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Diagnosis and Definitions
Acromioclavicular Arthritis back to top
Some joints in the body are more likely to develop problems due to normal wear and tear, or degeneration of the cartilage and joint lining. The type of arthritis that occurs due to degeneration over time is called osteoarthritis. The acromioclavicular (AC) joint, at the far end of the collarbone, is a common joint for developing osteoarthritis during middle age. [...]
Adhesive Capsulitis – Frozen Shoulder back to top
Adhesive Capsulitis, or Frozen Shoulder, is a common but poorly understood condition that can affect the shoulder in a variety of patients. Its name suggests the fact that the shoulder loses range of motion, and deep pain is a common component of this troublesome malady.
Cause
Very frequently, the condition develops because of trauma to the shoulder, which can include prior surgical intervention; however, many patients develop this condition spontaneously for unknown reasons. It is commonly seen [...]
Amputations back to top
Amputation is the removal of a body extremity by trauma, prolonged constriction, or surgery. As a surgical measure, it is used to control pain or a disease process in the affected limb, such as malignancy or gangrene. In some cases, it is carried out on individuals as a preventative surgery for such problems. A special case is that of congenital amputation, a congenital disorder, where fetal limbs have been cut off by constrictive bands. In some countries, amputation of the hands, feet or other body [...]
Arthroplasty back to top
To change (plasty) a joint. This can be a fusion (eliminating motion but giving stability/pain relief), a biologic arthroplasty (using tissues to alter a joint) or a replacement arthroplasty (using metal and plastic components to replace worn joint). [...]
Arthroscopy back to top
The use of fiberoptic technology with a viewing moniter to look inside a joint to make a diagnosis and treat the problem. This can now be done in some small joints in the hand as well as wrist, elbow and shoulder.
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Bankart Lesion – Bankart Repair back to top
A Bankart lesion is an injury of the anterior (inferior) glenoid labrum of the shoulder due to repeated (anterior) shoulder dislocation. When this happens, a pocket at the front of the glenoid forms that allows the humeral head to dislocate into it. It is an indication for surgery and often accompanied by a Hill-Sachs lesion, damage to the posterior humeral head. It is named after Arthur Sydney Blundell Bankart, an English orthopaedic surgeon, who lived from 1879-1951.
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Basal Joint back to top
The basal joint is where the thumb connects with the wrist. It's also known as the carpometacarpal joint or CMC-joint. It's this joint that gives our thumb the wide range of movement. It also allows the thumb to be put into the palm of the hand. This motion is called opposition. The joint is held together by ligaments.. When you sprain your thumb you can damage those ligaments. The end of the bones in the joint are covered by cartilage. It's smooth and spongy and acts like a sort of cushion. This [...]
Basal Joint Arthritis back to top
Thumb arthritis is the most common form of osteoarthritis affecting the hand. Also called basal joint arthritis, thumb arthritis occurs when the cushioning cartilage wears away from the adjoining ends of the bones that form your thumb joint (carpometacarpal joint). Thumb arthritis can cause severe hand pain, swelling, and decreased strength and range of motion, making it difficult to do simple household tasks, such as turning doorknobs and opening jars. Treatment for thumb arthritis may include self-care [...]
Biceps Rupture back to top
A biceps rupture involves a complete tear of the main tendon that attaches the top of the biceps muscle to the shoulder. It happens most often in middle-aged people and is usually due to years of wear and tear on the shoulder. A torn biceps in younger athletes sometimes occurs during weightlifting or from actions that cause a sudden load on the arm, such as hard fall with the arm outstretched. [...]
Bicipital Tendonitis back to top
Bicipital tendinitis, or biceps tendinitis, is an inflammatory process of the long head of the biceps tendon and is a common cause of shoulder pain due to its position and function. The tendon is exposed on the anterior shoulder as it passes through the humeral bicipital groove and inserts onto the superior aspect of the labrum of the glenohumeral joint. Disorders of the biceps tendon can result from impingement or as an isolated inflammatory injury. Other causes are secondary to compensation for [...]
Bony Gamekeeper’s Thumb back to top
This is a specific type of injury of the joint where the thumb joins the palm, on the index finger side of the thumb. Usually caused by a fall, some how catching the thumb on the way down. When skiing, the thumb may be injured in a fall, caught in the ski pole loop - referred to as a "ski pole thumb" - the same injury. [...]
