Total Hip Replacement is a surgical procedure we perform in Waterloo, Cedar Falls and surrounding communities in Iowa. This surgery is meant to replace damaged portions of the hip joint with higher functioning, prosthetic components.
Much like the shoulder, the hip operates as a ball-and-socket joint and is one of your body’s largest joints. The hip joint forms at the meeting place of your femur and pelvis, and encourages a wide variety of leg movements. A doorknob-like head to the femur fits inside a socket within the pelvis, known as your acetabulum. Both the end of your femur and the inside of your acetabulum are covered with smooth cartilage, which cushions the bones and enables mobility. Various ligaments strengthen and hold the joint together, while a thin cover-layer of tissue releases small amounts of moisturizing fluid to further eliminate friction.
Arthritis is one of the most common causes of hip pain that requires surgical treatment.
Osteoarthritis is age-related, primarily affecting individuals 50 years of age or older. Over time, protective, mobilizing cartilage wears away, causing bones to painfully rub against each other.
Rheumatoid arthritis is an inflammatory disease that causes the moisturizing tissue to swell and thicken. Over time, this inflammation disrupts cartilage and stiffens movement in the hip joint.
Post-traumatic arthritis follows many serious hip and upper leg injuries. When ligaments and bones are damaged near the joint, cartilage can follow suit and become completely destroyed over time, even following the surgical treatment of major hip injuries. Severe fractures or dislocations near the joint may limit blood flow to the connected portion of the femur. This lack of blood flow may cause the bone’s surface to collapse and lead to arthritis.
The overall goal of total hip replacement is to remove the portions of damaged bone and cartilage and replace them with higher functioning, prosthetic components. The femur’s doorknob-like head is removed and replaced by a metal ball. This metal ball is attached to a long stem inserted into the femur. Damaged cartilage is removed within the socket and replaced by a fabricated metal socket, and press fit in place with special instruments. To complete the procedure, a plastic spacer is inserted between these newly fabricated body parts to provide a smoother operating surface for each component.
Prior to hip replacement surgery, your orthopedic surgeon will conduct a complete orthopedic evaluation consisting of X-rays, physical examinations, and a full inquiry into your medical history. Most patients who undergo hip replacement surgery are 50 years of age or older. Unfortunately, there are weight restrictions for your protection. If your BMI is greater than 35, you are at a greater risk of developing complications such as infection, blood clots, or much worse, not to mention, the components implanted will wear out at a faster rate, resulting in possibly more complications and even revision surgery. Therefore, you may be asked to lose weight prior to the procedure to reduce stress on your newly reconstructed hip, and reduce the risk of more major, possibly life threatening complications.
You may be asked to donate and store your own blood in the event that you need blood following surgery.
Arguably the most important way to prepare for your surgery is to plan and adjust your home situation as much as possible before-hand. Adjust movement expectations and allow yourself to recover in a rehabilitation-friendly environment. Fasten safety bars to your shower and along stairways, utilize firm pillows and chairs, and set up a fully functional recovery station where you’ll spend a majority of your recovery time.
Following the procedure, you’ll need to stay in the hospital for 1-2 days. Doctors will closely monitor your newly reconstructed joint and wound, and look to effectively manage your pain. You will begin a physical therapy program to rebuild strength within the joint immediately. Physical therapy begins with light standing and supported walking, but extends to more intense stretches and exercises as rehabilitation improves.
Upon leaving the hospital, the first few weeks of home care are vital to full rehabilitation. Dressing and cleaning your wound, eating a balanced diet, and closely following your designated activity program are all ways to help ensure that your recovery process is positive in nature. Most patients are able to resume light, everyday activities within 3 to 6 weeks following surgery, but are unlikely to recover in full until at least 6 months after their procedure.
In our Waterloo and Cedar Falls locations, we perform total Knee Replacement surgery. This is meant to replace damaged portions of the knee joint with higher functioning, prosthetic components.
Your knee joint is formed at the meeting place of the thighbone (femur), shinbone (tibia) and kneecap (patella). At the end of each bone, where it would touch others, articular cartilage and other tissue works to protectively absorb shock and encourage free movement. The large thigh muscle strengthens and supports the joint which is held together by just four durable ligaments. The Lateral Collateral Ligament (LCL) and Medial Collateral Ligament (MCL) are located at the side of your knees and work to control sideways motion while limiting awkward, unusual movements. The Anterior Cruciate Ligament (ACL) and Posterior Cruciate Ligament (PCL) are located inside the knee joint and work together to control and stabilize your knee’s back-and-forth movements. The ACL is the most well-known and significant of the four ligaments, as it runs diagonally through the middle of the knee joint, providing protection and complete rotational stability.
Arthritis is one of the most common causes of knee pain that requires surgical treatment. Osteoarthritis is primarily age-related, affecting individuals 50 years of age or older. Over time, protective, mobilizing cartilage wears away, causing bones to painfully rub against each other.
Rheumatoid arthritis is an inflammatory disease that causes moisturizing tissue to swell and thicken. Over time, this inflammation disrupts cartilage and stiffens movement throughout the entire knee joint.
Post-traumatic arthritis follows many serious knee injuries. When ligaments and bones are damaged near the knee joint, cartilage can follow suit, even following the surgical treatment of major knee injuries.
Surgery is often recommended when non-surgical medications and injections prove to be insufficient in patients experiencing severe and debilitating pain. In many cases the knee joint can experience chronic swelling and even deformity.
Dr. Ben Torrez will perrform a surgical procedure to replace or reconstruct a knee joint. Knee replacement surgery requires anesthesia and a fairly large incision. While modern technology continually aims to make the procedure as minimally invasive as possible, a 5 to 12 inch incision in the front of the knee is typically required.
Also known as an arthroplasty procedure, knee replacement doesn’t actually replace bones but rather resurfaces the damaged areas of cartilage and bone. Damaged cartilage is removed along with small amounts of the underlying femur and tibia. These surfaces are then reshaped to fit artificial joints made of metal, plastic or ceramics, and are cemented to the resurfaced bones with a special material. Between these prosthetic components, a plastic spacer is then inserted to encourage smooth movement within the joint.
In the weeks leading up to your kneed replacement surgery, through communication with your Dr. Torrez, several actions can help adequately prepare you for the procedure. Dr. Torrez will run a full orthopedic evaluation, cardiogram, blood tests, and many other preparatory screenings. Exercise, healthy dieting, and establishing a rehabilitation action plan are all great ways to manage your pre-procedure process.
The actual procedure will take only an hour or two, but will require a hospital stay for several days. During your stay, nurses will provide necessary pain medication. Movement of the joint becomes possible almost immediately following the procedure and physical therapy will begin shortly after as well. Most patients will notice significant improvements within the first month, and with frequent exercise and therapy, are able to walk with minimal assistance in six weeks.
Total Shoulder Joint Replacement is a surgical procedure meant to repair damaged portions of the shoulder joint, often through the use of higher functioning, prosthetic components.
Your body’s shoulder joint consists of three bones: your upper arm (humerus), shoulder blade (scapula) and collarbone (clavicle). The upper arm slides into a shallow socket within the shoulder blade, creating a ball-and-socket type joint which allows for an incredible overall range of motion. Throughout the joint, cartilage surrounds the ends of each bone and keeps them from painfully rubbing against each other. An assortment of muscles and tendons strengthen and hold the joint together, while a thin, cover-layer of tissue eliminates friction by releasing small amounts of moisturizing fluid.
Arthritis is one of the most common causes of shoulder pain that requires surgical repair.
Osteoarthritis is age-related, primarily affecting individuals 50 years of age or older. Protective, mobilizing cartilage wears away over time, causing bones to painfully rub against each other.
Rheumatoid arthritis is an inflammatory disease that causes moisturizing tissue to swell and thicken. Over time, this inflammation disrupts cartilage and stiffens movement throughout the entire shoulder joint.
Post-traumatic arthritis follows many serious shoulder injuries. When ligaments and bones are damaged near the shoulder joint, cartilage can follow suit and limit functionality over time, even following the surgical treatment of major shoulder injuries. Severe fractures in the shoulder, specifically those that involve shattered bone fragments and can be difficult to repair, often call for a total replacement procedure. Long-standing tears on the rotator cuff can also cause changes within the joint and significantly damage cartilage.
Shoulder replacement surgery is typically recommended for older patients who are experiencing extreme amounts of shoulder pain and have not responded to other non-surgical treatment methods.
Depending on the specific injury involved, there are multiple types of shoulder replacement operations. All procedures require similar details, will involve anesthesia, and require a fairly large incision. Rather than completely replacing the shoulder joint, typical replacement surgery involves removing and reshaping the surface of the glemoid (socket). After the glemoid is reshaped and capped with plastic, a metal ball component and its stem is inserted into the end of the humerus. This ball is then positioned into the artificial, plastic socket within the shoulder blade to encourage natural mobility.
During preparation, your surgeon will likely schedule a complete physical examination to determine whether you’re healthy enough for surgery, and to learn of any medications you’re currently taking. Other simple ways to prepare for your operation involve eating healthy and planning ahead for early, post-surgery life at home.
Following surgery you’ll be given intravenous antibiotics along with other pain management and blood clot prevention medication throughout the first day of recovery.
Your shoulder will be bandaged and will likely contain a drain used to keep fluid from collecting near the repaired joint. Most individuals will return home after a few days of recovery and gentle exercise under the direction of a physical therapist. Continued recovery should continue in the form of an exercise or physical therapy program for the next several months. Familiarizing your reconstructed joint with regular motion is pivotal within the first 6 weeks of recovery. Afterwards, rehabilitation is focused on more extensive stretching, exercise, and strength training.
Arthroscopic Shoulder Labral Repair is a minimally invasive surgical procedure meant to repair damaged portions of labral cartilage in the shoulder.
The labrum, also described as labral cartilage, is a collection of thick, fibrous tissue found in the shoulder and hip joints. Specifically, the shoulder labrum forms a rim around the glenoid (socket) which helps deepen the shallow shoulder articulation with the humeral head. Much like a rotator cuff, the labrum provides the shoulder joint with stability and allows it to move freely in a variety of unique ways.
Injuries to this rim of tissue most commonly stem from acute trauma or other types of strenuous, repetitive arm motion. Specific incidents like absorbing a blow to the shoulder, or attempting to break a fall with an extended arm can cause significant damage within the labrum. Participation in certain sports that call for aggressive arm activity can also harm shoulder tissue over time. The labrum tears in multiple ways, and treatment differs depending on whether the tear occurs above or below the equator of the shoulder socket. Tears above the socket’s center, known as SLAP (Superior Labrum, Anterior to Posterior) Lesions, can also include damage to the biceps tendon. A tear below the socket is generally referred to as a Bankart Lesion, and typically accompanies a dislocated shoulder.
Damage or tearing in the shoulder labrum often leads to intense pain and a sense of instability when attempting overhead activities. Tears limit arm strength and mobility, and can present themselves in the form of uncomfortable locking, popping, or grinding sensations in the shoulder. Patients have also reported disturbed sleep as a common symptom of shoulder tissue damage.
In the event of a torn labrum, many patients respond favorably to non-surgical treatment, such as physical therapy, anti-inflammatory medication, cortisone injections, and simple rest. If pain and irritation persists, however, arthroscopic surgery to repair or debride (clean-up) the labrum is the most common recommendation.
Arthroscopic surgery is a minimally invasive procedure in which a high-definition, fiber optic camera is inserted through small incisions to evaluate the glenohumeral joint (shoulder joint), and supporting soft tissues, including the four rotator cuff muscles, labrum, biceps tendon, articular surfaces, ligaments, and bone. Once able to visualize the joint from inside, arthroscopic surgery allows surgeons to diagnose specific joint injuries and diseases, and even provides a way to treat certain problems by utilizing surgical instruments through tubes called cannulas.
Arthroscopic surgery to repair a damaged shoulder labrum most commonly involves: shaving away the torn portion to create a high-functioning, smooth edge, or physically repairing and reattaching torn tissue with anchors and sutures.
Generally, as arthroscopic surgery is performed in the least invasive manner possible, recovery is quicker and less painful. Most patients return home on the same day in which they have the surgery, and will have their arm protected in a sling or an abduction pillow for a 3-4 week period. Once removed from protection, it’s important to gradually increase flexibility in the shoulder and strengthen the biceps through physical therapy and exercise. Complete recovery varies, but 3-4 months typically pass before the shoulder will near full functional capacity from labral repair surgery. Complete healing of the shoulder, including resolution of swelling and minor aches and pains, may take as long as a year.
Arthroscopic Shoulder Rotator Cuff Repair is a minimally invasive surgical procedure meant to repair the damaged tendinous portions of prominent muscles holding the humeral head to the socket in the shoulder.
Your body’s rotator cuff is a collection of four muscles and their corresponding tendons in the shoulder which connect the upper arm and shoulder blade. Appropriately referred to as the rotator cuff, this collection of tissue forms a stable ‘cuff’ around the humeral head and helps the shoulder rotate freely.
There are several ways in which a rotator cuff can become injured, and a seemingly endless amount of potential causes for each injury. Repetitive overhead activity, heavy lifting for an elongated period of time, and bone spurs near the shoulder can all lead to tendon damage. Blue-collar occupations and sports participation that involve strenuous and repetitive arm motions can significantly wear-down and damage this tissue over time. Through any of these ways, and many more, your rotator cuff can develop tendinitis, subacromial bursitis, can become pinched or irritated by surrounding bones, and can even tear.
