Latest Articles

Memorial Day closing

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Raleigh Hand to Shoulder Center will be closed for the Memorial Day holiday. We will be open for usual office hours on Tuesday. We are on call for emergencies.

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Hand Injury Treatment in Raleigh NC

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The Raleigh Hand to Shoulder Center physicians have treated patients with hand and arm problems for three decades. From a minor cut to a severe hand injury, we have been specialty-trained to diagnose, treat, and rehabilitate patients with a variety of hand injuries. The hand is one of the most intricate and delicate areas of the human body. The hand has nineteen bones in addition to joints, tendons, muscles, nerves, and blood vessels. As you know, our hands are critical for independent function and livelihood. An alteration in the normal function of the hand can significantly impact a person’s life. At the RHSC, we strive to improve a patient’s quality of life through effective non-surgical and surgical treatments. We work personally with on-site hand therapists to optimize outcomes.

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Dr. Post lectures on ulnar-sided wrist pain at conference

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Dr. James Post of the Raleigh Hand to Shoulder Center discusses treatment of ulnar-sided wrist pain at WakeMed UNC orthopedic hand conference on Monday, 3/4/2019. Ulnar sided wrist pain can be related to TFCC injuries, tendonitis, arthritis, and ulnar impaction syndrome, among other causes.

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Dr. Messer lectures on flexor tendon reconstruction in the hand

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Dr. Terry Messer discussed reconstruction of flexor tendon injuries in the hand at WakeMed UNC orthopedic hand conference on February 4, 2019. Several hand surgeons, therapists, and orthopedic residents were present.

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Dr Erickson lectures on flexor tendon repair and rehab at hand therapy conference

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Dr. John Erickson of Raleigh Hand to Shoulder Center was the invited speaker for the quarterly meeting of the North Carolina Upper Extremity Special Interest Group. Dr. Erickson and 20 occupational therapists discussed current trends in surgical and rehabilitative treatment for patients with flexor tendon injuries in the hands.

https://ncuesig.com/quarterly-meetings

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Rotator Cuff Tear article by Raleigh Hand to Shoulder Center physician

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What is a rotator cuff tear?

A rotator cuff tear is an injury to the group of tendons/muscles that surround the shoulder joint called the rotator cuff where the tendon typically becomes torn away from the bone.  The rotator cuff is made up of the supraspinatus, infraspinatus, subscapularis and teres minor muscles and their tendinous attachment to the humerus (the arm bone). These muscles function to stabilize the shoulder and help control shoulder motion.

What are the signs of a rotator cuff tear?

A rotator cuff tear often results in a painful shoulder, particularly when trying to lift the shoulder overhead.  A larger tear can result in weakness or the inability to lift the arm overhead. The pain often is located in the shoulder and radiates down the arm partway toward the elbow.  Trouble sleeping on the affected shoulder is common.

What causes a rotator cuff tear?

A rotator cuff tear can be caused by an injury (traumatic) such as a shoulder dislocation or from a fall, or from gradual wear and tear (the most common).  Rotator cuff tears typically occur in adults and are less common in children. Repetitive overhead use of the arm over a long period of time is thought to be the most common cause of the wear and tear type of rotator cuff tear.  

What are the treatment options?

The treatment depends on the severity of the tear.  An MRI is often ordered to evaluate the problem and help determine the severity of the tear.  Most small/partial tears of the rotator cuff can successfully be treated without surgery. Often a regimen of rest, anti-inflammatories, therapy exercises, and/or corticosteroid injection can treat a small or partial rotator cuff tear.  A large tear where the tendon is pulled away from the bone would require surgery in order to repair this type of rotator cuff tear. The surgery is typically performed arthroscopically with small incisions in a minimally-invasive approach by the physicians at the Raleigh Hand to Shoulder Center.  An open surgical approach is another option for treating rotator cuff tears.

If you have signs or symptoms of a rotator cuff tear feel free to call our office to schedule an appointment with one of our fellowship trained Orthopedic hand and upper extremity surgeons that specialize in both the non-surgical and surgical treatments of shoulder pathology.

