EXPERT
Dr. Anisa Yalom, MD
Hand Surgeon
Dr. Anisa Yalom is a hand surgeon practicing in Torrance, CA. Dr. Yalom specializes in caring for hand, wrist and forearm problems without the option of surgery unless necessary. Many hand surgeons are also experts in diagnosing and caring for shoulder and elbow problems and tend to suggest non-surgical treatments such as hand therapy or physical therapy.
Dr. Anisa Yalom, MD
- Torrance, CA
- Smith College
- Accepting new patients
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Trigger finger caused by ulnar/median nerve surgery?
Hello, I am sorry that your condition has worsened. This must be a very distressing situation for you. There are a couple of reasons that people develop clawing of their ring and READ MORE
Hello, I am sorry that your condition has worsened. This must be a very distressing situation for you.
There are a couple of reasons that people develop clawing of their ring and small fingers and it is sometimes challenging to determine the exact underlying cause. Clawing of the ring and small finger can definitely be because of ulnar nerve dysfunction - either from a compressive neuropathy like cubital tunnel syndrome at the elbow or ulnar tunnel syndrome at the wrist. It can also be from nerve root compression in the cervical spine or from a traumatic injury of the ulnar nerve anywhere from the neck to the wrist. Occasionally the nerve can also be dysfunctional from a tumor within the nerve or compressing it externally. The exact location and cause of the dysfunction is usually made by a combination of physical exam, EMG and Nerve Conduction Study and sometimes an MRI. Hopefully you had a thorough exam prior to surgery to confirm the site of ulnar nerve dysfunction and to confirm that the flexion contracture of your fingers was in fact from ulnar nerve dysfunction or “clawing” and not from another process.
Dupuytren’s Disease can also cause flexion contracture if the digits which can be mistake for clawing and can sometimes also exist at the same time as ulnar clawing. Dupuytren’s causes abnormal scarring of the palm fascia which leads to chord formation that tethers your fingers in the flexed position. Dupuytren’s is sometimes worsened after surgery in the hand or trauma.
Trigger fingers do occasionally become locked but usually patients have a history of triggering or popping of the fingers on flexion and extension prior to becoming locked. There is also usually a tender nodule in the hand just below where the finger meets the hand in the flexor tendon at the A-1 pulley level.
You are quite you g to be suffering from Dupuytren’s as well as severe ulnar nerve dysfunction unless you have had a traumatic injury of your neck or upper extremity.
I would recommend getting a second opinion from another hand surgeon and ensuring that you have a complete physical exam and work up to look at all of the possible causes for your worsening symptoms.
There are a couple of reasons that people develop clawing of their ring and small fingers and it is sometimes challenging to determine the exact underlying cause. Clawing of the ring and small finger can definitely be because of ulnar nerve dysfunction - either from a compressive neuropathy like cubital tunnel syndrome at the elbow or ulnar tunnel syndrome at the wrist. It can also be from nerve root compression in the cervical spine or from a traumatic injury of the ulnar nerve anywhere from the neck to the wrist. Occasionally the nerve can also be dysfunctional from a tumor within the nerve or compressing it externally. The exact location and cause of the dysfunction is usually made by a combination of physical exam, EMG and Nerve Conduction Study and sometimes an MRI. Hopefully you had a thorough exam prior to surgery to confirm the site of ulnar nerve dysfunction and to confirm that the flexion contracture of your fingers was in fact from ulnar nerve dysfunction or “clawing” and not from another process.
Dupuytren’s Disease can also cause flexion contracture if the digits which can be mistake for clawing and can sometimes also exist at the same time as ulnar clawing. Dupuytren’s causes abnormal scarring of the palm fascia which leads to chord formation that tethers your fingers in the flexed position. Dupuytren’s is sometimes worsened after surgery in the hand or trauma.
Trigger fingers do occasionally become locked but usually patients have a history of triggering or popping of the fingers on flexion and extension prior to becoming locked. There is also usually a tender nodule in the hand just below where the finger meets the hand in the flexor tendon at the A-1 pulley level.
