthritis today. Doctors may recommend some lifestyle changes for a start. They may want you to stop smoking and to get more exercise, which can promote feeling better in general. They may also offer pain medications, or suggest over the counter medications to help with the pain. Physical therapy can help as well. However, you want to make sure that you receive your exercises from an actual physical therapist so you can be sure you arent doing anything that could aggravate your arthritis further.

In some cases, the doctor may feel that surgery is the best option for you. You can discuss the surgical choices available. They may want to fuse the joints, which can help to relieve pain, clear out some of the inflamed areas, or even replace the joints.

Whenever you are suffering from any type of injury to the hand, whether it is arthritis or something else entirely, please call or visit our hand doctor’s office in Howell, Warren, West Bloomfield, or Macomb to get in touch with a medical professional. You need to have a proper diagnosis if you are expected to heal.

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Conditions General

When Should I Contact My Doctor About Arthritis Pain?

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If you have pain and stiffness in your joints, it could be a sign that you are developing arthritis. Waiting too long to get any type of treatment could mean that the joint damage is permanent, and it could be very difficult to correct, even with surgery. While you may not feel you need to see a doctor yet, there are certain “telltale signs” that it is time to get help from a professional. Lets look at some of the reasons that you should get in touch with a doctor.

What Should You Watch For?

If you only have some pain and stiffness in one of your joints, and you havent had issues with your joints in the past, it might not be arthritis. You may simply need to rest and take it easy for a while. However, when you notice that the pain, stiffness, and the swelling are affecting more than one joint, it could be a sign that you are developing arthritis. Its a good idea to get in touch with the doctor at this point, as catching and treating the problem early is the best option.

If you notice that the joints are red and warm when you touch them, it is another potential sign of arthritis. Those who start to notice that it is more difficult to do all of their normal daily activities because they are having issues with their joints will want to contact their doctor.

When the symptoms last for three days or longer without dissipating, and when you have more than one or two arthritic episodes over the course of a month, you need to talk with a doctor as soon as you can.

Ultimately, you dont have to wait to see a doctor, even if the symptoms seem mild. Its better to talk with the doctor and learn more about whats happening to your body as early as possible. Whenever you have any doubt or concern, make an appointment.

Understand Your Type of Arthritis

More than 100 different types of arthritis exist. While they may share some similarities in their signs and symptoms, they are different and may require different approaches to treatment. A specialist will let you know whether you are suffering from rheumatoid arthritis, osteoarthritis, or any other type of arthritis. The will also be able to discuss your different treatment options so you can start to find ways to relieve your pain and stiffness.

In the beginning, they will likely want to try different types of nonsurgical treatments to see whether they help. If the pain is infrequent and mild, for example, some lifestyle changes and pain medication might be all you need. However, surgery is an option for some patients.

When it comes to arthritis, you might start out going to your primary physician, but you will eventually want to work with a specialist who can provide you with more detailed information about your condition and what you need to do to limit or eliminate the pain and stiffness.

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Conditions General Hands

Dupuytren’s Contracture: What You Should Know

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Dupuytrens Contracture is a rare type of hand disorder that tends to take a number of years to develop. It causes the layers of tissues that lay beneath the skin on the palm of the hand to begin to form knots. These knots thicken and can actually cause one or more of the fingers to bend. Once they are bent into this position, it will no longer be possible to straighten them. Since it is impossible to bend the fingers, it will make it difficult to do many normal activities and actions. You would not even be capable of putting on a pair of gloves. Eventually, it will become difficult to grasp large objects.

In most cases, only the ring finger and the pinky will be affected. In very rare cases, it can also affect the thumb and the index finger. The contracture tends to affect older men who have a Northern European heritage.

What Are the Causes?

Currently, the cause of Dupuytrens Contracture is unknown. Researchers have not been able to find any evidence that it is related to hand injuries or any occupations that could cause repetitive stress issues or injuries due to vibration. However, they have found a number of factors that can increase the risk of developing the condition.

Men, as mentioned are the most likely to develop the contracture, and it typically affects those who are 50 and over. The condition also tends to run in families. Those who have diabetes are also at an elevated risk. In addition, smoking can increase the risk of developing Dupuytrens Contracture, as can alcohol.

Talking With a Doctor

Chances are good that you will want to speak with a specialist about this condition. Your primary care physician can refer you to a specialist, who will want to know more about your medical history and how you have been dealing with the condition. For example, they want to know whether there is a history of Dupuytrens Contracture in your family, if youve tried any treatments, and what medications you are taking.

The doctor will also want to know when the symptoms first started. Since this condition comes on slowly, it can be difficult to pinpoint when it began. Let them know if you are in pain, if the condition has been getting worse, and how it currently affects your daily life.

Most of the time, the doctors will be able to diagnose you based on examining your hands. The signs of Dupuytrens Contracture are very obvious.

What Are the Treatments?