Brachial Plexus Injury back to top
The brachial plexus is a network of nerves that conducts signals from the spinal cord, which is housed in the spinal canal of the vertebral column (or spine), to the shoulder, arm and hand. These nerves originate in the fifth, sixth, seventh and eighth cervical (C5-C8), and first thoracic (T1) spinal nerves, and innervate the muscles and skin of the chest, shoulder, arm and hand. Brachial plexus injuries, or lesions, are caused by damage to those nerves. Brachial plexus injuries, or lesions, can [...]
Bursitis of the Shoulder back to top
A general term often referring to impingement syndrome of the shoulder, a painful condition related to inflammation of the shoulder rotator cuff tendons. Bursitis can also occur in other lubricating sacs around joints, such as the elbow (olecranon bursitis). [...]
Capsular Shift Shoulder Surgery back to top
As a ball-and-socket joint, the head of the arm bone (humerus) forms the "ball" that connects to the shoulder blade at the glenoid cavity, the shoulder's "socket." Surrounding ligaments, called the "shoulder capsule," provide the strong connective tissue that keeps the humeral head centered in the glenoid socket.
When the ligaments are stretched, due to repetitive overhead motion, capsular shift may occur. In effect, looser ligaments are less capable of maintaining shoulder stability. Through [...]
Carpal Metacarpal Surgery back to top
Degenerative arthritis (aka osteoarthritis) of the thumb carpo-metacarpal joint (CMC) is a common problem, which usually affects women beginning around the fifth decade of life. Arthritis is a condition where the articular cartilage or gliding surface of a joint becomes worn and degraded. This may ultimately result in a painful and stiff joint. [...]
Carpal Tunnel Release back to top
Carpal tunnel release is surgery to treat carpal tunnel syndrome. Carpal tunnel syndrome is pain and weakness in the hand that is caused by pressure on the median nerve in the wrist.
Description
The median nerve and the tendons that flex (or curl) your fingers go through a passage called the carpal tunnel in your wrist. This tunnel is narrow, so any swelling can pinch the nerve and cause pain. A thick ligament (tissue) just under your skin (the carpal ligament) makes up the top of this tunnel.
First, [...]
Carpal Tunnel Syndrome back to top
Carpal Tunnel Syndrome is extremely common, and is a very misunderstood condition. In recent years, it has received much coverage in the press but is still not completely understood, even by the scientific community.
The media has branded this condition as an occupational disease because of workers linking pain in their hands to repetitive activities, such as typing or assembly line work. Despite popular opinion, this condition is not caused by repetitive activity, although repetitive activity, [...]
Carpometacarpal Joint Surgery back to top
Thumb arthritis is the most common form of osteoarthritis affecting the hand. Also called basal joint arthritis, thumb arthritis occurs when the cushioning cartilage wears away from the adjoining ends of the bones that form your thumb joint (carpometacarpal joint).
Thumb arthritis can cause severe hand pain, swelling, and decreased strength and range of motion, making it difficult to do simple household tasks, such as turning doorknobs and opening jars.
Treatment for thumb arthritis may include [...]
Carpus back to top
Carpus is anatomical assembly connecting the hand to forearm. In human anatomy, the main role of the carpus is to facilitate effective positioning of the hand and powerful use of the extensors and flexors of the forearm, but the mobility of individual carpal bones increase the freedom of movements at the wrist. In tetrapods, the carpus is the sole cluster of bones in the wrist between the radius and ulna and the metacarpus. The bones of the carpus do not belong to individual fingers (or toes in quadrupeds), [...]
Clavicle Fracture back to top
A clavicle fracture is a bone fracture in the clavicle, or collarbone. It is often caused by a fall onto an outstretched upper extremity, a fall onto a shoulder, or a direct blow to the clavicle. Many research projects are underway regarding the medical healing process of clavicle fractures. [...]
CMC Joint Surgery back to top
The joint at the base of the thumb which allows for the swivel and pivoting motions of the thumb is referred to as the basal joint or thumb CMC (carpometacarpal) joint. Because of its design, it tends to wear out and develop arthritis early in life. Basal joint arthritis is also common in people who have osteoarthritis. [...]