You are quite you g to be suffering from Dupuytren’s as well as severe ulnar nerve dysfunction unless you have had a traumatic injury of your neck or upper extremity.
I would recommend getting a second opinion from another hand surgeon and ensuring that you have a complete physical exam and work up to look at all of the possible causes for your worsening symptoms.
Bulging Vein in Palm of Hand- Pain
Hello, there are many things that could be causing the symptoms you are describing but you will need a hands on physical exam and imaging (either an ultrasound or a CT angiogram) READ MORE
Hello, there are many things that could be causing the symptoms you are describing but you will need a hands on physical exam and imaging (either an ultrasound or a CT angiogram) to narrow down the differential diagnosis.
Given your history of heart palpitations I would be most concerned about an embolus or blood clot in the arteries of your hand vs an aneurism of one of the arteries in your hand. Please make an appointment to be seen by a hand surgeon ASAP because both of these issues would require timely treatment to prevent further problems.
Given your history of heart palpitations I would be most concerned about an embolus or blood clot in the arteries of your hand vs an aneurism of one of the arteries in your hand. Please make an appointment to be seen by a hand surgeon ASAP because both of these issues would require timely treatment to prevent further problems.
Lingering nerve pain following carpal tunnel steroid (40mg Kenalog) injection
Occasionally an injection into the carpal tunnel can cause trauma to the median nerve either from the increased pressure from the volume of the medication injected around the nerve READ MORE
Occasionally an injection into the carpal tunnel can cause trauma to the median nerve either from the increased pressure from the volume of the medication injected around the nerve or from direct, inadvertent injection into the nerve itself.
If your symptoms persist longer than 1 week after the injection you should return to see the surgeon who performed the injection. You may require release of the carpal tunnel to treat this problem surgically, but the surgeon would likely wait at least 6 weeks before performing the surgery to prevent wound healing complications from the steroid injection. If you aren’t already wearing a carpal tunnel splint while sleeping you should start that now.
If your symptoms persist longer than 1 week after the injection you should return to see the surgeon who performed the injection. You may require release of the carpal tunnel to treat this problem surgically, but the surgeon would likely wait at least 6 weeks before performing the surgery to prevent wound healing complications from the steroid injection. If you aren’t already wearing a carpal tunnel splint while sleeping you should start that now.
Tingling hands
Hello, so sorry to hear about your injury. Your hands could be tingling from an injury of your cervical spine. If the sutures in your forehead were needed because of forceful trauma READ MORE
Hello, so sorry to hear about your injury. Your hands could be tingling from an injury of your cervical spine. If the sutures in your forehead were needed because of forceful trauma to your head (as opposed to a laceration from a sharp object) I would go back to the ER for a full physical exam and further imaging, such as an MRI if the cervical spine. You will also need an exam of your hands and arms and potentially an EMG and Nerve Conduction Study, which could be done as an outpatient. For the most thorough evaluation you would need to see a hand surgeon ASAP to evaluate for other causes of hand tingling.
Removing permanent fiberwire stitches
Yes, the sutures could eventually be removed, but it would likely require opening the incision all the way again, possibly even wider if there are significant adhesions. Also, READ MORE
Yes, the sutures could eventually be removed, but it would likely require opening the incision all the way again, possibly even wider if there are significant adhesions. Also, if the sutures are removed and there is not complete healing of the tendon or if there is inadvertent loss of integrity of the tendon because of the removal of the fiber wire suture your surgeon may need to put additional sutures back in, either fiber wire or a different type like Prolene or PDS.
Fiber wire is not visible on Xray.
Normally the sutures are left in place in the tendon forever, unless they become symptomatic or infected, because if the risks involved in removing them outweighs the benefits if they are not symptomatic or infected.
Fiber wire is not visible on Xray.
Normally the sutures are left in place in the tendon forever, unless they become symptomatic or infected, because if the risks involved in removing them outweighs the benefits if they are not symptomatic or infected.