Doctors can help to treat the condition in a number of different ways. They may use a needle technique, in which the doctor will insert a needle into the affected area to break up the hardened tissues that is causing the finger to contract. They may also utilize enzyme injections. Those who have advanced stages of the disease can also have surgery to help remove the hardened tissue.

If you suffer from Dupuytrens Contracture, speak with a doctor about your condition to find the best treatment options.

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Conditions General

Understanding Dupuytren’s Contracture

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If you feel a tightening in your hands, or if from time to time your hands cramp up for no apparent reason, the cause could be Dupuytren contracture. This is a tightening in the fascia of your hands. Fascia are fibrous tissues that are located inside the palms of your hands, and progressive tightening can eventually result in difficulty using the hand along with an unsightly, claw-like appearance as your fingers begin to curl inward.

Diagnosing Dupuytren Contracture

As you might expect, diagnosis of Dupuytren contracture is done by examining the hand. During the examination, the doctor will usually find a tender nodule in the neighborhood of the third or fourth finger, in the palm. Initially, this nodule may cause pain, but eventually it will go away as the fingers begin to curl inward.

In order to effectively confirm or rule out Dupuytren contracture, your doctor will also take a complete history to determine if there is anything in your medical background that could be connected with the condition. If you consume excessive amounts of alcohol, or if you have diabetes or epilepsy, you are at a higher risk for Dupuytren contracture, although these are simply factors that seem to go hand in hand with Dupuytren contracture – the actual causes of the condition are not known.

What is known is that the condition appears to be hereditary, is more common in men than in women, and usually appears after the age of 45. There also appears to be a genetic component, but having the genetic makeup that is present in Dupuytren contracture sufferers does not necessarily mean that you will develop the condition. Approximately 5% of Americans have Dupuytren contracture. In about half of cases, both hands are affected. Interestingly, when the disorder affects only one hand, it is twice as likely to be the right hand.

Treating Dupuytren Contracture

If the condition is identified before the fingers start to curl inward, injection of a corticosteroid can relieve the symptoms. It is important to note, though, that this will simply ease the symptoms – it will not halt the progression of the condition.

Occasionally, Dupuytren contracture will go away without treatment, but usually at some point surgery will be required. Even after surgery, hand function may be limited. This is because removing the diseased fascia is not an easy procedure – the fascia protects a multitude of blood vessels, nerves and tendons, so the hand surgeon has to err on the side of caution.

The Final Word

If you are experiencing any of the symptoms of Dupuytren contracture, it is important that you see a competent hand surgeon in order to determine if the cause is actually Dupuytren disorder or due to some other condition. Then you can work together to agree on a course of treatment, which could include corticosteroid injections, and which may or may not include surgery. Although Dupuytren contracture does sometimes simply go away without treatment, that is the exception, not the rule.

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Conditions General

What Is a Ganglion Cyst and Does It Require Surgery?

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A ganglion cyst is a lump that people will develop on their hands and wrists. They are noncancerous, but they are full of fluid, which can cause pain if they are pressing on a nerve. The size of the cysts can vary greatly. Some are actually quite small, while others can be an inch or slightly larger in size. In some instances, the location of the cyst can make it difficult to move the joint.

The exact cause of ganglion cysts is unknown, and they will often disappear on their own. However, that is not always the case. Sometimes, you will need to have surgical treatment, which we will discuss further below.

What Are the Symptoms?

Most of the time, the cysts are painless. As mentioned though, if they are located close to a nerve, and they press on the nerve, this can cause a substantial amount of pain. Even a small cyst can cause problems, such as numbness and weakness in the muscle. The size of the cyst can change as well, depending on how often you use that joint. When you use the joint more often, the cyst could increase in size.

Whether you experience pain or loss of motion or not, you will want to make sure to head to a doctor so they can provide you with a proper diagnosis. You want to make sure it is a ganglion cyst and not anything more serious. The doctor will also be able to recommend treatment. As mentioned, many times, the cyst will go away without any type of treatment. Many doctors will want to see what happens with the cyst before providing treatment, as it might be unneeded.

Types of Treatment

When the doctor does decide that they need to treat the cyst, they have several options. First, they will likely want the patient to immobilize their wrist. This can help the cyst to shrink. For those cysts that do not go away, the doctor could aspirate the cyst. This involves using a needle, inserting it into the cyst, and then draining the fluid. Some doctors will then inject the area with steroids, which should help to keep the cyst from coming back. However, there is still the possibility of the cyst recurring.

Of course, there is a chance that the other treatments will not work. In those cases, the doctor will determine whether surgery is a good and viable option. The ganglion cyst surgery will remove not only the cyst, but also the connecting stalk that is attached to the tendon or the joint. While this is a good option for many, there is always the chance that the cyst could still return.

If you have a ganglion cyst, or a lump that you believe may be a cyst, you will want to get in touch with a medical professional who can examine you. You can talk to a specialist who performs hand surgery to determine whether removal is your best option to help get rid of the cyst.