Typically, rotator cuff injuries lead to pain in the front of the shoulder which radiates down the side of your upper arm. Pain is often described as a dull ache coming from deep with the shoulder. Patients have reported symptoms of disturbed sleep, arm weakness, and difficulty performing routine activities that involve reaching your arm above your head or behind your back.
Many damaged or torn rotator cuff tendons can be symptomatically treated non-surgically through physical therapy and anti-inflammatory medications or injections, but almost all tears will not heal entirely on their own. With repetitive use, rotator cuff injuries can become worse and tears can expand over time. If persistent pain or shoulder weakness continues to prove bothersome and debilitating, preventing normal activities of daily living, surgical procedures are recommended.
Surgery to repair a torn or damaged rotator cuff is primarily conducted arthroscopically. Arthroscopic surgery is a minimally invasive procedure in which a high-definition, fiber optic camera is inserted through small incisions to evaluate the glenohumeral joint (shoulder joint), and supporting soft tissues, including the four rotator cuff muscles, labrum, biceps tendon, articular surfaces, ligaments, and bone. Once able to visualize the joint from inside, arthroscopic surgery allows surgeons to diagnose specific joint injuries and diseases, and even provides a way to treat certain problems by utilizing surgical instruments through tubes called cannulas.
Arthroscopic surgery to repair a damaged rotator cuff commonly involves: removing debris that can inhibit movement near the joint, shaving or removing bone spurs which force tendons to become pinched, or sewing the torn edges of tendons back together and reattaching the tendon to the bone.
Generally, as arthroscopic surgery is performed in the least invasive manner possible, recovery is quicker and less painful. Most patients return home on the same day in which they have the surgery, and will have their arm protected in a sling and an abduction pillow for a set period of time. Recovery from rotator cuff surgery is very dependent on rehabilitation efforts. A lack of movement for extended periods of time can cause the repaired tendon to thicken and painfully restrict joint movement. Physical therapy programs and frequent exercise will help encourage movement, build strength and ultimately ensure that the joint remains healthy and active.
ACL Reconstruction is a surgical procedure meant to repair specific ligament damage in the knee joint, to the Anterior Cruciate ligament.
The knee joint is formed at the meeting place of the thighbone (femur)and shinbone (tibia). The joint is surrounded by various tissue and held together by four supporting ligaments. The Lateral Collateral Ligament (LCL) and Medial Collateral Ligament (MCL) are located at the side of your knees and work to control sideways motion while limiting awkward, unusual movements. The Anterior Cruciate Ligament (ACL) and Posterior Cruciate Ligament (PCL) are located inside the knee joint and work together to control and stabilize your knee’s front-to-back movements. The ACL is the most well-known and significant of the four ligaments, as it runs diagonally through the middle of the knee joint, preventing forward shifting of the tibia (shinbone) in relation to the femur (thighbone). The ACL also provides rotational stability.
Commonly recognized as a prevalent sports injury, ACL and other knee ligament damage frequently occurs when the joint buckles in an attempt to stop or change direction quickly. Damaged ligaments become sprained when slightly stretched or jerked loose, but are otherwise torn completely. Partial tears to the ACL may occur. Any injury to the ACL almost always includes damage to other structures within the knee joint, including the meniscus and cartilage on the surface of the bones.
A damaged or torn ligament can be distinguished fairly easily by the individual involved. A loud popping sound usually accompanies a tear, along with the feeling that your knee has given out from under you. Other common symptoms include intense pain and swelling, significant tenderness near the joint, and limited leg mobility that leads to discomfort while walking.
In the event of a torn ACL, non-surgical treatment will never fully heal the damaged tissue, but is sometimes suggested for elderly or low-activity individuals.
The diagnosis of ACL tear is typically confirmed and treated arthroscopically. Arthroscopic surgery is a minimally invasive procedure in which a thin tube (cannula) is used to examine the inside of a joint by inserting a high-definition, fiber optic camera through small incisions. Once able to visualize the joint from inside, arthroscopic surgery allows surgeons to diagnose specific joint injuries and diseases, and even provides a way to treat certain problems by utilizing surgical instruments through the cannulas.
Currently, ligament tears of the ACL cannot be reattached, but rather must be completely reconstructed using a tissue graft which provides a platform for new ligament growth.
Physical therapy is incredibly important to regaining your original strength and mobility following surgery. Firm instructions regarding the dressing and cleaning of incisions will be provided by your doctor, followed by an extensive postoperative treatment and rehabilitation program. Full recovery from non-reconstructive surgeries can be achieved in 6-8 weeks, but is also reliant on the extent of the original injury. Due to the regrowth progress required following complete ACL reconstruction surgery, it will take six months or more to return to high-functioning physical activity.