Colles’ Fracture back to top
Very common fracture at wrist involving the end of the radius forearm bone. Treated with cast or surgical means depending upon extent of displacement. Frequently seen in older patients with osteoporosis [...]
Comminuted back to top
Refers to fragmentation of a fracture. Cortisone – A generic term for a corticosteroid which is a class of drugs used to decrease inflammation and pain in either oral, intravenous or locally injectable form. It is a very helpful medication if not used excessively. [...]
Corticosteroid back to top
Corticosteroids are a class of chemicals that includes steroid hormones naturally produced in the adrenal cortex of vertebrates and analogues of these hormones that are synthesized in laboratories. Corticosteroids are involved in a wide range of physiologic processes, including stress response, immune response, and regulation of inflammation, carbohydrate metabolism, protein catabolism, blood electrolyte levels, and behavior. Glucocorticoids such as cortisol control carbohydrate, fat and protein [...]
Cubital Tunnel Syndrome back to top
Cubital tunnel syndrome is a condition brought on by increased pressure on the ulnar nerve at the elbow. There is a bump of bone on the inner portion of the elbow (medial epicondyle) under which the ulnar nerve passes. This site is commonly called the “funny bone”. At this site, the ulnar nerve lies directly next to the bone and is susceptible to pressure. When the pressure on the nerve becomes great enough to disturb the way the nerve works, then numbness, tingling, and pain may be felt [...]
DeQuervain’s Tendinitis – DeQuervain’s Tendinosis back to top
Dequervain’s tendinitis occurs when the tendons around the base of the thumb are irritated or constricted. The word “tendinitis” refers to a swelling of the tendons. Thickening of the tendons can cause pain and tenderness along the thumb side of the wrist. This is particularly noticeable when forming a fist, grasping or gripping things, or when turning the wrist.
Anatomy
Two of the main tendons to the thumb pass through a tunnel (or series of pulleys) located on the thumb side of the wrist. [...]
Diabetes and Hand Problems back to top
People with diabetes know that their disease may cause foot problems and are constantly on the alert for “danger” symptoms. But virtually nobody knows that diabetes is also a common element in hand problems. Do you have numbness or tingling in your fingers? This may be a complication of diabetes. Frequently, hand problems associated with diabetes are not severe, and hence are not brought to the attention of the doctor.
Numbness or tingling in the fingers, often ignored until it becomes persistent [...]
Dislocation back to top
Joint dislocation, or luxation occurs when bones in a joint become displaced or misaligned. It is often caused by a sudden impact to the joint. The ligaments always become damaged as a result of a dislocation. A subluxation is a partial dislocation. [...]
Distal Clavicle Resection back to top
Distal Clavicle Excision is a procedure used to treat impingement in the shoulder. Shoulder impingement is a painful condition in which the space between structures in a joint narrows, causing parts to rub or pinch that normally would not, which is very painful for the patient. This procedure treats impingement in the acromioclavicular (AC) joint to return the patient to pain-free mobility.
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Distal Humerus Fractures back to top
The three bones that come together to form the elbow can break (fracture) in different ways. A distal humerus fracture is one type of elbow fracture. The distal humerus is the end of the upper arm bone (the humerus) that forms the upper part of the elbow. These types of elbow fractures are fairly uncommon. They account for about 2% of fractures in adults. The elbow is a complicated joint and elbow fractures can involve both of the forearm bones, as well as the humerus. [...]
Distal Radius Fracture back to top
The radius is the larger of the two bones of the forearm. The end toward the wrist is called the distal end. A fracture of the distal radius occurs when the area of the radius near the wrist breaks. [...]
Dupuytren’s Contracture or Dupuytren’s Disease back to top
Dupuytren’s disease is an abnormal thickening of the tissue just beneath the skin known as fascia. This thickening occurs in the palm and can extend into the fingers. Firm cords and lumps may develop that can cause the fingers to bend into the palm, in which case it is described as Dupuytren’s contracture. Although the skin may become involved in the process, the deeper structures—such as the tendons—are not directly involved. Occasionally, the disease will cause thickening on top of the [...]
Elbow Arthroplasty back to top
Elbow joint replacement (also called elbow arthroplasty) can effectively treat the problems caused by arthritis of the elbow. The procedure is also becoming more widely used in aging adults to replace joints damaged by fractures. The artificial elbow is considered successful by more than 90 percent of patients who have elbow joint replacement. [...]
