General Orthopaedics

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The shoulder joint is made up of bones held in place by muscles, tendons, and ligaments. If one of these parts is disrupted, this can cause shoulder pain.

The most common shoulder problems are:

• Rotator Cuff Disease - involving the tendon, Tendinitis, or inflammation of a small fluid-filled sac that protects the shoulder joint, Bursitis.
• Shoulder Impingement - a condition in which the rotator cuff tendons become repetitively pinched under the shelf of bone at the top of the shoulder called the acromion
• Rotator Cuff Tear - the tendon is torn or ruptured from injury, frequent use, or aging. Sports or occupations that involve repeated overhead motion can also damage the rotator cuff. Aging causes tendons to wear down, which can lead to a tear
• Frozen Shoulder - the range of movement of the shoulder is restricted in people
• Fracture - a crack of bone. In the shoulder, a fracture usually involves the collarbone or upper arm bone
• Calcific Tendonitis - a condition of calcium deposits within a tendon -- most commonly within the rotator cuff tendons
• Shoulder Instability - a loose shoulder joint caused by trauma injury or wear and tear
• Stiffness of the joint
• Arthritis - the pain of the joints due to inflammation or damage
• Shoulder Impingement - The inflammation of the rotator cuff tendons and/or the bursa surrounding these tendons

Common Elbow Problems:

• Tennis Elbow - caused by the force of the tennis racket hitting balls in the backhand position
• Bursitis - also called olecranon bursitis, occurs as a result of injury or constant pressure on the elbow, which causes inflammation
• Fractures - falling on an outstretched hand or directly on the elbow's tip can result in dislocation and/or several types of fractures
• Arthritis - the pain of the joints due to inflammation or damage

Common Hand Problems:

Dupuytren's Disease

This condition is a genetic disease. The disease affects fibrous cords or nodules forming in the palm and eventually extends to the fingers, causing contractures, in which the fingers are drawn down into the palm. This problem is more easily treated in its early stage by removing the diseased fascia (fibrous tissue under the skin).

Basilar Joint Arthritis

This problem occurs primarily in women, but it can occur in men following an injury. The base of the thumb becomes quite painful. There is joint wear primarily because of the instability and deformity. Pain results over time. In the early stages, splinting and anti-inflammatory agents are successful. Sometimes corticosteroid injections will provide long-term relief, but, ultimately, most cases will require surgery. The surgery can consist of a reconstructive procedure using one's tissues to accomplish an arthroplasty (replacement) of the basilar joint. The other alternative is arthrodesis (fusion) of the thumb's metacarpal to the trapezium at the base of the thumb. This procedure also alleviates pain.

Trigger Finger

This condition occurs after repetitive activities and sometimes after an injury. Generally, there is no known cause. It results in "catching or locking" of the finger in flexion and pain with pressure over the finger's base in the palm. It can be treated with rest; however, if rest does not alleviate the problem, anti-inflammatory agents, injections of corticosteroid, or surgical release of the constricted area around the tendon should resolve the problem.

Tendon Lacerations

The tendons that flex your fingers are called "flexor tendons," and the tendons on the back of your hand that extend your fingers are called "extensor tendons." If these are lacerated or cut, you will lose the function of your finger. Such an injury should be promptly treated. Any fairly deep laceration to the fingers or palm should be evaluated, as the tendon's partial division can occur. Such division could subsequently result in rupture and loss of function of the finger.

Mucous Cysts

These cysts occur on top of the fingers at the last joint just back from the nail bed. They are the result of arthritic spurs causing fluid in the joint to be released. They can cause discomfort and thinness of the skin. They also can put pressure on the nail growth, causing grooves in the nail. The cyst and the offending spurs can be surgically removed.

Mallet Finger

This problem occurs when you "jam" your finger and cannot fully straighten the finger at the last joint. In the early treatment of mallet finger, splinting and immobilization hold the joint in position. Surgical intervention may be required if the injury is not immediately addressed.

Common Knee Problems:

• Arthritis
• Chondromalacia softening of the articular cartilage of the kneecap
• Meniscal Injuries
• Cruciate Ligament Injuries
• Medial and Lateral Collateral Ligament Injuries
• Tendon Injuries
• Osteochondritis Dissecans