Arthroscopic Biceps Tendon Repair is a minimally invasive surgical procedure focused on reestablishing a connection between muscles and bones in the arm.
Your biceps is a commonly known muscle located on the front of your upper arm that helps stabilize the shoulder and bend the elbow, but primarily functions as a forearm rotator (supinator). Tendons on each end of the biceps connect the muscle to the shoulder joint and the forearm.
Much like all shoulder and arm injuries, damage to the biceps tendon can occur through significant trauma involving falls and heavy lifting, or overuse.
Overuse is commonly reached through repetitive arm movements required in several blue-collar occupations and sports participation.
Tendinitis and other injuries in the shoulder and arm increase stress on the biceps tendon, leading to further weakness and damage.
Overstretching in the muscle can lead to strains, pulls, and fraying. As this damage progresses untreated, partial and complete tears can often develop within the biceps tendon.
Tears at the elbow often occur with sudden, extremely forceful loading of the hand, like attempting to pick up a pool table or catching the falling tailgate of a pickup truck.
Damage to the biceps tendon presents itself in the form of several common symptoms. Patients have described upper arm pain associated with tears as sharp and sudden, often accompanied by an audible pop or click. Pain and weakness can extend up to the shoulder or down through the elbow, and muscles can also become more susceptible to cramping. In many cases bruises or a visible bulge may appear above the elbow. As biceps injuries often coincide with other shoulder injuries, it’s both expected and important that your doctor conducts complete shoulder examinations, along with other physical exams, during the preparatory process.
In the event of a damaged or torn biceps tendon, non-surgical treatment is often suggested initially. Rest, Ice, physical therapy and anti-inflammatory medications are all proven to help limit pain and gradually minimize symptoms of an impaired biceps tendon. If pain and problems continue to arise, or in situations involving highly active people, arthroscopic surgery to repair or reattach the tendon is sometimes required.
Arthroscopic surgery is a minimally invasive procedure in which a thin tube (cannula) is used to examine the inside of a joint by inserting a high-definition, fiber optic camera through small incisions. Once able to visualize the joint from inside, arthroscopic surgery allows surgeons to diagnose specific joint injuries and diseases, and even provides a way to treat certain problems by utilizing surgical instruments through the tube.
Surgery to repair a torn biceps tendon is fairly simple, as it aims to re-anchor the torn tendon back to the bone, if the remaining tissue is viable for anchoring.
Upon the completion of surgery, your shoulder will require rest in a temporary sling. Physical therapy and exercise is imperative, and is suggested fairly early in the rehabilitation process. Rebuilding full strength and mobility can be a somewhat slow process, but treatment plans should eventually and completely correct all muscle deformity, weakness and functionality.
Achilles Tendon Repair is a surgical procedure that mends damaged portions of the Achilles tendon, while rebuilding a connection between calf muscles and the heel bone.
The Achilles tendon is the largest and strongest tendon in the body. Located at the back of your lower leg and ankle, this strong, fibrous cord connects your calf muscles to the heel bone. The Achilles tendon stretches and moves when calf muscles contract, and produces the majority of downward force used by your foot when walking, running, and jumping.
A ruptured Achilles tendon most commonly occurs while attempting physical actions that require explosive acceleration. When the ankle is flexed outside of its typical range of motion in a quick and physical fashion, it can cause the tendon to stretch beyond its capability and tear. Achilles injuries frequently occur due to overuse from athletic participation in intense sports. Direct trauma to the tendon and sudden activation following extended periods of rest are also common ways that an Achilles tendon can become injured. Achilles injuries are easily distinguishable, as ruptures are commonly accompanied by a loud popping sound, sharp and intense pain, and a warming sensation in the back of your lower leg. Along with being incredibly painful, a ruptured Achilles tendon will almost completely diminish your ability to walk properly.
Non-surgical treatments for Achilles tendon injuries involve wearing a cast or walking boot which contains heel elevating wedges. Resting and keeping your leg elevated can help expedite the healing process in less serious injuries, while anti-inflammatory medications manage pain. Most Achilles injuries occur as somewhat freak accidents, but there are a handful of valuable precautions you can take to best avoid such situations. Shoes with strong support help stabilize the Achilles tendon during physical activity. Stretching thoroughly, gradually increasing your level of intensity during a workout, and limiting the amount of uphill running in your regular regimen are other helpful prevention practices.
