Evaluation and Deliverance of prompt treatment by Proficient Hand Doctor
A unique functional part of body:
Bones, joints, ligaments, tendons, muscles, nerves, skin and blood vessels come together to frame the anatomy of the hand enabling it to perform multiple activities. The relationship between these structures is delicate and complex and an injury to even one of these structures can impair the functioning of the hand.
Injuries and Disorders of Hand comprise of:
Fractures, Dislocations, Ruptured Ligaments, Osteoarthritis, Tendinitis, Ganglion Cysts and other complications, resulting in restricted movement, stiffness, swelling, pain and weakness to the part of hand affected and need to be looked over by diligent hand doctor to relieve the patient of complex trauma.
As Qualified and specialist hand doctor:
Dr. Vikas diagnoses the conditional problems in the hand with advanced technology methods, treats all disorders with corrective treatment plan accordingly to provide maximum relief and insistently stresses on after care procedural methods to bring back rejuvenation in the patient.
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Considerations:
There are many techniques that are taken up by the hand doctor to treat acute conditions that affect the hand but before orthopedic intervention the hand needs to be stabilized and immobilized which is ensured by techniques known as splinting, casting or buddy taping.
Indications:
The conditions under which Splinting, Casting and Buddy Taping are applied include- - Acute, severe and non displaced fractures / sprains - Soft tissue injuries - Reduced Joint Dislocations - Tendon / Joint lacerations - Inflammatory condition such as arthritis or tenosynovitis - Injury in the fingersIntroduction to techniques:
The hand doctor applies any of these techniques according to their optimum effect on the condition.
Splinting:The technique of applying a hard material that is held with an elastic bandage is termed as Splinting. Splints are non circumferential immobilizers that are applied on acute and severe fractures or sprains to reduce swelling and provide stabilization. They are also referred to as partial casts and just like casts their inner layer is of soft cotton and the outer layer is hard. Usually applied before the casting technique and more so when the immobilization has to be for a temporary or short period.
Casting:The technique of applying a hard and big bandage on the hand to immobilize the bone and provide stabilization is termed as Casting. Cast is made of two layers, in which the inner layer which directly touches the skin is made of soft cotton and the outer one is hard made from Fiberglass or Plaster of Paris. It is applied when the injury is severe and the hand needs to be immobilized strictly for a definite period of time.
Buddy Taping:The technique that is applied by tapping two fingers together where one of them acts as a stabilizer or splint to the injured one. It is temporary and is done to block the movement of the injured finger.
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Before Application:
After the hand doctor has determined the cause of the debilitation in the hand he informs the patient of the technique that is optimum for his condition. Without much delay the technique most suitable is applied thereon and the patient is updated with all precautions and after care rehabilitation protocols.
Application of Techniques:
It is essential to provide a proper stabilization to the injured hand, wrist or finger before it is taken up for further treatment. Without delay the hand doctor applies the technique which is most effective. The application technique for casting or splinting is more or less the same with buddy taping applied more simply.
Splinting:Soft cotton layer is applied on the injured area as initial base. Thereafter the hand doctor places an already hard splint over it and then holds it firm with either Velcro straps or elastic bandage.
Casting:The hand doctor applies several layers of soft cotton on the injured hand and stabilizes it with an initial covering. Then wet outer covering is wrapped around the inner layer which slowly dries and becomes hard. A few cuts are made in the sides of the cast to allow room for swelling.
Buddy Taping:Two strips of half inches non stretchable white tape are taken and one is tied above the injured joint and one below the injured joint. This forms the anchor for supporting strips. Thereafter padded foam is placed between the fingers to be taped together. The hand doctor then applies two supporting strips from the anchor above the joint and two on the lower side so that the fingers may bend together but sideways movement gets limited.
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After Application:
After the hand doctor has applied the cast /splint or buddy taped the fingers, the patients are handed out verbal and written instructions regarding the care and precautions that they would have to take about elevation of the injured extremity, keeping the material dry and not pushing anything inside the cast to scratch. The patients are also advised to continuously monitor the hand for any indications of compartment syndrome and seek immediate medical help for the removal of cast or splint if they find any signs of vascular compromise.
Schedule for follow up visit is also mentioned in the prescription that is given to the patient which is usually kept within the first week of the application.
Precautions to be Undertaken:
Casts, splints and Buddy taping should be properly taken care of so that they do their job properly and enable effective healing. The patients should not let their splints or casts get wet, never scratch inside the cast with any foreign object, keep a check on the appearance of any cracks in the cast, not break any part of the cast and contact the doctor if the cast or splint feels too tight or uncomfortable.
Removal:
The casts are removed after a definite period when the hand doctor confirms that the bone or injured are must have healed. The cast is removed with a saw and the skin that comes out from beneath may be different. It may appear to be drier, scaly and the muscles may also seem smaller but the patient should not be worried as it is normal.
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Benefits:
Splints and casts act as stabilizers to the damaged part of the hand and bring down swelling. They are fast and easy to apply. The hand doctor considers them to be most preferential methods of immobilization and they are the course that can be adopted before and after orthopedic intervention.
Complications:
The most serious and irreversible complication that occurs after splinting or casting is the compartment syndrome. Compartment syndrome is a condition that causes tissue perfusion and interruption in the blood flow thereby causing permanent damage to the soft tissues. When the patient experiences intense pain, swelling, tingling and numbness, it is an indication that the cast needs to be removed immediately.
Other common complications that may occur after the application may be- bacterial or fungal infection underneath the cast or splint, stiffness in the joints or thermal injuries.
Rehabilitation:
It is essential to remove the stiffness in the hand, wrist or fingers that becomes prevalent after removal of splint, buddy tape or cast and bring back mobilization in the numb parts. A well formulated rehabilitation program is essential for the same. It comprises of exercises, massage and therapy that helps to stretch and relax the muscles. All these exercises are performed under the skilled guidance of a physiotherapist.
More About The Hand Doctor:
Dr. Vikas Gupta an MBBS and MS in Orthopedics has been in the field of upper extremity for the last 25 years and has provided relief to more than 6000 patients by surgical releases and innumerable with nonsurgical techniques. He is well renowned for his sharp and accurate diagnosis with equally deft hand in surgery. His intuitive and evaluating skills make patients seek his consultation steadfastly. The various hospitals from where he has delivered his professional services are AIIMS, Fortis, Medanta-The Medicity and at present he is an integral part of Max Healthcare- The super specialty hospital in Saket and Gurgaon. There is no debilitating condition of the hand that hand doctor, Dr. Gupta, is not skilled to treat. Fractures, dislocations, ligament tear, soft tissue injuries or any other condition that affects the hand are effervescently treated by him. Max Healthcare is the best hospital in the Delhi-NCR region that has joined hands with Dr. Gupta and made him one of their ingenious team of professional as head of the hand and shoulder division. Max Healthcare strives to bring revolutionary, cost effective and painless techniques to India and their belief in Dr. Gupta’s visionary approach to bring complete relief to each patient by facilitating aftercare rehabilitation has added an extra edge of finesse to their deliverance.