 

article by Dr George Edwards III

Video by American Academy of Orthopedic Surgeons

 

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Broken Finger Treatment in Raleigh NC

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Each finger in the hand is made up of 3 phalanges: the proximal phalanx, middle phalanx, and distal phalanx. The thumb has two phalanges. A phalanx fracture, also known as a broken finger, is a common hand injury. They can occur from a variety of injuries such as a fall, a motor vehicle collision, or sports injury. Satisfactory healing of this type of injury is important to restoring the overall hand function. Early diagnosis and treatment is very helpful.

What are the treatment options?

The treatment plan will depend on the severity of the fracture as noted on the x-rays and the patient’s medical condition, activity level, and desires. Most people have fractures which are stable and well-aligned, and, therefore, do not require surgery. Treatment in these cases is typically rest and protection with a splint for a few weeks. Sometimes “buddy-taping” to the uninjured, adjacent finger can be used in stable fractures. Follow-up x-rays are obtained in clinic to evaluate how the fracture is healing. Some fractures can be re-aligned without surgery with numbing medicine, called a “closed reduction” procedure, and those patients can also be treated non-operatively. Therapy is often helpful in improving range of motion and strength after the fracture heals.

Some patients have fractures which are more displaced and the alignment of the fracture is not satisfactory. Depending on the patient’s health and activity level, surgery may be advised to improve and maintain the alignment. A fracture which heals in poor alignment (“crooked”) can significantly affect the patient’s grip strength and hand function. Fractures which injure the joint surface are more prone to complications such as finger stiffness and arthritis.

Raleigh Hand to Shoulder Center doctors can advise you about how best to treat your broken finger.

What is involved with surgery?

The surgery is performed on an outpatient basis using either local anesthesia (injected numbing medicine) or regional anesthesia (nerve block at the shoulder) often with IV sedation. During the surgery, the doctor improves the alignment of the phalanx fracture bone and uses metal implants to stabilize the bones. Fluoroscopic x-rays are used in the operating room to confirm the alignment.

In some cases, we use a small plate and screws to fix the bones internally. The orthopedic hardware is covered by the skin and soft tissues of the finger and rests against the surface of the bone. This is called “open reduction and internal fixation” and requires an incision on the finger. In other cases, we use temporary pins (K-wires) through the skin to hold the fragments aligned while the bone heals. This is called “closed reduction and percutaneous pinning.” The pins can be removed in the office after 3-4 weeks. Which technique is used depends on the fracture pattern and is sometimes determined in the operating room by the surgeon.

Surgery does not really “heal” the fracture; it simply allows the bones to be held in good alignment while the body bridges the fracture site with new bone over a few weeks.

What is the recovery from surgery like?

Your fingers and hand will be protected in a plaster splint after the surgery. Rest and hand elevation is important to reduce swelling. The splint will be removed in clinic after a few days and a removable splint will be provided by our therapists. At this point, most patients can begin gentle wrist and finger range of motion with the oversight of a hand therapist. However, some patients need an additional few weeks of immobilization to protect the repair, depending on the severity of the fracture.  

Pain, swelling, and finger stiffness gradually improve over time. Most patients can return to normal function at about 2-3 months post-operatively, but maximum improvement can take several months. Recovery time varies among patients, depending on the severity of the injury, possible complications, and pain tolerance of the patient.

Ask a Doctor: Broken Finger

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New name — Raleigh Hand to Shoulder Center

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While our name may be new, it better reflects what we have been doing for years — caring for patients of all ages with hand, wrist, elbow and shoulder problems.

RHSC2019

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Dr Edwards III passed hand surgery board certification exam

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Dr George Edwards III of Raleigh Hand Center competed the final step in board certification for hand surgery. He was awarded the Subspecialty Certificate in Surgery of the Hand by the American Board of Orthopedic Surgery (ABOS). He is now double-board certified in orthopedics and hand surgery. Congratulations Dr Edwards!

Dr Edwards III

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Dr. Messer discusses Elbow Arthroscopy surgery at conference

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Dr. Terry Messer of Raleigh Hand Center discussed “Elbow Arthroscopy” surgery at orthopedic hand conference at WakeMed hospital on 11/12/2018. Orthopedic residents, occupational therapists, radiology, local hand surgeons and PAs were in attendance. Elbow Arthroscopy surgery is available for some patients with elbow arthritis, synovitis, lateral epicondylitis, joint contracture, and unstable cartilage fragments.

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