Whether at work, school or on the sports field, accidents do happen and at times require immediate surgical attention. Our hands, in particular, are prone to injury, which may include damage to the nerves, ligaments, muscle, tendon, blood vessels or bone. We use our hands every day to perform basic mundane tasks, some of us even more so when playing sports with plenty of wrist movement. Dr Freed works tirelessly to repair the hand's nerves, soft tissue, and bone for a complete range of motion.
Falling and landing on outstretched hands may result in a potential wrist fracture. Age is most likely a determinant as people over sixty are susceptible to injuries of this nature. This is not to say young people are unlikely to suffer wrist fractures and may sustain such an injury when hiking or playing an extreme sport such as squash.
Fractures of this kind involve several tiny bones known as carpal bones at the bottom of the hand and are extremely painful and need to be repaired in the emergency unit. In the event of a hand fracture, the most immediate sign of this is a person’s inability to make a fist. Typically sprains and dislocations accompany this particular fracture.
Ligaments are strong fibrous cords that connect one bone to another and enable swift movement. Injuries to ligaments are prevalent and affect the movement of the wrist. Instead of the tiny carpal bones moving together, they operate separately and cause joint instability. Over a long time, such a condition can cause joint pain and friction, often leading to arthritis.
Besides fractures, the hand is prone to infections, bites and cuts. A complex and major injury such as a laceration that injures the nerve will require complete reconstructive surgery of the hand.
Splinting or wrapping the wrist joint immobilises the entire structure and promotes healing. Dr Freed prescribes anti-inflammatories and suggests physical therapy. Should there be a need for physical therapy, he recommends a qualified physiotherapist to ensure full mobility of the joint.
Prior to surgery, Dr Freed evaluates the severity of the condition and controls bleeding, especially if it is in excess. A severe fracture happens when the bone breaks into many pieces and, in this case, requires the use of plates and screws to attach the portion in place. If the bone is crushed, Dr Freed will use a bone graft to make up for space.
Debridement of necrotic tissue happens due to infection from a human or animal bite. With a small cut, the infection is likely to spread faster because only the top layer is visible, while a tooth-like puncture is apparent and needs to be cleaned immediately. Concerning a small cat bite, squeezing and disinfecting the inside out will make the wound easier to treat. An infection that spreads with significant damage in its wake needs intravenous antibiotic treatment.
Whatever the extent of injury, Dr Freed carries out x-rays and irrigates blood to prevent further damage to the joint. He will discuss his plans with close family members to ensure they are aware of the status of the patient's condition.
Rooms: Life Wilgeheuwel Hospital, Amplifier Street, Radiokop Ext 13, Roodepoort
Tel: (0)11 794 8629
E-mail: hands24wilg@gmail.com
The orthopaedic surgeon, Dr Neil M Freed, is fellowship-trained. This means that the doctor qualified first as a specialist in orthopaedic surgery and thereafter spent time at an academic institution doing just hand surgery to obtain his fellowship in that subspecialty. He has been practising hand surgery exclusively since 1992.
