Winter Hand and Wrist Injuries

Winter sports, slippery sidewalks and snow blowers pose risks to many parts of the body, but hands and wrists in particular take a beating when temperatures plummet and snow accumulates, according to David Wei, MD, hand, wrist and elbow expert at ONS.

“The most common upper extremity injury in the winter months occurs when people extend their arms in front of them to break a fall when they slip on the ice or while engaging in a winter sport,” said Dr. Wei, who noted that several injuries can result from this reflexive action.

If the fall occurs while skiing, the skier can suffer a condition known as Skier’s Thumb if they land with the ski pole still in their hand.

When this happens, the ulnar collateral ligament of the thumb located at the base of the thumb can get strained or tear. A simple strain can be managed with a thumb stabilization brace, over-the-counter anti-inflammatory medications and ice. Surgery may be necessary to reattach the ligament if a complete rupture has occurred and the thumb is unstable.

Compression, or buckle fractures, of the wrist can also result from an outstretched arm during a fall.  If this occurs near the growth plate in a child, a wrist cast or brace will allow the bone to heal in 3-4 weeks. In comparison, for adults fractures generally take about six weeks.  If a more complicated fracture occurs, where both bones of the forearm break and there is severe deformity of the forearm, the entire arm — including the elbow — may need to a cast.

Dr. Wei said the one way to minimize these injuries is to try to land on your forearms instead of using your hands to break a fall. Wrist guards may also provide additional protection for snowboarders and skiers. When possible, falling backwards, or uphill, may reduce the risk of higher impact injuries to the arms and hands. Finally, be mindful that skiers and snowboarders should refrain from attempting terrain that is above their ability and importantly. When fatigued, winter sportsmen should take frequent breaks or call it quits.

“Many of these injuries can be treated at an orthopedic urgent care facility,” said Dr. Wei. ONS offers after-hours, walk-in urgent orthopedic care at its Greenwich office from Monday through Friday, 5:00 – 8:00 pm, and on Saturday from 12:00 to 4:00 pm.

However, a trip to the emergency department is essential if the injury more severe, such as the ones that may occur with improper use of a snow blower. “The rotor at the bottom of the blower can get jammed from debris, such as a newspaper under the snow in a driveway,” said Dr. Wei. “People lose fingers by reaching in between the blades to remove the blockage. When the blades suddenly are free, they can continue to spin like a loaded spring injuring anything in its path.”

If such an event happens, the best course of action to save any amputated parts is to wrap them in gauze soaked with clean water and place the wrapped parts in a sealed plastic bag. The sealed bag should then be put into another bag that is filled with ice.  The patient should be transported immediately to an emergency department for evaluation and treatment by a specialty-trained hand and microvascular surgeon.

 

 

Treatments for Tennis Elbow

ONS DR. DAVID WEI TALKS ON TREATMENT FOR TENNIS ELBOW. 

Tennis season is in full swing and so are the risks of overuse injuries such as Tennis Elbow.

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Tennis Elbow typically happens when a repetitive swinging motion pulls on the extensor tendons that connect the muscles in the forearm to the elbow, creating microscopic tears. Despite its name, there are many types of activities that can injure these tendons, especially those involving repetitive wrist motion. Although it continues to be a mystery as to why some patients develop Tennis Elbow while others are not affected, we do know that the end result is an abnormal change in the quality of the tendon itself, called angiofibroblastic hyperplasia.

Typical symptoms are pain along the outer side of the elbow with wrist motion and with gripping. The pain can be especially exacerbated by activities involving lifting objects with your elbow extended and the palm of your hand facing downward.

Recent data suggests that nearly all cases may resolve spontaneously, and the mainstay of treatment always begins with non-operative options. Avoiding aggravating activities or modifying the way you perform them can help decrease pain. For instance, lift things closer to your body, with your palms up. A splint or a counterforce brace can also help by relieving the strain on the tendon. In some cases, a physical therapy program and possibly injections will help the condition.

Most people don’t require surgery for Tennis Elbow. If, however, non-operative measures fail and the pain persists beyond six months, it may be time to consider surgery to repair the damaged tendons. Recovery time from surgery is relatively fast, but the tendons need time to regenerate, requiring approximately six to eight weeks.

