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General Treatments

How Does a Fractured Arm Heal? – Arora Hand Surgery

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Fractures are very common injuries, and the healing process is essentially the same for all fractures – it happens in stages, as new bone begins to form and fill in the area that was fractured. With severe fractures, healing may happen more slowly. A fractured arm heals in five stages:

  1. Inflammation

This is the stage where swelling occurs. It begins when you incur the fracture, and it is caused by bleeding from the bone and tissue. This stage typically lasts anywhere from 2-3 weeks.

  1. Soft Callus

Around the third or fourth week, the swelling will ease and the injury will become less painful. Stiffness will occur as the new bone begins to develop. This stage typically lasts between 4-8 weeks.

  1. Hard Callus

In 1-2 months, the fracture is bridged by the growth of new bone. Within 3 months, new bone should have filled in the fracture.

  1. Bone Remodeling

At the 3-4 month point, the site of the fracture begins to remodel itself. This is when deformities that may have occurred as a result of the injury begin to correct themselves. In adults, this will probably take the full 4 months. Children typically heal more quickly.

Complications

Most of the time, fractures will heal without complications. That said, though, most of the time fractures are also due to a severe injury, and sometimes that injury can result in swelling that is so bad that pressure is placed on the blood vessels, preventing blood from getting to the muscles surrounding the fracture. When this happens a condition known as “compartment syndrome” can result – the muscles begin to die, and long-term disability can result. In extreme cases, amputation of the affected limb may be necessary.

Other complications can include:

  • Infection – In cases of an open fracture, the bone ends are exposed to air and contaminants, and infection can result. In severe cases, infections due to arm fractures can lead to the need for intravenous antibiotics, and possibly several days in hospital.
  • Neurovascular Injury – This is a type of complication that can occur when the injury is so severe that the nerves and blood vessels around the injury are also harmed. Usually surgery is needed to repair the damage.
  • Growth Abnormality – This is a type of complication that occurs when a childs bone is fractured. One side of the arm bone, or even the entire bone, stops growing normally, and develops an abnormal angle. This can result in one arm ending up shorter than the other.
  • Post-Traumatic Arthritis – When a fracture extends into the joint, the bones can meet abnormally, and premature arthritis can result.

Most of the time, complications will not occur. Broken arms happen with great regularity, and generally speaking, they heal as they should. When the injury is severe, though, and complications result, medical professionals have a number of ways of dealing with them. Assuming that you follow your doctors directions, you can usually expect a full recovery, free of complications, from a broken arm.

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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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General Hands

Beware of the Text Claw! – Arora Hand Surgery

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This condition is not an official medical diagnosis just yet, but give it time. Text claw is also sometimes referred to as texters thumb, and anyone who uses their smartphone a lot knows the kind of workout that their thumbs get. Prolonged use can lead to cramping and soreness not just in the thumbs, but in the wrist, fingers and forearms.

This is because texting is what is known as “fine motor activity,” and it can lead to muscle or tendon pain. It may not even be due to texting – any type of fine motor activity, be it peeling vegetables, rolling a cigar, or doing needlepoint, can lead to this type of discomfort.

So Why Text Claw?

We perform fine motor activities every day. The problem is that in recent years, we have added smartphone use to our daily activities, thereby increasing the level and frequency of our fine motor activities. Essentially, we are overusing our hands, fingers and thumbs, and the evolutionary process has not yet caught up to the point where we are naturally adapted to that increased use. Because we are so welded to our smartphones, we run an increased risk of inflammation in the tendons that attach the muscles and bones in our hands.

But Im Using My Thumbs – Why Do My Hands Hurt?

Everything is connected. Your thumbs might seem as though theyre doing all the work, but because of the connection to the rest of your hand, the repetitive motions cause pain throughout. Keep it up, and eventually your muscles can become scarred and fibrotic. This leads to loss of strength, reduced mobility, and pain. Your thumbs and fingers may even begin to turn inward, hence the term “text claw.”

Treatment

If you are determined that you simply cant live without your smartphone for any length of time, here are five things that you can do to reduce the pain and improve flexibility.

  1. Apply Heat – Using a hot towel or heating pad can help to ease the pain and relax your muscles.
  2. Stretch – Hold your arm outward with the hand extending backward, and reach forward. This will stretch your tendons and muscles.
  3. Massage – As you stretch, look for tight areas. See if there are any nodules in your forearm. They will feel like little balls. Rub gently, pressing downward. This eases the tension. Make sure you dont overdo it, though, and dont press too hard on or near your thumb. This is because there is a large nerve in that area, and it can hurt if you press too hard.
  4. Pray – Not literally, unless you feel so inclined. But hold your hands together in a prayer-like position, and hold for several seconds. Repeat 6-8 times.
  5. Flex – With your palm up and your wrist turned down, pull your fingers gently toward your body. Next, turn your wrist up and press your fingers gently away from your body. Repeat 6-8 times.

