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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, Warren, 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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Fingers General

12 Fun Facts About Fingers

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Here are some fun facts about fingers. This picture is a closeup of a woman's hands.

Usually we try to be serious here. But once in a while we like to step outside the box, and just have some fun. So, how about some fun facts about fingers?

1. Big Hand Man

The man who has the largest hand in the entire world is Lui Hua, of China. His index finger is nearly a foot long, and his left thumb is more than ten inches. He has a condition known as “macrodactyly” – in other words, big fingers.

2. Only One Muscle

When you think about the movements that your fingers are capable of, it might be hard to believe that each finger has only one muscle, but its true. It’s called the arrector pili muscle, and it moves all of your finger joints.

3. Manly Man

Did you know that the more testosterone you have, the longer your ring finger will be? You didn’t? Well, now you do.

4. The Ring

If you have ever wondered why you wear your wedding ring on your left finger, wonder no more. It’s because there is a vein in that finger, the vena amoris (vein of love) that was once believed to be connected directly to your heart.

5. Longer is Better

Experts have actually conducted research that seems to indicate that the most successful men have ring fingers that are longer than their less successful counterparts.

6. Math Experts

Studies show that children who have long fingers are better at math.

7. Just Try It

Curl your middle finger inward and lay your hand flat on a table. Then lift your thumb, index finger, and pinkie. No problem, right? Now try the ring finger. You can’t lift up it up, right? That’s because it shares a muscle with your pinky and middle fingers, and it can’t work independently.

8. Dem Bones

Each hand has 29 major and minor bones, as well as 123 ligaments holding the whole structure together.

9. Watch It Grow!

Your fingernails grow about four times as fast as your toenails. Your slowest-growing nails are the ones that are on the shortest fingers. The nail on your middle finger grows fastest.

10. Hand to Mouth

You know that your fingerprints are unique, but did you know that the odds of one human being having the same tongue print as another are about one in a million? Interestingly, there are also a handful of people worldwide who have no fingerprints at all. No one knows why this happens.

11. Eww…

Fingernails are actually modified hairs, structurally speaking. They are made of the same material.

12. Urban Legend

You know how people say that your fingernails will continue to grow after you die? They don’t. Nothing grows after you’re dead. This myth comes from the fact that dead bodies shrink, and the skin pulls back, giving the appearance of fingernails continuing to grow.

We hope you enjoyed reading these fun facts about fingers as much as we did putting them together!

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Fingers General

Ligament Tears on the Thumb – Arora Hand Surgery

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Ligament tears on the thumb happen fairly often. The ulnar collateral ligament is a piece of tissue that extends from the thumbs middle joint to the joint near the web area of the thumb. Constant stretching and overextending the ligament can cause it to weaken and eventually develop tears. In addition, accidents that cause the thumb to suddenly pull away from the palm can cause severe damage to the ligaments as well. This can happen if you fall on your palms. The injury is actually common with skiers, as their falls can often place these ligaments in danger. In fact, it is prevalent enough that doctors have taken to calling this type of tear “skiers thumb”.

What Are the Symptoms?

The symptoms of this type of injury include pain and swelling. Those who have torn ligaments will feel that their thumb is weak, and they will have trouble gripping anything. In addition, it may cause bruising around the area. Because of the pain and the weakness, it can make it very difficult to take care of normal daily tasks.

Diagnosis and Treatment

When you go into the doctors office, he or she will examine both of your thumbs and talk with you about the injury and the symptoms you are suffering.

To understand exactly what is happening with your thumb, you will have to undergo imaging tests. These tests will help to get a look inside of your thumb. An x-ray will check to see if there are any fractures in the thumb. The x-ray may not provide a good look at the ligaments though, so other imaging will likely be needed. In addition, they may perform a valgus stress test after administering a local anesthetic. The test will manipulate your thumb into different positions. The doctor will then be able to ascertain the joints stability and will have a better idea of the extent of damage to the ligaments.

For those who only have a partially torn ligament, it is possible for the ligament to heal on its own, although it does take some time. Your doctor will make sure the thumb is immobile for between four to six weeks by placing it in a cast. Once you have the cast removed, you will then need to do some physical therapy to ensure you build up your strength and your flexibility.