Dr. Wei discusses tennis elbow in greater detail in this video.

 

ONS Stamford: Off to a Great Start

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5 High Ridge Park, 3rd floor, Stamford, CT 06905

On the evening of June 22, 2015, Orthopedic & Neurosurgery Specialists (ONS) held a grand opening celebration of a second ONS location at 5 High Ridge Park in Stamford, CT. The event was a first look at the new facility for the public, complete with informative stations about injury prevention, exercise tips and sports medicine stations with medical models and video presentations. Throughout the evening, around 200 guests toured the office, and learned about injuries and treatments of the foot and ankle, hand and wrist, shoulder and elbow, hip and knee, spine and Platelet Rich Plasma treatment. ONS physicians were available to answer questions. ONS Physical Therapy showcased injury prevention exercises for tennis, golf and running. Local businesses participated in the evening as guests enjoyed food and beverage and displays and a drawing of exciting prizes. The ONS physicians, clinicians and staff members were pleased with the opportunity to meet and greet the Stamford community! To learn more about our new Stamford office please visit https://onsmd.com/ons-stamford/.

Ready for Spring Sports?

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Foot and ankle, hand and wrist injury prevention tips by orthopedics specialists

When: February 25, 2015 at 6:30 p.m.
Where: Noble Auditorium, Greenwich Hospital
Speakers: Mark Yakavonis, MD, MMS, Mark Vitale, MD, and Paddle and Tennis Professional Patrick Hirscht

If golf or racket sports are in your plans for the spring you will want to hear tips from fellowship trained orthopedic foot and ankle specialist Mark Yakavonis, MD, MMS and fellowship trained hand/wrist/elbow specialist Mark Vitale, MD, MPH who will discuss common injuries seen in golf and racket sports. Special guest and local tennis pro Patrick Hirscht will also speak. Learn about common injuries, and how to choose footwear, braces and exercises to prevent injury and play your best; whether it’s the foot, hand, wrist or elbow, they’re all at risk for injury when you’re active. Dr. Yakavonis and Dr. Vitale will discuss nonsurgical and surgical treatments, along with ailments particular to racket sports. You will have the opportunity to ask questions at the conclusion of the talk. The program is free and open to the public. Registration Requested. Call (203) 863-4277 or register online at www.greenhosp.org.

07/10/2019

ONS Orthopedic Surgeon and Hand Specialist, Mark Vitale, MD Presents at 69th Annual American Society for Surgery of the Hand (ASSH)

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Mark Vitale, MD

September 19, 2014, ONS orthopedic hand surgeon Dr. Mark Vitale traveled to Boston at the 69th annual American Society for Surgery of the Hand (ASSH), the premier annual hand surgery meeting where the nation’s leading hand surgeons gather to present new research and techniques for the care of hand, wrist, nerve and upper extremity problems.

Dr. Vitale presented two of the conferences’ 84 podium presentations to the community of hand surgeons in the U.S. and abroad. One of his presentations entitled, “Intra-articular fractures of the sigmoid notch of the distal radius: an analysis of progression to distal radioulnar joint arthritis and impact on upper extremity function in surgically treated fractures,” was a study that looked at fractures of one of the understudied joints of the wrist. This study will help surgeons guide treatment of these fractures to optimize wrist function in surgically treated fractures.

Traditional treatments for thumb arthritis involve removing the arthritic bone in the wrist called the trapezium which forms a joint with the base of the thumb and then using part of a patient’s own tendon to reconstruct the thumb. Dr. Vitale’s research revealed that the results with this more traditional “trapeziectomy” surgery are excellent and time tested.21

Dr. Vitale Speaking at the ASSH His second presentation, “A comparison of pyrolytic carbon hemiarthrioplasty versus Thompson suspensionplasty in the treatment of trapezial metacarpal arthritis,” was a study that compared a traditional treatment for thumb arthritis with a new pyrocarbon joint replacement for the thumb.

