Flexor Tendon Injuries: Causes, Symptoms And Treatment

by Administrator 25. April 2017 07:26

Tendons join the muscles to the bone and are responsible for the various hand movements. The tendons located on top of the fingers are known as extensor tendons and help to straighten the fingers. On the other hand, tendons located on the palm side are known as flexor tendons and assist in bending the fingers. Any injury in the hand can affect the flexor tendons and make thumb or finger movements difficult.
A flexor tendon injury can cause damage to the nerves in the fingers as well. In serious injuries, the blood vessels also get cut leaving the finger with no blood supply.

Causes

  • Sports injuries while wrestling or playing football
  • Rheumatoid Arthritis
  • Deep cuts on the hands or arms
  • ‘Jersey Finger’, where one player gets hold of other’s jersey and a finger gets pulled

Symptoms

  • Inability to bend the finger
  • A visible injury on the palm
  • Discomfort and pain while bending the finger
  • Numbing sensation in the fingertip
  • Tenderness along the palm

Diagnosis

  • A thorough physical examination of the patient’s hand may be done by the orthopedic doctor
  • The patient may be asked to make certain finger movements so that the extent of injury can be assessed
  • The patient’s hand may also be tested for sensation
  • The doctor may conduct examination to rule out injuries of the nerves and blood vessels
  • Imaging tests such as X-Rays may provide a clear picture of the injury and damage

Treatment

Generally, a tendon that has been cut will not heal without surgery. However, a partially torn tendon can be repaired with the use of splint or physical therapy.

Non-surgical treatment

  • Application of ice packs immediately after a cut on the hand may be beneficial
  • Keeping the hand in an elevated position to stop blood flow
  • The doctor may give an injection and administer antibiotics to prevent infection
  • The injured finger is placed in a splint to protect the hand from further damage before surgery

Surgical treatment

  • Surgery for a flexor tendon injury may be performed within ten days of the injury
  • A dressing and splint may be applied after the surgery
  • The fingers and wrist may be positioned in a bent arrangement to keep tension off the repair
  • Physical therapy may be recommended after surgery to regain normal hand motion
  • Long-term stiffness after flexor tendon injuries is common
  • In certain patients, another surgery may have to be performed to treat the scar tissue and help the patient use his hand normally

Get in touch with an hand and wrist doctors at OrthoTexas in case you suspect a Flexor Tendon Injury. For an appointment, call at (214) 618 – 5502.

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Carpal Tunnel Syndrome

by Administrator 22. April 2017 13:20

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TFCC Tear: Causes, Symptoms And Treatment

by Administrator 11. April 2017 03:25

TFCC or the triangular fibrocartilage complex is placed in the little finger of the wrist. It not only supports the small sized carpal bones but also allows the flexion, pronation, supination, deviation, and rotation of the wrist joint. The radius and the ulna (two bones of the forearm) are stabilized by this cartilaginous tissue. An injury to the TFCC may lead to dysfunction and chronic wrist pain.

TFCC Tears can be classified into two types:

  • Type 1 Tears- these are the traumatic tears caused by direct injury to the joint
  • Type 2 Tears- these are the degenerative type of tears that occur over a period of time as the body ages

Causes

  • Falling on an outstretched hand
  • Process of ageing can cause wear and tear of the soft tissues. People above the age of 50 years are at a greater risk
  • If the wrist or arm is rotated excessively or beyond comfort level
  • Inflammatory diseases such as Rheumatoid Arthritis
  • Gout
  • Injuries caused while playing tennis, basketball, squash, etc.
  • Fractures in the wrist
  • If the length of the ulna is longer, it may cause more stress on the TFCC. This is called the Ulnar Impaction Syndrome

Symptoms

  • A clicking sound in the wrist when it is moved
  • Pain may felt at the base of the little finger and when the wrist is rotated
  • Inability to grip objects
  • Inflammation
  • Weakness in the hand and wrist