Elbow Bursitis – Olecranon back to top
Bursas are thin, slippery sacs located throughout the body that act as cushions between bones and soft tissues. They contain a small amount of lubricating fluid that allows the skin to move freely over the underlying bone. The olecranon bursa lies between the loose skin and the pointy bone at the back of the elbow called the olecranon. Normally, the olecranon bursa is flat. If it becomes irritated or inflamed, more fluid will accumulate in the bursa and bursitis will develop. [...]
Elbow Dislocation back to top
Elbow dislocation is the most common dislocation in children; in adults, it is the second most common dislocation after that of the shoulder. The elbow is amazingly stable, relying more on bony anatomy configuration for stability rather than ligaments. Considerable force is necessary to dislocate the elbow; sports activities account for up to 50% of elbow dislocations, and this type of injury is more commonly seen in adolescent and young adult populations. [...]
Elbow Flexion Contracture – Stiff Elbow back to top
The causes of a stiff elbow are numerous including: post-traumatic elbow, burns, head injury, osteoarthritis, inflammatory joint disease and congenital.
Types of stiffness include: loss of elbow flexion, loss of elbow extension and loss of forearm rotation. All three have different prognoses in terms of the timing of surgery and the likelihood of restoration of function.
Contractures can be classified into extrinsic and intrinsic (all intrinsic develop some extrinsic component). Functional [...]
Elbow Trauma back to top
The humerus of the upper arm and the paired radius and ulna of the forearm meet to form the elbow joint, a hinge joint in the upper arm. The bony prominence at the tip of the elbow is the olecranon process of the ulna. The antecubital fossa lies over the anterior aspect of the elbow.
Injuries to the elbow are common and often accompanied by injury to shoulder or wrist joints. It is important to assess injuries promptly and accurately taking into account age and the mechanism of injury, particularly [...]
Endoscopic Cubital Tunnel Release back to top
Release of the painful ulnar nerve at the elbow is a common operation that is virtually always done via a large open incision. At Badia Hand to Shoulder Center, we have been doing the technique endoscopically, via a mini portal incision using an endoscope to release the ulnar nerve, often called the “funny bone”. This alleviates the numbness and pain, and allows the patient to use the arm immediately as this is done in Miami (Doral) as an outpatient procedure with local anesthesia. Virtually [...]
Endoscopy back to top
Endoscopy is a nonsurgical procedure used to examine a person\'s digestive tract. Using an endoscope, a flexible tube with a light and camera attached to it, your doctor can view pictures of your digestive tract on a color TV monitor. [...]
Epicondylitis back to top
Inflammation of the bony prominences at the elbow. Lateral epicondylitis is better known as tennis elbow and medial epicondylitis is golfer’s elbow. [...]
Finger Reattachment – Finger Replantation back to top
Finger reattachment (or replacement) is defined as reattachment of the part that has been completely amputated. [...]
Fingertip back to top
The extreme end or tip of a finger. A finger is a limb of the human body and a type of digit, an organ of manipulation and sensation found in the hands of humans and other primates. Normally humans have five digits, termed phalanges, on each hand (exceptions are polydactyly, oligodactyly and digit loss). The first digit is the thumb, followed by index finger, middle finger, ring finger, and little finger or pinky. Some other languages use the same generic term for all five digits of a hand. [...]
Flexor Tenosynovitis back to top
Flexor tenosynovitis (FT) is a pathophysiologic state causing disruption of normal flexor tendon function in the hand. A variety of etiologies are responsible for this process. Most acute cases of FT are the result of infection. However, FT also can be secondary to acute or chronic inflammation as a result of diabetes, overuse, or arthritis. [...]
Fracture back to top
A break in a bone. A displaced fracture indicates a break that is out of its normal anatomic position while a comminuted fractures means it is fragmented in several pieces. [...]
Frozen Shoulder – Adhesive Capsulitis back to top
Frozen shoulder, also called adhesive capsulitis, causes pain and stiffness in the shoulder. Over time, the shoulder becomes very hard to move.
Frozen shoulder occurs in about 2% of the general population. It most commonly affects people between the ages of 40 and 60, and occurs in women more often than men. [...]
