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Latest Articles

Lessons from the COVID-19 Pandemic

It is difficult to comprehend the vast amount of human suffering caused by SARS-CoV-2. As I type these words, the COVID-19 pandemic has caused illness in almost 2 million Americans and over 100,000 deaths. Over 40 million people in the United States have now applied for unemployment benefits due to the economic fallout of the […]

ORIF of 4th and 5th Metacarpal Fractures

This patient sustained displaced fractures of the fourth and fifth metacarpal shafts. The fractures were angulated and the fingers were not aligned well. Surgery was recommended for the patient. Open reduction and internal fixation surgery with plates and screws was performed and range of motion with hand therapy was begun early. Excellent results were achieved […]

Photos of Mucous Cysts in Fingers

A mucous cyst is a common type of fluid-filled cyst in the finger. These are called “mucous cysts” due to the thick, clear, mucous-like fluid within the cyst. This fluid has leaked out of the joint closest to the fingernail, the distal interphalangeal (DIP) joint. They are common in both men and women aged 50-70 […]

Closed Reduction and Pin Fixation of Hand Fracture-Dislocation

This patient sustained a fracture-dislocation of the 5th carpometacarpal (CMC) joint at the base of the small finger. The CT scan shows the comminuted fracture fragments and the joint malalignment. The red arrows point to the injury site and highlight the joint out of place. The patient underwent surgery, involving manipulation of the fracture site, […]

Elective Surgery is Allowed in North Carolina

COVID-19 Update: Effective May 1, 2020, North Carolina Governor Roy Cooper and NCDHHS Secretary Dr. Mandy Cohen have allowed elective and non-urgent surgery to be performed in our state. Certain guidelines have to be followed including: an assessment of the medical necessity of the procedure, maintaining protective personal equipment, protecting the exposure of patients and […]

How to Avoid Carpal Tunnel Surgery

I’m writing this article for people who want to avoid carpal tunnel surgery. Yes, I am an orthopedic surgeon and I’m trained to operate on patients with carpal tunnel syndrome (CTS). But I’m also a physician, and part of our jobs as physicians is to educate patients about prevention of disease. Hopefully I can teach […]

Surgical Repair of Fingernail Injury

This patient had a crushing injury to the fingertip with a laceration to the skin, disruption of the nail, and laceration of the nailbed. Repair of the nail was performed with local anesthesia numbing medicine and a finger tourniquet to minimize bleeding. The nail was replaced at the end of the procedure. The nail typically […]

Surgery for Finger Injury Cases

Case #1 This patient had an amputation to the index fingertip with exposed distal phalanx bone. A V-Y flap was performed to reconstruct the soft tissues. Case #2 The patient in the pictures below had a near-amputation to the middle finger with fracture of the distal phalanx. Surgery was performed to stabilize the injury.  Case […]

Finger Fracture Treatment with Percutaneous Pins

Finger fractures can lead to permanent stiffness, weakness, and limited function in the hand. If these are not treated carefully, patients can have a poor hand function. Much can be done to prevent many of these problems. There are a variety of techniques available for treatment of these injuries including splints, casts, therapy, and surgery. […]

Nerve Injury in the Hand

Nerves are fragile and can be injured in many ways — including compression, lacerations, or blunt trauma. Compression is caused by prolonged pressure on a nerve, such as in carpal tunnel syndrome. Nerve lacerations are caused by a sharp object such as a knife or broken glass. A cut nerve in the finger will make […]