Take a Break

If it is obvious that your pain is due to texting, you really should take it easy. Consider downloading a voice app so that you dont have to use your hands quite so much.

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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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General Hands Treatments

Is Hand Surgery Right for You? – Arora Hand Surgery

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Do you have issues with your hands? Are they painful and swollen much of the time, and does it cause you pain to do many of the things that youve always done and taken for granted, such as driving, holding a grandchild, or just typing? Have you had an injury to your hand, or have you developed a cyst or tumor on the hand? Many different things can go wrong with the hands, which are easily one of the most important, and often underappreciated, parts of the human body.

Determining the Right Course of Action

While some types of hand injuries can be remedied with medicine and rest, there are other injuries that could require surgical treatment. However, surgery is not the right option for all patients. Most of the time, doctors will want to avoid surgery unless it is the only or best option, and if other types of treatment have no effect.

You will need to speak with your hand specialist about whether surgery would work for your type of issue or not. In addition, you need to make sure that you are actually a good candidate for surgery.

You and the doctor will need to sit down and discuss the problems you are having with your hands (as they can vary so widely) and then come up with the best course of treatment. In some cases, they may want to move forward and consider surgery, but they need to make sure it you are actually a viable candidate. They will consider the type of condition and the severity, as well as whether you have exhausted other means of treatment. The doctor also wants to make sure you are healthy enough to have surgery, so they will ask a number of questions about your medical history and run tests.

In some cases, the patient may not be a good candidate. If they are smokers, are overweight or have other issues that could cause problems with the surgery, the doctors may request that they make some lifestyle changes first, to help make the surgery go more smoothly. Of course, this really depends on each individual case, and is something you can discuss with your hand specialist.

When you are speaking with the hand surgeon about the possibility of getting surgery, you should ask about the specific type of procedure being performed, the length of the procedure, how long it will take to heal, and what types of hand therapy might be necessary after the surgery. Getting answers to all of these questions in advance can help you determine whether it is the right option for you.

Emergency Surgeries

Of course, some types of surgery simply cant wait. A compound fracture, a crushing injury and the like will require immediate hand surgery in an attempt to repair damage and set the bones so the hand can heal. Emergencies are handled differently.

Find a Great Surgeon

When you are considering hand surgery, whether it is cosmetic surgery, surgery for arthritis, or any other issue, make sure you take the time to research and locate a respected hand surgeon in your area.

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General

The Eraser Challenge: A Fad that is Dangerous to Skin

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There is no getting away from the fact that young people often do foolish things. Sometimes, they do things that can be very destructive, without even realizing the potential for harm. Much of the time, these activities are engaged in as a way of gaining the admiration of their peers. One such activity that has been making the rounds for a number of years, and has even given rise to disturbing You Tube videos, is the “Eraser Challenge.”

What is the Eraser Challenge?

With the Eraser Challenge, the participant takes an ordinary eraser, and rubs it on his hand or forearm while reciting the alphabet. With each letter, the participant must come up with a word that begins with that letter. If you cant get to the end of the alphabet and form a word beginning with each letter, you fail. If you drop out because you cant stand the pain, you lose – unless someone else drops out before you do.

In a variation on the game, participants may simply rub their skin with the eraser, foregoing the alphabet component, until they cant stand it any longer. The participant who stays in the game the longest is usually the winner. Of course, you might not be rubbing the eraser hard enough, so in order to discourage cheating of that sort, the winner may be the one deemed by his or her peers to have the worst wound. Participants have been known to do this until the skin comes off and they begin to bleed.

The Internet

Any number of disturbing “Eraser Challenge” images and videos can be found online. Often, young people photograph and record their injuries in an attempt at achieving some sort of fame. It is important to understand that this type of self-mutilation is very different from “cutting” and other destructive activities in that it is not obsessive-compulsive behavior – it is a means of establishing “cred.” It isnt a mental disorder; rather its a means of achieving peer recognition.

The Danger

Sometimes, the injuries are minimal. There is, however, a great deal of potential for infections and permanent scarring. In extreme cases, there can be permanent loss of function. Simply stated, no one ever “wins” the Eraser Challenge. The potential for harm in both the short and the long term is serious. Parents, teachers and school nurses need to be vigilant, and look for signs that young people are participating in this harmful behavior, and doctors need to be able to ask the right questions so that when a teen presents with serious abrasions, they can determine whether an explanation like, “I fell and scraped my arm,” actually makes sense, or whether it is a case of deliberate self-harm to gain the admiration of ones peers.

Conclusion

There is probably no way of stopping young people from engaging in every sort of self-destructive behavior. Parents and others who are charged with the wellbeing of our teens, however, have to be aware of current trends in youthful “one-upmanship” and be able to respond effectively.

