https://www.schreibermd.com/blog daily 0.75 2019-10-23 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1483328012328-WI626CNAAMMQLO1Q694Z/shutterstock_111524120.jpg Raleigh Hand Surgery https://www.schreibermd.com/blog/2019/10/23/why-does-my-thumb-hurt monthly 0.5 2019-10-24 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1571876729752-RVU7186146BS2B04SQ5A/Thumb+arthritis+xray.png Raleigh Hand Surgery - Why does my thumb hurt? Thumb arthritis as seen on x-ray. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1571874746526-AUK9HKQVEILJSL4922CQ/Thumb%2Bsplint%2Bfor%2Bthumb%2Barthritis.png Raleigh Hand Surgery - Why does my thumb hurt? A commonly used splint for thumb arthritis. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1571875938083-MKGBUJC5CFK5YNMZ3QDC/Trigger+Finger.jpeg Raleigh Hand Surgery - Why does my thumb hurt? Trigger thumb is caused by swelling of the tendon that bends the finger. The abnormal nodule in the tendon prevents the tendon from gliding smoothly, resulting in clicking, catching, or locking when bending the thumb. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1571877275645-6SJY8SZB1L1CA539PA5Z/de+Quervain+tendonitis.png Raleigh Hand Surgery - Why does my thumb hurt? De Quervain tendonitis is caused by swelling of the tendons that extend the thumb. This prevents them from smoothly gliding through their tunnel (top image). If the swelling does not improve with conservative treatment, the roof of the tunnel can be released to allow for smooth and comfortable tendon gliding (bottom image). https://www.schreibermd.com/blog/2019/6/16/skiers-thumb monthly 0.5 2019-06-18 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1560861952382-Q0AUE5ER1WTTVDDPMCJF/Skier%27s+thumb.jpg Raleigh Hand Surgery - Skier’s Thumb https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1560691177002-R2YSG8Y55ZHOEX3WNIT9/Stener+Lesion+or+Skier%27s+thumb.png Raleigh Hand Surgery - Skier’s Thumb Some complete tears require surgery to repair. A "Stener lesion" is a situation when the torn ulnar collateral ligament gets folded backwards after tearing. A band of tissue called the adductor aponeurosis blocks the ligament from healing back to the bone. In surgery, the adductor aponeurosis is divided, and the torn ligament is sutured back to the bone. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1560862067927-VAHLHZHQ597TFZ8MJ7YR/Thumb+anatomy.png Raleigh Hand Surgery - Skier’s Thumb https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1560690721615-V4SO8DK1EXPE0YRLNGIE/Figure+2.png Raleigh Hand Surgery - Skier’s Thumb A suture anchor is placed into the proximal phalanx. The attached sutures allow for the torn ligament to be stitched back down to the the bone. Image from AO Foundation. https://www.schreibermd.com/blog/2019/2/12/dr-schreiber-in-the-news-e-scooter-injuries-are-on-the-rise monthly 0.5 2019-02-12 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1550011460637-JXYI7VDSWQN2EKIVP76G/eScooter+Injury Raleigh Hand Surgery - Dr. Schreiber in the news- E-scooter injuries are on the rise https://www.schreibermd.com/blog/2018/11/13/what-is-tennis-elbow monthly 0.5 2019-02-12 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1542146496726-73125SLP9E1XHPOENTNS/Elbow+pain+from+tennis+elbow Raleigh Hand Surgery - What is tennis elbow? https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1542146563784-NHJ5TDK9823EP2CRD10S/tennis+elbow Raleigh Hand Surgery - What is tennis elbow? Tennis elbow, or lateral epicondylitis, is an inflamed or torn tendon on the outside of the elbow https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1542146631387-SWFUSRTV8VSUDZSSRUPY/elbow+strap+for+tennis+elbow Raleigh Hand Surgery - What is tennis elbow? An elbow strap can stabilize the injured tendon, decrease pain, and prevent further injury. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1542146779630-0A8ZPAB7AARNTTV6L53U/tennis+elbow+stretch Raleigh Hand Surgery - What is tennis elbow? Wrist extensor stretches for tennis elbow. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1542146895173-PW7TPUHPWIRCBRNWBAQA/tennis+elbow+stretch Raleigh Hand Surgery - What is tennis elbow? Wrist flexor stretches for tennis elbow. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1542147004281-ECIM4T1UBR0ANT9I5GK9/tennis+elbow+MRI Raleigh Hand Surgery - What is tennis elbow? On the left shows a normal extensor tendon of the elbow. Notice the tendon (black on MRI) inserting into the bone. On the right shows a torn tendon. The tendon does not attach into the bone. Inflammatory tissue (white on MRI) blocks the tendon from healing back to the bone. https://www.schreibermd.com/blog/2018/8/27/can-using-a-computer-cause-carpal-tunnel-syndrome monthly 0.5 2019-06-16 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1535406286267-Y0PWYCWFVWBMMAT2X2LN/Carpal+tunnel+from+computer+use Raleigh Hand Surgery - "Can using a computer cause carpal tunnel syndrome?" https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1535406185161-ALER5THHLXMV2D653NFM/carpal+tunnel.jpg Raleigh Hand Surgery - "Can using a computer cause carpal tunnel syndrome?" https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1535406445288-43HS70DVM9X2DALP67JZ/carpal+tunnel+using+a+computer+mouse Raleigh Hand Surgery - "Can using a computer cause carpal tunnel syndrome?" https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1535405903142-E72JEY5VW6MHIYLLY7HO/Carpal+tunnel+proper+mouse+hand+position Raleigh Hand Surgery - "Can using a computer cause carpal tunnel syndrome?" https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1535405981340-9A8FHCTHXDKH69KUDSB3/Carpal+tunnel+proper+keyboard+hand+position Raleigh Hand Surgery - "Can using a computer cause carpal tunnel syndrome?" https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1535406013748-WSBD31XE9V70252JVZIZ/Carpal+tunnel+proper+keyboard+hand+position Raleigh Hand Surgery - "Can using a computer cause carpal tunnel syndrome?" Images courtesy of Mike De La Flor, Dr. Aaron Daluiski https://www.schreibermd.com/blog/2018/8/27/top-5-questions-about-trigger-fingers monthly 0.5 2019-02-19 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1535404862646-R2GI8VH1MOI0XPQHQ6P0/Trigger+Finger Raleigh Hand Surgery - Top 5 Questions About Trigger Fingers https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1550596620290-RW4YUSCTCATIXM3J39GJ/Trigger+Finger+Splint.png Raleigh Hand Surgery - Top 5 Questions About Trigger Fingers Placing CoBan tape, or a Band-Aid around the joint creases can limit flexion and decrease triggering, which can allow tendon swelling to subside. https://www.schreibermd.com/blog/2017/6/12/my-tingling-hands-wake-me-up-at-night monthly 0.5 2018-11-28 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1497308976860-COZ1KAXGMVIUYZU16YUG/Tingling+hands+at+night Raleigh Hand Surgery - “My tingling hands wake me up at night!” https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1534619384780-U7TPPLRZUUFB4Z489CHT/Carpel+tunnel+syndrome Raleigh Hand Surgery - “My tingling hands wake me up at night!” Carpal tunnel syndrome is caused by compression, or pinching, of the "median nerve" in the wrist. This causes numbness, tingling, or pain in the thumb, index, and middle finger. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1497954278869-VIRSVMGGWE3B8O4VTJTI/Cubital+Tunnel Raleigh Hand Surgery - “My tingling hands wake me up at night!” https://www.schreibermd.com/blog/2018/3/25/i-broke-my-wrist-now-what monthly 0.5 2018-11-28 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1521981709276-QUGZFTRAFUHLDUFROLYA/broken+wrist.jpg Raleigh Hand Surgery - "I broke my wrist, now what?" https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1521982490451-0T77CSZ5WA1AI4EWUBVT/image-asset.jpeg Raleigh Hand Surgery - "I broke my wrist, now what?" https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1521982382903-EY9WGWCAJ79SGXUTE2LT/Distal+radius+fracture.png Raleigh Hand Surgery - "I broke my wrist, now what?" https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1521982354128-940IIBDYIU3S12AHT2GK/distal+radius+fracture+2.png Raleigh Hand Surgery - "I broke my wrist, now what?" https://www.schreibermd.com/blog/2017/3/12/pain-on-the-back-of-your-wrist-it-may-be-dorsal-wrist-impingement-syndrome monthly 0.5 2018-11-28 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1489359645428-4YK556MXZG0V0ULSBXPA/Yoga+Upward+Facing+Dog Raleigh Hand Surgery - Pain on the back of your wrist? – It may be “Dorsal Wrist Impingement Syndrome” https://www.schreibermd.com/blog/2017/1/19/dr-schreiber-selected-winner-of-the-outstanding-paper-award-at-the-2017-american-association-of-hand-surgery-annual-meeting-in-hawaii monthly 0.5 2018-11-28 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1484838313200-JVQ62YN7UQVCTLFCSD26/Normal+Bone Raleigh Hand Surgery - Dr. Schreiber selected winner of the "Outstanding Paper" award at the 2017 American Association of Hand Surgery Annual Meeting in Hawaii https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1484838355210-FU2O4CJ77K9TLDKYDGJG/Osteoporotic+Bone Raleigh Hand Surgery - Dr. Schreiber selected winner of the "Outstanding Paper" award at the 2017 American Association of Hand Surgery Annual Meeting in Hawaii https://www.schreibermd.com/blog/2017/1/3/dupuytren-disease-from-vikings-to-napoleon-to-a-new-injection monthly 0.5 2018-11-28 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1483496697070-51RXLLYW268JEO64MKB4/Dupuytren+Disease Raleigh Hand Surgery - Dupuytren Disease – from Vikings to Napoleon to a New Injection Progression of Dupuytren disease https://www.schreibermd.com/blog/category/Blog monthly 0.5 https://www.schreibermd.com/blog/tag/Skier%27s+Thumb monthly 0.5 https://www.schreibermd.com/blog/tag/Tennis+Elbow monthly 0.5 https://www.schreibermd.com/blog/tag/Thumb+sprain monthly 0.5 https://www.schreibermd.com/blog/tag/Wrist+pain monthly 0.5 https://www.schreibermd.com/blog/tag/Wrist+fracture monthly 0.5 https://www.schreibermd.com/blog/tag/Computer+use monthly 0.5 https://www.schreibermd.com/blog/tag/Carpal+Tunnel+Syndrome monthly 0.5 https://www.schreibermd.com/blog/tag/Orthopaedic+Hand+Condition monthly 0.5 https://www.schreibermd.com/blog/tag/Osteoporosis monthly 0.5 https://www.schreibermd.com/blog/tag/Cubital+tunnel+syndrome monthly 0.5 https://www.schreibermd.com/blog/tag/Trigger+Finger monthly 0.5 https://www.schreibermd.com/blog/tag/News monthly 0.5 https://www.schreibermd.com/blog/tag/distal+radius+fracture monthly 0.5 https://www.schreibermd.com/blog/tag/Broken+wrist monthly 0.5 https://www.schreibermd.com/blog/tag/Elbow monthly 0.5 https://www.schreibermd.com/projects daily 0.75 2020-04-01 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1483490278468-0JIXBHCASJ96Y328GMD7/Building+Image.jpg Raleigh Orthopedic Clinic - Raleigh Hand Sugery https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1585736779699-VS2PWY8MW8NS4XMYBZUN/Hurricanes+AND+Dr.+Schreiber+AND+team+doctors Raleigh Orthopedic Clinic - Raleigh Hand Sugery https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1484708996659-00IFLDX3ZOV40LH3INEO/NC+State+AND+Dr.+Schreiber+AND+Team+doctors Raleigh Orthopedic Clinic - Raleigh Hand Sugery https://www.schreibermd.com/cubital-tunnel daily 0.75 2022-06-24 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1490059296581-O36LP2HE7E6DE27N5JCW/Cubital+Tunnel Cubital Tunnel Syndrome - Raleigh Hand Surgery Anatomy of cubital tunnel syndrome. Cubital tunnel syndrome is when one of the major nerves to the forearm and hand (the “ulnar nerve”) gets compressed as it passes along the inner side of the elbow. Cubital tunnel syndrome can cause numbness or tingling into the ring and small finger. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1486089043181-YN13S9QFTOFYQMTPWNP1/Cubital+Tunnel+Wrap Cubital Tunnel Syndrome - Raleigh Hand Surgery Keeping the elbow straight while sleeping minimizes tension on and irritation of the ulnar nerve. A homemade splint can be made with a towel loosely wrapped around the elbow and held in place with an ace bandage or tape. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1485645495054-SAZWSNIPANJIM8YY6C9I/image-asset.jpeg Cubital Tunnel Syndrome - Raleigh Hand Surgery Ulnar nerve gliding exercises. While keeping your head in a neutral position: 1) Begin with your arm out, palm side of the hand facing up. 2) Bend the elbow toward you, palm side facing you. 3) Rotate the palm of your hand outward and bend your wrist so that the fingers are pointing towards you. 4) Twist your wrist so that the palm of your hand is now facing upward. 5) While your wrist remains bent, stretch out your arm into a straight position, with your fingers bent towards the floor. Hold each position for 5 seconds, repeat series 3-5 times. https://www.schreibermd.com/fracture-hand daily 0.75 2021-10-26 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1483495252625-GVN52YZLTCCY3T1PL6LU/Metacarpal+Hand+Fracture Hand Fracture - Raleigh Hand Surgery Metacarpal fracture https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1521201904110-MJPKCIDGJU20GU4G162Q/hand+fracture+cast.jpg Hand Fracture - Raleigh Hand Surgery https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1521201376839-P38MZL2YHOV4R4RF1CM6/surgical+treatment+for+hand+metacarpal+fracture+using+pins Hand Fracture - Raleigh Hand Surgery Fracture of the 5th (small finger) metacarpal bone. When hand fractures are notably bent, or mal-rotated, surgery may improve alignment and motion of the finger. The images here show a small outpatient procedure. The fracture is reduced, or lined up, by manipulating the hand (no incision made). Next, 2 temporary pins are placed though the skin to hold the alignment during fracture healing. The pins are typically removed in the office 2-3 weeks after being placed. Motion is started at that point. More vigorous activities, such as lifting and strengthening, are started ~6 weeks after surgery. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1521201501834-7FIOBA83CMO6QG8M4L1Q/surgery+using+pins+to+fix+hand+metacarpal+fracture Hand Fracture - Raleigh Hand Surgery Fracture of the proximal phalanx bone of the ring finger. Spiral, oblique fractures such as this one tend to cause rotational deformities of the finger. In the x-ray on the left, the ring finger can be seen overlapping the pinkie finger. The abnormal positioning will adversely affect function of the finger if it is left to heal in this bent and rotated position. An outpatient procedure can improve the alignment and allow the bone to heal in a normal position. As shown above, the fracture is aligned, and temporary pins are placed through the skin (no incision) to hold the two fractured pieces together. The pins are removed 2-3 weeks later in the office, and motion is started. Strengthening and more vigorous activities are resumed once the fracture has healed (~6 weeks). https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1572604081878-GZLR1RHX4Q80S1P7KDZJ/Middle+Phalanx+CRPP.png Hand Fracture - Raleigh Hand Surgery Middle phalanx displaced fracture. This fracture was successfully treated with a closed reduction and percutaneous pinning (CRPP). The pin was removed 2.5 weeks after surgery and motion was initiated. The patient had complete return of normal motion, strength and function. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1635251368456-1N3XJDNIWP5YZ56U9GL6/Metacarpal+Nail.png Hand Fracture - Raleigh Hand Surgery - Make it stand out Metacarpal nail. Some metacarpal fractures can be treated with an “intramedullary” nail. This is a screw that goes down the canal of the bone and stabilizes the two fragments together. This technique can allow for earlier motion and return to activities. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1485005558269-4W0H3VSSHF0MSCD3GWCT/Metal+plate+and+screws+to+fix+hand+fracture+of+metacarpals Hand Fracture - Raleigh Hand Surgery Image from Acumed https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1548935232978-JB0XID0A3M9R4SB8AENZ/FDP+avulsion.png Hand Fracture - Raleigh Hand Surgery Distal phalanx fracture. Sometimes the tendon that bends the fingertip, called the flexor digitorum profundus tendon, will pull off a piece of the distal phalanx bone. These injuries are oftentimes fixed with one or two small metal screws to hold the pieces of bone back together. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1585735903770-EW3LH934KNGKEKRQR546/proximal+phalanx+pinning.png Hand Fracture - Raleigh Hand Surgery Proximal phalanx fracture of the small finger. The angulation was treated by setting the fracture, and temporary pins were placed through the skin to hold the fracture in place. https://www.schreibermd.com/aboutjosephjschreibermd daily 0.75 2022-11-13 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1585587706177-47RTXYR8SU4PB8STSG6P/Joseph+Schreiber.jpg Joseph J. Schreiber, MD - Raleigh Hand Surgery https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1585736359555-BSUO69EQRYMYT0FJ3OMM/Joseph+Schreiber+MD+Societies Joseph J. Schreiber, MD - Raleigh Hand Surgery Societies that Dr. Joseph Schreiber belongs to https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/100c09eb-6404-497f-a01f-1db3dca7d502/B04886DC-F859-4E4D-BECF-9B7EAE07BBEE.jpeg Joseph J. Schreiber, MD - Raleigh Hand Surgery - Make it stand out Whatever it is, the way you tell your story online can make all the difference. https://www.schreibermd.com/presurgery daily 0.75 2019-10-30 https://www.schreibermd.com/carpal-tunnel daily 0.75 2020-03-31 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1485004930245-W8291VHJ5DS7VR3DAEU7/Carpal+Tunnel Carpal Tunnel Syndrome - Raleigh Hand Surgery AreaArea of pain and numbness in hand that is caused by carpal tunnel https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1533652047179-SL92FTRWFRB2OOUX2RIU/carpal+tunnel.jpg Carpal Tunnel Syndrome - Raleigh Hand Surgery Carpal tunnel syndrome is when one of the major nerves to the hand (the “median nerve”) gets compressed as it passes through a tunnel leading from the forearm to the palm. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1485698895812-Q54K1GO1EIQVTZV2APOQ/Carpal+Tunnel+Excercises Carpal Tunnel Syndrome - Raleigh Hand Surgery Median nerve gliding exercises. 1) Begin with your wrist in a neutral position, fingers and thumb bent into a fist, with your thumb facing you. 2) Extend your fingers and thumb into a straight, neutral position. 3) Keeping your fingers and thumb straight, bend your wrist so that your palm faces up. 4) Keeping your hand in the same position, extend your thumb away from your hand. 5) Keeping your hand and fingers in the same position, rotate your wrist so that your palm faces away from you. 6) While in position 5, gently pull down on your thumb with your free hand. Hold each position for 5 seconds, repeat series 3 to 5 times. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1485005050737-V9GKRMQ6ET945OO3H6GU/Carpal+Tunnel+Surgery Carpal Tunnel Syndrome - Raleigh Hand Surgery Before and after picture of carpal tunnel surgery. https://www.schreibermd.com/dupuytren daily 0.75 2018-11-28 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1496852240062-FAGX4ZHU2CHIDKXP3T8X/Dupuytren Dupuytren Contracture - Raleigh Hand Surgery An abnormal growth of tissues in the palm of your hand, either in the form of “nodules” in the palm or “cords” in line with the fingers is known as Dupuytren contracture. Over time, these tissues can contract and result in the finger curling down into the palm. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1483792703038-NEI3PYTJS1WJZU0SZ0SS/Schreiber_Duputren+contracture.png Dupuytren Contracture - Raleigh Hand Surgery Image by H.A. Schreiber https://www.schreibermd.com/thumb-arthritis daily 0.75 2020-04-16 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1587033466085-HYQ9I1VLBFW8LP8QD133/Basal+Joint+Arthritis.png Thumb Arthritis - Raleigh Hand Surgery Thumb arthritis shown on an x-ray https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1485705818243-6RHWHAN5KJI7RIN3LI2L/Thumb+splint+for+thumb+arthritis Thumb Arthritis - Raleigh Hand Surgery Splint worn around the base of the thumb to support the joint and decrease arthritis pain. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1585649456978-A7HFCTZ8VZU0G2BYY548/CMC+arthroplasty.png Thumb Arthritis - Raleigh Hand Surgery Removal of the arthritic trapezium bone creates a new space at the base of the thumb https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1547143280514-MX3YW7GBLM2F59OU5LSC/Suspensionplasty.png Thumb Arthritis - Raleigh Hand Surgery Surgical treatment of thumb arthritis involves removing the trapezium bone, and suturing together the APL and FCR tendons, thereby creating a soft "hammock" to support the thumb https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1520899107205-I3FBFSLDYM09G5D9ROPL/Thumb+arthritis+splint.png Thumb Arthritis - Raleigh Hand Surgery Splint to treat thumb arthritis https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1520687937556-LE40H5MD8V29XRIW4ZCK/STT+scapho-trapezio-trapezoidal+surgery+to+treat+thumb+arthritis Thumb Arthritis - Raleigh Hand Surgery If the arthritis involves the “STT” (scapho-trapezio-trapezoidal) joint, in addition to removing the trapezium bone, a small portion of the trapezoid bone is removed to create a space. The defect fills in with scar tissue, which eliminates the “arthritic” STT joint. The thumb is suspended with sutures. The goal is to restore thumb motion and decrease pain. https://www.schreibermd.com/home daily 1.0 2021-01-08 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1483062111105-JGII0LEDQKB07IV63KAB/Dr+Joseph+Schreiber Dr. Joseph J. Schreiber - Raleigh Hand Surgery - Raleigh Orthopaedic Clinic - Dr. Joseph J. Schreiber Joseph Schreiber MD is a doctor at Raleigh Orthopaedic Clinic Hand surgeon, hand doctor, orthopedic surgeon He sees patients from Raleigh, Cary, Garner, and Holly Springs, North Carolina https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1585687687840-NQX6B33401SXR6FWK0LT/Word+Cloud+with+Caption.png Dr. Joseph J. Schreiber - Raleigh Hand Surgery - Raleigh Orthopaedic Clinic https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1585739948138-DFMR14ELB5GHZO6QRIQA/Hand+with+caption.png Dr. Joseph J. Schreiber - Raleigh Hand Surgery - Raleigh Orthopaedic Clinic https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1585687448292-92JR79FHIT4HBSN4E4D8/Grouped+Cert+Logo+w%3A+caption.png Dr. Joseph J. Schreiber - Raleigh Hand Surgery - Raleigh Orthopaedic Clinic https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1585687927504-6AG31HEPLWTEI0ACYT5Z/Artist+with+caption.png Dr. Joseph J. Schreiber - Raleigh Hand Surgery - Raleigh Orthopaedic Clinic https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1585737212302-5IPTHUQFZ4Q8H8KY5XZ9/Grouped+societies+2.png Dr. Joseph J. Schreiber - Raleigh Hand Surgery - Raleigh Orthopaedic Clinic https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1585737472545-7MVIDZBE8901O51765LC/Grouped+%27Canes+and+NCState+logos.png Dr. Joseph J. Schreiber - Raleigh Hand Surgery - Raleigh Orthopaedic Clinic https://www.schreibermd.com/trigger-finger daily 0.75 2020-03-31 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1521985358985-OXVU5W67IGWDAK50ZB7I/Trigger+finger Trigger Finger - Raleigh Hand Surgery Trigger fingers are caused by swelling of the tendons that bend the finger. During normal motion, the swollen portion of the tendon can get caught between the "pulleys" that guide normal motion, causing pain and catching. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1550596019317-X9QEZS2BW7YDWQDZHCAZ/Trigger+Finger+Splint.png Trigger Finger - Raleigh Hand Surgery Placing CoBan tape, or a Band-Aid around the joint creases can limit flexion and decrease triggering, which can allow tendon swelling to subside. https://www.schreibermd.com/post-surgery daily 0.75 2019-10-30 https://www.schreibermd.com/edwards-mill daily 0.75 2018-09-20 https://www.schreibermd.com/take-action daily 0.75 2020-04-01 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1482977843959-35UNZHXUQ9IIWXQHAAVA/Make+an+appointment.jpg appointment https://www.schreibermd.com/tennis-elbow daily 0.75 2020-03-31 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1483816153138-0RJRCGXK1XBANT2VSJ9L/Pathology+of+Tennis+Elbow Tennis Elbow - Lateral Epicondylitis - Raleigh Hand Surgery Tennis elbow, or “lateral epicondylitis”, is condition causing pain along the outside of the elbow. The muscles that extend the wrist and open the fingers insert into a portion of the bone on the outside of the elbow called the “lateral epicondyle”. Small tears of the muscle at its insertion site (the tendon) is a common cause of pain in the area that is experienced when lifting or grasping objects. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1501981174161-4G6IXAIGH4L74XK9GGB7/Tennis+elbow+strap Tennis Elbow - Lateral Epicondylitis - Raleigh Hand Surgery A counterforce strap decreases tension on the site of the tendon tear, which can decrease pain and facilitate healing https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1486088554855-2VU168ANS0OYPAJCUNND/Tennis+elbow+stretch+one Tennis Elbow - Lateral Epicondylitis - Raleigh Hand Surgery With your elbow straight and palm facing the floor, make a fist. Then, use your other hand to bend the wrist down. Hold the stretch for 30 seconds. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1486088981866-XZU3F4BMU1K270KMSISL/1.png Tennis Elbow - Lateral Epicondylitis - Raleigh Hand Surgery With your elbow straight and palm facing the floor, use your other hand to bend the wrist and fingers backward. Hold the stretch for 30 seconds. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1506901669204-D7NHMUCRGSFZGVIK68CZ/MRI+of+normal+elbow+and+tennis+elbow Tennis Elbow - Lateral Epicondylitis - Raleigh Hand Surgery Left: MRI of a normal elbow - the typical appearance of the extensor tendon (white arrows) insertion is a black line attaching to the bone Right: MRI of an elbow with lateral epicondylitis - the tendon has torn off of the bone. Fluid and scar tissue (white on MRI- white arrows) are interposed between the end of the tendon and the bone. An abnormal attachment results in pain along the outside of the elbow with use of the hand and arm. https://www.schreibermd.com/distal-radius-fracture daily 0.75 2020-04-16 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1490060421217-V2F0SJUD3U9BKTE3FH57/Wrist+fracture Distal Radius Fracture - Raleigh Hand Surgery https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1540338538222-LOVP1M5C5MYUE72DJXOI/Splint+for+wrist+fracture Distal Radius Fracture - Raleigh Hand Surgery Wrist fracture being immobilized with a custom-molded splint https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1483818392035-V5RPZ5OUS30NWNAMKKVH/Wrist+Fracture+x-ray Distal Radius Fracture - Raleigh Hand Surgery X-ray of a distal radius fracture after surgical treatment. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1483818288848-V7EDRISRTB862BBAJOA6/Wrist+fracture+surgery+metal+plate Distal Radius Fracture - Raleigh Hand Surgery Example of metal plate and screws used to surgically fix a distal radius fracture. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1573741405690-22RT8A4L6CNKXL8VVGFS/Lateral+xray+distal+radius+ORIF.png Distal Radius Fracture - Raleigh Hand Surgery Left: Lateral x-ray of a distal radius fracture treated with a metal plate and screws to restore alignment. Right: Bone model demonstrating how metal plate can help restore normal tilt of the joint surface. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1485009061553-P3PY4HVE4E9H2ANV9ITY/Stages+of+osteoporosis Distal Radius Fracture - Raleigh Hand Surgery Healthy bone (left), osteopenia (middle images), osteoporosis (right) https://www.schreibermd.com/de-quervain-tendonitis daily 0.75 2020-03-30 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1486089574920-S8ZIEDYL8L118BZCEN68/de+Quervain+Syndrome de Quervain Tendonitis - Raleigh Hand Surgery Region of pain experienced with de Quervain syndrome https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1565691212142-KGV48R756DUR56ND9C4J/de+Quervain+pathology+and+release.png de Quervain Tendonitis - Raleigh Hand Surgery De Quervain tendonitis is caused by swelling of the tendons that extend the thumb. This prevents them from smoothly gliding through their tunnel (top image). If the swelling does not improve with conservative treatment, the roof of the tunnel can be released to allow for smooth and comfortable tendon gliding (bottom image). https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1486307896774-M7EE0IBP9DX13NCYGIR5/Thumb+spica+splint de Quervain Tendonitis - Raleigh Hand Surgery Thumb spica splint https://www.schreibermd.com/buckle-fracture-radius daily 0.75 2019-10-17 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1537896860728-XPUCFCZS5MJXTSL3M0XF/Buckle+Fracture Buckle Fracture - Raleigh Hand Surgery Buckle fracture of the wrist (radius bone) in a child. A dent is seen on the back side of the bone (right image). This is like pushing your thumb into an empty paper towel roll - a dent is made but there is no complete “break”. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1490059467089-G4RNQFQZRT9Y8FS56S54/cast.jpg Buckle Fracture - Raleigh Hand Surgery https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1537896682289-SJ0FG2W90DSMTDYH4KWB/Buckle+fracture+remodeled+and+healed+before+and+after Buckle Fracture - Raleigh Hand Surgery Example 1. Left: A buckle fracture of the wrist is an indentation in the bone. Center: After one month, new bone can already be seen that the body has added to the indentation site to stabilize and protect it. Right: After two months, the bone looks completely normal on x-rays, a process called remodeling. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1534686835237-72I09BP7SHEUHW2422ES/Buckle+fracture+healed+before+and+after Buckle Fracture - Raleigh Hand Surgery Example 2. Left: more severe fracture that extends completely across the radius bone. Right: Healing after 6 weeks, showing a new layer of bone formation around the fracture. With more time, the fracture will disappear, as the new bone blends into the old bone. https://www.schreibermd.com/mallet-finger daily 0.75 2018-11-28 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1491270782343-RCAQFMCQ7ATT2IYGQK31/torn+extensor+tendon+causing+mallet+finger Mallet Finger - Raleigh Hand Surgery A mallet finger is a deformity of the fingertip resulting in an inability to fully extend, or straighten, the digit. A cut to the back of the finger may also cause a disruption of the extensor tendon. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1486090341031-6MGSD6AYWID3XJ7H6S7Q/Mallet+Finger Mallet Finger - Raleigh Hand Surgery A mallet finger is a deformity of the fingertip resulting in an inability to fully extend, or straighten, the finger tip. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1486090180947-AQ128BG4LO7Y7TDUMMKN/Mallet+Finger+Splint Mallet Finger - Raleigh Hand Surgery Soft tissue mallet finger splint https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1540330665675-LAV4YBOUX3M9936D57JB/mallet+finger+split Mallet Finger - Raleigh Hand Surgery Bony mallet finger splint https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1520769435407-QYBF6Q831SU8A4NVEFFM/Mallet+finger+healed+with+a+splint Mallet Finger - Raleigh Hand Surgery Example of a “bony” mallet finger that successfully healed after being treated in a splint. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1538082604575-8GO8UJ09X9YAYOARCOA9/mallet+finger+pinning Mallet Finger - Raleigh Hand Surgery Some occupations are not compatible with wearing a splint. One example is health care professionals, who require frequent hand washing and sterility measures. Sometimes a temporary pin will be placed across the joint to allow for healing in a normal position. With a pin holding the joint straight, no splint is required. The pin is buried underneath the skin and removed ~8 weeks later in the office under local anesthesia. https://www.schreibermd.com/biceps-tear daily 0.75 2020-03-30 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1491268520935-T11E7YPEMS8KGZ5IQLFF/Biceps Biceps Tendon Tear - Raleigh Hand Surgery Biceps tendon anatomy https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1486209730885-LH3TWVSEWMNRJ08DD11E/Biceps+Tear Biceps Tendon Tear - Raleigh Hand Surgery Schematic of biceps tendon repaired back to bone with suture and screw. Image from Arthrex. The avulsed tendon is reinserted into the bone, and held in place with both sutures and a small plastic screw. https://www.schreibermd.com/ganglion-cysts daily 0.75 2019-01-31 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1539035980640-NJ4N4KO9X2YY57ZM77N2/Ganglion+cyst+on+hand+and+wrist Ganglion Cyst - Raleigh Hand Surgery Dorsal wrist ganglion cyst https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1548935635017-840UEC61WMCM8Y42SMYW/Dorsal+Wrist+Ganglion+MRI Ganglion Cyst - Raleigh Hand Surgery Ganglion cyst on MRI. The red arrows outline a ganglion cyst on an MRI image of the wrist. Ganglion cysts appears white on MRI. Smaller ganglion cysts may only be seen on MRI, these will oftentimes cause pain when extending the wrist, such as with push-ups, yoga, or pushing up from a seated position. https://www.schreibermd.com/thumb-sprains daily 0.75 2019-06-16 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1560276495132-J3UOHPJF63S4T37YNZHJ/Stener+Lesion+thumb+sprain+skier%27s+thumb Thumb Sprains - Raleigh Hand Surgery Some complete tears require surgery to repair. A "Stener lesion" is a situation when the torn ulnar collateral ligament gets folded backwards after tearing. A band of tissue called the adductor aponeurosis blocks the ligament from healing back to the bone. In surgery, the adductor aponeurosis is divided, and the torn ligament is sutured back to the bone. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1486402160287-ADIX9AFDRUUWKV1FKWL6/Thumb+Sprain+x-ray Thumb Sprains - Raleigh Hand Surgery X-ray showing the most common site of injury in the thumb, the ulnar collateral ligament (UCL) of the metacarpal-phalangeal joint. Injuries to the other side of the thumb, the radial collateral ligament (RCL) can also occur, but are much less frequent. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1488630121430-C9RILVM2X0AHBZ96HFD0/UCL+tear+causing+thumb+sprain Thumb Sprains - Raleigh Hand Surgery Tear of the thumb UCL results in the joint "booking open" during pinching. Image from AO Foundation https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1488630252540-UZDPSZ6FZ1ZCX0GQQ8OS/Surgery+to+treat+thumb+sprain+or+UCL+tear Thumb Sprains - Raleigh Hand Surgery A suture anchor is placed into the proximal phalanx. The attached sutures allow for the torn ligament to be stitched back down to the the bone. Image from AO Foundation https://www.schreibermd.com/elbow-instability daily 0.75 2018-11-28 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1488415892666-XTGWCUWU4C1FZPEVTFMA/Elbow+instability+fall Elbow Dislocation - Raleigh Hand Surgery Falling onto an outstretched arm can result in tearing of the elbow's collateral ligaments. If the tear is severe enough, the elbow joint may subsequently dislocate https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1488633630360-LT9W95Z694AUSJV4GQTN/Medial+collateral+ligament Elbow Dislocation - Raleigh Hand Surgery Medial collateral ligament: The collateral ligaments on the medial side (inside) of the elbow provide stability during activities such as throwing. The "anterior" bundle of the ligament (shown in red and blue) is the most critical portion for maintaining elbow stability https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1488633710089-31N1QLNW6KJ2VP8W1FE4/Lateral+collateral+ligament Elbow Dislocation - Raleigh Hand Surgery Lateral collateral ligament: The collateral ligaments on the lateral side (outside) of the elbow provide stability during lifting and rotation. The posterior portion shown in green, known as the "lateral ulnar collateral ligament", is the most important structure for stability on the lateral side of the elbow. Injury to this structure can result a phenomenon known as posterolateral rotatory instability (PLRI). PLRI can result in symptoms of instability or frequent dislocations of the elbow joint https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1488630916436-YBCGRPQE1PUV3ON68TP7/elbow+instability+excercises Elbow Dislocation - Raleigh Hand Surgery Overhead motion exercises. These exercises are performed under the direct supervision of a therapist. The patient is positioned supine (lying on back) with the shoulder flexed, adducted, and in a neutral to external rotation position. This position eliminates gravitational varus and distraction forces. In this position, A elbow flexion, B extension, C pronation, and D supination motion exercises are performed. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1536160191853-VJUBGQ85M7Y6OH9M79IG/Radial+head+arthroplasty.png Elbow Dislocation - Raleigh Hand Surgery Elbow “fracture-dislocations” include both an elbow dislocation, and a broken bone within the joint. These injuries are often unstable, and if not treated appropriately, can result in decreased motion, arthritis, and repeat dislocations. A. An elbow fracture dislocation, showing a dislocated ulno-humeral joint and a radial head fracture. B. Despite an attempt at relocating the elbow joint, it remains unstable due to the fractured radial head. C. Fractures of the radial head involving >3 pieces are usually replaced with a metal implant, which is specifically sized to match the patient. D. In this patient, excellent range of motion was obtained and stability of the joint was restored. https://www.schreibermd.com/cast-care daily 0.75 2017-03-11 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1489233710919-SXD1MKV3EOGH5G9YCK5S/%2Fcast-care Cast care To learn more about taking care of your cast visit www.HandCare.org https://www.schreibermd.com/tfcc-tear daily 0.75 2021-08-27 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1573125352477-Q0GMTWQ4LJB1GN4Q2AO8/TFCC+tear+arthroscopy.png TFCC Tear - Raleigh Hand Surgery https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1520686867389-9ET0FHFUXK7VWSSA07HU/TFCC+Tear+MRI TFCC Tear - Raleigh Hand Surgery TFCC Tear. On MRI, a normal TFCC is a black band of tissue connecting the radius and ulna bones. This MRI arthrogram shows a tear in the TFCC, allowing the dye (white fluid on MRI) to leak out of the joint. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1630095380808-1DI9GM0PQP8JWA5O24JK/WristWidget.png TFCC Tear - Raleigh Hand Surgery - Make it stand out Whatever it is, the way you tell your story online can make all the difference. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1531568289135-HO8D7FZLSBBIPSDGLAJU/TFCC+Wrist+arthroscopy TFCC Tear - Raleigh Hand Surgery A. Tear in the central portion of TFCC with fraying of the edges. The torn portion can become pinched in the wrist joint with motion, causing pain and clicking. B. Probe is placed in the TFCC tear, demonstrating a defect or hole in the joint. C. Shaver is inserted into the wrist joint to trim away the torn edges of the TFCC tear (like a lawn mower). D. Edges of the TFCC tear have been trimmed to a stable rim, the torn fragments are removed. E. Cautery is inserted to gently “carmelize” and stabilize the periphery of the tear. F. At the completion of the procedure, the edges of TFCC tear are trimmed and cauterized to minimize the risk of future tearing or fraying. The TFCC is now smooth, and torn strands/fragments have been removed. https://www.schreibermd.com/medial-epicondylitis daily 0.75 2018-11-28 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1501970521353-4MTU6PQSGTUKBATMGMLQ/Medial+epicondylitis Medial Epicondylitis - Golfer's Elbow - Raleigh Hand Surgery Anatomy of forearm. Medial epicondylitis or “golfer’s elbow”, is a painful tendinitis condition that causes discomfort along the inside of the elbow. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1501980390256-I1PL7G8Q58HWOL4XRG39/counter+force+strap+for+golfer%27s+elbow Medial Epicondylitis - Golfer's Elbow - Raleigh Hand Surgery A counterforce strap decreases tension on the site of the tendon tear, which can decrease pain and facilitate healing. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1500424649625-XYQIRLQ930T9Q4G0D0L6/Stretch+1+for+medial+epicondylitis+or+golfer%27s+elbow Medial Epicondylitis - Golfer's Elbow - Raleigh Hand Surgery With your elbow straight and palm facing the floor, make a fist. Then, use your other hand to bend the wrist down. Hold the stretch for 30 seconds. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1500424707244-P9UZ0IML3JO2Y8TTBMLQ/Stretch+2+for+medial+epicondylitis+or+golfer%27s+elbow Medial Epicondylitis - Golfer's Elbow - Raleigh Hand Surgery With your elbow straight and palm facing the floor, use your other hand to bend the wrist and fingers backward. Hold the stretch for 30 seconds. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1501970715753-0JTJZ5OT03F82OKPDUFX/image-asset.jpeg Medial Epicondylitis - Golfer's Elbow - Raleigh Hand Surgery https://www.schreibermd.com/scaphoid-fracture daily 0.75 2020-04-16 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1587031460842-KWMUZT78WTO4A1ITXYJN/scaphoid+fracture.png Scaphoid Fracture - Raleigh Hand Surgery https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1520705117941-HX925GJCNEVM9I6DYVI9/scaphoid+cast Scaphoid Fracture - Raleigh Hand Surgery https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1520703556399-DG2RPDSFO9F4FVSFX7MP/scaphoid+fracture+surgery+screw+before+and+after+x-ray Scaphoid Fracture - Raleigh Hand Surgery Left: Broken scaphoid bone with gapping across the fracture site. Right: Screw is placed inside the bone and across the fracture site, this squeezes the two pieces together to facilitate healing. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1520703767155-O2W6QRRC5K2N2LOGCQS9/Scaphoid+fracture+non-union+cyst Scaphoid Fracture - Raleigh Hand Surgery Scaphoid non-union 1 year after injury. The fracture developed into a cyst, which filled in with scar tissue, but continued to produce pain. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1520703904099-JTORPVWVOVFHGZJHIQNQ/bone+graft+surgery+to+fix+scaphoid+non-union+fracture Scaphoid Fracture - Raleigh Hand Surgery In surgery for scaphoid non-unions, bone can be taken from the radius bone to fill in the defect. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1537897605384-MTQB1L15D29DOOIH0DUJ/scaphoid+fracture+bone+graft+to+fix+non-union Scaphoid Fracture - Raleigh Hand Surgery Example 2. Scaphoid non-union 2 years after injury, with “cyst” formation inside the bone. Due to continued pain, and to prevent arthritis changes, the cyst was filled with bone graft from the distal radius and a compression screw was used to squeeze the two scaphoid fragments together. The fracture healed, and the pain resolved. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1520703829447-0AFXGDQGF3AXAXLHDO59/scaphoid+non-union+arthritis+SNAC+wrist Scaphoid Fracture - Raleigh Hand Surgery Scaphoid non-union, resulting in necrosis of the scaphoid bone and arthritis throughout the wrist. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1520704014093-HJP368R7MD4H6MJ1S1MX/No+smoking.png Scaphoid Fracture - Raleigh Hand Surgery https://www.schreibermd.com/carpal-tunnel-excercises daily 0.75 2018-03-11 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1520773408559-KPCYE2N4MB1S4DRDX163/Slide1.jpg Carpal Tunnel Exercises - Nerve Gliding Exercises - Raleigh Hand Surgery Median nerve gliding exercises. 1) Begin with your wrist in a neutral position, fingers and thumb bent into a fist, with your thumb facing you. 2) Extend your fingers and thumb into a straight, neutral position. 3) Keeping your fingers and thumb straight, bend your wrist so that your palm faces up. 4) Keeping your hand in the same position, extend your thumb away from your hand. 5) Keeping your hand and fingers in the same position, rotate your wrist so that your palm faces away from you. 6) While in position 5, gently pull down on your thumb with your free hand. Hold each position for 5 seconds, repeat series 3 to 5 times. https://www.schreibermd.com/fracture-kids-elbow daily 0.75 2020-03-31 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1520896365978-E9EJCWDO8Y7AZRLOWX7S/supracondylar+humerus+fracture+SCH+fracture+surgery+x-ray Kid's Elbow Fracture - Raleigh Hand Surgery Lateral (side) x-rays of an elbow in a child. These show an angulated, or displaced, supracondylar humerus fracture. With this degree of angulation, surgery is usually recommended. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1520896440977-5DRWHFN3OR6G88TPQXNP/supracondylar+humerus+fracture+SCH+surgery+x-ray Kid's Elbow Fracture - Raleigh Hand Surgery X-rays (lateral and AP) of a supracondylar humerus fractured treated with a reduction (setting of the bone), with placement of pins through the skin to hold the bone in proper alignment. A cast is placed for ~3 weeks, and the pins are removed in the office. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1520896645702-6JUP1W8H80KBR0AS9KMF/supracondylar+humerus+fracture+SCH+surgery+healed+x-ray Kid's Elbow Fracture - Raleigh Hand Surgery Supracondylar humerus fracture that was successfully treated with a reduction and pinning. The bone has healed in a normal position, and activities are restarted as tolerated. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1571218843989-IBMSHPKYFZJBUT7365LJ/Medial+epicondyle+ORIF.png Kid's Elbow Fracture - Raleigh Hand Surgery Medial epicondyle avulsion fracture. This fracture was notably displaced (shifted) and was incarcerated or trapped inside the elbow joint. The fracture piece was restored to its normal position and held in place with a metal screw. https://www.schreibermd.com/dorsal-wrist-impingement daily 0.75 2018-11-28 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1520897778828-EWQJVF5Q7X31JOETHCGV/dorsal+wrist+impingement+syndrome Dorsal Wrist Impingement - Raleigh Hand Surgery Dorsal wrist impingement syndrome can cause pain in the wrist while doing yoga, particularly upward facing dog position ( Urdhva Mukha Svanasana). . https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1520898142726-MA6XIWBEYTURSZZ598NL/Dorsal+wrist+impingement+syndrome+1.png Dorsal Wrist Impingement - Raleigh Hand Surgery An MRI showing dorsal wrist impingement syndrome. The cause of pain along the back of the wrist could be caused by a ganglion cyst, tendinitis, or injured ligament. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1520898186303-ZN8H6CN5AM8I7ME4H2AJ/dorsal+wrist+impingement+syndrome+2.png Dorsal Wrist Impingement - Raleigh Hand Surgery Dorsal Wrist Impingement Syndrome: Images above are photos taken during arthroscopic wrist surgery. 1. On the left, abnormally thickened joint lining is caught between the radius and lunate bones, where it can be pinched and produce pain. 2. The middle image shows a probe along the abnormal tissue. 3. On the right, an arthroscopic shaver is shown. This acts like a vacuum, and has oscillating teeth that trims back the abnormal tissue. https://www.schreibermd.com/cubital-tunnel-exercises daily 0.75 2018-09-20 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1520773799330-8YJTEESJ4JVKNZBO2EUB/cubital+tunnel+ulnar+nerve+exercises Cubital Tunnel Exercises - Nerve Gliding Exercises - Raleigh Hand Surgery Ulnar nerve gliding exercises. While keeping your head in a neutral position: 1) Begin with your arm out, palm side of the hand facing up. 2) Bend the elbow toward you, palm side facing you. 3) Rotate the palm of your hand outward and bend your wrist so that the fingers are pointing towards you. 4) Twist your wrist so that the palm of your hand is now facing upward. 5) While your wrist remains bent, stretch out your arm into a straight position, with your fingers bent towards the floor. Hold each position for 5 seconds, repeat series 3-5 times. https://www.schreibermd.com/patient-experience daily 0.75 2020-03-30 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1585580741380-5N5O3MZG2BJ0Q25Z2X3Q/Joseph+Schreiber+Raleigh+Orthopedic+Hand+surgeon Patient Testimonials - Raleigh Hand Surgery https://www.schreibermd.com/pain-control daily 0.75 2019-01-09 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1533668696143-O5VM8LL777GW2T0TTA50/Screen+Shot+2018-08-07+at+3.04.30+PM.png Pain control https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1533668792682-P8P701JCCQBPO13B6NF4/Screen+Shot+2018-08-07+at+3.06.08+PM.png Pain control https://www.schreibermd.com/forearm-fracturekids daily 0.75 2020-04-01 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1533660517606-WVUTZ2OPSV54P8DDTOI4/shutterstock_517904482.jpg Kid's Forearm Fracture - Raleigh Hand Surgery https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1585736820943-PGD8O99J0FS2QTDPC6C5/both+bone+forearm+fracture+reduction.png Kid's Forearm Fracture - Raleigh Hand Surgery An angulated forearm fracture treated with setting the bone and applying a waterproof cast. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1534693150694-STR3URMM8YFVEPEKQUQH/Kids+Forearm+angulated+fracture+radius+surgery+before+and+after Kid's Forearm Fracture - Raleigh Hand Surgery Angulated fracture of the radius bone, which was set (reduced) to eliminate the bend. The arm was casted for 6 weeks, which allowed the radius to heal in a normal position. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1533656944978-UN290DVNIRR3KT5XVNFN/Kids+forearm+fracture+surgery+metal+plate+before+and+after+x-ray Kid's Forearm Fracture - Raleigh Hand Surgery Some fractures, especially in older kids, can be very challenging to properly align in a cast. Older kids (>10 years old) have less growth ahead of them, and therefore have less ability to “remodel”, or straighten, a fracture over time. In some severe fractures, surgery may be recommended to align the bone, which is then held with a small metal plate and screws. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1537993371143-ZXWBC1VZ6W5DAY0X5ICX/Kids+forearm+fracture+surgery+metal+plates+before+and+after+x-ray Kid's Forearm Fracture - Raleigh Hand Surgery Example 2. This child had fractured the forearm 3 times through the same location over a 2 year period. Another attempt was made at reducing/setting and casting. Unfortunately, given the obliquity (sloped angle) of the fracture, it continued to slide. A decision was made to align the broken forearm and hold in place with a metal plate and screws. https://www.schreibermd.com/fracture-olecranon daily 0.75 2018-11-28 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1534617527761-FCPDZT4ULSPH9P5B00GY/Olecranon+fracture+x-ray Olecranon Fracture - Raleigh Hand Surgery Side view of the elbow joint, showing a broken olecranon https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1534617840542-20USZTGTT3UZK6952I87/Olecranon+ORIF+fracture+surgery+metal+plate+before+and+after+x-ray Olecranon Fracture - Raleigh Hand Surgery Patient 1: Olecranon open reduction internal fixation (ORIF) https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1534618054544-A6X6IHNIYIEOK10YMI03/Olecranon+ORIF+fracture+surgery+metal+plates+before+and+after+x-ray Olecranon Fracture - Raleigh Hand Surgery Patient 2: Olecranon open reduction internal fixation (ORIF) https://www.schreibermd.com/wrist-arthritis daily 0.75 2018-11-28 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1538082100504-FXU97GNAUPICKFYL6ETN/wrist+arthritis+bone+spur+removal+x-ray Wrist Arthritis - Raleigh Hand Surgery In early stages of wrist arthritis, a proximal row carpectomy or wrist fusion can sometimes be avoided. In this patient with early SLAC (scapho-lunate advanced collapse) degenerative changes, a radial styloidectomy was performed with a wrist denervation. This removed the large bone spur at the end of the radial styloid, and resulted in significant improvement in pain and motion. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1539023962506-HNQR1ZNQ7FYBV92512K6/wrist+arthritis+Carpectomy+surgery+before+and+after Wrist Arthritis - Raleigh Hand Surgery Left: Wrist osteoarthritis seen on X-ray. This pattern of arthritis is known as a SLAC (scapho-lunate advanced collapse) wrist. This is due to a torn ligament between the scaphoid and lunate bones. Middle: Surgical treatment involves removing a row of arthritic bones from the wrist. This is called a “proximal row carpectomy”. The bones marked with an “x” are removed. The remaining, non-arthritic bones, slide into the space created and make a new wrist joint. Right: Same patient after a proximal row carpectomy was performed, with excellent clinical results and near complete improvement in pain. https://www.schreibermd.com/mucus-cyst daily 0.75 2018-11-28 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1539036242306-X5Z7CO6GRBPTCC573WD2/Removal+of+bone+spur+osteophyte+before+and+after+x-ray Mucous Cyst - Raleigh Hand Surgery Mucous cysts from the fingers can be excised. Before doing so, an x-ray is usually obtained to look for a bone spur (osteophyte). If present, the osteophyte is also removed, as doing so decreases the risk of recurrence. https://www.schreibermd.com/bennett-fracture daily 0.75 2018-11-28 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1542318566241-B3R1VDVS75LKT3GB9U2I/image-asset.png Bennett Fracture - Raleigh Hand Surgery https://www.schreibermd.com/humerus-fracture daily 0.75 2019-01-30 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1548851789058-4CE9B554EXE0GO9GUGI7/Distal+humerus+fracture Humerus Fracture https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1548765763309-EQSAVEX0KG3FNPOT2BZJ/Humerus+Fracture+Healing.png Humerus Fracture Non-surgical treatment with a brace. Many humerus fractures can be treated without surgery. The humerus shaft fracture above was successfully treated in a “Sarmiento brace”, which wraps around the upper arm and holds the bone aligned while it heals. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1548791871444-CQNAVUZIHDPHCK196FZA/Humeral+nail Humerus Fracture Humeral nail. Fractures in the middle of the humerus bone can oftentimes be treated with a metal nail that enters the inside of the humerus bone from the top, near the shoulder, and spans across the fracture. Several screws are placed through the nail to prevent rotation or shifting. This is a less invasive technique, that allows for patients to return to using the arm within the first week or two. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1548765847983-83V7ZU6Q3CMQ52HHEO1Q/image-asset.png Humerus Fracture Humerus ORIF (open reduction internal fixation). A “distal” humerus fracture is a break at the end of the humerus bone that oftentimes will extend into the elbow joint. These fractures are oftentimes treated with a metal plate and screws to hold the pieces together. Aligning the joint surface is important for restoring motion and function. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1548765882820-WD08MVDGACZUR9K9HZLA/Humerus+Non-Union.png Humerus Fracture Humerus non-union. A “non-union” is a fracture that does not heal on its own. This humerus fracture did not heal despite ~8 months in a brace, and despite the use of a bone stimulator (image on left). For humerus non-unions that do not heal in a brace, surgery with bone graft, a metal plate, and screws can be successful (as shown in the image on the right). https://www.schreibermd.com/finger-arthritis daily 0.75 2020-03-31 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1548686272547-T70X5E6XP1QNMI6Y2HN8/DIP+joint+arthrodesis Finger Arthritis Distal interphalangeal (DIP) joint arthrodesis. A DIP joint arthrodesis is a common procedure for finger arthritis. The DIP joint is the joint nearest the fingernail. When there is significant pain and deformity in the joint (see x-ray on the left), a fusion can be an excellent option. By placing a screw across the joint (see x-ray on the right), the deformity (or crooked appearance) of the joint can be improved. By preventing motion, pain can significantly decrease. After the procedure, a splint is oftentimes used for ~6 weeks to allow the bones to fuse together. https://www.schreibermd.com/xrays daily 0.75 2020-09-24 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1565803212878-MBWKB40XNLF9FPFM5T8G/AP+Hand+Xray.png X-Rays https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1600856929066-C7RSJ36AE0G505RXC61W/Normal+Hand+Radiograph.png X-Rays https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1600941630503-JZEKX9F1R4VQBF5K33WB/Lateral+hand+xray.png X-Rays https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1580913141398-2LAIEGGQ2E7XRJOHPIT5/Normal+Wrist+Xray.png X-Rays https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1585735265863-F1JXW0E5UUSLTBFD5ZOG/DRUJ+xray.png X-Rays https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1565803086196-72H2D6KN4661DURJA58I/Lateral+Elbow+Xray.png X-Rays https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1565803358405-EWYZ3Z8OYXQIN495G81I/AP+Elbow+Xray.png X-Rays https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1565809627221-775ACP00V2S2ZAKLWDB3/Roberts+Thumb+Xray.png X-Rays https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1576665163469-DC7JDCIOE1B1W16T462E/Abnormal+Pencil+Grip.png X-Rays https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1565802822029-EX5WHKX06C5TQAB1M0G2/Pencil+Grip+Xray.png X-Rays https://www.schreibermd.com/radial-head-fracture daily 0.75 2019-10-15 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1571151758429-8PSMYI6NO4IUMYIZ4V08/Radial+head+fracture+x-ray Radial Head Fracture - Raleigh Hand Surgery Side view of the elbow joint, showing a broken radial head https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1571153303745-VVA4EZ8ZO5JOSTF29BIZ/displaced+radial+head+fracture Radial Head Fracture - Raleigh Hand Surgery https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1571149883970-4YN4JMLD7HQQEJZWWF8P/Radial+Head+ORIF.png Radial Head Fracture - Raleigh Hand Surgery Patient 1: Radial head open reduction internal fixation (ORIF). The two pieces are lined up, and held in place with a metal screw. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1571150611308-62E373M85HJ7MLYPJR5J/Radial+head+ORIF Radial Head Fracture - Raleigh Hand Surgery Patient 2: Radial head ORIF with compression screw. Injury x-ray on the left, post-surgery x-ray on the right. https://www.schreibermd.com/kids-wrist-fracture daily 0.75 2020-09-24 https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1571306660625-7B5QBLQQEDETR66SAS8Y/Kids+Wrist+Fracture.png Kid's Wrist Fracture - Raleigh Hand Surgery A. Displaced distal radius fracture in a child. B. Fracture was aligned and held with temporary pins. C. After 3 weeks of healing, pins are removed in the office. D. Fracture has healed 6 weeks after the procedure, activities are resumed. https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1571249863749-JIFJVXYZKKOV0G8ORN9H/Physeal+separation+wrist Kid's Wrist Fracture - Raleigh Hand Surgery X-rays of a distal radius “physeal separation”. On the left, the portion of the bone called the epiphysis is not well aligned with the metaphysis. After reduction, the distal radius growth plate is well-aligned - “the golf ball is back on the tee.” https://images.squarespace-cdn.com/content/v1/585dd5afebbd1af27cd15d89/1600942616142-ZYDCPF12XJ1DK8GD5MU5/Physeal+Separation+Pinning.png Kid's Wrist Fracture - Raleigh Hand Surgery Some physeal separations (growth plate injuries) may be unstable, meaning the two pieces have a tendency to slide apart from one another. Temporary pins are then placed to hold the two piece of bone together in a normal alignment. These are then removed in the office ~3 weeks later. https://www.schreibermd.com/home-alt-bedford daily 0.75 2025-05-12 https://images.squarespace-cdn.com/content/v1/52a74d9ae4b0253945d2aee9/1390500612440-PGQSIY8KL9F7T5VIXQLO/chambers-2.jpg Home Alt A better world Starts with a choice Contact Us https://images.squarespace-cdn.com/content/v1/52a74d9ae4b0253945d2aee9/1390500503574-5BAPXZO9U06UV61P49UO/chambers1.jpg Home Alt Sustainability Starts with you Join Us https://images.squarespace-cdn.com/content/v1/52a74d9ae4b0253945d2aee9/1390500933384-LII4SRIPHFYOUFX0UCXC/chambers-4.jpg Home Alt A better world Starts with a choice Join Us https://images.squarespace-cdn.com/content/v1/52a74d9ae4b0253945d2aee9/1390504287124-HQ8GNX1JCE22V047MSQ9/chambers-8.jpg Home Alt Preserve Nature Join Us