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Elbows General

Funny Bone Facts – Arora Hand Surgery

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The so-called funny bone is actually not a bone. And when you whack it on something, it really is not all that funny. So what is the “funny bone,” and why does it cause so much discomfort when you hit it?

Actually, the funny bone is the ulnar nerve. This is a nerve that extends all the way from your neck to your hand, sending impulses to your hand and your forearm. It terminates at the point where your pinky finger and your ring finger join.

Why the Discomfort?

The ulnar nerve, like all the other nerves in your body, is protected by ligaments, muscles and bones throughout most of its length. However, when it reaches the elbow, it passes through the cubital tunnel. At that point, its only protection is fat and skin, and that makes it highly vulnerable to impact. When you hit it, the nerve comes up against the bone and becomes compressed. That is what causes the tingling, numbness and pain that shoots down your forearm, through your hand and into your fingers.

How Did It Get Its Name?

This is a matter that has been long debated. Some believe that the term is actually a pun, since the nerve runs along the bone known as the humerus, which, of course, sounds just lie “humorous.” Another school of thought is that the name is derived from the “funny” feeling that you get when you hit it. Regardless of the origin, though, our opinion is still that there really isnt anything all that “funny” about a blow to the ulnar nerve.

Could Matters Be Worse?

Yes, actually, they could. Imagine having the sensation of a blow to the funny bone that never goes away. Sometimes it happens, and the condition is known as cubital tunnel syndrome. This occurs when the ulnar nerve becomes obstructed, and then ends up being squeezed or pinched. Often, this is caused by sleeping with your arm folded under you. You get the same feeling as when you hit the funny bone – in other words, tingling, numbness and pain. The trouble is that it lasts longer, and eventually, it may not go away. If the irritation of the nerve is constant, numbness settles in, and the forearm and hand muscles weaken. Then, the ring and pinky fingers can end up curled into a claw-like position.

Treating Cubital Tunnel Syndrome

The most important thing you can do if you have cubital tunnel syndrome is to correct the posture that is causing the pressure on the ulnar nerve. Most often, the pressure is caused when you are sleeping, so putting a pillow under your arm before you go to sleep may offer some relief. If this doesnt help, then your doctor may consider splinting the elbow for a period of time. Hand therapy can also be helpful. In extreme cases, you may need surgery to open up the tunnel so that the nerve has more space, and the pressure on it is reduced.

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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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General Hands

Dealing With a Distal Radius Fracture

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A distal radius fracture can occur for a number of different reasons. Often, it happens when a person falls and lands on their outstretched hands with their palms hitting the surface of the floor or ground. It also happens in a number of car accidents because people will often put out their arms at the moment of impact, which causes the bone to fracture. The bone known as the radius will break. This is actually a common type of injury, and in some cases, the bone of the forearm will break as well.

What Are the Symptoms?

Those who suffer from a distal radius fracture will be in a substantial amount of pain, and the area around the break will swell. In many cases, this will cause a deformity in the wrist. Those who believe they have a fracture should visit the doctor so they can have an x-ray taken of the location. This will let the doctor determine whether there is a break, and the severity of the break. You may want to consider visiting an orthopedist, as they specialize in the field of bones. If the pain is severe, the fracture is open (the break comes through the skin), or if there is numbness in the area, you should visit the emergency room.

It is possible to treat a distal radius fracture in a number of different ways. The option chosen will depend on a number of factors including the nature of the injury and the patients history and age. In some cases, it may only need splinting and then a cast to heal, as long as the bone is in a good position. The cast will typically be removed after about six weeks. Again, it depends on the patient and the severity of the injury.

Treating a Distal Radius Fracture with Surgery

In some cases, a surgical option is the best way to deal with the injury. With some patients, the bone may be in a bad position, and it would not heal properly and allow the patient to make full use of their wrist. In those cases, surgery can help. The type of surgery can differ depending on the injury. Some may require and incision, and others may not. Once the doctor puts the bone in the proper position, they may choose to hold it in place with a cast, or they might hold it in place with metal pins or screws, or other techniques.

The healing time after the surgery will vary based on the type of surgery, and the patients natural ability to heal. In most cases, surgery will not be necessary, but the orthopedic surgeon will let you know what the best course of action will be for your wrist and hand to heal properly.

Those who have a distal radius fracture, or any other type of injury to the hand, forearm, and elbow should make sure they get in touch with a high quality, reputable orthopedic specialist. They need to make sue that they have the best care and treatment for their injury so they can heal properly.