Fusion – Arthrodesis back to top
A surgical technique where a joint is rendered stiff in order to eliminate pain and restore stability. Certain joints, such as the distal interphalangeal and wrist, are best suited for arthrodesis, whereas others are indicated for arthroplasty (replacement) such as elbow and shoulder. [...]
Ganglion Cyst back to top
Fluid filled cyst often seen in the wrist, both dorsal and palmar aspects, that may be painful and or unsightly and require removal in that case. Ganglion cyst or a bible cyst is a rounded lump, which is generally present on a muscle tendon near a joint. It is typically noticed as a slow growing or static swelling, which is painless and does not cause any functional restriction. Historically, ganglion cysts were treated by hitting them with a bible, and hence the name, “bible cyst“. Except the [...]
Golfer’s Elbow back to top
Golfer's elbow, or medial epicondylitis, is an inflammatory condition of the medial epicondyle of the elbow. It is in some ways similar to tennis elbow. The anterior forearm contains several muscles that are involved with flexing the fingers and thumb, and flexing and pronating the wrist. The tendons of these muscle come together in a common tendinous sheath, which is inserted into the medial epicondyle of the humerus at the elbow joint. In response to minor injury, or sometimes for no obvious reason [...]
Hand Surgeon back to top
Specialist with either orthopedic and/or plastic surgery background with further subspecialized training in surgery of the hand and upper extremity often including the shoulder. This includes nonsurgical treatment which may include medications and therapy. [...]
Hand Tendonitis back to top
Symptoms of hand tendonitis include pain and tenderness in the hand centralized along a tendon. Tendons are usually located near joints, so many patients describe the pain as joint pain. Tendonitis pain typically worsens at night. Also, activity or movement can make the pain worse. Repetitive motion is particularly aggravating for an individual with tendonitis. Because these symptoms can also indicate other hand conditions, like carpal tunnel syndrome and arthritis, patients who find the pain interfering [...]
Heterotopic Ossification back to top
Is the process by which bone tissue forms outside of the skeleton. [...]
Humerus back to top
Upper arm bone that can fracture in different segments and often treated by hand surgeons particularly if any associated nerve injury. [...]
Impingement Syndrome back to top
Common spectrum of shoulder problems related to degenerative problems of the rotator cuff and the overlying bursa (lubricating sac). Treatment may involve anti-inflammatories, injection, therapy and surgery, usually arthroscopic. [...]
Jersey Finger back to top
Traumatic condition, often sports related, where flexor tendon insertion ruptures near end of finger leading to incomplete flexion (bending) of digit. Opposite process of mallet finger. [...]
Keloid back to top
Thickening of scar on skin of patients who have a predisposition to this type of wound healing. [...]
Kienbock’s Disease back to top
A painful condition in the wrist where a small bone called the lunate loses its blood supply (avascular necrosis) and dies leading to possible collaps of this bone and later arthritis. [...]
Labral Tear – Detached Labrum back to top
The labrum is made of a thick tissue that is susceptible to injury with trauma to the shoulder joint. When a patient sustains a shoulder injury, it is possible that the patient has a labral tear. The labrum also becomes more brittle with age, and can fray and tear as part of the aging process.
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Ligament back to top
Soft tissue structure that connects two bones together. Rupture or tearing can lead to pain and/or dysfunction of that joint.
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Ligament Injuries back to top
Sprains and strains are among the most common orthopedic injuries. Sprains describe an injury to a ligament and strains describe an injury to muscle. Treatment of both sprains and strains is important for a timely recovery. [...]
Lunate back to top
Critical bone in the wrist lying next to the scaphoid which articulates with the radius forearm bone. [...]
Mallet Finger – Baseball Finger back to top
Traumatic injury where terminal extensor tendon of finger ruptures or pulls of small bone fragment leading to inability to extend (straighten) last joint (distal interphalangeal) of finger.
Read also: Mallet Finger [...]
Metacarpal back to top
Long bones in the palm which articulate with the phalanges in the fingers. [...]
Metacarpal Fracture back to top
If you have a "broken hand," you have a metacarpal fracture -- an injury to the bone at the level of the palm of your hand. You have five metacarpal bones, one for each of your fingers. The metacarpal bones support the hand, and the end of the metacarpal bone forms the knuckle on the back of your hand. [...]