Diagnosis

  • The wrist may be manipulated manually by an orthopedic doctor to check for the exact location of the pain
  • The patient’s medical history and lifestyle activities may be analyzed
  • X-ray imaging may be required to check for bone damage and fractures
  • MRI testing may show the condition of the tissue and cartilage
  • Wrist arthroscopy
  • An injectible dye may be used to highlight lesions if any in the joint

Treatment

The following methods of treatment may be applied to treat the condition:

  • Use of a splint or a cast to stabilize the wrist for about 6 weeks
  • Straps that support the wrist may be used if the condition has not deteriorated much
  • Prescription of anti inflammatory medicines and pain killers
  • Injecting corticosteroids directly into the joint for immediate relief
  • Surgery may be suggested only when the condition does not improve through conservative therapy. Arthroscopic surgery may be preformed to remove the damaged tissue and cartilage structures
  • The torn tissues may be fixed using sutures
  • Surgical shortening of the ulnar bone
  • Ultrasound therapy may be helpful in some cases
  • Physical therapy and activity modification may be required post-surgery to restore complete joint function

For treatment of TFCC Tear and other wrist conditions, visit the doctors at OrthoTexas. To request an appointment, call at (214) 618 - 5502,

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Thumb Fractures: Causes, Symptoms And Treatment

by Administrator 21. March 2017 12:08

The thumb has two bones - the distal phalange placed between the tip and the knuckle; and the proximal phalange extending between the knuckle and the base. The first metacarpal connects the thumb to the hand. A break or a crack in any of these bones is called the thumb fracture. The chances of developing Arthritis in the hand increases once the thumb gets fractured. The most difficult situation occurs when the bone near the base of the thumb breaks. The amount of time taken to treat the fractured thumb depends on the severity of the condition and it may take up to 3 months for it to heal completely.

Causes

  • Falling on an outstretched hand
  • Sports injuries (while catching or throwing a ball)
  • Contact sports such as wrestling and other sports like skiing or hockey may cause sudden muscle contractions, twisting and catching of the thumb
  • Occurrence of a bone disease increases the risk of fracture
  • Lack of calcium in the body may weaken the bones

Symptoms

  • Considerable amount of pain at the point of fracture
  • Swelling in the hand
  • Redness or discoloration
  • The joint may feel tender when touched
  • Limited ability to move the hand and thumb
  • Inability to grasp objects
  • Visibly deformed thumb
  • Numbness in the hand
  • The thumb may turn cold due to lack of blood supply

Diagnosis

  • Detailed assessment of the mode of injury besides the symptoms reported by the patient
  • The doctor may palpate the injured hand to diagnose the severity of damage and check for loss of sensation
  • X-ray examination may be required to study the level of bone damage and find the exact location of fracture
  • The doctor may also check the arm and other parts of the hand to see if they have suffered any additional damage

Treatment

  • Following a healthy diet to compensate for the loss of calcium and minerals in the body improves bone health
  • Use of protective tape to hold the thumb in place allows the joint to recover
  • Use of padded splint to prevent the thumb from moving or getting injured
  • Recommended use of a thumb spica-cast for a couple of weeks in case the middle part of the bone has been damaged
  • Surgical insertion of wires and pins to hold the bone in place and allow healing. This is called internal reduction
  • External fixation- in some cases, the bone may be held in place using pins and screws that are attached to an external device
  • A customized hand therapy program needs to be followed post-surgery or when the cast is removed to restore strength and function

Visit OrthoTexas for treatment of thumb fractures. The orthopedic doctors in Plano use advanced procedures to provide relief from hand and wrist pain. For an appointment, call at (972) 985 - 1072.

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Wrist Dislocation: Orthopedic Frisco

by Administrator 15. February 2017 10:38

The wrist joint connects the two bones of the forearm (ulnar and radius) to the smaller bones of the hand. There are eight carpal bones in the hand which are held together and connected to the other bones by ligaments. The eight carpal bones that form the wrist joint are named as the Capitate, Trapezoid, Hamate, Pisiform, Trapezium, Lunate, Scaphoid and Triquetrum. Displacement of any of these bones may result in Wrist Dislocation. The condition may also be accompanied by ligament and nerve damage.

Causes

  • Fall on an outstretched hand
  • Sports injuries
  • Vehicular accidents
  • Physical combat
  • Direct hit on the wrist with a ball while playing or any other object may cause dislocations and fractures
  • Past injuries or hand fractures make the wrist prone to dislocations
  • Workplace accidents

Symptoms

  • Severe pain
  • Visibly deformed wrist joint
  • Swelling and stiffness
  • The joint may feel tender when touched
  • In case of nerve damage, a tingling sensation in the thumb or the fingers may occur
  • Bruising
  • Range of motion may be affected

Diagnosis

  • Detailed observation of the injured hand by an orthopedic doctor
  • Palpation may be used to check for exact point of dislocations and swelling
  • The mode and time of injury may be taken into consideration besides the symptoms, past medical records and injuries, if any
  • X-ray imaging may be required to assess the damage to the bone structure
  • MRI scan may be required in some cases for a better view and if damage to nerve or ligaments is suspected
  • Neurovascular examination of the joint may be done

Treatment

  • Application of ice packs may help to reduce swelling
  • Pain killers may be prescribed
  • Use of a soft bandage for compression and support may be helpful
  • Splinting the wrist and fingers
  • The injured hand should be rested on an elevated surface
  • Simple bracing and cast may be used to reduce the dislocated bones and restore functionality of the joint in case of minor injuries
  • Surgical reduction (putting the displaced bone back in place) may be carried out and the process may involve use of pins, wires and screws to hold the bone in place
  • The hand may be secured using a cast for a few weeks
  • The surgical procedure may be followed by a physical therapy plan to promote strength, stability and restore range of motion
  • Some changes at the work place may be suggested by an occupational therapist for recovery and prevention of future damage to the joint

For comprehensive treatment of Wrist Dislocation, consult OrthoTexas, leading groups of orthopedic doctors and physicians serving Frisco, TX. To request an appointment, call at (214) 618 – 5502.

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Dupuytren’s Contracture: Orthopedic Treatment In Frisco

by Administrator 9. December 2016 13:46

Dupuytren’s Contracture can be defined as a deformity that results in thickening of the fascia, a thin elastic tissue under the skin of the palm. The fibrous cords in this tissue develop knots, causing the fingers to bend downwards. In most cases, it is the little and ring finger that gets bent towards the palm. Dupuytren’s Contracture is a progressive disorder that may affect one or both the hands and the symptoms tend to aggravate over the time.

Causes

  • Dupuytren’s Contracture is categorized as an idiopathic disorder as the exact cause has not been not clearly identified. However, the following factors may increase an individual’s susceptibility to the condition:
  • It could be a genetic trait that    
  • affects members of the same family
  • Men above the age of 50 years are more likely to develop the condition
  • Alcohol consumption and smoking are believed to cause changes in the blood vessels that may lead to skin contractures
  • Diabetic people are at a greater risk

Symptoms

  • Routine activities such as wearing gloves, shaking hands may become difficult
  • Visibly deformed fingers as they tend to bend towards the palm
  • The lumps of tissues may be visible in the hand and are sensitive when touched
  • Pain may or may not be experienced
  • Reduced flexibility of the hands and fingers
  • The deformity begins with the thickening of the skin of the palm and as it progresses, the palm may appear puckered due to thick knots
  • Inability to straighten the hand or grasp objects
  • Some patients may develop knots on their knuckles as well as soles of the feet

Diagnosis

  • Details of the patient’s family history, medical history and lifestyle may be noted
  • The orthopedic doctor may perform a physical evaluation of the hand which includes comparison of both the hands to identify the symptoms and palpation to detect knots or lumps under the skin
  • Table top test- The patient may be asked to place his hand flat on the table. Inability to do so confirms the presence of Dupuytren’s Contracture

Treatment

Treatment is aimed at ceasing the progression of the condition and enabling the patient to cope up with the symptoms. These may include:

  • Needling technique may be used to puncture the thick tissue cords in the palm. It can be used to pierce more than one finger at the same time as no incision is made
  • Splinting may be helpful in straightening the fingers in case of mild contractures
  • Surgical release or cutting of the affected tissue that causes bending of the fingers
  • Enzymes may be injected into the affected part of the palm to weaken the hard lumps and cords. The fingers are then manipulated to bring them back into their normal position and improve flexibility
  • In severe cases, all the tissues from the hand may be surgically removed followed by a skin graft to allow reconstruction of the palm.
  • Physical therapy may be recommended post-surgery
  • Wearing padded gloves while lifting weights or grasping objects may be helpful

The hand and wrist specialists at OrthoTexas provide comprehensive treatment for Dupuytren’s Contracture. Patients in Frisco, TX can call at (214) 618 - 5502 to schedule an appointment.

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Orthopedic Treatment For Ulnar Nerve Entrapment

by Administrator 21. November 2016 12:36

Ulnar Nerve Entrapment, also known as the Cubital Tunnel Syndrome, refers to a medical condition in which the ulnar nerve gets irritated or trapped. It is one of the three main nerves in the human arm that originates near the neck and runs down the entire length of the arm to the hand. The nerve provides sensation to the ring and the little finger besides enabling the arm muscles to form a grip. It may get compressed along this path, most commonly it happens at the collar bone, elbow joint or the wrist. The condition should be addressed with timely medical care as it may lead to muscle atrophy and physical disabilities.

Causes

  • Formation of bone spurs along the path of the ulnar nerve
  • Arthritis of the elbow joint
  • Past instances of bone fractures or dislocations in the arm, hand, wrist or collar bone
  • Repeated and excessive bending or flexing of the elbow joint may put the ulnar nerve out of place
  • A direct hit or injury to the elbow joint
  • Accumulation of joint fluid in the elbow may compress the nerve
  • Bending the elbow or leaning on it for long can result in nerve entrapment. This happens because the ulnar nerve passes over the small bony ridge called medial epicondyle when the elbow is bent. Repeated activity may irritate it
  • Some people have inherent structural problems which may make the ulnar nerve slide out of the cubital tunnel every time the elbow is bent.
  • Prolonged resting of the elbow on the armrest of the chair

Symptoms

  • Numbness in the hand, little finger and ring finger
  • A tingling sensation may occur sporadically in the fingers and hand
  • Flexing the fingers may become difficult
  • Loss of grip or ability to hold objects
  • The fingers may go numb or ‘fall sleep’ when the elbow is bent for a short stretch of time

Diagnosis

  • Details of the patient’s symptoms, past injuries, lifestyle, occupational requirements, may be noted
  • Physical tests may be conducted to check the level of strength and flexibility in the hand or wrist
  • The elbow may be bent to check if the nerve moves out of its place
  • X-ray imaging of the elbow, hand and wrist joint to assess the bone structure
  • Nerve conduction tests may be carried out by stimulating the ulnar nerve at a particular point and recording its response. This helps to determine damage to nerve and muscles

Treatment

  • Prescription of anti-inflammatory medicines to eliminate swelling in soft tissues around the nerve
  • A soft padded elbow brace or splint can be worn at night to keep the arm straight while sleeping
  • Specific exercises may be performed to guide the ulnar nerve to slide through the cubital tunnel when the elbow is bent
  • Surgical treatment may be required if the patient does not show improvement with conservative methods. These may include the following:
  • Cubital Tunnel Release-  Surgical cutting of the ligament within the cubital canal to make more space for the ulnar nerve
  • Ulnar Nerve Anterior Transposition- In this, the ulnar nerve is relocated from its original position to the front side of the forearm. This prevents it from sliding out of its position when the joint is moved
  • Physical therapy may be recommended post-surgery to prevent stiffness in the arm

For treatment of Ulnar Nerve Entrapment and other wrist conditions, visit OrthoTexas. To schedule an appointment with the orthopedic doctors in in Frisco, TX, call at (214) 436-8997.

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Kienböcks Disease: Orthopedic Treatment In Frisco

by Administrator 17. September 2016 06:33

Kienböcks Disease, also known as Avascular Necrosis Of The Lunate, is a medical condition in which the blood supply to the lunate bone in the wrist joint is disrupted. The condition may also lead to the death of the bone. Lunate is an important bone that provides support and assists in the movement of the joint. Damage to this bone can cause pain, stiffness and if left untreated, may lead to the development of Arthritis.

Causes

  • A fall on the wrist/outstretched hand can cause trauma to the joint and cease the blood flow
  • The lunate is supplied blood by two arteries but in some people one of them may be missing. This may reduce the amount of blood that reaches the bone and thus damages it
  • Disparity in length of the forearm bones- ulna and radius- may exert excessive pressure on the lunate bone

Symptoms

  • Pain in the wrist
  • Swelling
  • Stiffness in the joint
  • Inability to form a firm grip with the hand
  • Loss of range of motion
  • The middle portion of the wrist is tender when touched
  • The hand cannot be moved upwards

Diagnosis

  • Analysis of the patient’s medical history, symptoms and injuries to the wrist
  • The orthopedic doctor may examine the wrist and the movements that cause discomfort
  • X-ray imaging may be done
  • MRI scan may help to diagnose the severity of damage to the bone

Treatment

  • The disease may be managed through conservative methods of treatment in its initial stages.
  • Anti-inflammatory medicines may be prescribed to relieve pain
  • Immobilization of the joint using a cast or a splint for 2-3 weeks may relieve pressure from the wrist
  • Surgical Revascularization- A piece of bone along with an attached blood vessel is removed from the other hand and attached to the damaged lunate bone. External fixator devices may be used to facilitate fusion and re-growth of the lunate
  • Joint Leveling - If the wrist bones have difference in length, the doctor may use a bone graft to lengthen one of them or shorten the other by removing a part of it. Leveling may help to reduce pressure on the lunate bone and stop the progression of the disease
  • Proximal Row Carpectomy - A surgical procedure in which the lunate is removed along with two adjoining bones. This may be recommended in case the lunate has broken or is severely damaged
  • Bone Fusion - The lunate may be fused with one or more bones in the wrist joint for better support

For treatment of Kienböcks Disease, visit OrthoTexas. To schedule an appointment with the hand and wrist surgeons in Frisco, TX, you can call at (214) 618 – 5502.

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Scaphoid Wrist Fracture: Orthopedic Frisco

by Administrator 10. May 2016 12:43

Scaphoid or Navicular fracture is a medical condition that occurs with the breakage of one or more of the small bones present in the wrist and the base of the thumb. The wrist joint is formed where the two bones of the forearm namely ulna and radius meet the eight small sized carpal bones. The carpals are placed in two rows at the base of the hand. The scaphoid is one of these carpal bones which is located at the base of the thumb. Most scaphoid fractures occur in the middle portion of the bone.

The Scaphoid Fracture can be classified into:

  • Displaced- When the bone pieces dislocate from their normal position
  • Non-Displaced- The bone pieces are properly aligned in spite of breakage

Causes

  • Fall on an outstretched hand
  • Vehicular accidents
  • Sports injuries
  • Twisting and turning of the wrist
  • Direct blow to the wrist

Symptoms

  • Pain in the thumb
  • Swelling
  • Tenderness
  • Bruising, discoloration and redness
  • Pain may aggravate while trying to grasp an object
  • Deformation of the wrist joint
  • Loss of sensation
  • Restricted range of motion
  • A feeling of warmth in the hand and forearm

Diagnosis

  • Physical examination of the injured wrist
  • Evaluation of the cause of the injury and symptoms experienced by the patient
  • Analysis of the patient’s medical history
  • X-ray imaging may be required to assess the extent of damage to the joint and displacement of bone fragments
  • CT scan or MRI may be conducted to diagnose soft tissue injuries

Treatment

  • The wrist doctor may use a splint or cast to restrict the movement of the forearm and  hand
  • Prescription of pain killers and anti-inflammatory medicines to provide relief from the symptoms
  • Resting the injured wrist, application of ice packs, compression with a bandage and elevation of the arm may also help to ease pain
  • Lifting weights, participating in sports and doing activities that may stress the joint should be avoided
  • Bone stimulator may be used to deliver electromagnetic waves to aid healing
  • Surgery may be recommended in case of a displaced fracture. Arthroscopic surgery may be performed to put the bone fragments back in place. Artificial implants such as screws, wires and pins may be used to hold the bone.
  • A specific set of exercises suggested by a physical therapist may help restore motion and prevent stiffness in the wrist.

The hand and wrist surgeons at OrthoTexas provide comprehensive treatment for Scaphoid Wrist Fracture. To schedule an appointment with the orthopedic specialists in Frisco, TX, call at (214) 618 – 5502.

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Radial Head Fracture: Elbow Doctor Plano

by Administrator 11. March 2016 10:30

The elbow joint comprises of three main bones - the proximal radius, proximal ulna and the distal humerus. The radial head is the upper part of the radius, one of the two bones that form the forearm. A break, crack or displacement in this part of the elbow joint is termed as the Radial Head Fracture. Such fractures can be classified into categories based on their severity:

  • Type 1- These are small fractures or cracks which may not even be visible in X-rays. The bone remains intact and no displacement occurs
  • Type 2- May involve slight displacement and a larger part of the bone may have been damaged
  • Type 3- The bone is broken into multiple pieces and is largely displaced. Such injuries are serious and are accompanied by damage to the soft tissues as well as ligaments

Causes

  • Direct hit or trauma to the elbow joint
  • Falling on an outstretched hand
  • Sports injury

Symptoms

  • Swelling on the outer part of the elbow
  • Bruising
  • Pain which can be acute
  • Inability to move the arm, wrist or straighten the elbow
  • Visible deformity may occur in case of type 3 fracture
  • Tenderness in the injured part
  • The forearm, hands and fingers may turn pale or numb

Diagnosis

  • Detailed physical examination of the injured arm and symptoms
  • The elbow doctor may ask for details regarding the time and mode of injury
  • The doctor may palpate the injured elbow to check for deformity
  • Examination of the arm, wrist and fingers for loss of function or nerve sensation
  • X-ray images may be required to assess the severity and exact location of damage
  • MRI scans may be recommended in case the doctor suspects soft tissue or ligament injury

Treatment

  • Prescription of painkillers and anti-inflammatory drugs for immediate relief
  • Application of ice packs during the first 24-48 hours of injury may reduce pain and swelling
  • The injured arms should be rested by keeping it elevated
  • Use of a splint or sling may be recommended for a stipulated time period
  • Avoid moving the injured elbow joint and give it adequate rest
  • Joint aspiration- use of a syringe to drain out excess fluids if they accumulate in or near the joint
  • Surgical intervention may be required to remove bone pieces if they restrict joint movement
  • Screws, wires and plates may be used internally or externally to reposition the displaced bone
  • Surgery may be conducted for soft tissue or ligament damage if detected
  • Surgical replacement with an artificial radial head in case of severe damage
  • Specific range of motion exercises may be recommended to combat stiffness and restore flexibility of the joint

OrthoTexas provides comprehensive treatment for radial head fracture and other elbow problems. To schedule an appointment with our elbow doctors in Plano, TX, call at (972) 985 – 1072.

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