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General Hands

What Is Causing Your Hand Pain? – Arora Hand Surgery

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Hand pain can occur for a wide variety of reasons. Some people may have a physical injury to their hand, while others might suffer from hand pain because of a disease, such as arthritis.

Tendonitis

When the tendons start to swell in the hands and along the wrist, it can cause a lot of pain. In some patients, the pain starts gradually and builds over time. In other patients, the pain seems to come on suddenly, and it can extend and radiate from the site of the swollen tendons to other areas of the hand and arm. This can make it difficult to do a number of normal tasks, as it can be hard to hold objects, and you may lose mobility in the hand.

Carpal Tunnel Syndrome

Another common cause of hand pain is carpal tunnel syndrome, affecting up to 3% of the people in the United States. Those who suffer can experience pain in their hand and fingers, as well as the wrist and the forearm. The swelling in the carpal tunnel places pressure on the median nerve, which causes these symptoms to emerge. In addition to pain, it can also cause the sufferer to feel weakness and tingling in their hands.

Fractures

It is possible to break bones in the hand, wrist, and forearm, and it may be easier than you want to believe. Even a small fracture can cause swelling, pain, stiffness, and an inability to move the affected area. Complex fractures and compound (open) fractures are even more dangerous.

Arthritis

Arthritis is one of the most common causes of hand pain. The cartilage in the joints begins to deteriorate, which can happen with age and with repetitive use. This eventually causes painful swelling that will limit the persons ability to function properly. Many different types of arthritis exist, and all of them can be difficult to treat and manage.

Trigger Finger

Someone who suffers from trigger finger has a finger or thumb that becomes locked in an angle. This can be annoying, and it can be painful. It can be difficult, and sometimes impossible, for the sufferer to straighten their digit without a substantial amount of pain. This can occur when there is injury or irritation of the flexor tendons.

Finding Treatments to Deal With Hand Pain

As you can see, there are a number of causes of hand pain, which means that the treatment that works for one will not necessarily work for another. When you are suffering from any type of hand pain, you will want to speak with hand specialist to get to the root cause of the problem. You can then discuss a good and workable course of treatment, which could include physical therapy, medication, and surgery to help eliminate your hand pain.

Always make sure you are going to a specialist in the field who has experience dealing with the hand, wrist, and elbow. While a general practitioner can be helpful, getting a referral to a specialist is generally your best bet.

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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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General Hands

Sprains in Toddlers and Babies

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As a parent, you know that toddlers and babies can move around in ways that sometimes seem very unusual to the adults who are observing them. And every so often, they will trip or fall, or twist in a way that causes an injury. You may be observing your child and asking yourself, “How does he do that without spraining something?”

The fact is, young children hardly ever develop sprains. They are actually far more likely to break a bone, since bones in babies and toddlers are much weaker than ligaments. That said, sprains, although rare, can happen.

Identifying a Sprain in Your Toddler or Baby

Symptoms of a sprain, in addition to obvious pain, can include:

  • Swelling
  • Bruising
  • Limping
  • Reluctance to walk, move or be touched

Often, it can be hard to tell whether the problem is a sprain or a break, since the symptoms can be quite similar. Sprains will generally heal on their own, but if you suspect a break, you should see your doctor or go to the emergency room.

Treating a Minor Sprain

If you think that your toddler or baby has experienced a sprain, you should first try to get the child to remain still – and yes, we do know how difficult that can be. Perhaps a favorite toy or DVD would be in order.

Next, keep the wrist or arm elevated by propping it up on a cushion, and apply cold treatments to the affected area. You should never apply ice directly to a sprain, so if you are using ice, wrap it in a towel first. There are also medical cold packs that you can keep in your freezer for just such an emergency. And in a pinch, a bag of frozen vegetables will serve the purpose. Make sure that you dont use cold compresses for any more than ten minutes at a time.

If the child is in a good deal of discomfort, you can use over-the-counter pain medications like ibuprofen or acetaminophen (Tylenol). Keep in mind, though, that aspirin is not recommended for children.

Preventing Sprains

Obviously, you do not want your child to be hurt. We sincerely hope that you have already installed baby gates at the top and foot of your stairs, but if you havent, please do so immediately. Also, make sure that floors (especially play areas) are kept as free as is reasonably possible from any tripping hazards.

Also, never buy shoes that you think your child will “grow into.” It is shocking how many parents do this, but think about it – how well would you walk in shoes that are a couple of sizes too big? Children are meant to wear shoes that fit their feet now, not shoes that will fit them a month or two down the road.

It is far better to prevent a sprain than it is to deal with it once it has occurred, so follow these basic safety measures so that your child can be protected from the possibility of a painful sprain.

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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.