We are pleased to announce the addition of Samantha Tobin, OTD, OTR/L to the Raleigh Hand to Shoulder Center therapy department! Samantha obtained her Doctor of Occupational Therapy from Murphy Deming College of Health Sciences in 2018. She has worked as an occupational therapist at Greensboro Orthopedics and Emerge Orthopedics since then. She joins our practice with several years of therapy experience and an interest in pursuing her CHT. Her hobbies include cooking, gardening and spending time with her dogs. Welcome Samantha!
Dr. Terry Messer of Raleigh Hand to Shoulder Center discussed finger fracture dislocations on 11-13-2023 at WakeMed orthopedic hand conference. Treatment options for patients were discussed including nonsurgical treatment, surgery, and rehabilitation.
Starting in September, our office will be open for walk-in patients. No appointment is needed for patients with problems of the hand, wrist, elbow and shoulder. Our Orthopedic Surgeons in Raleigh will evaluate each patient in our office.
The Triangle area is fortunate to have great medical care. In Raleigh, orthopedic hand surgeons have offices in many locations around the city. How do you choose the right orthopedic hand surgeon who is best for you in Raleigh? Many patients are routinely referred to a surgeon or clinic after visiting the emergency room. However, patients are allowed to follow-up with the practice and surgeon who they prefer, no matter which emergency room or urgent care they visit initially.
Many patients choose the doctors at Raleigh Hand to Shoulder Center for their hand and upper extremity care. The Raleigh orthopedic hand surgeons are well respected in the medical community. Patients seek their practice for many reasons including: specialization in hand and arm conditions, personalized patient visits, and high-value healthcare.
After orthopedic residency, all the doctors in the practice completed an additional year-long fellowship to specialize in hand and upper extremity care. This additional year of training helped the doctors learn the important details about hand anatomy, pathology, and treatment. Every Raleigh Hand doctor is board-certified by the American Board of Orthopedic Surgery. Among the six physicians, the practice has over 100 years of combined experience treating patients.
The Raleigh Hand to Shoulder Center is a small private practice, independent of the hospital systems and larger orthopedic practices in Wake county. During every visit at the clinic in Raleigh, orthopedic specialists evaluate each patient personally. Hand and upper extremity occupational and physical therapy is also available on-site, which improves communication and coordination between the practitioners.
Additionally, the Raleigh Hand to Shoulder Center practice has been recognized for high-value healthcare. This designation shows that the doctors and therapists provide high-quality care at an appropriate cost. The doctors begin with non-surgical, conservative care for most patients. In many cases, patients can be treated without surgery using splints, medications, injections, and therapy. If surgery is necessary, the doctors perform most of their surgeries at Capital City Surgery Center, at a much lower cost than hospitals. Their surgery center has been recognized as the #1 Ambulatory Surgery Center in North Carolina for several years in a row. The doctors also perform in-office procedures for some conditions which provides a significant cost-savings to patients.
Orthopedic Hand Surgeons in Raleigh
If you or your loved one has a problem with their hand, wrist, elbow or shoulder, and live in the Raleigh area, please seek the best care possible and consider making an appointment with our orthopedic surgeons in Raleigh, North Carolina. The Raleigh Hand to Shoulder Center physicians have treated patients with hand and upper extremity problems for over 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 and arm problems. The hand is one of the most intricate and delicate areas of the human body, comprised of 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. The orthopedic hand surgeons in Raleigh strive to improve a patient’s quality of life through effective non-surgical and surgical treatments. All doctors are members of the American Society for Surgery of the Hand and are board-certified by the ABOS.
Dr. Post moved to Raleigh in 1998 and has been practicing at Raleigh Hand to Shoulder Center for 25 years. He believes that being part of a medical practice that has grown along with the city has been one of the most fulfilling parts of his career. “Our practice is unique in that we have grown but remain completely independent of hospital systems and larger orthopedic practices. This allows us to have a centrally located office dedicated to our goal of provided quality and cost effective care for our patients”
Outside of work, Dr. Post is active in the Midtown Kiwanis and has been past president of the club. He has been involved in Medical Mission work traveling to Nicaragua to educate residents and perform surgeries. He states “The physicians in the practice are like minded in that mission trips and giving back to the community are important to us.”
Dr. Post is married to Angie and has two children, Ryan and Shannon, and two grandchildren, Parker and Jack. His greatest joy in his personal life is spending time with family, and he travels frequently to visit his grandchildren. His hobbies include golfing and fishing.
Dr. James Post of Raleigh Hand to Shoulder Center discussed basial thumb arthritis (thumb CMC joint) at WakeMed Raleigh hand conference on Monday June 12, 2023. Treatment options including non-surgical treatment, hand therapy, injections, splints, and surgical options were discussed.
Do you have hand pain after punching a wall? It could be a boxers fracture. Boxers fractures are very common hand injuries. The typical cause is striking a hard surface with a clenched fist – such as punching a wall. These injuries can also occur in contact sports, automobile collisions, altercations, or falling to the ground on an outstretched hand.
A boxer’s fracture specifically is a fracture of the fifth metacarpal neck. The hand has five metacarpals, one for each finger and the thumb. The metacarpals make up the bony architecture of the hand between the wrist and the fingers. The fifth metacarpal is at the base of the small finger, or pinkie. The metacarpal neck is the part of the bone between the head and shaft of the metacarpal, closest to the MCP “knuckle” joint.
The most common signs of a boxer’s fracture are pain, bruising, swelling, limited finger range of motion, grip weakness, and deformity. The knuckle can look out of place or missing. The finger can also look deformed or crooked. If these symptoms do not go away within a brief period of observation, patients should be evaluated by a medical professional.