Microsurgery back to top
Surgical technique that requires the use of an operating microscope. This technique has nothing to do with the size of the incision but rather the use of magnification to repair small structures such as small arteries, veins and nerves that are barely visible with the naked eye. Arthroscopy uses tiny incisions but has nothing to do with microsurgery. [...]
Obstetric Palsy – Erb’s Palsy back to top
Erb's palsy (Erb-Duchenne Palsy) is a paralysis of the arm caused by injury to the upper group of the arm's main nerves, specifically the upper trunk C5-C6 is severed. These form part of the brachial plexus, comprising the ventral rami of spinal nerves C5-C8, and T1. These injuries arise most commonly, but not exclusively, from shoulder dystocia during a difficult birth. Depending on the nature of the damage, the paralysis can either resolve on its own over a period of months, necessitate rehabilitative [...]
Orthopedic Surgeon back to top
Surgical specialist dedicated to treatment of the musculoskeletal system, by both conservative and surgical means. They can subspecialize in areas such as the hand and upper extremity, spine, foot and ankle, pediatric etc.Osteoarthritis – Wear and tear arthritis commonly seen in older people but of unknown cause. It can be slow or rapidly progressive possibly requiring surgical treatment of a variety of joints. [...]
Osteoarthritis back to top
Osteoarthritis (OA) also known as degenerative arthritis or degenerative joint disease or osteoarthrosis, is a group of mechanical abnormalities involving degradation of joints, including articular cartilage and subchondral bone. Symptoms may include joint pain, tenderness, stiffness, locking, and sometimes an effusion. A variety of causes—hereditary, developmental, metabolic, and mechanical—may initiate processes leading to loss of cartilage. When bone surfaces become less well protected by [...]
Phalanx back to top
Bones inside fingers named according to digit and if farthest from palm (distal) or closest (proximal) . [...]
Proximal Humerus Fracture back to top
A proximal humerus fracture is a common injury to the shoulder. Especially common in elderly individuals due to osteoporosis, proximal humerus fractures are among the most common broken bones. [...]
Radius back to top
Long bone of forearm that rotates around fixed ulna to allow palm down (pronation) and palm up (supination) positions of wrist. [...]
Reflex Sympathetic Dystrophy back to top
Reflex sympathetic dystrophy (RSD), also known as complex regional pain syndrome (CRPS), is an incompletely understood response of the body to an external stimulus, resulting in pain that is usually nonanatomic and disproportionate to the inciting event or expected healing response. [...]
Reflex Sympathetic Syndrome back to top
Painful misunderstood condition now know as complex regional pain syndrome type I. It is due to an overactivity of the sympathetic nervous system and is treated with therapy , oral agents, and often a series of nerve blocks administered by a pain management specialist. [...]
Replantation back to top
The surgical reattachment of a completely severed digit or limb. This requires the use of microsurgery and an operating team experienced in this technique. The amputated part must be kept cool in a moist gauze protected from direct contact with ice in order to minimize tissue damage until the blood flow (perfusion) is surgically re-established to the severed part. [...]
Rheumatoid Arthritis back to top
Rheumatoid arthritis is a chronic inflammatory disorder that typically affects the small joints in your hands and feet. Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity. [...]
Rotator Cuff back to top
A common cuff of tendinous tissue made up of 4 separate muscle tendons that come together around the head of the humerus in the shoulder joint to help stabilize it. Tears are commonly seen in either acute or repetitive trauma and in degenerative processes seen in older patients. [...]
Rotator Cuff Tear back to top
Rotator cuff tears are tears of one or more of the four tendons of the rotator cuff muscles. A rotator cuff injury can include any type of irritation or damage to the rotator cuff muscles or tendons. Rotator cuff tears are among the most common conditions affecting the shoulder. The tendons of the rotator cuff, not the muscles, are most commonly torn. Of the four tendons, the supraspinatus is most frequently torn as it passes below the acromion; the tear usually occurs at its point of insertion onto [...]
Rotator Cuff Tendonitis back to top
Rotator cuff tendonitis, also knows as "bursitis" or "impingement syndrome" occurs when the rotator cuff gets irritated on the undersurface of the acromion. The reason this begins in the first place is a source of some debate. Some people are born with a "hooked" acromion that will predispose them to this problem. Others have rotator cuff weakness that causes the humerus to ride up and pinch the cuff. This means that the bursa — a water-balloon type structure that acts as a cushion between the [...]
