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  1. Texting Thumb and Repetitive Trauma

    August 14, 2012 by Greg Balourdas

    The conditions that we treat may not change much but the way that we injure ourselves changes with the technology.

    Take care that you don’t develop Texting Thumb.

    Recognized for a number of years and very treatable.

    Please don’t ignore your symptoms. And once in a while call!

     

     

    Such injuries from overuse include various tendonitis conditions and nerve entrapments (carpal tunnel syndrome etc.)  Many were recognized 100 years and more ago.

    Very interesting excerpt from a 1914 text on Occupational Disorders.  It goes on to describe conservative treatment similar to measures we employ today!  The more things change, the more they stay the same.

    From a textbook on Occupational Diseases published in 1914

    Check out the occupations associated with these conditions in 1914.  No texting to be found!

    And please don’t text and drive!

    Take Care,

    Greg Balourdas, MD

    TheHandDoctor.com


  2. Hand Surgery for the Stars

    August 7, 2012 by Greg Balourdas

    I remember many nasty lacerations from people trying to separate frozen hamburger patties with a knife dating back to my Orthopedic training at Case Western Reserve University in Cleveland.  More recently for me, here in Southern California and now for Meryl Streep, the avocado is a very dangerous fruit.  Please be careful and use the right tool for the job at your home.  Check out this link!

    http://www.showbiz411.com/2012/08/05/meryl-streep-is-not-actually-julia-child-cuts-through-her-hand-with-a-kitchen-knife

    Greg Balourdas, MD

    TheHandDoctor.com

    Facebook-TheHandDoctor


  3. Wrist sprain or Scaphoid fracture?

    July 25, 2012 by Greg Balourdas

    I indicated that I’d be covering the many injuries that can occur when you fall forward, sacrificing the health of your hand and wrist to protect your face!  I introduced you to FOOSH injuries which are common and usually heal in days to weeks.  However the occurrence of fractures and dislocations of the wrist are very common.

    The most common wrist fracture is a fracture to the scaphoid bone (peanut shaped bone at the base of thumb and also called the carpal navicular).  These fractures are common and notorious for problems in healing.  There a number of reasons wrist injuries are missed:

    • Contrary to popular wisdom you can still move the wrist even if it fractured

    • Scaphoid fractures occur without visible signs, sometimes even swelling is absent

    • Even when x-rays are taken in the first few days a fracture can be missed

    And why fractures of the scaphoid are slow to heal:

    • The bone is nearly completely covered by cartilage and therefor the blood supply is limited

    • Even stable scaphoid fractures, unlike finger and hand fractures must be immobilized for an extended time

    • The cast must include the thumb and many times requiring the elbow, making compliance difficult

    Certain fractures do not heal and require surgery with an embedded, headless screw.

     

     

     

     

     

     

    Here is an awesome video by Dr. Nabil Ebraheim in Toronto.

    For more information or assistance please contact our office and the educational page on this subject.  TheHandDoctor.com

     

    Take care,

    Greg Balourdas, MD

     

     


  4. Animated hand anatomy overview

    May 2, 2012 by Greg Balourdas

    Notice at 41 seconds how the carpal tunnel is filled with the tendons and tendon sheath… now put the median nerve in there.. not much room!
    Greg Balourdas, MD


  5. AAOS Orthopedic Annual Meeting

    February 12, 2012 by Greg Balourdas

    I spent a great 5 days in San Francisco at the annual international meeting of the American Academy of Orthopedic Surgeons.  Getting an update on the latest Technology and Techniques.  Saw a lot, learned a few things too!  Pictures are also posted on FB. https://www.facebook.com/TheHandDoctor.  Stay tuned for more information on the latest on the non-surgical treatment for Dupuytren’s Contracture…

     

    Trying some new surgical instruments


  6. FOOSH!!

    January 25, 2012 by Greg Balourdas

    You’ve FOOSHed before and probably didn’t even realize you were doing it!  In my world this stands for one of the most common events which result in injuries to the hand, wrist and arm. It’s a natural reflex to protect your head and face!

    • Fall
    • On an
    • Out-
    • Stretched
    • Hand

     

    We have all done it and thankfully we are usually able to protect ourselves without significant injury. Occasionally the FOOSHer ends up sacrificing certain body parts to protect other parts.  Such falls can result in sprains, breaks and dislocations… A significant portion of upper extremity Orthopedic trauma and reconstruction can be traced to such injuries! Thought I’d introduce the subject and branch out to talk about specific fractures and dislocations of the wrist. I think we’ll start with Scaphoid fractures (one of the bones of the wrist, also known as the carpal navicular)…. easy to break and sometimes slow to heal!  …then perhaps move on to even more complicated injuries of the wrist such as this extreme FOOSH!. – Greg Balourdas, MD

    Also find me on Facebook: The Hand Doctor – Greg M. Balourdas, MD and my office site.


  7. I just jammed my finger Doc

    January 6, 2012 by Greg Balourdas

    Ok now that professional basketball season in underway.. I seem to be seeing an increase in “jammed” fingers. Probably just coincidence but when my son jammed his finger playing goalie it prompted me to start thinking about these injuries which do occur when flying spherical objects contact extended fingers as in “ball” sports (basketball, volleyball and soccer). I never fail to cringe when I see a patient who says there finger was jammed and crooked so they (or a teammate) pulled on it to straighten it! While this frequently works (there are a lot of jammed fingers out there that thankfully don’t make it to a surgeon’s office) when it doesn’t it can become a major problem. The joints of the fingers are actually quite complex and in delicate balance. One of the giants of Hand Surgery, J. Littler, called the extensor tendon function a “fugue of motion”, denoting a very complicated interaction of forces each dependent on the other to maintain balance and precise function.

    Suffice to say that some these structure and certain injury patterns are very benign and heal without problem but others do not.
    So look out the following “Red flags” that suggest problems may be lurking:
    1. Obvious, even slight, persistent angulation or lack of finger extension (doesn’t stay straight)
    2. Significant restriction in joint motion that does not improve over a few days.
    3. Grating or clicking sensation with motion.
    4. Pain that persists and if simple (“popsicle stick” splint) immobilization doesn’t give you relief.
    5. Numbness or tingling in the fingertip.

    By the way, Happy New Year and be careful out there!
    – Greg Balourdas, MD

    A little anatomy review:

    Anatomy of the Tendons and Joints of the Finger


  8. Complex and Wonderfully Made

    December 17, 2011 by Greg Balourdas

    You don’t have to be a Hand Specialist to know that your hands are very important to you… but as a Hand Surgeon I do get a special appreciation for how complex and wonderfully made our hands are, and how much we take them for granted.  If you’ve ever experienced an injury to your hands or arm that prevented their normal use you know what I mean. Our hands are the main way that we interact with our environment… work, play, blog and just about everything we do depends on the normal use of our hands.  So be careful out there!  I look forward to sharing my perspective and experiences on this an other related subjects.

    Greg Balourdas, MD