Pyrolytic carbon joint replacement is a synthetic implant to replace the arthritic thumb/wrist joint that was initially developed and first used in conjunction with hand surgeons at the Mayo Clinic in Rochester, MN. It resurfaces the base of the arthritic thumb metacarpal bone while leaving more of the native trapezium bone in place. The pyrolytic joint replacement implant has been used since the early 2000s. The result of this study found some improved function in patients treated with the pyrocarbon joint replacement, but also a higher risk of need for future surgeries in those treated with the newer joint replacement.

Hand surgeons today debate about what surgical procedures are most appropriate for severely arthritic thumbs. The results of Dr. Vitale’s research will now help guide surgeons around the country to better treat patients.

Dr. Vitale commented, “The ASSH conference was a great success. The ONS Foundation for Clinical Research and Education has provided us with an incredible state of the art research and biomechanics lab from which we continue to drive the field of hand surgery, sports medicine and orthopedic surgery.”

Orthopaedic and Neurosurgery Specialists PC (ONS) is an advanced multi-specialty orthopedic and neurosurgery practice in Greenwich, CT. ONS physicians provide expertise in sports medicine, minimally invasive orthopedic, spine and brain surgery, joint replacement and trauma. For more information, please visit www.onsmd.com.

ONS Docs Included in Castle Connolly New York Top Doctors Guide, 17th edition

14 Specialists from ONS included in New York Area Medical Guide Book top primary care and specialty care doctors in the tri-state metropolitan New York area.

Fourteen physicians from Orthopaedic and Neurosurgery Specialists (ONS) on Valley Drive are included in the latest edition of Castle Connolly Top Doctors, New York Metro Area guidebook. The resource directory, which is in its seventeenth edition, is a guide to finding the top primary care and specialty care doctors in the tri-state metropolitan New York area. It details information on over 6,400 physicians in 65 specialties. Physicians profiled in the guide were nominated by their peers and screened by a research team at Castle Connolly.

Castle Connolly Top Doctors® are nominated by their peers including physicians and hospital executives throughout the New York metropolitan region in an online survey process. Nominations are open to all board certified MDs and DOs. Nominated physicians are selected by the Castle Connolly physician-led research team based on criteria including medical education, training, hospital appointments, disciplinary histories and much more.

ONS physicians included in the 17th edition of the guide are neurosurgeons Paul Apostolides, MD; Mark Camel, MD;  Amory Fiore, MD; and Scott Simon, MD, orthopedic surgeons Michael Clain, MD; John Crowe, MD; James Cunningham, MD; Frank Ennis, MD; Steven Hindman, MD; Brian Kavanagh, MD; Seth Miller, MD; Paul Sethi, MD; and Katie Vadasdi, MD and physiatrist Jeffrey Heftler, MD.

“We congratulate our physicians who have been recognized as ‘Top Doctors’ by Castle Connolly,” said hand and wrist specialist Dr. John Crowe. “Having fourteen of our fine doctors included in this authoritative guide is a reflection of the commitment and quality of excellence of all our physicians and entire staff at ONS. The multidisciplinary nature of ONS makes it possible to provide patients with access to the most advanced care available in orthopedics, neurosurgery and physiatry.”

Survey recipients are asked to nominate those doctors who, in their judgment, are the best in their field and related fields– especially those to whom they would refer their own patients and family members.

Orthopaedic and Neurosurgery Specialists PC (ONS) is an advanced multi-specialty orthopedic and neurosurgery practice in Greenwich, CT. ONS physicians provide expertise in sports medicine, minimally invasive orthopaedic, spine and brain surgery, joint replacement and trauma. For more information, please visit www.onsmd.com.

ONS Doctors Receive 40 Under 40 Award

Congratulations to Dr. Vitale and Dr. Vadasdi of Orthopaedic and Neurosurgery Specialists, Greenwich, CT, who received the 40 Under 40 award June 19, 2014, at the Palace in Stamford!

Dr. Vitale is  recognized for his career adv40Under40Winnersances, contribution to published research, community involvement and organizing trips to the country of Haiti where he and a group of clinician/physicians provide medical services to those in need.

