Clavicle Injuries & Conditions | Hand Microsurgery in Erie, PA

The professional medical staff at Hand Microsurgery specialize in the treatment of the upper extremities, including the clavicle. The clavicle, otherwise known as the collarbone, connects the arm to the body and is located between the shoulder blade and the ribcage. The clavicle is one of the most commonly broken bones and lies above many significant blood vessels and nerves. However, these important blood vessels and nerves are rarely injured when the clavicle becomes fractured.

Clavicle Fracture

The orthopaedic staff at Hand Microsurgery are specialized in providing medical treatment for the upper extremities and can help you recover from clavicle fractures. Most clavicle fractures occur in the middle of bone.

At times, the clavicle bone will break where it attaches to the shoulder blade or rib cage. A direct blow to the shoulder is what causes most clavicle fractures. This can happen during a fall onto the shoulder, a car collision, or a fall onto an outstretched arm.In babies, clavicle fractures can even occur during the passage through the birth canal. 

Thoracic Outlet Syndrome

The space between your first rib and your clavicle is known as the thoracic outlet. This slim passageway is loaded with blood vessels, muscles, and nerves. If the shoulder muscles in your chest are not strong enough to hold the collarbone in place, it can slip down and forward which puts pressure on the nerves and blood vessels that lie under it.

This causes a multitude of symptoms including:

• Faint, aching pain in the neck, shoulder, arm, or hand
• Pain, numbness, or tingling on the inside of the forearm as well as the fourth and fifth fingers
• Swelling and/or redness in the arm
• Difficulty with overhead activities
• Limited range of motion

Thoracic outlet syndrome can result from injury, disease, or can be present from birth. Thoracic outlet syndrome is more common in women than men. Poor posture and obesity can also cause more irritation and discomfort. Psychological changes are often seen in patients with thoracic outlet syndrome but it is not known whether these changes are a cause or result of the syndrome.

Shoulder Injuries & Conditions | Hand Microsurgery in Erie, PA

Hand Microsurgery has medical staff members who are specialized in treatment of the upper extremities. The shoulder is made up of three bones including your upper arm bone, shoulder blade, and collarbone. Your arm is kept into place within your shoulder socket by your rotator cuff which is a network of four muscles that come together as tendons to protect the end of your upper arm bone. These separate parts of the shoulder function together to help raise, rotate, and swing your arm in motion. If parts of the joint are injured, the shoulder can become unstable and could cause pain or limit the movement. Listed below are a few shoulder injuries and conditions that may require professional assistance and/or medical treatment from Hand Microsurgery.

Dislocated Shoulder

The shoulder joint can dislocate forward, backward, or downward. A common type of shoulder dislocation is when the shoulder slips forward. This means the upper arm bone moved forward and down, out of its joint. It may happen when the arm is put in a throwing position. The shoulder is one of the easiest joints to dislocate. 

A partial dislocation means the head of the upper arm bone is partially out of the socket. A complete dislocation means it is all the way out of the socket. Both partial and complete dislocations cause pain and unsteadiness in the shoulder. 

Frozen Shoulder

Frozen shoulder causes pain and stiffness in the shoulder and over time, the shoulder becomes very hard to move. It most commonly affects people between the ages of 40 and 60, and occurs in women more often than men. With frozen shoulder, the shoulder capsule thickens and becomes tight, which causes stiff bands of tissue to begin to develop. There are three stages of frozen shoulder which include:

• Freezing: During this stage, you slowly begin to have more and more pain. As the pain worsens, your shoulder loses range of motion. Freezing typically lasts from 6 weeks to 9 months.
• Frozen: Painful symptoms may actually improve during this stage, but the stiffness remains. During the 4 to 6 months of the “frozen” stage, daily activities may be very difficult.
• Thawing: Shoulder motion slowly improves during the “thawing” stage. Complete return to normal or close to normal strength and motion typically takes from 6 months to 2 years.