Treatment of boxers fracture
Early treatment for a boxer’s fracture includes resting the hand, immobilization, ice, elevation, and oral anti-inflammatory medications to relieve pain, swelling, and inflammation. Most patients do not require expensive medical treatment or surgery in order to achieve a good functional result. Several studies have shown that most patients benefit from simple treatment and can expect good long-term hand function. However, patients should be advised that there may be a cosmetic difference between the injured and uninjured hands.
Patients with these injuries may benefit from specialized orthopedic care. This treatment includes x-ray evaluation, custom splinting, and hand therapy. Traditionally, many patients have been treated with closed reduction and casting of fifth metacarpal fractures. This involves the use of a local anesthesia injection and manipulation of the fracture site to improve the x-ray alignment. Recent studies have shown us that this procedure may not provide any long-term benefit to patients with mild-to-moderate severity fractures.
In most cases, treatment consists of activity modifications and using a removable splint for 3-6 weeks. As patients heal, they are guided to increase their hand activity within their pain tolerance and progress through a series of range of motion and hand strengthening exercises. Hand therapy is available to help patients regain their pre-injury hand function more quickly. Most patients typically regain normal hand function about 2-3 months following this injury.
Occasionally surgery is recommended for patients with a boxer’s fracture. If there is significant angulation at the fracture site or if the finger is malrotated, surgery can be helpful to realign and stabilize the fractured bone. Complications from surgery include infection, stiffness, scar tissue formation, and possibly the need for additional surgery such as the removal of implants or scar tissue.
A word of caution: not all fifth metacarpal fractures are boxer’s fractures. Inexperienced clinicians often mislabel a fifth metacarpal shaft fracture as a “boxer’s fracture.” Fractures involving the shaft of the metacarpal can result in significant hand impairment if not treated adequately. Consider consultation with an orthopedic hand specialist to guide your hand care appropriately.
The Raleigh Hand to Shoulder Center physicians have treated patients with hand and upper extremity 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 and arm problems. The hand is one of the most intricate and delicate areas of the human body, comprised of 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. T
Osteoarthritis is one of the most common ailments affecting the hands. Wear and tear arthritis within the joints can lead to weakness, deformity, limited range of motion, inflammation, and pain. These symptoms can impair the function of the hand and reduce a person’s quality of life. Conventional medical treatments for hand osteoarthritis in the United States include oral anti-inflammatory medications (NSAIDs), oral acetaminophen, topical medications, splints, hand therapy, and corticosteroid injections. Opioid medications are prescribed less frequently for this condition due to the concern for adverse effects, addiction, and overdose. Surgery can also reduce the symptoms, but this is considered a last-resort option for many people.
Side effects and adverse reactions from conventional osteoarthritis medications are well-known. Due to the limitations of these treatments, many people have turned toward alternative options. These include dietary changes, oral supplements such as glucosamine, chondroitin, and turmeric, and topical cannabidiol (CBD) products.
Cannabidiol (CBD) products became widely available in the United States after the passage of the Agriculture Improvement Act in 2018, known as the Farm Bill. This bill legally differentiated hemp from marijuana. Marijuana and hemp are closely related plants in the cannabis family. Industrial hemp is now defined as cannabis with less than 0.3% THC, the psychoactive component of marijuana. Marijuana is defined as cannabis with greater than 0.3% THC. Although several US states have legalized the recreational use of marijuana, the federal Drug Enforcement Agency considers marijuana a controlled substance with a high potential for abuse.
CBD is one of the many cannabinoid compounds found within the cannabis plant. CBD is thought to have antioxidant, anti-inflammatory, and analgesic (pain-relieving) effects in the body. CBD does not have the psychoactive effects of THC. CBD products derived from licensed hemp growers can be legally purchased over-the-counter in most US states, including North Carolina. CBD is available in many product forms including oral and topical (absorbed through the skin) application.
A recent article in the Journal of Hand Surgery evaluated the safety and efficacy of topical CBD for treatment of thumb basal joint arthritis. In this study, half of the patients were treated with 2 weeks of topical CBD cream and the other half were treated with a topical placebo. This was a randomized, controlled trial in which the patients did not know whether they were using the CBD cream or the placebo cream. The patients using the CBD cream reported significantly less pain than the control group, noting a 60% reduction in pain on average. There were no adverse events reported. The study concluded that “twice-daily topical CBD application resulted in improvements in thumb basal joint arthritis-related pain and disability without adverse events.” Additional studies are needed to confirm these results and to determine the safety and efficacy of topical CBD in longer term use.
Many CBD products on the market today do not meet the US Food and Drug Administration (FDA) quality standards. It is unknown which brand or concentration of CBD is preferred. Third-party, independent company testing is available to confirm the purity and quality of CBD products. The FDA is also concerned about potential health effects of CBD treatment including liver toxicity, drug interactions, and fertility issues. The FDA has not approved the marketing of CBD for treatment of osteoarthritis.
All current osteoarthritis remedies are aimed at treating the symptoms of arthritis. They do not change the underlying degenerative joint disease process. In 2022, there is still no known “cure” for osteoarthritis. Manufacturers may promise miraculous results, but many medical claims are unproven. Consumers should be skeptical of unrealistic expectations.
Based on recent research, the results appear to be encouraging for short term use of topical CBD products for hand osteoarthritis symptoms. However, the FDA has not approved the marketing of CBD for treatment of osteoarthritis. More studies are required to determine the safety and efficacy of these products.