This blog is for informational purposes only.
It is not to be used as a substitute for advice from your own doctor, physician or health care provider.
If you are a current patient at the Hand Center of Western Massachusetts DO NOT USE THIS blog to relay
concerns or questions regarding acute problems or current status, pick up the phone and call the office!! Even when the office is closed the service will handle a message and relay it to one of the physicnans... 24 hours a day.
There is no way to make this site confidential or reply in timely fashion to handle current patients or acute situations.
Tuesday, February 10, 2009
Welcome to this blog..PLEASE READ THIS IMPORTANT NOTICE
PURPOSE:
Id like to address some common hand problems and their treatments and other issues regarding care of the hand and upper extremity here.
please read this!!!!
If you have any questions please feel free to post them. But please....This cannot be used for acute clinical questions
for current patients of the hand center at this time. If you are a current patient of the hand center of western massachusetts and have a question regading current treatment
please call the office.
Please understand this is not a confidential site and anything posted here will be seen by everyone. Questions and topics here should not substitute for device form your own doctor or any health care provider with whom you have a relationship.
please read this!!!!
If you have any questions please feel free to post them. But please....This cannot be used for acute clinical questions
for current patients of the hand center at this time. If you are a current patient of the hand center of western massachusetts and have a question regading current treatment
please call the office.
If you have a general question about hands or hand surgery please dont be afraid to ask.
Please understand this is not a confidential site and anything posted here will be seen by everyone. Questions and topics here should not substitute for device form your own doctor or any health care provider with whom you have a relationship.
These blogs are NOT for direct care and do not constitute specific advice and should not be taken to constitute a patient doctor relationship.
Again if you are a current patient of the Hand center of western massachusetts please DO NOT use this as a way to communicate in an acute setting or for questions regarding current care. At present there is no way to insure that posts here can be handled in a timley fashion and should not be used for acute care or communication with any treating physician. IF YOU ARE A CURRENT PATIENT AND HAVE A CURRENT OR ACUTE QUESTION CALL THE OFFICE .
What is endoscopic carpal tunnel release? How is it performed? What are the potential benefits?
Endoscopic carpal tunnel release uses an endoscope, an instrument attached to a video monitor to visualize the undersurface of the transverse carpal ligament. This avoids the need to make an incision in the palm. Instead the surgeon makes the incision in the wrist crease near the base of the palm.
The surgeon esssentially releases the ligament from the inside out, avoiding damaging the tough tissues called fascia in the palm that give the palm its shape and contour. In addition the plam skin incision is avoided. For many this reduces the immediate problem of using the hand more fully in the early post operative period. It does not mean that there will be absolutely no discomfort but many feel it is less. Typically however one must realize that there are many people who undergo so called regular open carpal tunnel release who have very little pain and many do not need to take pain medicine at all. However those who have endoscopic release who do well, do well a little bit sooner.
The greatest potential benefit is for those patients who need to get back to a job or activity that requires a lot of palm contact. Somethinig that we refer to as a "palm-intensive" activity.
While 5-6 weeks down the line most patients with either an open or endoscopic release are at nearly the same place with respect to activities, the endoscopically released hands seem to be more comfortable sooner.
Must my carpal tunnel be released endoscopically?
No. It is important to understand that this is one method that for some people can be beneficial. Standard carpal tunnel release is a tried and true method and typically has very good results.
IS Endoscopic Carpal Tunnel... LASER SURGERY?
No. The term laser surgery is a misnomer. In other words, some people call endoscopic or arthroscopic surgery laser surgery for some reason but there is no laser involved. While lasers are used by surgeons for a variety of conditions there is no role for laser here. Despite this, that question gets asked often by a lot of people who have heard about someone getting laser surgery for their carpal tunnel.
What should I do if I want to have this method used?
There are several different ways of doing an endoscopic carpal tunnel release in terms of instruments and the type pf endoscope used. You should make sure your surgeon has experience in their chosen method and instrumentation.
Where is the surgery done?
Like regular open carpal tunnel release endoscopic carpal tunnel release is done typically in an outpatient surgery center setting. The Hand Center of Western Massachusetts is located directly above the Pioneer Valley Surgical Center and Dr. Wint does many of the endoscopic carpal tunnel releases there.
For more information, it is vital to speak to a physician who can discuss with you with regard to whether you might be a candidate for this procedure and what the risks and benefits are. This page is for introduction of this topic and should not be used as a sole source of information.
For additional information: PLEASE NOTE THAT SOME OF THE INFORMATION ON THESE LINKS MAY HAVE A COMMERCIAL BIAS
Baystate Health Systems Article from 2001
American Academy of Orthopedic Surgeons Bulletin 1997
Instrumentation used by Dr. Wint in endoscopic carpal tunnel release
Jeffrey C. Wint, M.D.
THE HAND CENTER OF WESTERN MASSACHUSETTS
Endoscopic carpal tunnel release uses an endoscope, an instrument attached to a video monitor to visualize the undersurface of the transverse carpal ligament. This avoids the need to make an incision in the palm. Instead the surgeon makes the incision in the wrist crease near the base of the palm.
