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Conditions General Hands

Common Causes of Hand Problems in Children

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Problems in Children's Hands

You cannot overestimate how important the human hand is when it comes to development and the ability to achieve and complete tasks. There are a lot of congenital defects that may affect a child’s hands. There are a few hand problems in children that are very common, and they range from minor issues to some that are major and may require the child to have some sort of surgical correction.

Congenital problems with the hands stem from something that went wrong as the child was developing in the mother’s womb. It is important to recognize that as a child is developing, there are thousands of different processes that are taking place at the same time for every part in the body.

Arm development begins somewhere between four to six weeks after pregnancy. Over time, signals are sent that lead to the development of the bones, muscles and tissues that eventually end up being the hand. If at any time during this process just one step is confused or just one step is thrown off, a congenital hand problem can develop.

Some of the more common hand problems in children include:

  • webbed fingers
  • fused fingers
  • missing hands or fingers
  • extra fingers
  • fetal band syndrome.

Many people are surprised to learn that just about one out of every 20 children is going to have some kind of hand problem. Many of these hand problems are so minor that doctors do not need to do anything to correct them. However, others are so severe that if doctors do not take immediate steps to correct them, they can lead to problems for the child down the road.

As an example, if a child has webbed or fused fingers, this can be easily fixed through surgery not too long after the child is born. Or if the child has an extra digit, in most cases, surgery can be used to correct this. Most congenital hand problems in children can be treated using some form of surgery.

When treating hand problems in children, the end goal is to help the child have as normal a life as possible. If your child has an issue with his or her hand(s), schedule a consultation at Arora Hand Surgery, with offices in West Bloomfield, Howell, Warren, and Macomb. Contact us today to book an appointment to learn about the available treatment options.

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General Hands

Determining if Your Child Has Hand Problems

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Child Hand Problems

Hand problems can range from trivial to disabling. As it is not always easy to judge the severity of a hand injury, getting to a doctor after injuring your hand is prudent. When it comes to your child, it is even more important to diagnose the cause of his or her hand problems as quickly as possible.

Sprains and Dislocations of the Finger

Finger sprains and dislocations are among the most common injuries that cause hand problems. The most frequently injured joint is the proximal interphalangeal (PIP) joint. The PIP joint sits between the first and second finger bones, with the first or proximal fingerbone being the nearest to the hand.

Accidents like jamming a finger while playing basketball can force the joint to bend backward, a condition known as hyperextension. Under normal conditions, the joint has ligaments and tissues that keep the fingers from bending sideways or backward. In a sprain, those tissues are stretched or partially torn, causing swelling and stiffness.

In a dislocation, the tissues are completely torn, and the joint’s bones become separated and misaligned. Like a sprain, a dislocation is accompanied by swelling and stiffness. Since it is not easy to determine the severity of a sprain or dislocation, a child suspected of having such an injury should be taken to a doctor. While splinting and icing a joint can take care of a sprain, a dislocation requires medical intervention to properly realign the joints.

Hand Problems from a Broken Wrist

A broken wrist is a common sports injury, especially in football, but it can occur anytime somebody tries to break a fall with an outstretched hand. The joint most commonly affected is the scaphoid. A child with a fractured scaphoid will have a swollen and painful wrist, but they will still be able to move it. Scaphoid fractures are among the more notoriously hard hand problems to detect, especially during the first week. Our doctor may therefore recommend taking a repeat X-ray after that week.

Hand Problems from Animal bites

As with practically every other part of the human body, some hand problems and injuries can result in infections. Animal bites are a common cause of infections; cat bites are especially infamous for causing an infection. Cats have small and narrow teeth that can penetrate deep into the skin. The resulting small punctures heal deceptively quickly and trap the bacteria from the cat’s mouth under the skin. In some cases, this can result in an abscess. An infected hand will be red, abnormally warm, and swollen. There may also be red streaks near the wound. The child may also have a fever, sweats, or chills.

When to Call for Help

A parent should take their child to visit Dr. Arora if any of the following are true:

  • The child’s hand looks “wrong” and is in a strange shape or position.
  • The child is in severe pain
  • There is a lot of swelling within 30 minutes after an injury
  • The child still has a lot of pain and swelling two days after getting hurt
  • There are signs of nerve damage like tingling, numbness, or weakness
  • There are signs of infection like redness, warmth, fever and increased pain
  • The skin is pale or blue and feels colder than the skin on the uninjured hand.

At Arora Hand Surgery, our skilled and experienced doctor will be able to diagnose the cause and severity of your child’s hand problems. You can rest assured you receive the comprehensive, personalized care you deserve when you choose Dr. Arora. Contact one of our offices in Macomb, Warren, Howell, or West Bloomfield to schedule your consultation.

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Conditions General Hands

What is Kienbock’s Disease?

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What is Kienbock's disease, and how is it treated? A basic overview is provided in our hand surgery blog.

What is Kienbock’s disease, and how is it treated? Those are the first questions patients may ask upon hearing this phrase.

