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CONDITIONS
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Arthritis
Finger Arthritis
Basal Thumb Arthritis
Wrist Arthritis & DRUJ Arthritis
Elbow Arthritis
Rheumatoid Arthritis
Tendon Injuries & Disorders
Flexor Tendon & Extensor Tendon Lacerations
Mallet Finger & Boutonniere Finger
Trigger Finger/Trigger Thumb
Sagittal Band Tear
Swan Neck Deformity
De Quervain's Tenosynovitis (Mommy Thumb)
Intersection Syndrome
Wrist Tendonitis
Tennis elbow (Lateral Epicondylitis) & Golfer's Elbow (Medial Epicondylitis
Nerve Disorders
Carpal Tunnel Syndrome
Cubital Tunnel Syndrome
Guyon's (Ulnar Tunnel) Syndrome
Radial Tunnel Syndrome
Nerve Injuries and Lacerations of the Hand and Upper Extremity
Hand Numbness
Fractures
Phalanx Fractures
Boxer's Fracture and other Metacarpal fractures
Scaphoid Fractures
Triquetral Fractures
Distal radius/ulna fractures (Wrist Fractures)
Radial Head and Neck fractures
Elbow Fractures and Dislocations
Finger & Wrist Sprains
Gamekeeper’s & Skier's Thumb
Finger Sprains & Dislocations
Wrist Ligament Injuries (including Scapholunate and TFCC injuries)
Elbow Sprains
Hand Conditions
Dupuytren’s Contracture
Finger Stiffness
Nail bed Injuries
Nail Infections & Deformities
Hand Infections
Cysts/Masses
Finger Mucous Cysts
Ganglion cysts
Other Lumps (Lipomas, Cysts, and Solid masses in the Hand & Upper Extremity)
Foreign Bodies
Glomus Tumor
Hand Tumors
Elbow Conditions
Elbow Arthritis
Loose Bodies
Plica Syndrome
Other
Retained Hardware
Lower extremity fractures (hip, knee, and ankle)
Do you ever wake up at night with your hand numb or asleep? Does driving, or even holding your iPad or tablet cause your hand or your arm to burn or tingle? You may have carpal tunnel syndrome or another nerve condition in your arm.
Carpal tunnel syndrome occurs when a large nerve, the Median Nerve, becomes pinched and compressed upon entering your wrist. This can happen to almost anyone – men or women, young or old, active or maybe not so active.
Of course, not all numbness in the hand is from carpal tunnel syndrome. Other nerve disorders, such as cubital tunnel syndrome, cervical pinched nerves, thoracic outlet syndrome, diabetes, and many other conditions may be occurring. These symptoms should not be ignored over time, but should be discussed with your doctor so they may be treated effectively.
When is a bump on your hand or finger just a bump, and when is it more? Ganglion cysts are simple, fluid filled sacs commonly found on both the front and back of the wrist, around the last knuckle of the fingers, or at the base of the fingers on the palm side. These may be associated due to a minor trauma, nearby joint arthritis, or sometimes the reason is unknown.
Many of these can be treated with non-surgical therapy, including rest, anti- inflammatory medications, or aspirating the fluid. Dr. Timothy Larson, MD uses ultrasound imaging to guide the needle into the cyst to ensure proper placement and to minimize discomfort. Surgery does remain the most effective way to eliminate the cyst permanently.
Not all lumps and bumps are simple or benign.
De Quervain’s is a painful tendon condition affecting the tendons on the thumb side of the wrist. Typically, there are two tendons that attach to the thumb that must pass through a confined tunnel on their way back to the forearm. Inflammation or injury to this area can cause severe pain with wrist motion, especially radial or ulnar deviation.
To treat De Quervain’s, usually one or more treatment modalities is helpful. These include corticosteroid injections, therapy, bracing, and anti-inflammatory medications (NSAIDS). Non-surgical treatment is usually safe and effective, but for certain people whose pain persists, surgery may become necessary.
Dupuytren’s Contracture is an inherited disorder of the collagen fibers that make up the structure to our hand. Over time, the fingers or thumb of the hand may be drawn into the palm, unable to be fully extended. While usually pain-free, this can cause dysfunction to the hand, and make it difficult to put the hand flat on a surface, or get your fingers into a glove.
Fortunately, there are several ways to address Dupuytren’s Contracture, including monitoring the hand, surgery, percutaneous procedures, and Xiaflex injections. The method of treatment will be chosen by the patient and the surgeon, and selected to best fit the patient’s desire and need.
Painful conditions about the elbow can make it difficult to use the entire arm, whether we are trying to lift heavy objects or paint with fine brush strokes. Tennis elbow, or lateral epicondylitis, isn’t just limited to tennis players, and can severely affect our grip strength and hand function. A variety of other elbow conditions, including arthritis, radial tunnel syndrome, biceps tendonitis or tears, golfer’s elbow, and many others can be treated and allow you to resume your life’s activities, whatever they may be.
The hand and wrist are very unique and high-functioning parts of our body. Broken bones, or fractures, can cause a lot of disruption to our lives, even if only minimal treatment is required. Some fractures, such as a wrist fracture that occurred from a simple fall onto an outstretched hand, can indicate weakening of the skeleton or osteoporosis.