Pain from frozen shoulder is usually dull or aching, and is typically worse early in the course of the disease. The pain is usually located over the outer shoulder area and sometimes the upper arm. The causes of frozen shoulder are not fully understood. A few factors may put you more at risk for developing frozen shoulder such as diabetes, immobilization, and other diseases.

Shoulder Separation

A shoulder separation is not truly an injury to the shoulder joint. The injury actually involves the AC joint. The AC joint is where the collarbone meets the shoulder blade. The most common cause for a separation of the AC joint is from a fall directly onto the shoulder. The fall injures the ligaments that surround and stabilize the AC joint. If the force is severe enough, the ligaments attaching to the underside of the clavicle are torn. This causes the “separation” of the collarbone and wing bone. The wing bone actually moves downward from the weight of the arm. This creates a “bump” or bulge above the shoulder. The injury can range from a little change in configuration with mild pain, to quite deforming and very painful.

Shoulder Treatment

Often, the orthopaedic surgeons of Hand Microsurgery will prescribe a series of exercises aimed at strengthening the shoulder muscles. Shoulder exercises may include basic shoulder strengthening using an elastic band, wall push-ups, or shoulder press-ups. Anti-inflammatory medication also may be prescribed to reduce pain and swelling. Certain injuries may require surgical treatment if severe enough. However, the medical staff of Hand Microsurgery will ensure to consider non-surgical options first.

Upper Arm Injuries & Conditions | Hand Microsurgery in Erie, PA

The experienced medical staff of Hand Microsurgery specialize in treatment of the upper extremities, including the upper arm. The head of your upper arm bone fits into a rounded socket in your shoulder blade called the glenoid. A combination of muscles and tendons keeps your arm centered in your shoulder socket. The biceps muscle is in the front of your upper arm. It helps you bend your elbow and rotate your arm and also helps keep your shoulder stable. The biceps muscle has two tendons that attach it to bones in the shoulder. The long head attaches to the top of the shoulder socket. The short head of the biceps tendon attaches to a bump on the shoulder blade called the coracoid process.

Biceps Tendonitis

Biceps tendonitis is inflammation of the long head of the biceps tendon. This usually occurs along with other shoulder problems and in most cases, there is also damage to the rotator cuff tendon. In the early stages of biceps tendonitis, the tendon becomes red and swollen. As tendonitis develops, the outer covering of the tendon can thicken and possibly grow larger. The tendon in these late stages is often dark red in color due to the inflammation. Occasionally, the damage to the tendon can result in a tendon tear, and then deformity of the arm. A few symptoms of biceps tendonitis include:

• Pain or tenderness in the front of the shoulder, which worsens with overhead lifting or activity
• Pain or achiness that moves down the upper arm bone
• An occasional snapping sound or sensation in the shoulder

In most cases, damage to the biceps tendon is due to a lifetime of overhead activities. As we age, our tendons slowly weaken with everyday wear and tear. This degeneration can be worsened by overuse or repeating the same shoulder motions again and again. Swimming, tennis, and baseball are some sports examples of repetitive overhead activities. Many jobs and routine chores can cause overuse damage as well. Repetitive overhead motion plays a part in other shoulder problems that occur with biceps tendonitis. Rotator cuff tears, osteoarthritis, and chronic shoulder instability are often caused by overuse.

Biceps Tendon Tear at the Elbow

Your biceps tendons attach the biceps muscle to bones in the shoulder and in the elbow. If you tear the biceps tendon at the elbow, you will lose strength in your arm and be unable to forcefully turn your arm from palm down to palm up. Once torn, the biceps tendon at the elbow will not grow back to the bone and heal. Other arm muscles make it possible to bend the elbow fairly well without the biceps. However, they cannot perform all the functions, especially the motion of rotating the forearm from palm down to palm up. A few symptoms of a biceps tendon tear at the elbow incude:

• Swelling in the front of the elbow
• Visible bruising in the forearm and elbow
• Weakness in bending of the elbow
• Weakness in twisting the forearm
• A bulge in the upper part of the arm created by the recoiled, shortened biceps muscle
• A gap in the front of the elbow created by the absence of the tendon

The main cause of a distal biceps tendon tear is a sudden injury. These tears are rarely associated with other medical conditions. Biceps tendon tears can be either partial or complete. In most cases, tears of the distal biceps tendon are complete. This means that the entire muscle is detached from the bone and pulled toward the shoulder. Other arm muscles can substitute for the injured tendon, usually resulting in full motion and reasonable function. Left without surgical repair, however, the injured arm will have a 30% to 40% decrease in strength, mainly in twisting the forearm. 

