Yearly Archives: 2018

Wrist Lump: Carpal Boss, Ganglion Cyst or …?

The most common cause of a wrist lump is a ganglion cyst, a noncancerous and usually harmless condition. However, a bump on the back of the wrist might be something known as a carpal boss instead.

wrist lump carpal boss

Also known as a carpometacarpal boss (or simply bossing), a carpal boss is a bony, benign overgrowth that can be mistaken for a ganglion cyst. An experienced hand and wrist specialist can tell the difference between these two conditions.

Symptoms of a Carpal Boss

A wrist bump caused by carpal bossing typically feels firm and immoveable, and for many patients, the lump presents no other symptoms. In some cases, however, bossing comes with pain, particularly with upward and downward movement of the wrist. Restricted joint mobility and joint instability can also occur with this condition.

Symptoms of a Ganglion Cyst

A wrist bump caused by a ganglion cyst may feel soft and spongy. Or in some cases, the lump might be firm like a carpal boss. Most often, this condition is painless; however, if the cyst puts pressure on a nerve, then pain, tingling and muscle weakness can occur.

Diagnosing the Cause of a Wrist Lump

Light can pass through many ganglion cysts, which is helpful in determining the cause of a lump. To make an accurate diagnosis, however, imaging studies accompany the light permeability test and a physical examination. An X-ray can reveal a carpal boss or bone condition, while an MRI or ultrasound can show a cyst or other soft tissue disorders.

Treatment Options for a Wrist Lump

Treatment is only needed when a wrist bump becomes painful or limits activity.

For both carpal bossing and ganglion cysts, conservative treatments can be effective. Avoiding activities that create pain, wearing a splint, icing the area and taking nonsteroidal anti-inflammatory medication (NSAIDs) may provide relief. Other nonsurgical options — such as steroid injections for bossing or aspiration for a cyst — may also be considered. When conservative treatments fail, surgery to remove the lump might be recommended.

Other conditions — including fibrosis, neuroma, enchondroma or a malignant tumor — can also cause a wrist lump to develop. For that reason, an experienced hand and wrist specialist should evaluate every bump. Dr. J. Douglas Burrows at the Center of Orthopedic & Rehabilitation Excellence is northern Utah’s leading fellowship-trained, board-certified expert in hand and wrist conditions.

With more than 20 years of experience serving the greater Salt Lake City area, Dr. Burrows has the training, knowledge and skill to provide you with an accurate diagnosis and successful treatment plan. Contact our West Valley City office and schedule a consultation to find out if a carpal boss, ganglion cyst or some other condition is the cause of your wrist lump.

How Hand Conditions May Be Affected by Smoking

Did you know that many hand conditions may be aggravated by smoking? This habit can also inhibit healing after hand surgery or other treatments.

Hand Conditions May Be Affected by Smoking

Whether you smoke cigarettes, e-cigarettes, pipes or cigars, the nicotine you inhale can negatively affect your fingers, hands and upper extremities. The health consequences of smoking may not be immediate or visually apparent, but regularly lighting up can contribute to a variety of adverse conditions.

Smoking Is Linked with Multiple Issues that Affect the Hands

Researchers have found that smoking is associated with several health conditions that can involve problems in the hands. If you’re a smoker, you have a greater risk of developing the following:

  • Reduced blood flow to the fingers and hands
  • Poor circulation
  • Slow wound healing
  • Complications during the healing process

In addition, smoking has been statistically linked with complex regional pain syndrome, formerly known as reflex sympathetic dystrophy. This condition, which can occur after trauma or surgery, causes intense pain — often a burning or pins-and-needles sensation — along with swelling and blood vessel dysfunction. Dupuytren’s contracture, an abnormal thickening of the palm tissue, is also more common in smokers.

Smoking Can Worsen Some Hand Conditions

For patients who already have known hand conditions, smoking can make the problem worse.

For example, disorders resulting from added pressure on a nerve are often worse in smokers who have circulation problems. Smoking can also hinder healing, particularly for upper-extremity fractures. In some smokers, broken bones never completely heal. And nicotine intake has been shown to increase hand tremors.

Smoking and Hand Surgery

Doctors recommend that patients quit smoking to improve their overall health. What you may not realize, however, is that quitting the habit is particularly important if you’re in need of hand surgery.

Smoking compromises the healing process, extending the surgery recovery period and increasing the risk of complications. To avoid this, you’ll be advised to quit a week or two before having a surgical procedure. Depending upon your health status and the specifics of your hand surgery, you may even be asked to take a nicotine test for proof that you have stopped smoking.

