INDEX

CONDITIONS TREATED

• Basal Joint Arthritis

  Basal joint arthritis is a condition that affects the joint at the base of the thumb. Arthritis is simply irritation of a joint that can lead to inflammation, pain, and in severe cases it causes joint degeneration and destruction. There are many different types of arthritis, however, osteoarthritis (“wear-and-tear” arthritis) most commonly affects the joint at the base of the thumb.

• Bites

• Burns

• Carpal Tunnel Syndrome

  Carpal Tunnel Syndrome is a condition that often presents as numbness and tingling in the fingers and hands. It may present as pain or weakness and can affect the entire arm. Carpal tunnel syndrome occurs when the median nerve, one of the three main nerves to the hand, becomes “pinched” at the carpal canal within the wrist. The carpal canal is formed by the bones of the wrist and the overlying, tough and fibrous transverse carpal ligament. Any condition that causes an increase in pressure within this canal exerts pressure on the median nerve resulting in carpal tunnel syndrome.

• Cold Hand

  Also see information on Vascular Disorders.

• Congenital Deformities

  When children are born with hands that are different from what is functionally normal they are said to have a congenital hand difference. Normal is defined as one thumb, one index finger, one long finger, one ring finger, and one small finger with all of the normal and expected joints of the fingers, hand, and wrist. The arm begins to form between four and eight weeks after conception. As it only takes one mis-step in a series of millions of steps, it is remarkable that more congenital differences are not seen.

• Cubital Tunnel Syndrome

  Cubital tunnel syndrome is a condition that often presents as numbness and tingling in the fingers, hands, and arms much like it’s cousin Carpal Tunnel Syndrome. Cubital tunnel syndrome involves pressure on the ulnar nerve at the elbow. This “pinching” can be secondary to compression from bone (the medial epicondyle or “funny bone”), muscle tendon, or a ligament.

• Dequervain’s Tendinitis

  DeQuervain’s tendinitis is a condition that affects the tendons at the base of the thumb. This tendinitis, or inflammation, is caused by the tendons becoming irritated within their sheath (a compartment or tunnel), which results in further swelling and pain with movement of the thumb or wrist. Commonly referred to as “Mother’s Thumbs” as this condition is seen in new moms secondary to lifting the infant many times a day. Pain can also be experienced with grasping objects or making a fist.

• Distal Radius Fracture

  Distal radius fractures are a condition in which the bone (the radius) on the thumb side of the forearm becomes broken near the wrist. It can occur alone or involve the ulna (the bone on the little finger side of the arm). This injury is usually the result of falling onto an outstretched arm to “break the fall”. Pain, swelling, and deformity can result after this type of fracture. Distal radius fractures are diagnosed by visual inspection, physical exam, and with X-rays.

• Dupuytren’s Disease

  Dupuytren’s disease is a condition that results from an abnormal thickening of the fascia of the palm. This fascia is a structure that anchors the skin to the underlying structures to keep the palmar skin from sliding loosely like the skin on the back of your hand (which would make it particularly difficult to grip, for example, a screwdriver). Dupuytren’s does not involve tendons directly, but it can become wrapped around nerves and cause the overlying skin to change. Dupuytren’s can also cause skin thickening over the knuckles (knuckle pads), or cords or nodules on the bottom of the feet (plantar fibromatosis).

• Finger Injuries/Amputations

  Finger injuries can result from being smashed, cut, ground, electrocuted, or even severed. Fingers are very complex and consist of skin, nails, nerves, veins, arteries, tendons, ligaments, and bone. Thus, these injuries can be minor to severe as in the case of a crush or amputation. Amputations can be partial, meaning only part of the finger or thumb is lost, or it can be complete. These types of injuries can result in chronic (long-term) dysfunction or pain.

  Also see information on Powersaw Injuries.

  Also see information for Replantation.

• Fractures

  Fractures or a “broken bone” can affect the bones of the arm, wrist, or the small bones of the hand. A fracture can result following trauma, including a fall, a twist or torque, a crush injury, or from a direct blow as often seen in sports injury. Fractures may be closed, meaning the skin is not cut or broken. Fractures may also be open or “compound”, meaning the skin is broken. In this type of fracture bleeding is common and bone may or may not be visible. Diagnosing a fracture relies on visual inspection or looking at the injury, palpating or feeling the injury, and with X-rays.