In many cases, you will need to have surgery in order to repair your injury to a torn ligament, as it will not be able to heal itself entirely. Different types of surgery can work based on the extent of the injury. Suture repair requires that the hand surgeon open up the hand and repair the ligaments using stitches which will hold them in place so they can heal. In other cases, they may utilize fusion surgery instead, which will graft new tissue onto the ligaments. This could limit some of the mobility though.

If you have a torn ligament, you will want to speak with your surgeon about the options available to find the one that works best for your injury.

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Fingers General

Children and Finger Crush Injuries – Arora Hand Surgery

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Sometimes it seems like its a wonder that children get through their early years, given the abuse that their fingers take. Crush injuries to the hand or fingers are incredibly common among toddlers and young children, usually occurring when a heavy object falls on the hand, or the hand is slammed in a door.

Often, these childhood injuries do not require an emergency room visit, although it is usually a good idea to see your doctor as soon as you can, just to make sure that everything is all right. There are things that you can do at home while you are waiting for the doctors regular office hours.

Keep an Eye On the Child

Realistically, a few hours will not make a difference. So before you rush off to the ER, just watch the child for a while. If he or she uses the hand, even a little, then chances are good that nothing is broken. For that matter, a small break, if left unattended for even several hours, will not cause any lasting harm. You can safely wait for the doctor.

Having said that, if the hand seems extremely swollen, or if fingers look like they are bent, a trip to the ER is warranted. You should expect some swelling with a crush injury, but unless it is severe or accompanied by disfigurement, it can wait.

If the crushing has occurred to the fingernails, you can expect to see nails bleeding or appearing bruised. Again, this does not necessarily mean that any bones are broken. If the nail appears to have been pulled out, either completely or partially, then you may wish to make a trip to the ER in order to have it sewn back in place. Sometimes, if this is not done, a new nail may not grow back in to replace it. If you decide not to go to the ER, apply an antibiotic ointment to the injured area and tape the nail down so that is protected from being pulled out accidentally.

Treating the Injury

You can reduce swelling, and ease the pain, by applying ice to the injury. Never apply ice directly – you can soak the childs hand in a bowl of water that contains some ice cubes, or use a medical cold pack. In a pinch, even a bag of frozen vegetables can work as a cold pack. You can also offer childrens ibuprofen or acetaminophen to ease the pain. Keep in mind, though, that children should not be given aspirin.

Conclusion

Hand and finger crush injuries are very common in young children. Most of the time the parent feels worse about it for longer than the child does. Also, most of the time these types of childhood injuries can be treated quite effectively at home with cold packs and over-the-counter pain killers. However, if swelling is excessive or the fingers appear bent out of shape, see your doctor or go to the emergency room.

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Fingers General

Problems With Artificial Nails

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Its a given that all women want beautiful nails. Often, that means not living with what nature gave you, and indisputably artificial nails are very popular. You might be a woman, or know a woman, who builds a trip to the nail salon into her weekly budget. But are acrylic nails safe? Read on.

Safe, Sort Of

Acrylic nails in and of themselves arent harmful. But depending on how theyre installed, and how long you leave them on, they could be harmful to your natural nail bed.

One of the most common problems is actually damage to the acrylic nail causing damage to the underlying nail. The acrylic nail cracks, or loosens from the natural nail, and then a gap occurs. This makes for a wet, warm environment that is ideal for bacteria to grow and cause infections.

Another problem is that nail files can never be effectively sterilized. So when you go to the salon, youre not just bringing in whatever is on your nails – youre picking up what was on the customer before, and the customer before that, and the… well, you get the idea. Ideally, you should bring your own nail file to the salon and have the nail technician use it.

Allergies

You probably think of allergies as affecting your sinuses or your skin, but the reality is that you can be allergic to any number of the compounds that are used on your nails in the course of having acrylic nails installed. Adhesives are a common culprit, and signs of an allergy can include redness and swelling.