Scaphoid back to top
A kidney shaped bone in the wrist near the base of the thumb that is critical to wrist function. Fractures are common here and can lead to healing problems due to relatively poor blood supply to this bone that may require bone stimulation (with a device) and/or surgery usually consisting of bone grafting. [...]
Shoulder Arthritis- Glenohumeral back to top
Arthritis is a condition that occurs in various joints in the body, especially in the knees, hips, and spine. It can affect any joint, but the shoulder is affected infrequently. When arthritis occurs, the cartilage that covers the ends of the bones making up the joint breaks down and often flakes off into the joint. The joint becomes swollen and stiff, and the lining tissue of the joint (the synovium) becomes overgrown. Frequently, spurs will develop around the margins of the joint and can, sometimes, [...]
Shoulder instability back to top
Shoulder instability and dislocation occur when the shoulder capsule is stretched or torn, and/or when the labrum is detached from the glenoid. [...]
Shoulder Pain back to top
Deep persistent pain in the shoulder can affect young and old alike. The causes, however, can be very different and require a thorough diagnostic process to understand the underlying problem and lead to a solution.
Young active patients often feel that shoulder pain stems from overuse. This may be the case, but it is important to understand why. Current exercise regiments usually emphasize strengthening the deltoid muscles, but the rotator cuff is largely ignored. This leads to an instability syndrome [...]
SLAP Tear – SLAP Lesion back to top
A SLAP tear or SLAP lesion is an injury to the Glenoid labrum (fibrocartilaginous rim attached around the margin of the glenoid cavity). SLAP is an acronym that stands for "superior labral tear from anterior to posterior".
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Subacromial Decompression back to top
The operation aims to increase the size of the subacromial area and reduce the pressure on the muscle. It involves cutting the ligament and shaving away the bone spur on the acromion bone. This allows the muscle to heal.
A nerve block is used during the operation which means that immediately after the operation the shoulder and arm may feel numb. This may last a few hours. After this the shoulder may well be sore and you will be given painkillers to help this whilst in hospital. These can [...]
Suspensionplasty back to top
Suspensionplasty: Basal Joint Arthritis Suspensionplasty is the use of abductor pollicis longus (APL) tendon as sling. First, the bone at the base of thumb (trapezium) is removed. Then the APL is taken from its attachments to the carpometacarpel (CMC) and threaded to the two tunnels. One tunnel goes through the bone of the index figure. While the other goes through the thumb. The APL is stitched to another tendon to hold in its place. The overall effect is to stop the deforming force of the APL on [...]
Synovitis – Joint Swelling back to top
Synovitis is the medical term for inflammation of the synovial membrane.This membrane lines joints which possess cavities, known as synovial joints. The condition is usually painful, particularly when the joint is moved. The joint usually swells due to synovial fluid collection. Synovitis may occur in association with arthritis as well as lupus, gout, and other conditions. Synovitis is more commonly found in rheumatoid arthritis than in other forms of arthritis, and can thus serve as a distinguishing [...]
Tendonitis back to top
Tendinitis (informally also tendonitis), meaning inflammation of a tendon (the suffix -itis denotes diseases characterized by inflammation), is a type of tendinopathy often confused with the more common tendinosis, which has similar symptoms but requires different treatment. The term tendinitis should be reserved for tendon injuries that involve larger-scale acute injuries accompanied by inflammation. Generally tendinitis is referred to by the body part involved, such as Achilles tendinitis (affecting [...]
Tendons back to top
Soft tissue structures that connect a muscle to a bone and render function across a joint. These may require repair or even transfer to substitute function in conditions where a joint is disabled. [...]
Tennis Elbow – Lateral Epicondylitis back to top
Lateral epicondylitis is a tendonitis commonly known as “tennis elbow”, although the majority of people with lateral epicondylitis have never played tennis. The condition causes pain on the outside portion of the elbow over a bony prominence named the lateral epicondyle. Pain occurs with activities such as grasping, pushing, pulling, and lifting. As the process progresses, the pain may occur with limited activities or even at rest. Of note, a separate entity termed golfers elbow, or medial epicondylitis, [...]
Tenosynovitis back to top
Tenosynovitis is inflammation of the lining of the sheath that surrounds a tendon (the cord that joins muscle to bone). [...]
