HAND & ELBOW SURGERY

The hand and elbow surgery service involves treatment of traumatic injuries to the bones, joints, tendons and nerves of the upper extremity. Reconstructive care is also provided for arthritic conditions, nerve compression syndromes, tumors and congenital conditions. Diagnosis is commonly made on careful physical examination alone. Roentgenograms, electrical studies and occasionally advanced imaging studies are additional diagnostic modalities which can be employed where indicated.

SPECIFIC TREATMENTS/PROCEDURES OFFERED

The type of conservative care provided depends on the diagnosis and prognosis of the individual condition. Splints, injections and individualized occupational therapy programs are frequently used in this regard. When indicated, surgical procedures involve care of the acutely traumatized upper extremity (fracture and joint injuries, tendon lacerations, etc.), arthroscopic procedures on the wrist and elbow, reconstructive surgery for degenerative and rheumatoid arthritis (including joint replacement in the hand, wrist and elbow), nerve compressive syndromes and congenital hand deformities. Microsurgery forms an integral part of the hand service not only in the acute setting (replantation and revascularization of amputated or injured parts) but in other orthopaedic conditions requiring free tissue (muscle or bone) transfer carried out on an elective basis.

OUTSTANDING PROGRAM ACHIEVEMENTS

The hand and upper extremity service is actively involved in clinical and basic science research in an effort to improve the care of our patients. Research involves the use of lighter weight casting materials which are customly applied, the development and testing of new internal and external fixation devices for the operative fixation of fractures, bone substitutes which harden and can obviate the need for cast immobilization in certain fractures of the wrist and research in the biomechanics and function following total joint replacement of the arthritic elbow.

PROCEDURES Trauma Fractures, tendon injuries, joint injuries, internal and external fixation of the hand, wrist, elbow, vascular and nerve repair, soft tissue coverage of exposed bone/tendons including pedicle flap and microvascular free flap coverage. Reconstructive Tendon transfers, Dupuytren¹s contracture release, joint replacement of the hand, wrist and elbow, stabilization of arthritic joints, release of post-traumatic contracture of the hand, wrist and elbow. Nerve Compression Open or arthroscopic carpal tunnel release, release of entrapped ulnar, median or radial nerves in the forearm or arm. Congenital Correction of congenital deformities including syndactyly, locked digits, constriction band syndrome, absent digits, etc. Vascular Repair of acutely injured vessels, repair of thrombosed vessels with vein grafts. Arthroscopy Arthroscopic evaluation and treatment of the wrist, elbow and shoulder. Tumors Surgical treatment of benign and malignant tumors of the upper extremity including soft-tissue and tumors of bone.

PHYSICIANS

Scott A. Rubinstein, M.D.