If you’d like to give up your smoking habit to improve your health or a specific upper-extremity condition, your hand surgeon can offer resources and tips to help. If you live the greater Salt Lake City area, schedule an appointment with Dr. J. Douglas Burrows at the Center of Orthopedic & Rehabilitation Excellence for expert advice on preventing hand conditions and preparing for hand surgery.

Dr. Burrows, a leading northern Utah hand surgeon with more than 20 years of experience, is known for providing exceptional treatment and compassionate care. For more information on how your hand conditions may be affected by smoking, contact our West Valley City office today to schedule a consultation.

Cold Hands: Causes, Treatments & Warning Signs

As any hand specialist will tell you, having cold hands isn’t always a cause for concern. The issue could simply be related to how your body maintains a normal temperature.

cold hand causes and treatments

However, persistently cold hands can also be due to a problem with your circulation or blood vessels. So if your hands are always cold, consulting with a hand specialist can help you rule out any potential medical problems.

Causes of Persistently Cold Hands

Generally speaking, decreased blood flow is usually to blame when hands are always cold. This can occur in one of two ways:

  • Vasoconstriction: To regulate blood flow, muscles around the major arteries automatically constrict and relax. Sometimes, these muscles apply too much pressure and inhibit proper circulation.
  • Vaso-occlusion: Decreased blood flow can also be caused when one or more of the blood vessels in the hand or wrist is blocked.

A number of cold hand diseases can cause vasoconstriction and vaso-occlusion. Raynaud’s disease is the most common, but Buerger’s disease, anemia, scleroderma, circulatory disorders and many other conditions can lead to decreased blood flow to the hands.

Warning Signs of Circulation or Blood Vessel Problems

A hand specialist may suspect a circulation or blood vessel problem when cold in the hands is accompanied by certain warning signs. Symptoms that may indicate a cold hand disease include:

  • Changes in skin color, such as the fingers or hands turning white, blue or red
  • Numbness, tingling or pain in the fingers at cold temperatures
  • Cold in the hands during mild weather
  • Difficulty in healing from minor wounds on the fingertips
  • Hardened or tightened skin

Remedies and Treatments for Cold Hands

For symptomatic relief, a hand specialist may recommend adopting behaviors to boost blood flow. Wearing warm, protective gloves can help, as can rubbing the hands together and waving the arms in a circular motion.

Some cold hand diseases require additional treatment. Medication or steroid injections might be necessary to alleviate vasoconstriction and vaso-occlusion. In some cases, a hand specialist may advise surgery to restore proper blood flow.

If you’re bothered by persistently cold hands, an experienced local hand specialist such as Dr. J. Douglas Burrows at northern Utah’s Center of Orthopedic & Rehabilitation Excellence can determine the cause and plan an appropriate course of action to improve your symptoms.

As a leading board-certified, fellowship-trained hand specialist with over 20 years of experience, Dr. Burrows has the skills and qualifications to successfully manage disorders, diseases and injuries involving the hands, fingers and wrists. Contact our West Valley City office today to schedule a consultation to discuss your cold hands.

Power Saw Hand Injuries — Prevention and Treatment 

Every year, thousands of people suffer serious hand injuries while using power saws. All types of saws — including circular saws, jigsaws, reciprocating saws and table saws — can easily send you or a loved one to the hospital for emergency hand surgery.

Power Saw Hand Injuries

Hand injuries from power saws can be minor, but many are more serious, requiring emergency reconstruction and surgical treatment. The good news is that this type of injury can be prevented if tool operators are careful to follow safety protocols and precautions.

Types of Power Saw Hand Injuries

The severity of a power saw injury depends upon its location — finger, hand or wrist — as well as the depth of penetration. Certain saw characteristics, including blade thickness, tooth pattern and force, also have an effect on the degree of injury.

Contact with the blade can cause injury to both soft tissues and bone. Sometimes, only the skin is injured. In most cases, however, the tendons, muscles and/or nerves are involved, which may result in a loss of feeling or motor function along with circulation problems. A saw can also break a bone, cause an amputation or generate electric shocks and burns.

Treatment Options for Power Saw Hand Injuries

Surgical treatment is a must for most hand and upper extremity injuries from power saws. Stitches may be enough for cuts, while larger skin injuries may require grafts. Tendons and nerves can sometimes be repaired, and some amputations can be reattached. Broken bones may need repair with wires, plates and screws, followed by casting.

Not all treatment options are appropriate for every power saw injury. A hand and wrist specialist can recommend a feasible approach, with the goal of optimizing overall function. However, even with treatment, some patients may continue to experience weakness, numbness and stiffness.