Following are some of the basic facts about this hand condition.

What is Kienbock’s Disease, and What Causes It?

Also known as avascular necrosis of the lunate, Kienbock’s disease is a condition in which the blood supply feeding the lunate is somehow blocked. The lunate, which is one of the eight bones in the wrist, eventually dies and collapses. The condition, which usually involves only one wrist, is most common in young men.

Kienbock’s disease has multiple causes. It can be caused by such congenital defects like an abnormally short ulna. The radius and ulna are both forearm bones, and they share the force transferred from the hand to the forearm when the person grips something. An abnormally short ulna puts all of the pressure on the radius. The lunate, which is between the radius and the capitate bone, ends up absorbing excess pressure.

The disease can also be caused by injuries to the wrist, be they a single acute injury or chronic repetitive injuries that damage the blood vessels. Diseases that affect the blood vessels like sickle cell anemia can also cause Kienbock’s disease.

What are the Symptoms?

The chief symptoms of Kienbock’s disease are wrist pain coupled with limited mobility. The patient may also have trouble gripping items. During the early stages, the patient may feel only pain during or after actually using their wrist. As the disease progresses, the pain becomes constant.

A patient with this disease may also develop swelling in the wrist. The area around the lunate, the lower palm below the little and ring fingers, may become tender. The patient may also develop arthritis, but that symptom is associated with late-stage Kienbock’s disease, which takes years to develop.

How is the Disease Diagnosed?

During the early stages, the disease can be difficult to diagnose. Dr. Arora will likely begin by taking a medical history and examining the wrist. He will also order X-rays and MRIs. The X-rays can be used to determine how badly the lunate has deteriorated, while the MRI can be used to determine the damage to the blood vessels feeding the lunate. If necessary, the doctor may also order a CT scan of the bones.

What are the Treatments for Kienbock’s Disease?

There are several treatments for Kienbock’s disease. As the disease has several stages, the treatments vary accordingly. If our team catches the condition early, the wrist can be immobilized. This treatment is intended to let the damaged blood vessels and lunate heal on their own.

If the immobilization proves unsuccessful, or the patient has late-stage Kienbock’s disease, our doctor will recommend surgery. He may also recommend surgery if the Kienbock’s is caused by a birth defect, like an abnormally short ulna. In that situation, Dr. Arora can lengthen the ulna, shorten the radius or fuse certain bones so that the two bones meet the wrist bones above them properly.

The types of surgical procedures used will depend on how advanced the disease is. Wrist fusion, for example, is a procedure typically used for very late-stage Kienbock’s characterized by a wholly arthritic wrist.

Schedule a consultation at Arora Hand Surgery in West Bloomfield, Howell, Warren, or Macomb to have your condition evaluated and to learn more about what Kienbock’s disease is. Contact us today to book your appointment and get started with a treatment plan that can bring you relief.

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General Hands

Need to Know Information About Hand Joint Replacement

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Patients who are suffering from debilitating cases of arthritis, and who are unable to find relief through other types of treatment, turn to surgery for help. One of the procedures that can help these sufferers is joint replacement surgery, also known as arthroplasty. They actually replace the small joints in the hand, including the knuckles.

Why Do People Need Joint Replacement Surgery for the Hand?

The hands undergo a substantial amount of stress each day, and it can take a toll on the joints. For those who are typing all day, for example, the joints can start to swell and cause a lot of pain. The joints become stiff and achy, and it can limit the mobility of the hand and fingers. Ultimately, this becomes a quality of life issue. People are in near constant pain, and it is difficult for them to do normal daily tasks.

When resting and using medications no longer helps, the doctor will consider different types of surgery to find the procedure that will help the patient the best. They may consider fusing the joint as well as removing cartilage growth and bone spurs from the area. Those who are older and who have a lower level of activity will often be good candidates for the joint replacement surgery. It can relieve pain and improve mobility. However, older patients are not the only ones who can benefit. You can discuss with your surgeon which option could help you the most.

What Types of Joint Replacement Options Exist?

Your doctor will be able to replace nearly any of the joints in your hand. A DIP join, which is the joint that is the closest to the tip of your finger, can be a very difficult joint replacement, simply because the bones are so small. The most common joint replacement is a PIP replacement, which replaces the second joint from the tip of the finger. The most common fingers to receive these new joints are the little finger and the ring finger. The MCP joint is the third joint from the tip of the finger, and the thumb basal joint is where the thumb connects to the wrist.

When you have your consultation with the surgeon, you can discuss whether your hand condition makes you a good candidate for this type of surgery, or if you might benefit from a different procedure. All surgeries in the hand are complex, and they take a very skilled surgeon.

When you are choosing a hand surgeon, make sure that you vet them to ensure they are capable of providing you with the quality surgery and care that you need. You will also want to evaluate the team that works with them, so you can be sure you are getting the best overall treatment. Make sure that you discuss the pros and the cons, as well as what to expect during and after the procedure, including your recovery time. While joint replacement might not be the solution for all arthritis sufferers, it is something that you and the doctor can discuss.