The goal of surgery is to reestablish the connection between your calf muscles and heel bone by repairing and reconnecting the torn portions of your Achilles tendon.
While there are different ways in which surgery to repair an Achilles tendon can be performed, most cases involve a single, large incision in the back of the leg. After finding each end of the ruptured tendon, surgeons use sutures to sew the tendon back together, and then close the incision.
Because of the Achilles’ direct effect on your ability to walk, many patients seek immediate treatment at a hospital’s emergency department following a rupture. Your doctor will discuss your injury, ask for a complete medical history, and conduct physical tests during the diagnosis process. If uncertain whether the tendon has been completely, or only partially torn, your doctor may also conduct an MRI scan of your leg.
Following surgery to repair an Achilles tendon, patients are placed in a cast and temporarily directed not to put weight on the operated leg. Patients are fitted for crutches, a knee scooter, or a wheelchair to provide mobility during early recovery stages, and encouraged to elevate their leg when resting. After a few weeks the cast is removed and patients are positioned into a walking boot and allowed to begin light, weight-bearing exercises. At six weeks most patients began extensive physical therapy programs outside of the boot. Exercise and physical therapy is critical to complete rehabilitation, and dependent on each individual’s response to physical activity. Most patients are able to return to full activity within six months.
Carpal Tunnel Release is a surgical procedure meant to encourage free movement of the hand by expanding the amount of space between prominent tendons and a nerve in the wrist.
Multiple tendons and the median nerve, allow you to flex and curl your fingers. These tendons pass through a narrow, channel-like structure in the wrist known as the carpal tunnel. Bones in the wrist called carpal bones help form and stabilize the carpal tunnel at its bottom and sides, while a band of strong tissue called the transverse carpal ligament supports the top of the tunnel when the palm is pointed toward the ceiling.
The carpal tunnel passage is extremely narrow, so even minor tissue swelling within the tunnel can pinch the median nerve and cause pain. Carpal tunnel syndrome occurs when the already confined space becomes significantly overcrowded by swelling. Heredity is an important factor that often contributes to the development of carpal tunnel syndrome, along with other medical conditions such as diabetes, rheumatoid arthritis, and thyroid gland imbalance. Excessive hand use over time can play a significant role in the disease, which fittingly occurs more frequently in older individuals.
Symptoms of carpal tunnel syndrome will most often present themselves gradually, without a specific injury, and are commonly more severe on the outside (thumb-side) of your palm. Patients have cited numbing and tingling sensations in their hand, as though it’s falling asleep. Symptoms, specifically pain, come and go and tend to intensify in different areas of the hand, almost as if the pain is moving up your fingers, or up your arm towards your shoulder. Pain is said to increase when mobility is limited, or the hand is held in a similar position for an extended period of time. If untreated for a significant time span, symptoms of carpal tunnel syndrome can become more constant and begin to affect your ability to perform delicate, everyday tasks.
Non-surgical treatment options such as bracing or splinting, anti-inflammatory medications, and steroid injections are heavily utilized prior to the suggestion of carpal tunnel release surgery. Doctors will work with you to adjust your schedule and limit the amount of aggravating hand activities performed throughout your day, but in many cases these activities are occupational and unavoidable. If pain and symptoms persist following simple treatment measures, surgical release is a viable next step for many patients.
To determine whether carpal tunnel release would benefit your situation, your doctor will thoroughly examine your hand and perform a number of physical tests. Before the procedure your doctor will go over your medical history and typically ask that you do not eat or drink for 8 hours leading up to your surgery.
During carpal tunnel release surgery, an incision is made at the base of the hand’s palm, providing the surgeon with visible access to the transverse carpal ligament. This ligament is cut in order to reduce swelling and release pressure on the median nerve. In rare occurrences, excess tissue also needs to be removed to relieve further pressure on the nerve.
A fairly simple procedure, carpal tunnel release surgery is performed on an outpatient basis and does not require an extended hospital-stay. Following surgery, your wrist will be bandaged for roughly 2-3 days. Upon examining surgery results, your doctor will encourage you to begin a mobilizing physical therapy program. Full recovery varies depending on how damaged the median nerve was and how long symptoms occurred before treatment. Most patients regain their full grip in 2 months if problems do not recur.
Trigger Finger Release is a surgical procedure that expands constricted tissue space, and encourages free movement within the fingers.
Trigger finger is a painful condition which causes the fingers to latch and lock in place when moved into a bent position. Strong, thick bands of tissue called tendons are located throughout each of your fingers, helping to connect muscles and bones within your hand. In the limited amount of space your finger has to offer, these tendons are organized within a sheath. Trigger finger occurs when one or more of these specific tendons become so inflamed and swollen that they can no longer glide easily through the sheath.