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Conditions General Hands

How to Deal With Skin Cancer of the Hand – Arora Hand Surgery

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Cancer is a condition that ranges widely and which can appear in almost any part of the body. It does occur on the extremities, including the hands and arms, and it is best treated quickly and by a qualified hand surgeon or expert.

Naturally, it may be difficult to recognize when skin cancer of the hand is present. Interestingly enough, it is the skin that is the organ most commonly affected by cancer, and on the hands the most common types of cancer to appear are:

  • Squamous cell carcinoma
  • Basal cell carcinoma
  • Melanoma

There are other rare forms of skin cancer of the hand, as well, and it takes a medical professional to perform any diagnosis. However, you can know if you are at greater risk for developing it. The following list of factors tend to apply:

  • Chronic sun exposure
  • Immune suppression
  • Fair or light complexion
  • Exposure to chemicals and/or radiation
  • If you have pre-malignant lesions in the past
  • Family tendency to melanoma
  • Genetic conditions relating to skin cancer

And while there are many online resources with photographs of various forms of skin cancer of the hand or upper extremity, the best way to get diagnosed is through a visit to a hand expert. Though there are some very clear indicators that can be used to visually identify potential carcinomas and melanomas (such as discolored nodules appearing on the skin, cutaneous horns forming in odd locations, and areas that wont heal), the expert opinion is the best.

Diagnosis and Treatment

You hand doctor will do a visual inspection and take a biopsy or sample of the tissue in question. This is sent to a lab that assesses it and determines if the tissue is indeed cancerous or pre-cancerous. In some cases a larger sample may be required to make a definitive diagnosis.

If cancer is present, the next step is often to examine the lymph nodes to be sure that the cancer has not metastasized (or expanded to another area of the body). This is done through biopsy or through a range of different scans, such as a CT scan.

When a full diagnosis and assessment is done, the most common treatment is removal of the tissue by a qualified hand surgeon. The traditional approach is to remove all of the tissue infected with cancer cells along with tissue at the edges of the cancerous region. A surgeon will also perform all essential repairs at the same time, such as grafting healthy skin over the excised area.

In certain types of cancer, removal is followed by radiation or chemotherapy to be sure that all cancerous tissue has been eradicated. And in extreme cases there can be a need for amputation, but this is, as indicated, an extreme.

If you suspect that you are at risk for developing skin cancer of the hand or upper extremity, or have noticed a long-lasting change in the skin of one part of the hand, do not hesitate to visit a surgeon. As the experts say, the best treatment for skin cancer of any kind is prevention (SkinCancer.org, 2015). If you suspect something wrong, your next best treatment is early detection and rapid action in the care of a hand surgeon.

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Conditions General

Understanding Ganglion Cysts

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As you may already know, cysts can form on different parts of the body. They are usually benign and can be a frustration more than anything. This is definitely the case with ganglion cysts, which can form on certain parts of the hands. Generally, they appear on the outer side of the wrist, on the palm side of the wrist, at the base of the finger, and on the farthest joint in the finger.

Ganglion cysts are filled with clear fluid and they can change in sized at different times. Sometimes, they may seem to disappear before reappearing. Because they are filled with clear liquid, many people describe them as looking as if a water balloon is trapped under the skin.

They do not spread to other parts of the body, although some people may have more than one ganglion cyst on their hands.

The Causes of the Cysts

There is no specific cause of a ganglion cyst and they can develop on anyone at any age. Some doctors do believe that injury to the joint or excess use and stress on the area may contribute to the development of the cysts.

The Symptoms

A ganglion cyst is usually fairly easy to diagnose by a hand doctor. Symptoms may include:

  • A round or oval rise or projection on the parts of the hand as mentioned.
  • The bump will have a clear quality, and a light beam will pass through it.
  • The lump may or may not be painful, and some people state that they only feel pain when the lump is bumped or hit on something.
  • A times, a ganglion cyst can be accompanied with a bone spur, especially if it occurs near the tip of the finger.

Many people experience no discomfort or pain from the cyst, so treatment usually isnt needed. However, if the cyst is causing problems, is limiting mobility, and is painful, then a combination of a splint and anti-inflammatory medication may be used. At times, the cyst may be aspirated with a needle. If all else fails, then surgery may be needed. During the surgery itself, the cyst will be removed and so will part of the joint capsule. While surgery is usually successful, there is still a chance that the cyst may come back over time.

A ganglion cyst is not just a bubble under the skin. It usually has something called a root that connects to the nearby joint. This is why they can, at times, interrupt usability of the finger or hand. However, in most cases, the cysts are left alone as they do not cause any problems whatsoever. Additionally, they have been known to disappear all on their own with the patient doing nothing at all. No matter the case, if you believe you have a ganglion cyst, it would be a good idea to see your physician. Together with your doctors help, you will be able to determine whether or not you should pursue treatment for the problem.

Resources:

http://www.emedicinehealth.com/ganglion_cyst/article_em.htm

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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.