If you have any questions about hand joint replacement surgery, please call or visit our hand surgeon’s office in West Bloomfield, Howell, Warren, or Macomb.

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General Hands

An Overview Of Crush Injuries To The Hands – Arora Hand Surgery

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A crush injury to your hand occurs when your hand is caught between objects that are coming together under a lot of pressure. The damage can be minimal (perhaps just a bit of bruising), or bad enough to involve several broken bones, lacerations, bleeding, and a condition known as “compartment syndrome.” The severity of the injury often depends on how long the hand was between the objects.

Effects of a Crush Injury

A minor crush injury will usually have no lasting effects. For instance, if you slam a finger in a door, most of the time you will be in pain for a day or two, and then you will go about your life and forget about it.

With major crush injuries, there can be damage to the hand well below the skin. If the flow of blood has been cut off for any length of time, tissue damage could result, and the chance of infection will increase. Layers of skin could be removed, further raising he danger of infection. In severe cases, infection can even lead to the need for amputation.

With some crush injuries, compartment syndrome can be a complication. This occurs when the tissues are left without blood for a long period of time. The nerves can become damaged, and muscle tissue can die. Compartment syndrome usually happens in the legs, but it can happen anywhere in the body if the affected part has been trapped for too long. It is rare in the hand, but it can occur. When it sets in, the first symptom is severe pain, followed by a “pins and needles” sensation. Then paralysis sets in, and the hand has no pulse. The skin may appear shiny and swollen.

Treating Crush Injuries

With a minor crush injury, you probably will not require medical attention. If the wound is bleeding, make sure that you clean it. You can elevate the hand, and apply a cold pack to ease the pain. If swelling seems to be excessive, though, or you have little or no mobility, you should see your doctor or go to the hospital emergency room. Most likely the hand will need to be x-rayed in order to determine if there is a fracture. This is important, because fractures can cause compartment syndrome.

If there is moderate to heavy bleeding, you will probably need medical intervention. At the very minimum, you will need a tetanus shot if your immunization is not up to date (a tetanus shot is good for ten years). You may also require antibiotics. It is also important to determine if the injury is severe enough to warrant surgery to ease pressure on the nerves and blood vessels, or to repair broken bones. In some cases, severe crush injuries can require multiple surgeries.

The Final Word

Minor crush injuries may require no treatment at all. Just, as they say, “Walk it off.” However, if the injury is severe, you should seek medical assistant immediately.
For any questions call our Michigan Hand & Wrist Surgery Office at (734) 943-3838 or (248) 485-8300.

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General Hands

Hand Fractures in Children and Treatment Options

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The symptoms of hand fractures in children do not really differ from those in adults, but treatment methods are often different, simply because a childs bones are still growing, and will heal differently from those of an adult.

Signs of a Broken Bone

Some signs of a broken bone are perfectly obvious. For instance, if a bone is protruding through the skin, that is clearly a compound fracture. Other indications of broken bones can include:

  • Bruising, bleeding or swelling
  • Extreme pain
  • Numbness, tingling, or weakness
  • A joint or bone that looks as if it is misshapen or out of place
  • Difficulty moving the hand

When a child or teenager breaks a bone, most likely there will be significant pain at the break site, and they will find it difficult to move the affected area. Pain and/or loss of movement mean that you should take your child to the emergency room.

Diagnosing Hand Fractures in Children

First, the doctor will examine your childs hand to determine how the bones are lining up when the hand is moved. He or she will also check for related injuries, like damage to the joints, ligaments, tendons, and the tissue under the fingernail. If it appears as though one or more bones are fractured, x-rays will be needed so that the doctor can determine how to proceed with treatment. Usually, x-rays are taken from three different angles so that the breakage can be clearly identified.

A proper diagnosis is extremely important, because a simple break can usually be treated effectively with a cast or a splint, whereas breaks that are more complex may necessitate surgery. Additionally, the bone may be broken near a growth plate. Growth plates themselves cannot be seen on x-rays, but some indications of damage may be present. If this is the case, magnetic resonance imaging (MRI) or another type of scan may be needed to identify damage to the growth plate area.

Healing

Children are considerably more flexible than adults, so their bones could actually bend after breaking, and then straighten out during the healing process. This is known as “remodeling,” and it is actually an advantage that a young person has – because of the remodeling process, the broken bone will require less treatment, and will heal more effectively, than the same type of break in an adult. Some types of fractures, though, may look simple, but actually cause problems that affect bone growth. This is because of the “growth points” that we mentioned previously. In children and teenagers, bone growth happens at these specific points. Often, these growth points occur near the ends of the bones, and if they are damaged, the bone could actually stop growing. This can stop a bone from developing and change the way in which it is functioned. If only a part of the growth point is harmed, then the bone could grow unevenly.

Conclusion

In children, it is very important that fractures be properly identified and treated. Treating a childs hand fracture will require procedures different from those used in treating adults.

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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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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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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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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.