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Dr. Post discusses Nerve Injuries at conference

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Dr. James Post of Raleigh Hand Center discussed the treatment of patients with nerve injuries at WakeMed UNC orthopedic hand conference on 10/30/2017. Local area hand surgeons, orthopedic residents, and therapists were in attendance. Primary surgical repair, autograft, conduit, and allograft reconstruction were discussed as treatment options.

Dr. Post

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Dr. Messer returns from Nicaraguan mission trip

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Dr. Terry Messer returns from a week-long medical mission trip to Leon, Nicaragua. 

“I recently traveled to Nicaragua with a group of doctors and nurses.  We are part of a group called COAN, a Triangle based group founded nearly 20 years ago, whose mission is to improve the quality of orthopeadic care in Nicaragua.  On our first day there, we saw more than 80 patients in the clinic with a variety of orthopedic problems, ranging from simple problems like carpal tunnel syndrome and trigger finger, to more complex problems like distal radius malunions, recurrent shoulder dislocations, severe ankle arthritis, and scoliosis.  Throughout the remainder of the week, we performed more than 30 surgeries, and we helped teach the orthopedic surgery residents and attendings at HEODRA Hospital in Leon.  In the end, our team left feeling like we received much more than we gave.  I look forward to returning to Nicaragua next year!”  — Dr. Messer, Raleigh Hand Center

Dr Messer and COAN in Nicaragua

For more information about COAN, please visit our website at coanhealth.org
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Pumpkin Carving Safety Tips

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Use caution during the Halloween season, and take steps to prevent hand injuries when carving.

“Every Halloween season we see four or five patients — both adults and children — who come into our office with severe injuries to their hands and fingers,” says Jeffrey Wint, MD, an ASSH member from The Hand Center of Western Massachusetts in Springfield, Mass. “Treatment can often run three to four months, from the time of surgery through rehabilitation.”

To prevent hand injuries, the American Society for Surgery of the Hand (ASSH) suggests the following safety tips:

CARVE IN A CLEAN, DRY, WELL-LIT AREA

Wash and thoroughly dry all of the tools that you will use, including: carving tools, knife, cutting surface, and your hands. Any moisture on your tools, hands, or table can cause slipping that can lead to injuries.

ALWAYS HAVE ADULT SUPERVISION

“All too often, we see adolescent patients with injuries because adults feel the kids are responsible enough to be left on their own,” says Wint. “Even though the carving may be going great, it only takes a second for an injury to occur.”

LEAVE THE CARVING TO ADULTS

Never let children do the carving. Wint suggests letting kids draw a pattern on the pumpkin and having them be responsible for cleaning out the inside pulp and seeds. When the adults do start cutting, they should always cut away from themselves and cut in small, controlled strokes.

SHARPER IS NOT BETTER

“A sharper knife is not necessarily better, because it often becomes wedged in the thicker part of the pumpkin, requiring force to remove it,” says Wint. “An injury can occur if your hand is in the wrong place when the knife finally dislodges from the thick skin of the pumpkin. Injuries are also sustained when the knife slips and comes out the other side of the pumpkin where your hand may be holding it steady.”

USE A PUMPKIN CARVING KIT

Special kits are available in stores and include small, serrated pumpkin saws that work better because they are less likely to get stuck in the thick pumpkin tissue. “If they do get jammed and then wedged free, they are not sharp enough to cause a deep, penetrating cut,” says Wint.

HELP FOR AN INJURY

Should you cut your finger or hand, bleeding from minor cuts will often stop on its own by applying direct pressure to the wound with a clean cloth. If continuous pressure does not slow or stop the bleeding after 15 minutes, an emergency room visit may be required.

Copyright © American Society for Surgery of the Hand 2009.

Metacarpal fracture treatment in Raleigh NC

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Metacarpal fractures are common hand injuries. They can occur from a variety of injuries such as a fall, a motor vehicle collision, or striking the fist against a hard surface. There are five metacarpals, one for each finger and the thumb. The metacarpals contribute to the bony architecture of the hand. Satisfactory healing of this fracture is important to restoring hand function. A fracture of the 5th metacarpal neck (the small finger) is sometimes called a “boxer’s fracture,” as they can be seen in punching injuries.

The treatment plan will depend on the severity of the fracture and the patient’s medical condition and activity level. Most people have fractures which are well-aligned, and, therefore, do not require surgery and are treated in a splint or cast. Follow-up x-rays are obtained to evaluate how the fracture is healing. Hand therapy is sometimes necessary to improve strength and range of motion of the hand.

Some patients with displaced fractures can be treated with manual realignment of the fracture. This is performed in the office or emergency room with local anesthesia such as lidocaine (numbing medicine). Once the bones are “set,” a splint is placed to maintain the alignment for a few weeks.

Surgery may be recommended to patients with more severe fractures, such as those fractures with poor alignment or when the bone breaks through the skin (open fracture).

WHAT IS INVOLVED WITH SURGERY?

The surgery is performed as an outpatient often using regional anesthesia or a nerve block. During surgery, the bones are realigned and stabilized. In some cases, a low-profile plate and screws are used to fix the bones internally. This is called “open reduction and internal fixation” and requires an incision on the back of the hand. In other cases, temporary pins are placed through the skin to stabilize the bones while they heal. This is called “closed reduction and percutaneous pinning.” The pins can be removed in clinic after a few weeks. Other options include intramedullary nail fixation and external fixation. Which technique is used depends on the fracture pattern and is often determined in the operating room. The bone healing process takes about 6 weeks, but full recovery for maximizing hand function can take a few months.

Call Raleigh Hand Center for a consultation on treatment of your metacarpal fracture 

 

4th and 5th metacarpal fractures

 

Open reduction and internal fixation of 4th and 5th metacarpals

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Dr. Messer lectures on TFCC injuries

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Dr. Terry Messer presented at WakeMed UNC hand conference on Monday October 9, 2017 and discussed TFCC injuries of the wrist. Local hand surgeons, therapists, residents, and radiologists were present. 

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Dr. Erickson returns from national hand conference

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Dr. Erickson attended the annual Robert E. Carroll Hand Club meeting June 21-24, 2017. The meeting was held in Bolton Landing, NY. Attending orthopedic and plastic surgery hand specialists discussed current treatment options for their patients with hand and upper extremity conditions. 

Dr John Erickson Raleigh Hand Center

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Dr. Messer presents at Regional Hand Conference

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Dr. Terry Messer of Raleigh Hand Center presented “Variations in clinical practice among hand surgeons in a private practice hand and upper extremity group” at the 40th Annual Southeastern Hand Society (SEHS) Meeting in Kiawah Island on April 27-30th. He served as Vice-President of the SEHS at the time of the meeting, and he is now the President-Elect.

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Dr. Erickson lectures at two conferences

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Dr. John Erickson provided a lecture on “Benign and Malignant Bone Tumors of the Hand and Wrist” at WakeMed UNC Orthopedic Hand Conference on 4/10/2017. Dr. Erickson also presented “Dupuytren’s Contracture Treatment” at Duke Raleigh Hospital Orthopedic Grand Rounds on 6/14/2017.

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Dr Edwards III discusses infection control at conference

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Dr. George Edwards III gave a lecture at the AORN regional meeting on 3/4/2017 in Chapel Hill. He discussed infection control in the operating room.

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