The surgeon esssentially releases the ligament from the inside out, avoiding damaging the tough tissues called fascia in the palm that give the palm its shape and contour. In addition the plam skin incision is avoided. For many this reduces the immediate problem of using the hand more fully in the early post operative period. It does not mean that there will be absolutely no discomfort but many feel it is less. Typically however one must realize that there are many people who undergo so called regular open carpal tunnel release who have very little pain and many do not need to take pain medicine at all. However those who have endoscopic release who do well, do well a little bit sooner.
The greatest potential benefit is for those patients who need to get back to a job or activity that requires a lot of palm contact. Somethinig that we refer to as a "palm-intensive" activity.
While 5-6 weeks down the line most patients with either an open or endoscopic release are at nearly the same place with respect to activities, the endoscopically released hands seem to be more comfortable sooner.
Must my carpal tunnel be released endoscopically?
No. It is important to understand that this is one method that for some people can be beneficial. Standard carpal tunnel release is a tried and true method and typically has very good results.
IS Endoscopic Carpal Tunnel... LASER SURGERY?
No. The term laser surgery is a misnomer. In other words, some people call endoscopic or arthroscopic surgery laser surgery for some reason but there is no laser involved. While lasers are used by surgeons for a variety of conditions there is no role for laser here. Despite this, that question gets asked often by a lot of people who have heard about someone getting laser surgery for their carpal tunnel.
What should I do if I want to have this method used?
There are several different ways of doing an endoscopic carpal tunnel release in terms of instruments and the type pf endoscope used. You should make sure your surgeon has experience in their chosen method and instrumentation.
Where is the surgery done?
Like regular open carpal tunnel release endoscopic carpal tunnel release is done typically in an outpatient surgery center setting. The Hand Center of Western Massachusetts is located directly above the Pioneer Valley Surgical Center and Dr. Wint does many of the endoscopic carpal tunnel releases there.
For more information, it is vital to speak to a physician who can discuss with you with regard to whether you might be a candidate for this procedure and what the risks and benefits are. This page is for introduction of this topic and should not be used as a sole source of information.
For additional information: PLEASE NOTE THAT SOME OF THE INFORMATION ON THESE LINKS MAY HAVE A COMMERCIAL BIAS
Single-Portal Endoscopic Carpal Tunnel Release Compared with Open Release A Prospective, Randomized Trial
Baystate Health Systems Article from 2001
American Academy of Orthopedic Surgeons Bulletin 1997
Instrumentation used by Dr. Wint in endoscopic carpal tunnel release
Jeffrey C. Wint, M.D.
THE HAND CENTER OF WESTERN MASSACHUSETTS
Recommendations for safe use of a jammed snow blower snow blowers include :
1. If the snow blower jams, immediately turn it off
2. Disengage the clutch
3. Wait 10 seconds after shutting of to allow Impeller Blades to stop rotating
4. Always use a stick or broom handle to clear impacted snow. The stick most be strong enough to avoid breakage or eye injures can result from flying fragments
5. Never put your hand near chute or around blades
6. Keep all shields in place. Do not remove safety devices on machine
7. Keep hands and feet away from moving parts
8. Keep a clear head, concentrate and ...
Do not drink alcoholic beverages before using a snow blower
As physicians dedicated to the care of the Hand and Upper extremity we want to inform the public concerning the perils and pitfalls of improper snow blower use. Physicians, nurses, allied health professionals and therapists who deal with these injuries live in fear of the first heavy wet snow of the season. Invariably injuries are seen despite general knowledge that these injuries occur. These safety tips cannot guarantee against injury but hopefully if you are reading these or even better spreading these... it is one more step towards preventing these types of injuries.
News organizations and weather services can help.
Conditions that are associated with a higher incidence of injuries, hay wet snow exceeding 6 inches of accumulation and temperatures above 28 degrees Fahrenheit offer good opportunities to provide warning for the public. We need your help to reduce the incidence of these preventable injuries.
www.handctr.com
1. If the snow blower jams, immediately turn it off
2. Disengage the clutch
3. Wait 10 seconds after shutting of to allow Impeller Blades to stop rotating
4. Always use a stick or broom handle to clear impacted snow. The stick most be strong enough to avoid breakage or eye injures can result from flying fragments
5. Never put your hand near chute or around blades
6. Keep all shields in place. Do not remove safety devices on machine
7. Keep hands and feet away from moving parts
8. Keep a clear head, concentrate and ...
Do not drink alcoholic beverages before using a snow blower
As physicians dedicated to the care of the Hand and Upper extremity we want to inform the public concerning the perils and pitfalls of improper snow blower use. Physicians, nurses, allied health professionals and therapists who deal with these injuries live in fear of the first heavy wet snow of the season. Invariably injuries are seen despite general knowledge that these injuries occur. These safety tips cannot guarantee against injury but hopefully if you are reading these or even better spreading these... it is one more step towards preventing these types of injuries.
News organizations and weather services can help.
Conditions that are associated with a higher incidence of injuries, hay wet snow exceeding 6 inches of accumulation and temperatures above 28 degrees Fahrenheit offer good opportunities to provide warning for the public. We need your help to reduce the incidence of these preventable injuries.
www.handctr.com
Monday, February 9, 2009
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