Fractures

A fracture is another term for a broken bone. This can occur as a result of many types of trauma such as falls, sports and work related injuries. The small narrow bones of the fingers, hand (metacarpal bones) and wrist (carpal bones, radius and ulna) are all very susceptible to fractures even with minor injuries. While all fractures do not require surgery to heal properly, treatment by a trained hand surgeon can optimize the outcome. Seek consultation if:

• You experience pain/swelling in your forearm, wrist, hand or fingers after an injury
• Bruising of injured area
• Any noticeable deformity of finger, hand, wrist or forearm

 

Dislocations

Dislocations are injuries that occur when one of the two bones that make up a joint is forced from its natural (anatomic) position. The severity of these injuries can vary, some effect the soft tissue that hold the joint in place while others can be associated with fractures. Certain patterns of dislocations can require surgery to heal properly. However dislocations that cannot be properly aligned (reduced) require urgent medical attention. You may have suffered a dislocation if:

• Any noticeable deformity of finger, hand or wrist after an injury
• An incident in which the joint had to be ‘popped’ back into place (reduced)

Sprain

Traumatic injuries may not be severe enough to cause fractures or dislocations. A sprain occurs when the structures that hold the bones into place are stretched or strained. Sprains can be associated with nagging symptoms that last for weeks to months. Without proper attention certain types of sprains can lead to loss of motion or stability at the level of a finger, hand or wrist joint. Seek consultation with a hand specialist if after an injury you continue to have:

• Swelling
• Pain with motion
• Joints that feel unstable
• Point tenderness or isolated pain at the injury site

Infection

Hand infections can be quite serious and debilitating. Our hand surgeons understand the urgent nature of these conditions and will accommodate patients on a same day basis for evaluation. Please seek consultation if you experience signs of infection: pain, redness, swelling, warmth or drainage in the upper extremity. Common sites for infection include:

• Nails
• Finger tip
• Tendons
• Wrist
• After animal bites (especially cats and small dogs)
• Puncture wounds
• Lacerations

Lacerations

Traumatic lacerations of the hand not only can injure skin but can easily damage the underlying blood vessels, nerves and tendons that are critical to hand function. Even a simple cut with a kitchen knife can disrupt the delicate structures that make up the hand. If you have sustained a traumatic laceration of the hand or forearm and are having numbness or tingling, decrease hand function or decreased hand strength an evaluation by one of our trained hand surgeons. Urgent referrals will be accommodated.

Work Related injuries

Injuries that occur at the workplace can be acute or chronic and include fractures, tendonitis, carpal tunnel syndrome, lacerations, nerve and tendon injuries. Not only will our Hand surgeons help get you back to work but our highly trained staff will help navigate the complicated Workers Compensation system so you get the care you need when you need it. If you have sustained an injury to your upper extremity while on the job let our doctors assist you in getting back to work.

Nail Injuries

Injuries to the nail typically are a result of a crush injury to the end of the finger. A subungual hematoma, or collection of blood under the nail, can lead to permanent nail disfigurement if not treated acutely. In addition, because of the close proximity to the underlying bone, finger fractures are not uncommon with this type of injury. If you have sustained and injury to the finger nail as a result of a crush injury or laceration please seek consultation with one of our trained hand surgeons. Preventing permanent nail disfigurement is best addressed at the time of injury. Our surgeons will always attempt to accommodate urgent consultations to help prevent you from long wait times at the emergency room.

Finger Tip Injuries

Table saws, knives, snow blowers and car doors all can cause significant injuries to finger tips. Even a simple puncture wound can lead to a serious infection which requires medical attention. From local wound care to complex reconstructive procedures our hand surgeons are prepared to help you maintain finger function, sensitivity, motion and length as you recover from injuries to the finger tips.

Amputation

Replanting amputated digits is a difficult and complex procedure. After advanced training in hand and microsurgery at one of Harvard’s teaching hospitals in Boston, MA, Dr. Jacob Bloom brings his experience and knowledge to the operating room. Even when a digit is successfully replanted, patients need months of dedicated hand therapy to maximize their hand function.

Animal and Human Bites

Bites from domestic and wild animals as well as human bite wounds can be quite serious and have disastrous complications in the hand and upper extremity if not properly attended to. While large animals like dogs use their strong jaws to rip or tear human tissue. Smaller animals such as cats use their sharp teeth to puncture the skin. Fight bite wounds occur when a tooth punctures the skin of a closed fist, usually during a fist fight. The later two have a propensity to trap bacteria in the soft tissue below the skin. This can lead to a rapidly progressing infection that requires urgent medical attention from a trained hand surgeon. Please seek urgent consultation if you experience:

• An animal bite to the fingers, hand or forearm
• Have increased warmth, redness and pain at the site of a recent bite
• Decreased or painful motion of a joint, digit or hand
• Sustained a laceration from a human tooth during a fist fight

Tennis Elbow

Also called lateral epicondylitis, tennis elbow is a form of tendinitis that can arise at the outside (lateral) elbow. This condition is caused as micro-tears form in the junction of the muscle and tendon. Motion like cocking your wrist back can illicit pain at the elbow that can sometimes travel up and down the arm. There are many strategies that can be used to treat tennis elbow. They usually require a combination of physical therapy, splints and home exercise programs. Occasionally steroid injections and surgery are needed to treat this condition. Please seek consultation if you experience:

• Pain with motion of fingers or wrist
• Swelling around the elbow
• Pain with gripping objects or extending the wrist
• Pain on the outside of the elbow (Tennis Elbow)

Golfers Elbow

Known as medial epicondylitis golfer’s elbow is a form of tendinitis that can arise at the inside (medial) elbow. This condition is caused by micro-tears form in the junction of the muscle and tendon. Motion such as flexing the wrist or pushing an object can illicit pain at the elbow that can sometimes travel up and down the arm. There are many strategies that can be used to treat golfer’s elbow. They usually require a combination of physical therapy, splints and home exercise programs. Occasionally steroid injections and surgery are needed to treat this condition. Please seek consultation if you experience:

• Pain with motion of fingers or wrist
• Swelling around the elbow
• Pain with gripping objects or extending the wrist
• Pain on the inside of the elbow (Golfer’s Elbow)