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— HandCare (@HandCareMD) August 14, 2015
— HandCare (@HandCareMD) August 14, 2015
from the Naples Herald by Gary Levine
Zion Harvey…an archetypal eight-year-old in so many ways…yet wistfully distinctive in so many others…was the recipient, last week, of a gift like no other.
As a toddler (age 2), Zion horrifically lost both hands and both feet to Sepsis…a life-threatening complication from infection. Two years later, the infection severely damaged his kidneys and required a kidney transplant…the organ donated by his mother, Pattie Ray.
Despite unimaginable misfortune, Zion is bursting with bravura…with determination…with a gutsiness that most could never muster.
Approximately three years ago, Pattie began the search for prosthetic hands for her son. She approached Dr. Scott Kozin, Chief of Staff at Shriners Hospital for Children in Philadelphia who, along with his partner, Dr. Dan Zlotolow, offered a far more progressive suggestion…Vascularized Composite Allotransplantation…make Zion the youngest recipient of a bilateral hand transplant.Zion has already been successfully fitted for prosthetics for his feet and utilizes them to the fullest.
Drs. Kozin and Zlotolow referred Pattie and Zion to the Children’s Hospital of Philadelphia Hand Transplantation Program…led by Dr. Scott Levin.
There are both intrinsic and extrinsic muscles of the hand. The intrinsic muscles are in the hand itself, while the extrinsic muscles are in the forearm and control things such as your ability to grip an object. The intrinsic muscles include:
- Interossei: Located between the bones of the hand
- Hypothenar: Located in the palm
- Lumbricals: Each of the four lumbrical muscles are associated with a finger.
- Thenar: Located at the base of the thumb
Dr. David J. Bozentka answers your questions about wrist fractures, commonly known as a distal radius fracture.
Q: What is a distal radius fracture?
A: The radius is the forearm bone on the thumb side of your wrist. When you break the radius bone about an inch from the wrist it is considered a distal radius fracture. These are the most common fractures of the wrist and occur most often when you fall on an outstretched hand. You will notice pain, swelling, and sometimes a deformity after the injury. The fracture can range in severity from very mild (requiring a splint for treatment) to a more severe injury in which the bone is shifted out of position and might need surgery.
Q: What should I do if I believe that I have broken my wrist?
A: You should support your wrist with a splint, apply ice, and elevate it. You should have an evaluation by a hand surgeon as soon as possible. The hand surgeon will often obtain an x-ray and place you in a well-molded, supportive splint or cast. You may need to have the wrist placed in a better position; this is called “reducing” the fracture. You will be asked to follow-up with your hand surgeon.
Q: What studies are performed in treating a distal radius fracture?
A: X-rays are performed in all patients to evaluate the extent of the injury. A CT scan might be needed to better evaluate the number of fragments and displacement. X-rays might be repeated every week or few weeks if you are treated without surgery to determine if the fracture has shifted out of alignment. A final set of x-rays are also taken to confirm that the fracture has healed, which occurs at six weeks or longer after the injury. If you are over 50 years of age, whether you are a male or female, ask your doctor about an evaluation for osteoporosis. A DEXA scan is often performed in the workup in the evaluation.
Watch this touching story about Zion and his journey to receive new hands through a bilateral hand transplant, a 14-hour surgery that required an entire team of surgeons, nurses and anesthesiologists. Learn more about hand surgery at www.handcare.org.
Cubital tunnel syndrome: Hand numbness and tingling is not always carpal tunnel syndrome.
I have a funny tingling in my small and ring fingers while holding my cell phone to my ear or while holding a book when reading in bed. Why?
That “funny” sensation could be compression of the ulnar nerve at the elbow. The path of the ulnar nerve runs just behind the boney part on the inside of the elbow. The nerve is close to the skin and runs through a boney ridge without any substantial padding. The nerve must slide and stretch through this cubital tunnel with elbow movement.
Wait a minute! What does the nerve at my elbow have to do with the funny sensations in my hand?
Good question! The job of the ulnar nerve is to facilitate communication from your brain to your hand. This communication operates the muscles that help you perform coordinated movements with your fingers. Another job of the ulnar nerve is to take information about sensation at the ring and small fingers back to the brain. If the nerve is compressed or irritated, it can’t do its job. This condition leads to difficulty manipulating objects with your hand, feelings of weakness and sensations of tingling, numbness, burning or tightness in your fingers.
That doesn’t sound good. What can I do?
There is good news. There are some things you can try that might calm the nerve. Nerves do not like to be crowded. The ulnar nerve becomes crowded at the elbow with direct pressure over its path or when the elbow is held in a bent position for an extended period of time.
Here are a few tips: