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.
- 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
- 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
- Range of motion may be affected
- 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
- 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.
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.
- 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
- 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
- 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 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.
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.
- 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
- 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
- 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
- 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.
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.
- 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
- Pain in the wrist
- 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
- 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
- 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.
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
- Fall on an outstretched hand
- Vehicular accidents
- Sports injuries
- Twisting and turning of the wrist
- Direct blow to the wrist
- Pain in the thumb
- 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
- 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
- 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.
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
- Direct hit or trauma to the elbow joint
- Falling on an outstretched hand
- Sports injury
- Swelling on the outer part of the elbow
- 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
- 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
- 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.
12. January 2016 05:56
A sprain refers to an injury of the ligaments or the connective tissues joining the bones. The human wrist consists of many ligaments that can be stretched or torn leading to a sprain. It may be a result of forceful bending of the wrist, a sudden fall on an outstretched hand or any day to day activity that might injure the joint. Such injuries are most commonly seen in sportspersons involved in skateboarding, gymnastics, basketball, skiing etc. Wrist sprains can be classified on the basis of severity of the injury as follows:
- Grade 1- involves mild stretching of the ligaments
- Grade 2- moderate injury which may lead to partial tearing of the ligaments and some loss of function
- Grade 3- severe injury which is accompanied by complete tearing and damage to the ligaments. The tear may involve breaking a part of the attached bone and is referred to as an avulsion fracture
In most cases, wrist sprain can be treated by conservative methods and the time required to recover may vary from two to ten weeks.
- A sudden fall on the hand that puts pressure on the forearm and the hand
- Twisting the wrist
- Direct trauma or hit to the wrist
- Swelling and tenderness at the point of injury
- Pain which can be mild to severe depending on the severity of the injury
- Pain worsens with movement
- A popping sound at the time of injury
- A sense of heat or warmth may spread across the injured wrist and arm
- Stiffness, redness, bruising
- Loss of function which can range from partial to complete
- The wrist joint feels loose
- Discoloration of the skin around the wrist
- Thorough physical examination by the orthopedic doctor
- Detailed analysis of the patient’s previous medical records and injuries to the wrist or hand
- Imaging tests such as X-ray, CT scan, MRI to determine the location and extent of damage that has occurred
- Arthrography test may be conducted for a better view of the ligaments
- Resting the injured wrist and arm on an elevated surface to reduce swelling and strain
- Applying ice packs at regular intervals for the first 48 hours of injury or as suggested by the physician
- Compression with an elastic bandage
- Pain killers and anti inflammatory drugs may be prescribed
- Immobilization of the wrist using a splint or a cast for about a week or more
- Physical therapy and suitable stretching exercises to regain mobility and strength
- Grade 3 injuries may require surgical intervention
- Arthroscopy which may involve surgically repairing the torn ligament
For treatment of wrist sprain and other orthopedic conditions, visit OrthoTexas. To schedule an appointment with the hand and wrist specialists in Frisco, TX, you can call at (214) 618 – 5502.
5. January 2016 12:22
Ulnar Tunnel Syndrome affects the ulnar nerve located between the little finger and the wrist. It is one of the three main nerves that extend downwards from the neck to the arms, hand and the little finger. It ensures sensation in the forearm, palm and the fourth and fifth fingers of the hand. This nerve is in fact a part of the brachial plexus and can be constricted at any point in the arm or the hand resulting in pain. Overuse of the hand may subject this nerve to excessive pressure resulting in pain, weakness and/or other types of discomfort. The condition is also known as Guyon’s Canal Syndrome as the ulnar nerve passes from the wrist to the little finger through the Guyon canal. This syndrome commonly affects cyclists whose hands tend to get pressed against the handle bars resulting in ulnar nerve compression.
- Compression of the ulnar nerve
- Overuse of the hand
- The tissues near the ulnar nerve become swollen or thickened
- Injury to the elbow, hand or wrist
- Fractures or trauma
- Development of a ganglion (hard bump) on a tendon which can pressurize the ulnar nerve
- Nerve entrapment near the elbow or wrist joint
- Presence of cysts/Arthritis or bone spurs near the elbow joint
- Repetitive flexing or bending movement of the elbow
- Leaning on the elbow for long duration may pressurize this nerve
- Previous dislocations may result in nerve entrapment
- Pain in the little finger or middle finger or both
- Feeling of needle pricks in the finger
- Numbness, weakness or tingling sensation
- Loss of motor function of the hand muscles
- Loss of gripping capacity of the hand
- Intrinsic muscle wasting may occur in some cases
- A detailed physical examination by the orthopedic doctor which would include a variety of physical tests to assess the range of motion of the hand/wrist/elbow
- Analysis of the patient’s medical history
- Conducting EMG (electromyography) to check nerve transmissions in the hand
- X-rays can help detect bone spurs, Arthritis or displacements
- Providing adequate rest to the affected hand and finger. The elbow should be kept straight most of the time
- Application of ice packs at regular intervals
- Use of splint, particularly at night, to provide support to the finger/hand or the elbow
- Prescription of anti-inflammatory drugs or pain killers
- Physical therapy can help restore muscle strength and functioning
- Surgical treatment to relieve pressure on the ulnar nerve
- Use of specific gloves to prevent pressure on the nerve
The orthopedic surgeons at OrthoTexas provide effective treatment for Ulnar Tunnel Syndrome. To schedule an appointment, you can call at (214) 618-5502 or visit 5757 Warren Pkwy, Frisco, TX 75034.
