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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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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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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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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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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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Patient

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.