From Your Elbow to Your Fingers: Treating the Upper Extremities

From trauma, arthritis and animal bites...to carpal tunnel syndrome and soft tissue injuries...the work of the hand surgeon is as varied as the patients we see: children, athletes, laborers, office workers, seniors.

Most problems of the elbows, wrists and hands are treated with non-surgical approaches, including hand therapy, medications, and injections. If surgery is called for, minimally invasive techniques performed on an outpatient basis are usually highly effective.

"With five hand surgeons on staff, Bryn Mawr has the expertise to treat acute injuries and long-term conditions like arthritis," says Jack Abboudi, M.D., orthopedic hand surgeon at the Bryn Mawr Hospital Orthopedic Center in the Philadelphia suburbs. "We also supervise the rehabilitation process, working with certified hand therapists to get patients functioning at their peak level."

The most common concerns of the upper extremities are:

• Arthritis. The joint most likely to suffer wear and tear is where the wrist and thumb meet. If non-operative treatments, such as anti-inflammatory medications and steroid injections, are not effective, reconstructive surgery to replace the joint may be an option.

• Injury and Trauma. Broken bones, severed nerves or tendons and sprains need immediate medical attention. "Sometimes a sprain looks like a fracture and a fracture looks like a sprain," says Marwan A.Wehbe, M.D., orthopedic hand surgeon. "Appearance is not always a reliable indicator of the severity of the injury. A medical examination to make a proper diagnosis is critical."

• Carpal Tunnel Syndrome. When the median nerve gets trapped in a relatively tight area in the wrist, numbness and tingling in the fingers can result. Splinting and cortisone injections often bring relief; an outpatient surgical procedure to treat this condition is another option.

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