Minimize Your Risk

Of course you want beautiful nails, but if you are going to have acrylic nails installed at a salon, make sure that the salon is state licensed, and only work with nail technicians who are board licensed. Make sure that your technician sterilizes every single tool that he or she uses, and washes hands before serving you. And as we have stated before, bring your own nail file.

Let Your Nails Breathe

Keep in mind that your nails are not meant to be covered for any great length of time. At least every three months, you should forego your acrylic nails and let your real nails get a bit of oxygen.

Prevention

To prevent problems with acrylic nails, start off slow. Have just one nail installed, and wait to see if you experience any itching, redness, pain, or other symptoms. If any of these symptoms develop, do not use acrylic nails. If any separation of the artificial nail from the nail bed occurs, remove the artificial nails immediately. You can often do this with at-home treatments, or you can go to a salon to have the nails removed.

Keep in mind that if you continue to wear artificial nails in the face of the above-mentioned problems, you are risking permanent damage to your nail bed. Looking good is important, but not at the cost of your health. Enjoy your manicure, but be careful.

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Fingers General

Is Knuckle Cracking Harmful?

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Lets begin by saying, before we say anything else, that if you crack your knuckles you are probably driving the people around you crazy. But is knuckle cracking harmful? Truthfully, its hard to say. The jury is still out.

What Mom Said

Your mother probably told you that cracking your knuckles would cause brain damage. That is not true. She may have also told you that it would cause you to develop arthritis in later life, and honestly, that theory has been debated to death. The conventional wisdom today is that it likely wont. But are those maddening clicks and pops anything more than an annoyance? Lets talk about your knuckles.

What are Knuckles?

Your knuckles are the joints in your fingers (and also in your toes, for that matter) that are located where the bones meet. They contain a liquid, synovial fluid, that lubricates them. Occasionally, a gas bubble occurs in the synovial fluid, and when the joint moves in a certain way, that bubble bursts and makes a cracking or popping sound.

Now, about arthritis. It is a common problem in older adults. In fact, most people over the age of 65 have at least some form of arthritis. Osteoarthritis is the most common form, and it is caused by ordinary wear and tear on your joints. Rheumatoid arthritis, on the other hand, is due to joint inflammation, and it can ultimately cause joint deformity and loss of function.

Is There a Connection?

The current research suggests that there is no connection between cracking your knuckles and developing arthritis. On the other hand, think about what we just said about wear and tear. Constant knuckle cracking is almost certainly going to cause wear and tear on the joints. Whether it is sufficient to cause arthritis is still up for debate. It doesnt seem unreasonable to think that prolonged knuckle cracking could lead to trouble in the joints, but how much does it take? Also, many people develop arthritis, and many people crack their knuckles. What is cause, and what is effect? Or is there any correlation at all? No one really knows.

A Study

In 1975, Drs. Robert and Stuart Swezey studied 28 nursing home residents who may or may not have cracked their knuckles – most of them couldnt remember. They x-rayed the subjects hands, and decided that there was no link between arthritis and knuckle cracking. Heres the thing, though – how do you determine cause and effect when your subjects cant even remember if they cracked their knuckles?

Another study, possibly more reliable, was published in the Annals of Rheumatic Disease. It evaluated a group of 300 known knuckle crackers. None of them developed arthritis. They did, however, experience less strength in their hands, and were more likely to have swelling in the hands. Again, though, whether knuckle cracking caused hand problems, or people with hand problems were more likely to crack their knuckles was left open to interpretation.

The Final Word

Dont crack your knuckles. It might not make a bit of difference, according to studies. But why not err on the side of caution?

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Fingers General

How To Treat Fingernail Injuries

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We use our fingers all of the time all throughout the day. As a result, they are always at risk of some type of injury. Your fingertips are packed with nerve endings, more than almost anywhere else in the body. Thats because you need all of those nerves to fine tune your ability to feel and use your fingers. Of course, with all of those nerve endings hanging out in your fingertips, an injury to this area can be very painful.

Fingertips can be damaged in a number of different ways, ranging from very minor to extremely serious. Because the fingertip skin is so unique, if it becomes destroyed, it usually cannot be replaced.