Elbow Injuries & Conditions | Hand Microsurgery in Erie, PA

Hand Microsurgery has specialized orthopaedic surgeons and physicians to treat elbow injuries and conditions as well as other upper extremity injuries. The elbow contains extensor muscles, which allow you to straighten your fingers and rotate your lower arm or wrist. A tendon attaches these extensor muscles to your elbow, where they reach out to your wrist and fingers. Repetitive use or an injury can cause the tendon tissue to become inflamed or irritated. The nerves around the tendon make moving your elbow painful.

Tennis Elbow

Tennis elbow occurs when tissue attaching muscle to the bone becomes irritated, and causes an inflammation around the outer side of the elbow. Playing a racket sport can cause tennis elbow as well as any action that extends your wrist or rotates your forearm. The tissue may become inflamed more easily with age.

A few common symptoms of tennis elbow include:

• Pain on the outer side of the elbow and down the forearm
• Swelling
• Redness
• Warm to touch

The experienced physicians at Hand Microsurgery can usually diagnose tennis elbow from your symptoms and by simply looking at and feeling your elbow. At times, an x-ray might need to be ordered to be sure the bone is not diseased or fractured.

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Elbow Bursitis

Bursae are thin sacs throughout the body that act as cushions between bones and soft tissues. If the bursae become irritated or inflamed, more fluid will accumulate and elbow bursitis will develop. A few of the main reasons elbow bursitis can occur include trauma, prolonged pressure, infection, or other medical conditions. Swelling is often the first symptom. The skin on the back of the elbow is loose, which means that a small amount of swelling may not be noticed right away. If the bursitis is infected, the skin becomes red and warm. If the infection is not treated right away, it may spread to other parts of the arm or move into the bloodstream which can cause serious illness. 

Osteoarthritis of the Elbow

Osteoarthritis of the elbow occurs when the cartilage surface of the elbow is damaged or becomes worn. This can happen because of a previous injury or condition. It may also be the result of degeneration of the joint cartilage from the natural aging process. The elbow is one of the least affected joints because of its well matched joint surfaces and strong stabilizing ligaments. As a result, the elbow joint can tolerate large forces without becoming unstable. One of our specialized physicians can usually diagnose osteoarthritis of the elbow based on symptoms and standard x-rays. Most patients who are diagnosed with elbow osteoarthritis have a history of injury to the elbow, such as a fracture that involved the surface of the joint, or an elbow dislocation.

Cubital Tunnel Syndrome

Cubital tunnel syndrome is a set of symptoms that may occur if the ulnar nerve in your elbow gets pinched. This may happen if you bend or lean on your elbows often. Many other things can cause the ulnar nerve to get pinched such as holding a phone to your ear for a long time, sleeping with arms tightly bent, a sudden elbow injury, or a past elbow fracture. Symptoms can be minor at first but may worsen over time. Common symptoms include:

• Loss of finger or hand strength
• Inability to straighten fingers
• Sharp, sudden pain when elbow is touched

Rest, medication, and changes in how you do various tasks can help ease the pain. One of our physicians at Hand Microsurgery will examine your hand and elbow and ask about your daily tasks in order to diagnose. They may also request to have some tests done such as x-rays. Most treatment plans for cubital tunnel syndrome begin with changing your actions that may have originally caused the problem.