A wide range of repetitive activities can contribute to, or directly cause trigger finger over time. Blue-collar occupations that ask individuals to forcefully grab and hold onto an object for long durations can cause significant damage to tendons within your fingers. Smokers and even musicians are also at higher risks of developing trigger finger due to repetitive, awkward, and somewhat strenuous finger use. Other common conditions such as diabetes, rheumatoid arthritis, gout and old age have been regularly linked to trigger finger as well.
Trigger finger is not a dangerous condition, but rather an inconvenient one. Non-surgical treatment methods such as anti-inflammatory medications and steroid injections can be attempted before surgery if personally requested. Symptoms commonly start without any specific injury, and are fairly easy to distinguish. Tender swelling near finger joints or in your palm is common, along with a painful popping sensation when attempting to bend or straighten your finger.
The goal of trigger finger release surgery is to widen the opening of the tendon sheath so that tissue is able to once again move freely throughout the finger. The procedure requires only a very small incision in the palm. After this incision is made, the tendon sheath is cut in a way that frees the locked portion of tissue and allows tendons to smoothly move throughout the finger again. A fairly simple procedure, trigger finger release surgery takes roughly 15 minutes from the opening incision to the closing of the wound.
Release surgery is typically performed as an outpatient procedure. While palm soreness is common, most people are able to move their fingers immediately after surgery. Full recovery is typically reached within a few weeks.
Surgery to repair a femur fracture is meant to reposition the broken portion of bone back where it belongs, and keep it from shifting out of place until it has time to heal properly.
Your femur, also known as your thighbone, is the single longest and strongest bone in your body. The femur makes up the majority of your upper leg, extending from your hip joint to your knee joint.
Because the femur is so strong, it takes a significant amount of force to break it. High-energy collisions, such as severe falls and motor vehicle crashes are the most commonly seen causes.
Like with most bones, your femur can experience a large variety of fracture types. Femur fractures are first classified by their exact position on the bone. Distal fractures occur near the knee joint, middle fractures occur along the bone’s shaft, and proximal fractures occur near the hip joint. Fractures are then classified based on the breakage pattern, and whether or not skin and muscle tissue has been damaged by the injury. In more serious injuries, the fractured portion of the femur can break the skin (open fracture), or even break into more than two pieces (comminuted fracture). Fracture classification is very important to surgeons as treatment difficulty varies depending on the type of break. Fractures that involve portions of other joints and tissue, or in which the broken portion of the bone is displaced from its original position are typically more difficult to repair.
Femur fractures cause immediate and severe pain, limit your ability to put weight onto the injured leg, and often give the leg a deformed appearance. Non-surgical treatments are only utilized in rare situations involving young children. Almost all femur fractures require surgical repair to provide the best opportunity for a return to normal function.
To help your doctor diagnose your specific fracture, it’s important that they know the ins and outs of your injury. Prior to surgery your doctor will conduct multiple medical history and physical examinations, as well as X-rays and CT scans. If skin around your fracture is not lacerated, your surgeon will wait until you’re stable before operating. In the event of an open fracture, surgery is required within 8 hours of the injury. Prior to realigning the fracture, exposed tissue and bone must be thoroughly cleaned and antibiotics are provided to help avoid infection.
Multiple methods might be utilized by your surgeon in repairing a femur fracture, depending on the severity and the type of fracture being operated on. The most common method used by orthopedic surgeons is known as intramedullary nailing. During this procedure, a long metal rod is inserted into the marrow canal of the femur. From the inside, this rod extends through the full length of the bone, including the fractured portion. Then, using titanium screws, the rod is screwed into position at each far end of the femur. This keeps the metal rod and the connected bone held into position until the fracture can properly heal. Other surgical procedures typically involve an incision that allows direct access to the broken portion of bone. After repositioning the fracture, metal plates and screws are used to hold the bone in a correct position while it heals.
Most doctors will encourage early leg motion and weight-bearing activity during recovery. Physical therapy programs help rebuild strength in damaged muscle tissue and can drastically improve mobility. Most femur fractures heal completely in 6-8 months.
Surgery to repair a distal radius fracture aims to reposition the broken portion of bone back where it belongs, and keep it from shifting out of place until it has enough time to heal properly.
The radius is the larger of two bones that make up your forearm. The far end of the radius that extends into the wrist joint is referred to as the distal end.
