Finger Numbness at Night

Many people experience numbness that occurs at night or even persists throughout the day. There are many causes of such symptoms and if the problem is consistent and persistent, it is important to undergo an evaluation by someone trained in such conditions such as an upper extremity specialist. Usually, with a simple exam and occasionally an electrical study, the problem can be identified and often corrected.

One of the most common causes for such numbness the hand is Carpal Tunnel Syndrome. There is a wealth of information available on the subject, but not all is necessarily reputable or helpful. As carpal tunnel syndrome is one of the most frequent conditions that I see, I thought it would be worth preparing an informative article on the subject that can help my patients start the process of learning about Carpal Tunnel Syndrome here.

In short, Carpal Tunnel syndrome is a progressive compression of one of the major nerves of the hand that causes numbness in the thumb, index, middle, and half of the ring finger, along with weakness and clumsiness in hand function. The compression on the nerve starts out initially as a transient and reversible condition, but reliably progresses to permanent and irreversible nerve damage if left untreated for years.

Treatment starts with education and interventions such as splinting or injections, but if the compression persists and progresses, so far the only reliable way to relieve pressure permanently is to surgically release the Carpal Tunnel in a relatively minor day procedure that takes less than a half an hour. Patients can often work the next day if their work allows a soft dressing.

If you have Carpal Tunnel Syndrome or are simply interested in learning more, please contact me – I would consider it a privilege to help you learn more and will take the time necessary to help you understand your options. You can contact me by email here or by contacting my office at 206-633-8100.

Orthopedic Specialists of Seattle’s New Ballard Location: Grand Opening January 3, 2012

After 40 years of service and the addition of expert surgeons, Orthopedic Specialists of Seattle has outgrown its NW Market Street Ballard location. It has now moved to a new Ballard location at 5350 Tallman Avenue NW, Suite 500. This office is located in the same building as the Swedish Hospital/Ballard emergency room.

The new Ballard location serves as an orthopedic clinic, while also offering same day emergency appointments. This clinic is using new, state-of-the-art X-ray equipment and offers a full scope of orthopedic services. Along with these services, this location gives access to all of its orthopedic surgeons.

All surgeons working at the Ballad location, Dr. Downer, Franklin, Ruhlman, Shapiro, Weil, Peterson, and Watt are experts in many orthopedic problems including sports injuries, total joint replacements, hand surgery and pediatric orthopedic care. To make an appointment with an orthopedic surgeon please call (206) 784-8833.

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Seattle Orthopedic Ballard

I Broke My Wrist!

Ok, I didn’t break my wrist, but I treat many people who have sustained such an injury.  Due to the common nature of the injury, I have prepared answers to the common questions that arise in such situations.

Other common names:  Distal Radius Fracture, Fracture of the end of the Radius, Broken Wrist, Wrist Fracture

What is a Broken Wrist? 

Though there are 10 bones that make up the wrist, and each bone has the potential to fracture (medical term for broken bone), by far the most common broken bone in the wrist is a fracture of the end of the radius bone.

Typically, a patient sustains a broken wrist from one of two scenarios; one is that they were in an accident, or fell with such force on their hand that the otherwise normal wrist crushed under significant forces.  The second scenario involves one with less than ideal bone density who falls on an outstretched hand in a way that causes the bone to break.

The difference between the two is the difference in the quality of the bone and the amount of force required to break the bone. The distinction between the two mechanisms is significant as the patient with higher quality bone often has multiple injuries due to the significant force of the injury, and in the patient with poorer bone quality, a thorough bone quality investigation should be considered.

How are Fractures to the end of the Radius evaluated?

X-rays and a physical exam can usually give the information needed to evaluate a distal radius fracture. Occasionally, further imaging such as a CT or MRI may be considered, but this is rare.  In addition to the bone, there is certainly injury to the surrounding soft structures such as tendons, ligaments, muscles and nerves which will affect your outcome.

How is my broken wrist going to be treated? Do I need surgery?

Many factors go into deciding the best treatment for your wrist fracture, but typically I choose the treatment regimen which will allow the best recovery potential, both in the short term and in the long term. This usually initially involves an attempt at manipulating the fracture into the most ideal healing position and holding that position with a splint or cast.

If the wrist fracture falls into an unacceptable position for healing despite maximal non-operative care, then surgical intervention is considered. With experience, training and careful review of current research, I can often predict which fractures can be treated without surgery and which ones will need further surgical stabilization.

How long is the recovery from my broken wrist?

Most patients, regardless of the type of break, have very good long term results. Most fractures treated without surgery will require 6 weeks in a cast, and another 6 weeks to regain most of the strength that was lost. Distal Radius fractures which require surgical stabilization often only need 2 weeks of splinting, followed by 4 weeks of exercise to regain range of motion and another 6 weeks to regain strength.

Most patients are able to do most activities by three months after the injury, but individual circumstances certainly vary.

Educational Feature: Common Shoulder Injuries

Common shoulder injuries typically involve the muscles, ligaments and tendons – and rarely, fractured bones.

Repetitive, stressful sport activities as tennis, pitching, or weightlifting can weaken the shoulder and injure the ligaments.

Intensive training routines, involving excessive, repetitive overhead motion of the arm and shoulder, can over time cause shoulder instability and impingement, and a great deal of pain. … read more

Pediatric Orthopedics at OSS

Highly Specialized Care, Easy Appointment Access, and Plenty of Stickers and Teddy Bears

Did you know that you – and your 9-year-old son who just took a serious tumble and likely has a broken or sprained wrist – can receive top-quality pediatric orthopedic care, quick– right in our cozy Wallingford, Ballard and Mercer Island offices? Drs. Franklin, Peterson, Ruhlman, Watt and Weil all provide orthopedic care for pediatric patients, from infants to adolescents.

Common Pediatric Conditions

The most common pediatric conditions our physicians see are fractures (broken bones), ACL and meniscal tears in adolescents, as well as a wide range of sports- and activity-related injuries in active kids. OSS physicians also care for children with orthopedic deformities, such as webbed digits or congenital trigger thumb; often there are simple treatment options, and if surgery is required, we pride ourselves in a child-friendly experience from start to finish. … read more