Elbow Dislocation

When the joint surfaces of an elbow are separated, the elbow is dislocated. In a complete elbow dislocation, the joint surfaces are completely separated. In a partial dislocation, the joint surfaces are only partially separated. Elbow dislocations are not common and typically occur when a person falls onto an outstretched hand. When the hand hits the ground, the force is sent to the elbow, usually with a twisting motion. This can drive and rotate the elbow out of its socket.

Elbow Fractures

When you bend your elbow, you can easily feel its “tip,” a bony prominence that extends from one of the lower arm bones. This tip is positioned directly under the skin of the elbow, without much protection from muscles or other soft tissues. It can easily break if you experience a direct blow to the elbow or fall on a bent elbow. There are many types of elbow fractures.

Forearm Injuries & Conditions | Hand Microsurgery in Erie, PA

The specialized medical staff at Hand Microsurgery are experienced in treating the upper extremities, including the forearm. The forearm is made up of two bones, the radius and ulna, along with a variety of muscles that are located on the outside and inside of the arm below the elbow. These muscles work together to control the movement of the hand and wrist. The forearm flexor muscles curl the hand down and forward while the extensor muscles curl the hand back up.

Forearm Fractures

Forearm bones can break in several ways whether it cracks slightly or it breaks into many pieces. In some cases, the bone will break in such a way that bone fragments stick out through the skin or a wound penetrates down to the broken bone. This is called an open fracture and requires immediate medical attention because of the risk for infection. Since it takes an extremely strong force to break the radius or ulna in the middle of the bone, more often than not adults break both bones during a forearm injury. The ulna is usually the bone to break when only a single bone is broken.

A few of the main symptoms people experience with a broken forearm include:

• Swelling
• Bruising
• Inability to rotate arm
• Numbness or weakness in the fingers or wrist

A broken forearm usually results in immediate pain and an obvious deformity, if both bones are involved, by appearing bent and shorter than your other arm. You will most likely need to support your broken arm with the other arm. Treatment of forearm fractures usually involves casting procedures since it is crucial to put the broken pieces back into position and keep them from moving until completely healed.

Wrist Injuries & Conditions | Hand Microsurgery in Erie, PA

Hand Microsurgery has an experienced medical staff that specializes in treatment of the upper extremities, including the wrist. The wrist is a complex joint with eight small bones and many connecting ligaments. The wrist is also a mobile joint that can move up and down and from side to side, as well as rotate. Its many small bones, bound to one another by ligaments, enable these actions to occur. On the hand side of the wrist, there are two rows of bones at the base of the hand, with four bones in each row, which are called carpals. The long thin bones of the hand radiate out from one row of carpals and form the basis of the fingers and thumb. The radius and the ulna are the two bones of the forearm that form a joint with the first row of carpals.

Wrist Sprains

A sprain is an injury to a ligament. Ligaments are strong bands of connective tissue that connect one bone to another. There are many ligaments in the wrist that can be stretched or torn, resulting in a sprain. This occurs when the wrist is bent forcefully, such as in a fall onto an outstretched hand. A few common symptoms experienced include:

• Swelling in the wrist
• Pain at the time of the injury
• Persistent pain when you move your wrist
• Bruising or discoloration of the skin around the wrist
• Tenderness at the injury site
• A feeling of popping or tearing inside the wrist
• A warm or feverish feeling to the skin around the wrist

Wrist sprains can range from mild to severe. They are graded, depending on the degree of injury to the ligaments. Sometimes, a wrist injury may seem mild with very little swelling, but it could be that an important ligament has been torn that will require surgery to avoid problems later. Wrist sprains are most often caused by a fall onto an outstretched hand. This might happen during everyday activities, but frequently occurs during sports and outdoor recreation. 

Wrist Fractures

The wrist may fracture at the end of the radius and sometimes at part of the ulna. This fracture often results from a sudden fall on an outstretched hand. One of our experienced physicians at Hand Microsurgery may reposition a broken bone by closed or open reduction. Reduction can be done for all types of fractures. However, treatment will vary for each fracture and depend on the extent of injury. Treatment may also include self-care, such as wrist exercises, or a cast to prevent movement. 