While distal radius fractures almost always occur within an inch of the wrist joint, breaks come in many specific shapes and sizes. One of the most common breaks, a Colles fracture, occurs when the broken end of the radius tilts upward, giving your wrist a visibly distorted appearance. Fractures are also classified by whether the break extends into the wrist joint or not. Intra-articular fractures extend into the wrist joint, while Extra-articular fractures do not. In more serious injuries, the fractured portion of the distal radius can break the skin (open fracture), or even break into more than two pieces (comminuted fracture). Fracture classification is very important to surgeons as treatment options vary depending on the type of break. Fractures that involve portions of the wrist joint, or in which the broken portion of the bone is displaced from its original position are typically more difficult to repair.
Osteoporosis breaks down bones and can lead to distal radius fractures in many individuals. Most fractures are caused by a fall onto an outstretched arm. Osteoporosis can cause a fairly minor fall to result in a broken wrist, but even completely healthy bones can break frequently with enough force.
A fracture to your distal radius would cause immediate pain, tenderness, bruising and significant swelling. It’s also common for the wrist to hang or bend oddly.
Depending on the type of fracture involved, your age, and your activity level, there are many treatment options for a distal radius fracture. If the broken portion of bone is in a good resting position, doctors will typically apply a plaster cast to hold the bone in place until it heals. In fractures where broken bone fragments are slightly out of alignment, doctors may use a non-surgical technique known as reduction to re-align the broken bone before applying a cast. Casts are commonly removed after 6 weeks when patients begin physical therapy. Prior to treatment, your wrist is protected with a splint and an ice pack is applied immediately. During diagnosis, doctors will confirm the classification of your specific break through X-ray and then make an appropriate treatment suggestion.
Surgery becomes a necessity when bone fragments are so far out of place that corrections cannot be maintained in a cast. The surgical procedure involves an incision that allows direct access to the broken portion of bone. Upon repositioning the fracture, metal plates, pins, and screws are often used to hold the bone in a correct position while it heals. When dealing with Open fractures, surgery is required within 8 hours of the injury. Prior to realigning the fracture, exposed tissue and bone is thoroughly cleaned and antibiotics are provided to help avoid infection.
Most patients return to any and all former activities following a distal radius fracture, but each fracture is unique and carries its own recovery timetable. Wrist stiffness is common following surgery, and will generally loosen within a few months. Physical therapy can help expedite the recovery process, but most patients are able to comfortably return to all types of activities within 3 to 6-months.
Surgery to repair fractures near the ankle joint aims to reposition the broken portion of bone back where it belongs, and keep it from shifting out of place until it has time to heal properly.
Your ankle joint forms at the meeting place of three different bones. The tibia and fibula make up your shin and lower leg, and rest on a small bone called the talus, which separates and cushions the shinbones from your heel. Several ligaments and other fibrous tissue surround the ends of these bones and work to hold them in place.
The ankle joint can become injured in a variety of different ways. Awkward twisting, rotating or rolling of the ankle joint can lead to severe sprains or even fractures. The ankle sprains when only the ligaments connecting the bones give away and tear. Fractures occur when high levels of stress force the bone itself to give away and break. Fractures can also occur due to the force of high-level impact, experienced in certain falls and car accidents. Breaks can occur in either the tibia or fibula, or both, and most commonly occur at the far end of the bone nearest to the ankle joint.
Upon breaking an ankle, patients will quickly experience severe pain, tenderness, swelling, bruising, weakness and sometimes mild deformity. Severe ankle sprains can feel similar to ankle fractures and should always undergo thorough examination by a doctor to confirm the diagnosis. Along with a physical examination, your doctor will discuss medical history and likely conduct a variety of different imaging tests before treatment.
With three relatively small bones operating so close together, several different types of fractures can occur. Ankle fractures are classified by severity, position, orientation, etc. Surgical procedures to repair these fractures differ slightly depending on the credentials of each individual break, but the overall process remains fairly consistent. During the procedure, your surgeon will make an incision near the ankle joint which provides access to the broken portion of bone. Bone fragments are repositioned into their original alignment and held in place to heal through the use of metal screws and plates. In cases where the fracture has not been significantly forced out of place, non-surgical treatment options are initially utilized, and are often successful. In this instance, your doctor will apply a short leg cast and ask that your avoid putting weight on your leg for several weeks.
With such a wide range of ankle injuries and treatment options, the way individuals respond to surgery varies from patient to patient. In most cases, broken bones heal in 6 weeks, while any damaged ligaments surrounding the joint typically take a bit longer. Exercise and physical therapy helps build strength and encourage mobility within the ankle, and can help expedite the healing process when practiced properly. Most patients comfortably return to everyday activities within 3 to 4-months.