Some common examples of injuries to the fingertips include:

  • Crushing damage if the finger is closed in a door, hit with a hammer, or has something heavy dropped on it
  • Cuts from knives, power tools, etc.
  • Bent and broken from being caught in equipment, ropes, or nets.

If you have a fingertip injury, the first thing your doctor will do is examine the area, check for mobility in the finger and then get x-rays. It will need to be determined if any of the bones in the finger have been broken.

Treatment of Fingertip Injuries

How the injury will be treated depends solely on the type of injury itself. Here are some examples:

  • Severe crush injuries may mean that some tissue needs to be removed or the whole finger has to be removed.
  • It bone has been exposed, then skin grafts may be used to cover the injury.
  • If soft tissue has been lost, then this may be replaced along with skin grafts to cover the area.
  • At times, a flap of skin is lifted from the adjacent finger and used to cover the injury and provide blood flow while the finger heals. Once the wound is healing, the flap can be stitched back down to its original finger site.
  • If the finger has been fractured, then a splint will be used to stabilize the area.
  • If the fracture is severe, then pins may be placed within the finger bone to help it set in the proper manner.

If damage to the fingertip is extremely severe, then likely, amputation will be needed. Thats because it is very hard to replace tissues in the finger when most of the existing tissue has been destroyed.

Injuries to the fingertip can mean loss of sensation for a long time. In fact, some people report it taking several months to get full feeling back in the finger. Scarring to the nailbed may mean the fingernail grows back deformed or does not grow back at all.

Every day, your fingers are exposed to injury. So, it should come as no surprise that fingertip injuries are common. Depending on the type of injury or trauma, there could be ways to treat the situation and return the finger to normal function, but in severe cases, the finger may be lost altogether.

Resources:

http://orthoinfo.aaos.org/topic.cfm?topic=A00014

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Fingers General

When You Have Trigger Finger

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If you understand that your fingers are constructed of pulley-like tissue known as tendons, and that these are what bend and flex the thumb and fingers, it is a very helpful visual for a diagnosis of trigger finger. This is because the condition, which is technically known as stenosing tenosynovitis, occurs when one of the pulleys at the bottom of a finger (or thumb) thickens and can no longer move fluidly. Essentially, it will lock the finger in an unnatural, curved position, and become an ongoing and worsening condition.

To envision what is happening when you suffer trigger finger, try to envision a series of pulleys, which are ring shaped structures through which ropes run in order to lift or move objects. So, your finger is a series of bones, and connected to them are those pulleys, and through those pulleys run tendons that connect to muscles and which cause the fingers to bend and flex when needed.

Imagine if a pulley at the bottom of a finger got clogged with a sticky residue that caused the tendon to catch or be unable to glide freely through the pulley. This would cause the tendon to become irritate with repeated catching issues, and this irritation would lead to swelling. This is what happens with trigger finger, and eventually, the tendon below the lowest pulley will swell to such as degree, or even form a nodule, that it cannot pass back upward through the pulley. This locks the finger in that hooked position, that looks similar to someone pressing the trigger of a pistol.

Why Does This Happen?

Obviously, it makes many wonder why the pulley would swell in the first place, and experts are not quite sure on the underlying cause. (ASSH.org, 2015) Some patients with arthritis may get this condition, and some with diabetes or gout will develop it. However, there are some who suffer trigger finger without any apparent cause, though trauma to the hand does seem to be related to the development of some cases.

It doesn’t happen instantly, though, and there are indicators that you may be developing trigger finger. You may have discomfort in your palm or tenderness when pressure is applied. Additionally, the sensation of the middle or large knuckle catching is often an indicator (though it is not the precise location of the problem) that trigger finger may be developing.

Trigger Finger Treatment

How does a hand doctor unlock this caught tendon? The first steps are to attempt to reduce the swelling and allow the tendon to begin moving freely again. This can often be done with a combination of splinting and anti-inflammatory medications. Injectable steroids may also be used to release or reduce the swelling. Should these conservative efforts fail, the next step is to perform a surgical release that opens the pulley and allows the tendon to return to its normal position.

Any treatment must be done by a hand doctor, and therapy is often required to ensure that the problem has been resolved and that the pulley is no longer causing the tendon to be captured.

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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.