Dr. Vadasdi was recognized for achievements in her medical career in orthopedics and sports medicine, for her community work and as an athlete.

Each year WAG Magazine and Fairfield County Business Journal recognize 40 professionals under the age of 40 as leaders in the workplace and community. Nominees are submitted and winners are decided by a panel. This year marked the 10th anniversary of this award. We are proud of both our winners, the work they do here at ONS, in the community and abroad.

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Orthopedic Surgeon offers “Hands on” advice for common hand and wrist issues at Greenwich Hospital Seminar

On Thursday, November 15th at 6:30 p.m., orthopedic surgeon and hand and wrist specialist Dr. Mark Vitale will present a talk at Greenwich Hospital; “Hands On”, Common hand conditions and their solutions.

A presentation and discussion on conditions of the hand and wrist will include information on carpal tunnel syndrome, arthritis of the fingers and wrist, trigger finger, common forms of tendonitis of the wrist and Dupyutren’s contractures of the fingers. The talk will also offer information on common misconceptions as well as treatments for these maladies which affect millions of people each year in the US.

After graduating Tufts University, Dr. Vitale earned a doctorate in medicine and a master’s in public health from Columbia University. He completed his residency training in orthopedic surgery at Columbia-Presbyterian Medical Center, where also he served as chief resident. He received fellowship training in hand surgery at the Mayo Clinic and was recognized as the Alice D. Jensen fellow in hand surgery.

Dr. Vitale has been a leader in orthopedic and hand surgery research over his career having published more than 20 peer-reviewed scientific papers, and authored book chapters and invited articles. He has given numerous scientific presentations at national and international conferences. For more information about Dr. Vitale and a list of published research, click here. For appointments, call ONS at 203-869-1145.

Hand and Wrist Surgeon Mark Vitale, MD joins ONS

New physician brings microsurgery and other advanced treatments to Practice

Dr Mark Vitale
Hand and wrist surgeon Dr Mark Vitale

We are pleased to announce that orthopedic surgeon Mark Vitale, MD has joined the ONS team and is now seeing patients in our Greenwich office.  Dr. Vitale is a specialist in operative and non-operative management of hand, wrist, forearm and elbow disorders. He brings special expertise in microsurgical reconstruction of nerve injuries, treatment of ganglion cysts, and upper extremity tendon repair and reconstruction to ONS. He is highly skilled in treatments for arthritis of the hand, wrist and elbow, fractures of the upper extremity, rehabilitation of sports injuries, arthroscopic treatment of wrist and elbow disorders, and nerve compression syndromes of the upper extremity, such as carpal tunnel syndrome.

“Dr. Vitale’s experience in microsurgery and other advanced minimally invasive techniques will be a tremendous asset to our patients,” said Dr. John Crowe. “Arthritis of the hand is one of the biggest orthopedic problems we see, so we consider it essential that ONS be on the forefront of new procedures and treatments, such as small joint replacement.”

After graduating Tufts University, where he majored in biopsychology, Dr. Vitale earned a doctorate in medicine and a master’s in public health from Columbia University. He completed his residency training in orthopedic surgery at Columbia-Presbyterian Medical Center, where also he served as chief resident. He received fellowship training in hand surgery at the Mayo Clinic and was recognized as the Alice D. Jensen fellow in hand surgery.

Dr. Vitale has been a leader in orthopedic and hand surgery research over his career having published more than 20 peer-reviewed scientific papers, and authored book chapters and invited articles. He has given numerous scientific presentations at national and international conferences.

Save the Date – On Thursday, November 15th at 6:30 p.m. Dr. Vitale will present a talk at Greenwich Hospital; “Hands On”, Common hand conditions and their solutions. The presentation and discussion on common conditions affecting the hand and wrist will include information on carpal tunnel syndrome, trigger finger, arthritis of the fingers and wrist, common forms of tendonitis of the wrist and Dupyutren’s contractures of the fingers. Learn about common misconceptions as well as treatments for these maladies which affect millions of people each year in the US.

For more information about Dr. Vitale and a list of published research, visit Dr. Vitale’s profile on our website.  For appointments, call ONS at 203-869-1145.