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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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General Hands

Hand Fractures: Symptoms and Treatment

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Take a moment to imagine what life would be like without having the ability to use one of your hands? It would be difficult to drive, dress, shower, and complete all of the activities that you currently take for granted. However, hand fractures are more common than many believe. Whether you were in a car accident, a sporting accident, had your hand slammed in a car door, or anything else, the damage can be severe, and you need to know what to expect and how to treat these types of injuries.

What Happens With a Hand Fracture?

The term “hand fracture” encompasses many different bones. Each hand has 27 bones, and any of them could fracture and need treatment. Bones in the hand could break near the wrist, near the knuckle, or closer to the middle part of the bone. When a break occurs, you will feel pain and experience swelling. Some may also see a deformity in their hand based on the severity of the break and the amount of swelling. It will not be possible to move the fingers, at least not without a massive amount of pain. The knuckle may have an indented or depressed appearance and the affected finger could appear shorter than it should.

To determine the type of injury and the severity of the injury, the doctor will need to take an x-ray. This will give them an inside look at the fracture to determine the precise location and the type of fracture it is. Some patients will also undergo a test to ascertain the range of motion they have left in the hand, as well as a sensation test. The sensation test tries to determine if there is any nerve damage to the hand.

Types of Treatment

With many hand fractures, it will be possible for the doctor to move the bones and realign them without surgery so that they can heal properly. Once they have the bones in alignment, they will apply a brace, splint, or a cast, which will help to keep the bones in place until they can heal properly. After setting the hand, the doctor will want to take a second set of x-rays (generally about a week afterwards) to ensure they are set properly and healing. The length of time that you are in the cast will vary, but it is typically about three to four weeks.

Some types of hand fractures are much more severe though, and they will require surgery. If the hand has been crushed or the fracture causes pieces of the bone to protrude through the skin, surgery is in order. The hand surgeon will use a variety of techniques and implants, such as wires or plates, to help keep the bones aligned during the healing process. In some cases, they will remove the implants after the bone heals; other times, they will need to remain in the hand. After the surgery, you may need to do exercises and therapy to restore the mobility of your hand.

Hand fractures can be serious and those who feel they may have a broken bone in their hand should seek the advice of a medical professional as soon as possible.

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General Wrists

Carpal Tunnel Syndrome Symptoms, Causes, and Treatments

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Many people do not even realize that they are beginning to get carpal tunnel, as it has a tendency to start slowly. It will often begin with a numb or tingling sensation that starts in the fingers. In the beginning, this is not permanent. Sometimes you will feel it and sometimes you will not. Most of the time, you will not feel it in your little finger, but you will feel this sensation in your thumb and the other fingers.

You may begin to feel this when you are gripping something, such as a phone or tablet, when you are reading, typing, or even driving. In some cases, it can even cause people to wake up at night. While most people will only feel it in their hands and fingers at first, it is possible to have the feeling spread up the forearm. As carpel tunnel worsens, these sensations become permanent quite often.

Many who have carpal tunnel will also find that they have weakness in their hands, making it more difficult to hold onto things with a good grip. Those who have these signs and symptoms should certainly consider speaking with a doctor about what they can do next and whether surgery will be necessary.

What Causes Carpal Tunnel?

When the median nerve in the wrist is compressed, it causes carpal tunnel syndrome. The nerve extends from the hand, through the carpal tunnel, and up through the forearm. It may be difficult to isolate the cause of the carpal tunnel. It is more prevalent in women than in men. Certain anatomical factors can be a cause as well. Those who have smaller carpal tunnels are at a higher likelihood of injury. Other causes can include diabetes and other conditions that damage the nerves, fluid retention, obesity, and of course, factors in the workplace. In any job where there is repetitive flexing of the wrist, there is a chance of people developing carpal tunnel syndrome.

Endoscopic Carpal Tunnel Surgery

Several different options are available for carpal tunnel treatment, and endoscopic surgery is one of the top choices for many. One of the benefits of getting endoscopic surgery is that the incisions tend to be small and the recovery time minimal for most types of surgery. This includes surgery to help people deal with their carpal tunnel syndrome. The surgeons will make a small incision in the hand, near the wrist, and then guide the endoscope into the hand to see the wrist. The tools utilized tend to be very small, which also go through the small incision.

During the surgery, the surgeon will cut the transverse carpal ligament as a means to help reduce the amount of pressure being placed on the median nerve. The goal is to help eliminate the symptoms that people with carpal tunnel suffer. While there are certainly benefits to the smaller incisions, endoscopic surgery may not be the right solution for everyone. You will need to speak with your hand surgery specialist about the best course of action for your own hands.