19. November 2015 11:33
Mallet Finger, or Baseball Finger, is a common sports injury to the tendons in the outermost joint in the finger. Tendons are tissues that connect the muscles to the bones and help in movement. The extensor tendons are those that keep the fingers straight while the flexor tendons allow them to bend. Mallet Finger occurs when the extensor tendon gets dislocated or torn, leading to deformity in the joint.
The condition usually occurs when the ball hits the finger with a sudden force and damages the tendons that straighten the fingers. As a result, the tip of the finger droops and loses the power to straighten on its own. Besides sports, the injury may also occur due to a cut at the end of the finger or at the side of the nail while working in the kitchen, workplace or outdoors.
- Drooping finger tip
- Redness and swelling
- Inability to move or straighten the finger
- Bruising and discoloration
A Mallet Finger test may be conducted to diagnose the condition. In this, the orthopedic doctor holds the affected finger and asks the patient to straighten it without using the other hand. X-rays may also be conducted to determine any misalignment in the bones of the joint.
In most cases, Mallet Finger can be treated with non-surgical interventions and may take a few weeks to heal completely. In case a fracture or joint displacement accompanies the condition, surgical treatment may be required. Depending upon the severity of the symptoms, the orthopedic doctor may recommend the following treatment options:
- Applying ice wrapped in a piece of clean cloth or towel to reduce swelling and pain.
- Keeping the forearm elevated above chest level to prevent blood flow to the finger tips.
- Compressing with an elastic bandage to control bleeding in case of a cut.
- Taking a prescribed course of anti-inflammatory medications to reduce inflammation.
- Wearing a splint for a few weeks to keep the fingertip straight.
- Performing certain exercises to strengthen the fingers and prevent stiffness.
- Inserting screws, pins or wires to surgically realign the finger joints.
- Using a tendon graft to tighten the tissues and bring back the finger in shape.
It is a general tendency to treat Mallet Finger as a minor injury and people do not seek immediate medical intervention. However, delayed diagnosis and treatment may hamper the healing process and, in some cases, lead to permanent deformity of the affected finger.
Consult the doctors at OrthoTexas for complete diagnosis and treatment of Mallet Finger. To schedule an appointment an appointment, call at (214) 618-5502 or visit 5757 Warren Pkwy, Suite 180, Frisco, TX 75034.
6. July 2015 16:38
Wrist pain can be caused due to an injury or damage to the tendons, ligaments and tissues connecting the different joint structures of the wrist. The condition can be due to a minor injury such as sprain, strain etc. or a chronic degenerative condition such as Wrist Arthritis. However, it is important to diagnose and treat the cause of wrist pain to avoid the condition from worsening.
- Muscle overuse
- Wrist fracture
- Direct blow to the joint
- Sports injuries
- Overextending the hand
- Falling on an outstretched hand
- Repetitive wrist movements such as constant typing work
- Degenerative conditions such as Arthritis
- Carpal Tunnel Syndrome
- Ganglion Cysts
- Kienbock's Disease
- Wrist Tendonitis
- Sudden or sharp pain in the wrist
- Numbness or tingling sensation in the hand or fingers
- Swelling and tenderness
- Redness and warm sensation at or near the site of pain
- Difficulty making a fist or grasping objects
- Bruising or discoloration
- Visible deformity in the joint
- Inability to move or rotate the joint
- Difficulty lifting objects
The wrist specialist may physically examine the joint to look for swelling, pain and signs of any injury. The patient may be asked to move the wrist in certain positions to evaluate range of motion. The orthopedic doctor may also suggest certain imaging tests to identify if any specific medical condition is causing wrist pain.
- Rest And Immobilization: Taking proper rest and refraining from activities that may put strain on the joint can allow the sore muscles to heal.
- Ice And Heat Packs: Applying ice or heat packs, as recommended by the orthopedic doctor, may help to compress swelling and ease pain.
- Medications: The orthopedic surgeon may also prescribe anti-inflammatory medications to eliminate pain and discomfort in the wrist.
- Injections: These are usually recommended for severe cases of wrist painthat obstructs the daily activities of the patient.
- Wrist Support: The patient may also be suggested to wear a wrist brace to provide support during physical activities and avoiding any further injury to the joint.
- Surgery: This is usually required if wrist pain is caused due to some underlying medical condition such as a fracture or Carpal Tunnel Syndrome.
The orthopedic surgeons at OrthoTexas, Frisco providecomprehensive diagnosis and treatment forwrist pain. To schedule an appointment with the wrist doctors, you can call at, (214) 618 – 5502 or visit 5757 Warren Pkwy, Suite 180, Frisco, Texas 75034.