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Wrist Arthroscopy

Wrist arthroscopy is used mostly for diagnosis but in some cases can be used for treatment. It works best for showing ligament tears, or damage to the TFCC or cartilage. Arthroscopy involves using a small instrument called an arthroscope that allows for the surgeon to see inside the joint without making large incisions into the muscle and tissue. Often times, diagnosis and repairs are both done during the arthroscopy procedure.

Hand Injuries & Conditions | Hand Microsurgery in Erie, PA

The professional medical staff at Hand Microsurgery specializes in the treatment of the hand, as well as the upper extremities. The hand is one of the most intricate and flexible structures of the body. Your hands are made up of more bones and moving parts than most areas of your body. Not only do hands enable us to grasp and move objects, they also detect warmth and texture. The hand is incomparable in its sensitivity, mobility and strength. Your hands play a vital role in nearly everything you do. Since hands have so many different functions, they are often prone to accident or injury. Three common hand problems are tendinitis, lumps, and contractures. If one of these problems is causing you pain or impairing function, it may be time to consider professional medical assistance. Listed below are a few common hand injuries or conditions.

Arthritis of the Hand

The hand and wrist have multiple small joints that work together to perform a motion. When the joints are affected by arthritis, activities of daily living can be difficult. Arthritis can occur in many areas of the hand and wrist and can have more than one cause. Over time, if the arthritis is not treated, the bones that make up the joint can lose their normal shape. This causes more pain and further limits motion.

A few common symptoms experienced by people with arthritis include:

• Pain, most commonly after periods of increased joint use
• Swelling
• Changes in surrounding joints
• Warm to touch
• Grating or grinding sensation in the joint area
• Small cysts

Fractures, particularly those that damage the joint surface, and dislocations are among the most common injuries that lead to arthritis. Even when properly treated, an injured joint is more likely to develop arthritis over time. When arthritis occurs due to disease, the onset of symptoms is gradual and the cartilage decreases slowly. The two most common forms of arthritis from disease are osteoarthritis and rheumatoid arthritis.

Hand Fractures

Fractures of the hand can occur in either the small or long bones of the fingers. They can result from a twisting injury, fall, crush injury, or direct contact in sports.

A few of the main hand fracture symptoms people experience are:

• Swelling
• Tenderness
• Deformity
• Inability to move finger
• Shortened finger
• Finger crosses over its neighbor when making a partial fist

In the event of a fracture, there are many forms of medical treatment available. These include passive exercises, active (flexing and extending) exercises, and splints to maintain or increase range of motion achieved through therapy. Most cases are able to be treated without surgery. Our team of experienced medical staff at Hand Microsurgery are specialized in treating the hand.

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Finger Injuries & Conditions | Hand Microsurgery in Erie, PA

Hand Microsurgery has experienced medical staff available to provide specialized finger treatment for patients. The finger joints function in a similar way to hinges when you bend and straighten your fingers. Tendons connect muscles in your forearm to the bones in your fingers and are surrounded by a protective tendon sheath. This sheath is lined with a fluid that allows tendons to slide easily when you bend and straighten your fingers. Injuries to the finger joints are common and usually heal without significant problems. Some injuries are more serious and may develop problems if not treated carefully.

Trigger Finger

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Trigger finger affects the tendons inside the finger or thumb. Tendons connect muscle to the bone and allow you to bend or straighten your fingers. With trigger finger, the tendons become swollen and inflamed which makes it difficult for your fingers to function naturally. Generally, the cause of trigger finger is unknown. Pain and swelling can occur where the finger or thumb joins the palm. As the tendon becomes more inflamed, the finger may catch when straightened. When the locked tendon releases, the finger pops as if releasing the trigger of a gun. This further irritates the tendon and may set up a cycle of swelling and catching.

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Fingertip Injuries

Black Nail: Hitting the fingernail with a hard, direct blow can cause bleeding beneath the nail where the blood will need to be pulled. In most cases, it will disappear with growth of the new nail. Sometimes special medical treatment by a physician is needed to relieve pressure and pain.