TFCC Repair – Triangular Fibrocartilage Complex Tear back to top
A TFCC tear is a tear in the triangular fibrocartilage complex, a structure found in the little finger side of the wrist. Within the forearm are 2 bones, the radius (thumb side) and the ulna (little finger side), and within the wrist there are 8 wrist bones (carpals). The TFCC sits between the ulna and 2 carpal bones, the triquetrum and lunate.
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Thumb Arthritis – Osteoarthritis of the Hand or Fingers back to top
Thumb arthritis is the most common form of osteoarthritis affecting the hand. Also called basal joint arthritis, thumb arthritis occurs when the cushioning cartilage wears away from the adjoining ends of the bones that form your thumb joint (carpometacarpal joint). Thumb arthritis can cause severe hand pain, swelling, and decreased strength and range of motion, making it difficult to do simple household tasks, such as turning doorknobs and opening jars. Treatment for thumb arthritis may include self-care [...]
Thumb Arthroscopy back to top
Thumb arthroscopy is a safe and effective technique. It’s a reliable procedure that offers the orthopaedic surgeon a chance to directly evaluate the status of the joint. Like the other endoscopic and arthroscopic procedures at OS, the Thumb Arthroscopy is minimally invasive meaning patients are able to start their recovery sooner than the alternatives. By leaving little to no scarring, the surgeon reduces the risk of infection which allows the patient to return to their life quickly and with a [...]
Tommy John Surgery back to top
Tommy John Surgery, known in medical practice as ulnar collateral ligament (UCL) reconstruction, is a surgical graft procedure in which the ulnar collateral ligament in the medial elbow is replaced with a tendon from elsewhere in the body. The procedure is common among collegiate and professional athletes in several sports, most notably baseball.
The procedure was first performed in 1974 by orthopedic surgeon Dr. Frank Jobe, then a Los Angeles Dodgers team physician who served as a special advisor [...]
Total Shoulder Replacement back to top
Although shoulder joint replacement is less common than knee or hip replacement, it is just as successful in relieving joint pain.
Shoulder replacement surgery was first performed in the United States in the 1950s to treat severe shoulder fractures. Over the years, shoulder joint replacement has come to be used for many other painful conditions of the shoulder, such as different forms of arthritis.
Today, about 53,000 people in the U.S. have shoulder replacement surgery each year, according [...]
Trapezium Bone – Greater Multangular Bone back to top
The trapezium bone (greater multangular bone) is a carpal bone in the wrist. It forms the radial border of the carpal tunnel. The trapezium is distinguished by a deep groove on its anterior surface. It is situated at the radial side of the carpus, between the scaphoid and the first metacarpal bone (the metacarpal bone of the thumb). It is homologous with the first distal carpal of reptiles and amphibians. [...]
Trauma back to top
In medicine, however, the words trauma patient usually refer to someone who has suffered serious and life-threatening physical injury potentially resulting in secondary complications such as shock, respiratory failure and death. [...]
Trigger Finger back to top
Trigger finger is a condition that affects the tendons in your fingers or thumb. It can limit finger movement. When you try to straighten your finger, it may lock or catch before popping straight out.
Anatomy
Tendons are tissues that connect muscles to bone. When muscles contract, tendons pull on
bones. This is what causes some parts of the body to move.
The muscles that move the fingers and thumb are located in the forearm, above the wrist.
Long tendons – called the flexor tendons – [...]
Tumor back to top
A tumor or tumour is commonly used as a synonym for a neoplasm that appears enlarged in size. Tumor is not synonymous with cancer. While cancer is by definition malignant, a tumor can be benign, pre-malignant, or malignant, or can represent a lesion without any cancerous potential whatsoever. [...]
Ulnar Collateral back to top
Long bone of forearm (fixed) starting at elbow tip and going to small finger side of wrist. [...]
Wrist Arthroscopy back to top
Arthroscopy is a surgical procedure used to diagnose and treat problems inside a joint.
Arthroscopy utilizes a small fiber optic instrument called an arthroscope that enables the surgeon to see inside the joint without making large incisions into the muscle and tissue.
The wrist is a complex joint with eight small bones and many connecting ligaments. Arthroscopic surgery can be used to diagnose and treat a number of conditions of the wrist, including chronic wrist pain, wrist fractures, ganglion [...]