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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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General

When Should You Talk With a Hand Specialist?

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Your hands are vital to all of the things that you do in your daily life. You use them to type, to use your phone, to get dressed, drive, eat, and so much more. Most people tend to take their hands and their wrists for granted. Take a moment to think about all of the normal things that you do each day. Now, try to imagine doing those things without the use of your hands. You will find that most of the things that you do would no longer be possible, at least they would not be as easy to do as they are now. You need to take good care of your hands, and that means you need to know when to talk with a hand specialist about issues you might be having.

Uncontrollable Swelling

Having swollen hands and wrists happens occasionally, and most of the time it goes away quickly and doesnt return. Other times, the swelling is persistent, and this could be a sign of trouble to come. In some cases, the swelling could be the result of arthritis. Other times, it might be due to an injury caused by repetitive motion. This could lead to carpal tunnel syndrome if it hasnt already – we will touch more on this later in the article. In some cases the swelling will affect not only the hands and wrist, but also the elbow. It is a smart idea to contact a hand specialist sooner rather than later so the problem does not get worse.

Trouble Moving the Hand

If you have issues moving your hand or your wrist, it could be a sign of a number of different problems. You may have arthritis, or you could even be suffering from a hairline fracture. Regardless of the cause, this type of pain in the joints means that you need to get in touch with a specialist to help determine the issue. When you are able to catch these types of problems early, it can help to make recovery much easier. In some cases, you may be able to make some changes that will help you avoid surgery. Other times, surgery might be the best option for you. A specialist will let you know what you should be doing to heal properly.

Numbness

If you experience a tingling sensation or numbness in your wrist and fingers, it could also be a sign that you are suffering from a hand injury that will only worsen over time. This could be one of the early signs of carpal tunnel syndrome, and catching it early can help you to eliminate the need for surgery later.

Whenever There Is a Concern

Ultimately, you will want to speak with a hand specialist whenever you feel any concern over the function, health, and safety of your hands, wrists, and elbows. Its always best to be cautious and to try to catch any potential problems early. Of course, if you suffer from a serious injury, such as a fracture, a serious burn, or a crushing injury, your first stop should be the emergency room. Then, you can get in touch with a hand specialist to determine how to proceed and get the right treatment.

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General Hands

Most Common Ways to Injure the Hand

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The hand is one of the most impressive parts of the human body. Its a complex piece of biological machinery that lets people hold and manipulate items in ways that other creatures cant. If not for our hands, despite the power of the human brain, we may not have evolved to become the most dominant species on the planet. As important as our hands might be, they are also prone to injury. If you injure your hand, you will find that you cant do many of the things that you take for granted right now. For example, you would not be able to use your phone or tablet. Typing would be difficult, even driving and opening doors would be difficult if you do not have full use of your hands!

What Types of Injuries Affect the Hand?

The hand is exposed to many different types of injuries. Lacerations are quite common. Cutting your hand with a knife in the kitchen, for example, has happened to nearly everyone. Most of the time, cleanup and a bandage are all that you need. In severe cases though, there could be a deep cut that includes nerve damage. In those instances surgery would likely be necessary to restore full function of the hand.

Fractures and dislocations are common as well. These types of injuries could require the doctor to set the bone, and then splint or cast it so it can heal properly. In the event that the bones are not setting properly, it could require hand surgery. Other potential injuries from the hands come from burns, infections, crushing, soft tissue injuries, and amputations. Naturally, the symptoms for these different types of injuries vary.

Anyone who has a hand injury thats more than just a small cut or bruise may want to seek out a medical professional. Even with the small cuts, you will need to be careful to ensure that infection does not set in and cause more issues to the hand.

If there are any deep wounds, fractures, dislocations, bites, or burns (other than minor burns), contact a physician to get the proper care. Whenever there is any doubt as to whether it is a minor injury that can heal on its own or a more substantial injury, you should err on the side of caution and speak with a doctor.

Treating the Injuries

Because there are so many different types of hand injuries, the types of treatments necessary to repair the problem vary quite a bit. In some cases, simply resting the hand may be all that you need. For those who have a fracture, they will need to have the hand doctor set the bone and make sure it heals properly, as mentioned. Those who have burns will need a different course of treatment, and those who have amputated fingers will need a variety of treatments. In some instances, reattachment of a lost finger may be possible. However, regaining full function of the finger is not a guarantee.

Talk with your doctor about your injuries to determine the proper course of treatment, and with a hand surgeon for those issues that require surgery to correct properly. Its the best way to minimize your risks.

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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.