Finger Crushing: A crushing blow to the fingertip can fracture the finger bone. The bone can become fractured in several places, and the nail will then be driven upwards off the bone. Treatment involves the removal of any debris or small bone fragments and thoroughly cleaning the entire area.

Mallet Finger

A mallet finger is a tear in the tendon that controls the tip of your finger and causes the loss of ability to straighten the end of your finger. Initial treatment of mallet finger is non-surgical, and will most likely require splinting.

Your splint must be removed on a daily basis to examine your skin. While changing the splint, your finger must remain supported in the extended (straight) position. This is most easily accomplished by placing the tip of your finger on the edge of a table. 

If proper care instructions are followed, your mallet finger should heal in approximately 8-12 weeks. If left unsupported, however, re-injury will occur causing your splinting time to start again.

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Thumb Injuries & Conditions | Hand Microsurgery in Erie, PA

Hand Microsurgery has a specialized medical staff on-hand that is experienced in providing medical assistance for the upper extremities, including the thumb. The basal joint is formed by one of the wrist bones and the first of the three bones in the thumb. This joint allows the thumb to move and pinch with the fingers. Tendons connect in your wrist and forearm to the bones in your thumb. The tendons are surrounded by a protective tendon sheath which is lined with synovium and produces a fluid that allows the tendons to slide easily when you straighten your thumb. If the tendons are irritated or injured, they will become inflamed.

Basal Joint Arthritis

Arthritis causes cartilage to wear away and often affects the basal joint which is at the base of the thumb. When arthritis occurs in the basal joint, it slowly damages the joint. Basal joint arthritis is most common in women older than 40, but anyone can get it. Basal joint arthritis is often caused by wear and tear in the joint due to aging. It also might be more likely to occur if you have broken or injured your thumb previously. Repeatedly gripping, twisting, or turning objects with the thumb and fingers may make the condition worse. A few common symptoms of basal joint arthritis include:

• Pain in the lower part of the thumb
• Dropping of objects
• Pain from weather changes
• Joint swelling
• Stiff or deformed thumb

Basal joint arthritis can often be diagnosed by examining how the thumb looks and moves. X-rays may be ordered to see how much of the joint is damaged. Based on the results, the physicians of Hand, Microsurgery and Reconstructive Orthopaedics can then work with you to plan the treatment that best fits your needs.

Sprained Thumb

A thumb sprain is an injury to the main ligament in the thumb. Ligaments are soft tissue structures that connect two bones to make a functioning, stable joint. If you tear the main ligament at the base of your thumb, your pinch and grasp ability will be weak. There may or may not be pain right away. Other symptoms include bruising, tenderness, and swelling. 

Nerve Injuries & Conditions | Hand Microsurgery in Erie, PA

The orthopaedic surgeons of Hand Microsurgery are experienced in providing specialized medical treatment. Nerves are fragile and can be damaged by pressure, stretching, or cutting. Nerves are part of the “electrical wiring” system that carries messages between the brain and the rest of the body. Motor nerves carry messages between the brain and muscles to make the body move. Sensory nerves carry messages between the brain and different parts of the body to signal pain, pressure, and temperature. A ring of tissue covers the nerve, protecting it just like the insulation surrounding an electrical cable. Nerves are composed of many fibers, called axons. These axons are separated into bundles within the nerve. The bundles are surrounded by tissue layers, just like the outer tissue layer that surrounds the nerve. Injury to a nerve can stop signals to and from the brain, causing muscles not to work properly, and a loss of feeling in the injured area. 

Burners and Stingers

Burners and stingers are common injuries in contact or collision sports. A burner or a stinger is an injury to the nerve supply of the upper arm, either at the neck or shoulder. The injury is named for the stinging or burning pain that spreads from the shoulder to the hand. This can feel like an electric shock or lightning bolt down the arm. In most cases, burners and stingers are temporary and symptoms quickly go away.

A few commonly experienced symptoms include:

• Burning or electric shock sensation
• Arm numbness and weakness immediately following the injury
• A warm sensation