Surgery may be indicated when the fracture is displaced, or shifted, or involve nearby joints. Often, surgery can help expedite recovery, and allow less dependence on casts or splints, helping us regain function and perform all of the wonderful activities that our hands let us do. Some fractures require percutaneous fixation and insertion of wires, while other surgeries require incisions and direct fixation of the bone. Some injuries may have happened in the past and may require bone grafting and more technical procedures. Dr. Timothy Larson, an orthopedic surgeon with fellowship-developed skill in hand and upper extremity procedures, is well trained to help your hand and wrist fracture.
There are many types of arthritis that can cause pain and loss of ability to the fingers, thumb, hand, and wrist. Osteoarthritis (also known as degenerative arthritis) as well as Rheumatoid Arthritis and other less common conditions can all be treated with medicines, therapy, or surgery.
Arthritis in the fingers can sometimes require joint replacement, where the two opposing joint surfaces are replaced, or a fusion (arthrodesis) procedure, when the joint surfaces are removed and the bones are fused together. Treatment is tailored to the location and desired use of the afflicted body part.
The thumb carpometacarpal joint, or CMC joint, is a very common place for arthritis to occur, especially in women. Debilitating joint pain at the thumb can also be managed quite successfully with non-operative methods, but fortunately there are surgical procedures to help treat those thumbs that cannot.
Wrist arthritis can occur as a result of trauma, gout or other diseases, or as part of osteoarthritis and rheumatism. When needed, these and other wrist conditions can be treated with a variety of surgical considerations, each tailored to the patient’s specific pattern of arthritis and desired uses of the wrist. Partial or complete wrist fusions, wrist joint replacement, or select removal of offending bones are all surgical options.
Children are not simply young adults. The growing skeleton has many unique features, as does each child. Our active youth are involved in a wide variety of activities, and it seems like bumps, bruises, and even broken bones are an inevitable part of growing up.
While most injuries that occur in childhood can be treated without surgery, some require reduction and casting, and others may require bracing or casting for protection during the healing process. Muscle and tendon conditions may benefit from guided therapy that will help your child reach their potential.
Please see the following website from the American Academy of Orthopedic Surgeons for helpful information on child safety: orthoinfo.aaos.org
Injuries both small and large can injure the tendons in the hand and fingers. Tendons are the connective structures that attach the muscle to bone and cause movement of our joints. In the hand, there are flexor tendons that bend the fingers and wrist down, and extensor tendons that straighten them back out. Traumatic injuries can happen from the fingertips to the forearm.
Tendon repair is a surgical procedure that reattached the torn ends. Occasionally, and tendon transfer procedure may be necessary, which is when one tendon is taken and reattached to another area to better restore strength and function. A detailed therapy regimen is then prescribed with a certified hand therapist to help the body recover.
Timing of tendon repair is critical – most injuries should be repaired within 10-14 days from the injury itself!
The thumb carpometacarpal joint, or CMC joint, is a very common place for arthritis to occur, especially in women. Debilitating joint pain at the thumb can also be managed quite successfully with non-operative methods (steroid injections, PRP injection, braces, medicines, and therapy), but fortunately there are surgical procedures to help treat those thumbs that cannot.
Dr. Larson performs surgery for CMC arthritis of the thumb using several methods, depending upon which one is the best for you. Arthroscopic debridement can be an option for early arthritis, as can thumb joint denervation - a procedure which removes the small nerve endings to the joint itself.
Most commonly, thumb arthritis surgery is performed by removing a small bone at the base of the thumb, the Trapezium, and then using either the patient’s own tendon or a medical device to support the thumb. All of these procedures are excellent at treating pain and restoring thumb function.
Trigger finger, also known as “stenosing tenosynovitis,” is a painful condition that can cause any finger or thumb to catch or lock in a bent or straightened position. The problem arises from a constriction of the finger tendons as they pass through a series of tunnels, called pulleys, as they leave the palm and enter the finger.
Trigger finger may be associated with diabetes, rheumatism, or thyroid disorders, but is frequently due to overuse, repetitive activities or trauma to the hand. Fortunately, trigger finger or thumb can frequently be cured with a corticosteroid injection into the tendon sheath. Sometimes surgery is required to correct the problem. Fortunately this procedure can be done under local anesthesia only, and can safely been done in the office!
Dr. Larson’s training at The Carolinas Medical Center, in Charlotte, NC - one of the country’s premier orthopedic residency training programs - has well prepared him for traumatic injuries to the lower extremity as well. Since coming to Denton, Dr. Dr. Larson consistently treats a variety of lower extremity conditions and takes general orthopedic call at Texas Health Presbyterian Hospital in Denton, TX.
Hip fractures, which come in many different varieties, as well as long bone fractures to the femur (thigh bone) or the tibia or fibula (bones in the lower leg), and ankle fractures unfortunately are quite common. Proper treatment of these conditions requires skill, knowledge, and often a team approach to get patients the care they deserve so they can get back on their feet.
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