Mallet Finger

The diagnosis is evident by the appearance of the finger. Dr. Kim will often order x-rays to see if a piece of bone pulled away and to make sure the joint is aligned. A mallet finger is a deformity of the finger caused when the tendon that straightens your finger (the extensor tendon) is damaged. When a ball or other object strikes the tip of the finger or thumb and forcibly bends it, the force tears the tendon that straightens the finger (see Figure 1a and 1b). The force of the blow may even pull away a piece of bone along with the tendon (see Figure 2). The tip of the finger or thumb no longer straightens. This condition is sometimes referred to as baseball finger.

Nonsurgical Treatment

The majority of mallet finger injuries can be treated without surgery. Ice should be applied immediately and the hand should be elevated (fingers toward the ceiling.) Medical attention should be sought within a week after injury. It is especially important to seek immediate attention if there is blood beneath the nail or if the nail is detached. This may be a sign of a nail bed laceration or an open (compound) fracture.

There are many different types of splints/casts for mallet fingers. The goal is to keep the fingertip straight until the tendon heals. Most of the time, a splint will be worn full-time for eight weeks. Over the next three to four weeks, most patients gradually begin to wear the splint less frequently. The finger usually regains acceptable function and appearance with this treatment. Nevertheless, it is not unusual to lack some extension at the conclusion of treatment. Your surgeon or hand therapist will instruct you about how to wear the splint and will also show you exercises to maintain motion in the middle joint (the proximal interphalangeal joint) so your finger does not become stiff. Once your mallet finger has healed, your surgeon or hand therapist will teach you exercises to regain motion in the fingertip.

In children, mallet finger injuries may involve the cartilage that controls bone growth. Dr. Kim will carefully evaluate and treat this injury in children so that the finger does not become stunted or deformed.

Surgical Treatment

Surgical repair may be considered when mallet finger injuries have large bone fragments or joint mal-alignment. In these cases, pins, wires or even small screws are used to secure the bone fragment and realign the joint. Surgery may also be considered if splint wear is not feasible or if non-surgical treatment is not successful in restoring adequate finger extension. Surgical treatment of the damaged tendon can include tightening the stretched tendon tissue, using tendon grafts or even fusing the joint straight. Your surgeon will advise you on the best technique in your situation.


Dr. Kim is one of a few board certified hand surgeons in the area. In addition to doing 5 years of general surgery, 2 years of plastic surgery training , 1 year of research in wound healing, he also completed a 1 year hand surgical fellowship at the famous Kutz-Kleinert hand institute in Louisville, KY. Dr. Kim participated in the first US hand transplant in 1999. Dr. Kim has passed the intensive examinations to obtain (CAQH) board certification in hand surgery. He is also a member of the ASSH (American Society of Surgery of the Hand). He performs many of his hand surgeries with WALANT ( wide awake local anesthesia no tourniquet ) which makes the procedure and recovery fast and comfortable. LEARN MORE >>

Arthritis of the Hand

The base of the thumb or basilar joint is the most common joint Dr. Kim sees with arthritis. Cortisone injections are often helpful. A joint is where bones connect and move. Arthritis is thinning of the cartilage, which is the smooth covering of the joint. The body reacts to loss of the joint surface by forming bone spurs. Thumb arthritis is a genetic predisposition: like graying and thinning of the hair, it comes with age and it shows up earlier in some families. Unlike thinning of the hair, women tend to get thumb arthritis sooner than men do.

Patients with thumb arthritis report pain and weakness with pinching and grasping. For instance, opening jars, turning doorknobs or keys, and writing are often painful.

As with other aspects of aging, we adapt to thumb arthritis and treatment is often unnecessary. Options for treatment include non-surgical methods and surgery. Treatments without surgery range from ice/heat, pain medicines, splinting, and injections. Surgery consists of removing the joint either by removing a bone or connecting the bones together. There are options for moving one of your tendons to secure or cushion the bone. After surgery, a splint or cast is worn for several weeks.


Avoiding Fingertip Injuries


Boxer's Fracture


Importance of Certification


Dr. Kim is one of a few board certified hand surgeons in the area. In addition to doing 5 years of general surgery, 2 years of plastic surgery training , 1 year of research in wound healing, he also completed a 1 year hand surgical fellowship at the famous Kutz-Kleinert hand institute in Louisville, KY. Dr. Kim participated in the first US hand transplant in 1999. Dr. Kim has passed the intensive examinations to obtain (CAQH) board certification in hand surgery. He is also a member of the ASSH (American Society of Surgery of the Hand). He performs many of his hand surgeries with WALANT ( wide awake local anesthesia no tourniquet ) which makes the procedure and recovery fast and comfortable. LEARN MORE >>

Ganglion Cyst Removal

Ganglion cyst removal

Ganglions (ganglion cysts) are the most common lumps seen in the hand. They usually appear on the wrist, but also at the base of the finger and finger tip and even sometimes can occur in the ankles or feet. The joint lubricating fluid or the fluid around tendons herniate through a defect which is acting as a one-way valve. Though not usually painful they can enlarge to stretch nerves or tendons or distort the nail and this can result in varying levels of discomfort. Ganglions sometimes rupture spontaneously and shrink away only to reappear.

When a ganglion cyst presses on a nerve it can be painful. And depending on its location, a ganglion cyst may restrict movement.

