TENDONITIS/TENDON DAMAGE
Tendons are the thick fibrous cords that attach muscle to bone. When the tendons become inflamed, irritated, or damaged, patients experience potentially debilitating pain and tenderness around the adjacent joints. Dr. Asaf Yalif, lead surgeon at Y Plastic and Reconstructive Surgery, is triple Board Certified in Plastic Surgery, Hand Surgery, and Orthopedic Surgery and is highly experienced diagnosing and treating tendonitis and other conditions involving tendon damage to the hands, wrists, and forearms, such as:
Tendonitis (can also be spelled as tendinitis): the inflammation, irritation, or microscopic tearing of tendons is known as tendonitis (tendinitis)—this condition is typically caused by overuse (a particular motion is repeated too often) or when the intensity of a physical activity is increased too rapidly. Tendonitis of the upper extremities can manifest as: tennis elbow, golfer’s elbow, and/or tendonitis of the wrist. Symptoms of tendonitis typically include: pain in the tissues surrounding a joint; weakness in the joints; and redness, swelling, and localized warmth in the affected area. The application of ice packs 3-4 times a day at 20-minute intervals and anti-inflammatory OTC medications for several weeks may help to ease symptoms. It is also important to give the injured area time to rest and heal itself. The severity and location of the tendonitis will determine whether you will need temporary bracing, splinting, or a sling. For patients who present with more severe cases of tendonitis, Dr.Yalif may inject a corticosteroid drug or local anesthetic into the affected tendon, and may also refer you to a physical therapist for more localized treatments (i.e. friction massage, water therapy, and deep heat treatments).
De Quervain Syndrome: patients suffering from de Quervain syndrome typically present with painful tendons on the thumb side of the wrist and experience discomfort when moving their hand and thumb, particularly when performing motions that involve forceful grasping or twisting. In cases of de Quervain syndrome, the soft tissues of the tunnel where the tendons run begins to thicken, causing the tendon to rub up against the sides of the tunnel and create irritation, inflammation, and pain. Non-surgical treatments that can help to relieve symptoms include: anti-inflammatory medications (i.e. ibuprofen, aspirin), wearing a special forearm and thumb splint (thumb-spica splint), and, if necessary, an injection of cortisone into the irritated tunnel, which helps to reduce the swelling and provides temporary relief of symptoms. If non-surgical options prove insufficient, a surgical release of the roof of the tunnel may be necessary to make more room for the tendons and prevent further irritation.
Mallet Finger: the condition called “mallet finger” occurs when the distal interphalangeal joint (DIP) of the finger is injured and the tendon attached to the small bone underneath is damaged—if left untreated, the end of the finger may be unable to straighten completely, causing the end of the finger to droop. Symptoms of mallet finger include pain and swelling around the DIP joint and the inability to straighten the finger voluntarily. The first course of non-surgical treatment is uninterrupted splinting (the splint remains on at ALL times) for the first six weeks–as healing progresses, scar formation repairs the tendon. More severe cases may require surgical correction, such as: DIP fixation, fracture pinning, or finger joint fusion.
Trigger Finger (stenosing tenosynovitis): trigger finger is a painful condition wherein a thumb or finger is locked in a bent position and then sporadically snaps back to a straight alignment (similar to the motion of pulling and releasing a trigger). Patients with trigger finger commonly experience the following symptoms: discomfort, irritation, a ‘popping’ or ‘clicking’ sensation when flexing or extending the digit, and/or a digit locked in a straight or bent position. Mild cases of trigger finger may be treated with physical therapy, iontophoresis (using a mild electric current to push anti-inflammatory medication into the inflamed area), or a steroid injection into the affected digit’s tendon sheath to decrease swelling. However, severely advanced cases of trigger finger may require surgical release to widen the constricted portion of the pulley that is preventing the tendon from sliding smoothly.
Metacarpophalangeal (MCP) Joints/Proximal IP (PIP) Joints: the main knuckle joints are called the MCP joints, which work like hinges when during the bending and straightening of the fingers and thumb. The PIP joint is closest to the MCP joint, and when the PIP joint is injured, the finger will become painful and swollen—if the joint has completely dislocated it will appear deformed. When the ligaments have been sprained or partially torn, exercise, “buddy taping” to an adjacent finger, and/or a short period of splinting may be all that is necessary for treatment. In severe cases, surgery may be required to repair any damage to the volar plate or collateral ligaments.
CONTACT Y PLASTIC AND RECONSTRUCTIVE SURGERY
Dr. Asaf Yalif, lead surgeon at Y Plastic and Reconstructive Surgery, is uniquely qualified to provide advanced, cutting-edge surgical treatment options for degenerative or traumatic hand and upper extremity issues. The only surgeon in the Atlanta area specializing in the rare combination of hand and plastic surgery, Dr. Yalif is triple Board Certified in Plastic Surgery, Hand Surgery, and Orthopedic Surgery. His unique perspective on soft tissue, joint, and bone-related conditions of the hand, fingers, wrist, and elbow enables him to offer a variety of medical and surgical options unavailable at traditional orthopedic practices. Y Plastic and Reconstructive Surgery is a friendly, welcoming boutique medical practice where cutting-edge surgical techniques are coupled with an emphasis on the patient experience; whether you are dealing with a traumatic injury or a long-standing degenerative disease, Dr. Yalif will take the time to listen to your concerns, answer your questions, and work closely with you to develop a personalized treatment plan tailored to ensure that your hands can work as hard as you do!
Y Plastic and Reconstructive Surgery has offices conveniently located in Atlanta, Roswell, and Woodstock, Georgia. If you are suffering from tendonitis or tendon damage and are interested in learning how Dr. Yalif can help, or would like information on the surgical options available at Y Plastic and Reconstructive Surgery, we encourage you to contact us today for an initial consultation. We look forward to hearing from you!