Preventing Hand Injuries from Power Saws

Following safety precautions is essential to preventing hand injuries. When using power saws, keep these tips in mind:

  • Never override safety guards
  • Don’t wear loose clothing or jewelry
  • Don’t look away from your work
  • Use the correct saw and blade for the task
  • Use only sharp blades
  • Keep your finger off the trigger when moving the saw
  • Check for proper blade guard operation before making a cut
  • Let the saw reach full speed before cutting
  • Support your work materials so they don’t shift around
  • Switch off and unplug the saw before trying to restart the saw from a stall
  • Keep a clear head and never use alcohol during saw operation

If you suffer any type of industrial injury to the hand, you’ll need prompt medical attention and potentially emergency hand surgery. For expert care in the greater Salt Lake City area, contact Dr. J. Douglas Burrows at the Center of Orthopedic & Rehabilitation Excellence.

Dr. Burrows, a leading northern Utah hand and wrist specialist, has more than two decades of experience performing plastic and reconstructive orthopedic hand and upper extremity surgery. To schedule a consultation or for more expert advice on preventing power saw hand injuries, contact our West Valley City office today.

Scaphoid Wrist Fracture Treatment Options

A scaphoid wrist fracture is a break in the scaphoid bone, one of eight small carpal bones that connect the hand to the forearm. Also known as a navicular fracture, the wrist injury results in pain, tenderness and swelling below the base of the thumb. The pain may get worse with pinching and grasping as well as when the thumb and wrist are moved.

Scaphoid Wrist Fracture

Scaphoid fractures can occur during a motor vehicle collision or sporting activity. But they most frequently occur as a result of falling onto your outstretched hand, so they’re considered FOOSH injuries. People of all ages — including children — can suffer this type of wrist fracture.

Treatment can depend upon the location of the bone break, whether bone fragments are displaced and the amount of time that’s passed since you suffered the injury.

Types of Scaphoid Wrist Fractures

Scaphoid fractures can occur in the mid-portion of the bone, the waist or at either end of the bone. The injuries are classified according to how far the bone segments have moved from their normal positions.

A non-displaced scaphoid fracture is one in which the bone segments line up exactly as they should.

A displaced scaphoid fracture is a more severe injury, as it involves bone fragments that are not in their proper positions. The pieces of bone may overlap, or there might be gaps between the segments.

Conservative Treatments for Scaphoid Wrist Fracture

For a non-displaced scaphoid fracture that’s near the distal pole of the bone, or the end that’s closest to the wrist, a forearm splint or cast reaching from the elbow and including the thumb may be worn for several weeks.

Non-displaced wrist fractures with breaks in the waist or near the proximal pole, or elbow end of the bone, can also be treated through casting. But since these scaphoid bone areas don’t have a good blood supply, the cast is usually extended above the elbow.

For some patients, a bone stimulator, or a device that delivers ultrasonic or pulsed electromagnetic waves, may assist in wrist fracture healing.

Surgery for Scaphoid Wrist Fracture

Surgical treatment is recommended for patients with displaced scaphoid fractures. Many patients with breaks at the proximal pole or waist are also advised to get surgery.

Surgery for a wrist fracture involves manipulating the bones back into position. This may be done through an open or arthroscopic procedure. In some cases, internal fixation with metal implant screws or wires is necessary to hold the bone fragments in place for proper healing. Some patients also need bone grafts to stimulate bone growth and injury recovery.

Parts of the scaphoid bone have a poor blood supply, and a fracture makes the problem worse. As a result, complications during the healing process from scaphoid wrist fractures are common. For that reason, working with an experienced hand and wrist specialist — such as Dr. J. Douglas Burrows at northern Utah’s Center of Orthopedic & Rehabilitation Excellence — is crucial.

For more than 20 years, Dr. Burrows has provided expert hand and wrist fracture treatment for patients of all ages in the greater Salt Lake City area. To schedule a scaphoid wrist fracture consultation, contact our West Valley City, Utah, office today.

How to Prevent FOOSH Injuries During the Harsh Utah Winter

In the winter, FOOSH injuries — or those that are caused by falling onto an outstretched hand — are quite common. Slip on the snow and ice, and you could end up with a sprain, strain, a broken bone or other seriously painful injuries.

prevent foosh injuries during the harsh winter

Extending your arms to brace yourself is your natural instinct when falling, and there isn’t much you can do to change that. So the key to preventing FOOSH injuries this winter is to reduce your chances of suffering a fall.

Keep Walkways Clear of Snow and Ice

As soon as possible after a snowstorm, head outside to clear the walkways and driveway — or hire a teen neighbor for the job. You can also add salt to help melt any ice and reduce the risk of falls and subsequent FOOSH injuries.

Wear Proper Winter Footwear

When the weather outside is frightful, make sure you wear boots with good traction. The proper footwear might not be as stylish as you’d like, but you can always switch to more fashionable shoes when you arrive at your destination.

Watch Where You’re Walking

Businesses and shopping centers try to keep their sidewalks and parking lots clear and safe, but icy areas might have formed since the last salting. To avoid falling, try to stick to walkways that have clearly been salted and do not appear wet or icy.

Give Yourself Extra Time

Rushing in the wintertime can easily lead to FOOSH injuries. Take a few extra minutes and walk slowly and carefully. It’s better to arrive a little bit late than to fall.

Year-Round Tips to Prevent FOOSH Injuries

Winter isn’t the only time to worry about FOOSH injuries — people slip and fall all year long. To help prevent that from happening to you, consider the following tips:

Keep your floors at home clear of clutter and cords
Make sure your area rugs have skid-proof backing or tack them to the floor
Wear supportive shoes all the time — don’t walk around in socks or flimsy slippers
Install handrails on both sides of your stairways, and keep the areas well lit
Learn the correct techniques and wear proper protective gear when playing sports

If you happen to slip and fall as a result of northern Utah’s snowy and icy conditions, schedule a consultation with Dr. J. Douglas Burrows at the Center of Orthopedic & Rehabilitation Excellence.

With more than 20 years of experience as a board-certified, fellowship-trained hand and wrist specialist, Dr. Burrows is known for providing exceptional treatment — even other Salt Lake City-area surgeons and specialists turn to him for expert care. To schedule an appointment with the area’s leading specialist in FOOSH injuries, contact our West Valley City, Utah, office today.

A Guide to Carpal Tunnel Release Surgery

Carpal tunnel release surgery isn’t always necessary because for many patients, the pain, tingling and numbness caused by carpal tunnel syndrome can be eased through conservative treatments.

carpal tunnel release surgery

In some cases, however, nonsurgical methods simply don’t help. When symptoms persist after trying other treatment measures, carpal tunnel release surgery may be recommended.

Two Types of Surgical Procedures

During surgery, the hand surgeon cuts through the carpal ligament to create more room for the median nerve and tendons. The procedure may be performed in two different ways:

  • Open release surgery — The hand surgeon makes an incision up to 2 inches long along the wrist and through the underlying tissues to reach the carpal ligament. This is the traditional surgical procedure, and it is usually performed under local anesthesia on an outpatient basis.
  • Endoscopic release surgery — The hand surgeon makes one or two small incisions about ½ inch long in the wrist and/or palm. To reach and cut the carpal ligament, tiny surgical tools are guided through a narrow tube inserted into the incision. Like open surgery, endoscopic surgery is an in-office procedure typically done under local anesthesia.

Recovery from Carpal Tunnel Surgery

After surgery, the wrist is placed in a heavy bandage or splint for anywhere from a few days to a couple of weeks — the amount of time depends upon the particulars of the patient’s surgical procedure. While the wrist is wrapped, the patient is encouraged to move their fingers to prevent stiffness.

Pain is often controlled through medication, though elevating the wrist and applying ice also help to reduce post-surgical discomfort.

Once the wrap is removed, physical therapy exercises may be advised to speed healing and strengthen the finger, hand and wrist muscles.

Results from Carpal Tunnel Surgery

In most cases, symptoms disappear after surgery. Full recovery from the procedure may take just a few days, but some patients aren’t symptom-free for a few months. The recovery time depends upon how badly the nerve was damaged.

A small number of patients find that surgery doesn’t relieve their symptoms. The pain, tingling and numbness may not go away, or they may return at some point. The chance of success is greater if surgical treatment is completed in the earlier stages.

Carpal tunnel release surgery is one of the most common surgical procedures performed in the United States. If you’re thinking about pursuing this treatment option, you’ll want to find a hand surgeon with extensive experience. In northern Utah, the go-to expert is Dr. J. Douglas Burrows at the Center of Orthopedic & Rehabilitation Excellence.

As a leading fellowship-trained, board-certified hand surgeon with more than two decades of experience serving the greater Salt Lake City area, Dr. Burrows has the skills and training to successfully complete your carpal tunnel release surgery. To schedule an appointment, contact our West Valley City, Utah, office today.

Can You Get a Hand Injury from Your Smartphone?

If you want to avoid a hand injury, you may need to take a look at how you’re using your smartphone.