• Fractures in Children

• Ganglion Cyst

  Ganglion cysts are a very common cause of “lumps and bumps” found in the hand and wrist. They can be found on either side of the wrist or hand and result from a collection of “joint fluid” escaping from a hole in the joint capsule. They can occur spontaneously or after trauma. Ganglions are not dangerous as they are benign (not cancer), and can be treated when painful or unsightly.

• Gout and Pseudogout

• Hand and Wrist Tumors

• Hand Infections

• Hand Stiffness

• Joint Replacement

• Mallet Finger

  Mallet finger is a condition that results when the tendon responsible for extending or straightening the finger (extensor tendon) becomes damaged. This can occur when an object, often a ball, strikes the finger and injures the tendon. The tendon can rupture (break) or it can pull off a piece of bone from the last bone in the finger (distal phalanx) causing the end of the finger to droop. If this happens, the finger cannot be extended.

• Mucous Cyst

  Mucous cysts are benign cysts related to ganglions. They occur around the last joint or “knuckle” of the finger. They are usually associated with osteoarthritis or “wear-and-tear” arthritis and are not cancerous. They can be painful and result in changes to the fingernail. Rarely do they become infected, but if infected, it is theoretically an “infected joint” which is an urgent, if not emergent situation.

• Nailbed Injuries

• Nerve Injuries

  Nerves are like bundles of electric wires that conduct signals from a part of your body to your brain. These signals (or information) relate to pain, pressure, and temperature (hot / cold) sensations. Nerve injuries can result from being smashed, stretched, torn, or cut. Depending on the severity and type of injury, nerve injury can be complete and irreversible, or they can heal completely. Generally, nerves are very slow to heal and may take up to a year to finally declare their final long-term function.

• Numbness

  Numbness in the hand or arm is often caused by carpal tunnel syndrome, however there are other conditions that can result in numbness, tingling, and even pain. Any process that presses or “pinches” a nerve (compression neuropathy) can result in these similar findings and a surgical evaluation is warranted.

• Osteoarthritis

  Osteoarthritis is a condition characterized by joint degeneration or “wear-and-tear” of a particular joint. This condition can cause deformity and pain. There is no cure for osteoarthritis, so my job is to help you minimize your symptoms and offer surgery only when conservative treatment has failed.

• Rheumatoid Arthritis

• Soft Tissue Masses

  Soft tissue masses, or tumors, are “lumps and bumps” that can occur in the skin, fat, muscle, nerves, blood vessels, or joints. A tumor is just an abnormal collection of cells that have grown too much. They can be benign (not cancer) or malignant (cancer). In most cases we do not know why they occur. It can be the result of trauma, radiation or chemical exposure, or even from viral infections. Some tumors are even genetic, meaning they have been passed down to you from your parents.

• Systemic Diseases

• Tendinitis

  Tendinitis is a condition in which the tendons become inflamed. Tendons are the structures that connect muscle to bone. Tendinitis can cause swelling, pain, and loss of function. Rarely it can lead to a rupture (or break) in the tendon.

• Tendon Injuries

  Tendons are the tough, rope-like cords that connect muscle to bone. When a muscle contracts (or flexes), it pulls on the tendon which moves the bones around the joints. Tendons may be injured by trauma (cutting or crushing) or they may be injured by medical problems such as Rheumatoid Arthritis or diabetes.

• Tendon Transfer Surgery

• Tennis Elbow/Golfer’s Elbow

  Tennis elbow and Golfer’s elbow is a condition in which the tendons connected to the muscles that extend and flex the wrist become weak. These tendons insert into the outside of the elbow (lateral epicondyle for tennis elbow) and the inside of the elbow (medial epicondyle for golfer’s elbow). These tendons can have tiny or microscopic tears within them that cause pain. This pain can be chronic (long-term) and cause a significant decrease in the ability to enjoy daily life.

• Thumb Sprains

  Also see information on Ski and Snowboard Injuries.

• Trigger Finger/Trigger Thumb

  Trigger finger (or thumb) is a condition that results from swelling within the tendon that bends the fingers. This tendon is held close to the bone by a series of pulleys that are similar in function to the line guides on a fishing pole. As the tendon swells, a nodule forms that catches on these pulleys. This catching leads to clicking or snapping of the tendon as it passes beneath the pulley. As the condition progresses, locking of the finger in either an open or closed position is common. Pain may be present and is often felt at the base of the finger where it meets the palm.

• Wrist Pain

  Wrist sprain is a condition that results when the wrist is forcefully flexed, extended, or twisted causing small or large tears in the ligaments. Ligaments are very short, tough structures that connect bone-to-bone and provide for the stability of joints. These tears can cause significant pain, swelling, and disability.