Ganglion cyst removal is usually an outpatient procedure and may be performed under local or general anesthesia. Before surgery, Dr. Kim may draw a line above the cyst to mark the incision location. Dr. Kim then numbs the treatment area and cuts along the line with a scalpel. The doctor then identifies the cyst and cuts it out along with its capsule or stalk. Once the cyst is removed, your doctor stitches the opening to let the skin heal.

Recovery

  • After your surgery, rest as much as you can for a few days. This will encourage the site of your cyst removal to heal. Limit movement of your hand and wrist to minimize pain and avoid irritation of the removal site.
  • Minimal, nonrepetitive activity is okay after a cyst removal, such as writing or carrying light objects. Your doctor may recommend finger exercises involving stretching your fingers and thumb as far out as possible and then bending them as much as is comfortable.
  • You may experience localized pain after surgery, which can be relieved by numbing medications, over-the-counter pain medications, or prescription pain medications.
  • You may also experience swelling at the removal site. Swelling can be treated with ice and will eventually go away.
  • LEARN MORE

Dr. Kim is one of a few board certified hand surgeons in the area. In addition to doing 5 years of general surgery, 2 years of plastic surgery training , 1 year of research in wound healing, he also completed a 1 year hand surgical fellowship at the famous Kutz-Kleinert hand institute in Louisville, KY. Dr. Kim participated in the first US hand transplant in 1999. Dr. Kim has passed the intensive examinations to obtain (CAQH) board certification in hand surgery. He is also a member of the ASSH (American Society of Surgery of the Hand). He performs many of his hand surgeries with WALANT ( wide awake local anesthesia no tourniquet ) which makes the procedure and recovery fast and comfortable. Learn more

De Quervain's Tendon Release

De Quervain's tendon release Release

The condition called de Quervain's tenosynovitis causes pain on the inside of the wrist and forearm just above the thumb. It is a common problem affecting the wrist.

Dr. Kim usually performs the surgery under local anesthesia. Dr. Kim will make a small incision along the thumb side of the wrist and moves aside other tissues and locates the tendons and the tunnel. An incision is made to split the roof, or top, of the tunnel. This allows the tunnel to open up, creating more space for the tendons. The tunnel will eventually heal closed, but it will be larger than before. Scar tissue will fill the gap where the tunnel was cut.

The skin is then stitched together, and your hand is wrapped in a bulky dressing.

Recovery

  • Full recovery could take several months. Pain and symptoms generally begin to improve after surgery, but you may have tenderness in the area of the incision for several months.
  • You may need to attend occupational or physical therapy sessions for six to eight weeks. You'll begin doing active hand movements and range-of-motion exercises. Therapists also use ice packs, soft-tissue massage, and hands-on stretching to help with the range of motion. When the stitches are removed, you may start carefully strengthening your hand and thumb by squeezing and stretching putty.
  • LEARN MORE.

Hand injuries more prevalent in the summer


Importance of Certification


Picking the Right Plastic Surgeon

Dr. Kim is one of a few board certified hand surgeons in the area. In addition to doing 5 years of general surgery, 2 years of plastic surgery training , 1 year of research in wound healing, he also completed a 1 year hand surgical fellowship at the famous Kutz-Kleinert hand institute in Louisville, KY. Dr. Kim participated in the first US hand transplant in 1999. Dr. Kim has passed the intensive examinations to obtain (CAQH) board certification in hand surgery. He is also a member of the ASSH (American Society of Surgery of the Hand). He performs many of his hand surgeries with WALANT ( wide awake local anesthesia no tourniquet ) which makes the procedure and recovery fast and comfortable. LEARN MORE.

Trigger Finger Release

Trigger Finger Release

This is a condition that affects the pulleys and tendons that are responsible for bending your fingers. It causes a painful ‘catching’ or ‘locking’ of the fingers or thumb as the tendon catches on the pulley. Ongoing damage every time the tendon ‘catches’ leads to further irritation and swelling. The finger may be difficult to bend (or straighten) and may even become locked in a fixed position.

Dr. Kim performs trigger finger release under local anesthesia. A small incision is made at the base of the affected finger and the pulley is released. The cut is stitched and a light dressing applied. It is encouraged that you start moving your finger almost immediately after surgery. You should be able to return to normal activities as soon as you feel comfortable.

Recovery

Recovery usually takes a few weeks with full range of motion and grip strength returning in this time. You may be required to undergo hand therapy to aid in your healing and rehabilitation. LEARN MORE


Treatment for Trigger Finger


Avoiding Fingertip Injuries


Importance of Certification


Picking the Right Plastic Surgeon


Dr. Kim is one of a few board certified hand surgeons in the area. In addition to doing 5 years of general surgery, 2 years of plastic surgery training , 1 year of research in wound healing, he also completed a 1 year hand surgical fellowship at the famous Kutz-Kleinert hand institute in Louisville, KY. Dr. Kim participated in the first US hand transplant in 1999. Dr. Kim has passed the intensive examinations to obtain (CAQH) board certification in hand surgery. He is also a member of the ASSH (American Society of Surgery of the Hand). He performs many of his hand surgeries with WALANT ( wide awake local anesthesia no tourniquet ) which makes the procedure and recovery fast and comfortable. Learn more

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