Hand Injury from Your Smartphone

We all love our smartphones, but constantly using them can lead to injuries involving your fingers, hands and wrists. Overdoing it with the scrolling and tapping can lead to painful conditions like trigger finger, thumb tendonitis and carpal tunnel syndrome.

Fortunately, with the right strategies, these overuse injuries can often be prevented. To avoid a hand injury related to your smartphone, consider some of our tips below.

Pay Attention to Your Wrist and Elbow Positions

When you hold your smartphone, is your wrist always kinked? And is your elbow always bent? To avoid hand injury, keep your wrist and elbow as straight as possible most of the time. Otherwise, you could end up with symptoms of carpal tunnel or cubital tunnel syndrome.

Keep Your Smartphone in a Case

Sleek smartphones are all the rage, but thinner handsets often require our thumbs to stretch further to reach the screen. This stresses the tendons, leading to thumb or hand injury. To avoid this, keep your phone in a case — the added bulk will allow your thumbs to operate within their natural range of motion.

Take Regular Breaks from Your Smartphone

Sure, it’s hard to put down the smartphone if you’re trying to beat the next level of your favorite game or checking out the latest news on Facebook or Twitter. But take regular breaks to give your fingers and hands time to rest and recover. When you’re on break, do some simple hand and wrist stretches.

Use Other Forms of Communication

Instead of relying so heavily on texting, use your laptop or desktop to send messages. Using a regular-size keyboard to type your texts is much easier on the fingers, hands and wrists. Don’t have a computer? Plug a keyboard into your smartphone.

Consider Wearing a Supportive Brace

If you’re planning on a session of heavy smartphone use, you might want to slide a wrist brace on first. Wearing one can provide you with much-needed support for a texting or gaming marathon, and it might just help you avoid hand injury.

If your fingers, hands and wrists are already feeling the effects of your constant smartphone use, prompt treatment may stop the problems from getting worse. Wait too long, and you might end up needing surgery. In either case, Dr. J. Douglas Burrows at the Center of Orthopedic & Rehabilitation Excellence can help.

Dr. Burrows, a leading northern Utah hand surgeon, has more than 20 years of experience successfully managing injuries, disorders and conditions of the hands, fingers and wrists. To schedule a consultation for hand injury diagnosis or treatment, contact our West Valley City, Utah, office today.

After Hand Surgery, Do You Have to Wear a Cast or Splint?

After hand surgery, casts and splints are used for support and protection of the injured bones and tissues. And, yes, you’ll most likely need to wear one or the other as you recover from the procedure.

After Hand Surgery

Hands usually need to be immobilized for a period of time after surgery to allow for proper healing. Your hand surgeon will decide which type of support is right for you and how long you will need to wear the cast or splint, if you need one all.

When Hand Surgery Patients Need Casts

Most hand surgery patients actually don’t need casts. Casts are usually only used in treating broken bones.

A cast immobilizes the injured area, surrounding it with a hard, inflexible plastic or fiberglass material. The rigidity is necessary for many wrist, arm and hand fractures. However, the inflexibility of a cast can lead to serious issues if the injured tissues swell or if the cast is applied too tightly.

When Hand Surgery Patients Need Splints

A splint is the support of choice for most patients. Splints are commonly used after surgical treatment for carpal tunnel syndrome, Dupuytren’s contracture, de Quervain’s tenosynovitis and a number of other hand injuries, disorders and conditions.

Splints may be constructed from hard plastic and molded for a perfect fit, or a hand surgeon may opt for a padded gauze splint.

How Long Will You Have to Wear a Cast or Splint?

Every surgery is different, and the number of days or weeks you’ll need to wear the cast or splint is based upon the particular injury and surgical treatment.

With a fracture, you could be in a cast for several weeks. After arthroscopic surgery, the support may need to be worn for just a few days. Following tendon surgery, a splint may be required for anywhere from four to 10 weeks.

The only way to know the amount of time you’ll need to keep the splint or cast on is to ask your hand surgeon.

If your hand surgery is scheduled with Dr. J. Douglas Burrows at the Center of Orthopedic & Rehabilitation Excellence in northern Utah, you will learn all the details of your procedure ahead of time. You’ll know whether you’ll come out of surgery wearing a cast or splint, and you’ll know how long you must wear the support.

Dr. J. Douglas Burrows, a leading board-certified, fellowship-trained hand surgeon with over 20 years of experience, will take the time to answer your questions and address your concerns before you come in for the procedure. Contact our West Valley City office and schedule an appointment to discuss hand surgery recovery today.