- Orthopaedic and Hand Surgery
- Work Related Injuries
- Fracture Care
- Accidents and Trauma Care
- Pediatric Injuries
- Sports Medicine
- Second Opinions and IMEs
- On-site Radiology and X-ray
- Hand Therapy
- Custom Splinting and Casting
- Ergonomic Assessments
Orthopaedic and Hand Surgery
Hand Surgeons come from several surgical disciplines including orthopaedic surgery, plastic surgery, and general surgery. Hand surgery is defined as the treatment of all upper extremity conditions including problems with fingers, hands, wrists, lower arms, elbows, upper arms and shoulders. Our surgeons completed a bachelor's degree (4 years,) medical school (4 years,) training in general orthopaedic surgery (5 years,) and then returned to school for additional year of "fellowship" training in hand surgery (total 14 years of advanced education.) Our surgeons are board certified in orthopaedics by the American Board of Orthopaedic Surgeons.
Our patients receive the highest quality of hand surgery and orthopaedic care available. Common conditions that we treat include: arthritis, carpal tunnel syndrome, fractures, Dupuytren's Disease, ganglions, tennis elbow, trigger fingers, shoulder impingement, and wrist pain. The most common surgeries we perform include: carpal tunnel release, trigger finger release, ganglion cyst removal, rotator cuff surgery, Needle Aponeurotomy and Xiaflex injection for Dupuytren's Disease, and simple and complex fracture care. Since The Hand to Shoulder Center opened, we have treated over 14,000 patients, including over 1,000 carpal tunnel release surgeries, over 800 of which have been treated using an endoscopic technique that allows our patients to return to their activities, work and lives in a fraction of the time of traditional carpal tunnel release techniques.
In addition to the specialized services our Center offers for the hand, elbow, arm and shoulder injured patient, we also service all general orthopaedic conditions including hip, leg, knee, ankle and foot injuries.
Just as Hand Surgeons are a sub-specialty of general orthopaedic care, other orthopaedic surgeons are trained in the sub-specialty of orthopaedic "spine" care. Our surgeons typically refer neck, back and spine cases out of our office to the appropriate provider for these injuries.
Work Related Injuries
The Hand to Shoulder Center has treated worker's compensation patients since the Center opened in 2000. We have extensive experience in working with these patients, Worker's Compensation Insurance carriers, nurse case mangers, and attorneys.
Our goal is to create a team between all parties involved to get the injured worker back to work and at their maximum level of function as quickly as is possible. One advantage the Center has over other facilities is the collaborative working relationships that we create between physician, Hand Therapist and patient, to set realistic goals and achievable outcomes.
Common work-related injuries include finger tip amputations, lacerations, crushing injuries, fractures, carpal tunnel syndrome, lateral epicondylitis, cumulative trauma or repetitive-stress injuries and others.
Because our physicians were first trained as orthopaedic surgeons, all of our fracture patients receive state of the art care for all fractures. Our skilled team of surgeons and Hand Therapists manage a full range of fractures including simple buckle fractures in children, to highly complex traumatic wrist and elbow fractures requiring the use of surgical plates and screws that help stabilize these breaks.
Our hand therapy team has the highest training available in the fabrication and management of custom splints that specifically address the needs of each patient. Depending on the type of injury, some patients will receive multiple custom made splints to support the patient during the healing process.
Accidents and Trauma Care
Our physicians attend to both Waterbury Hospital and St. Mary's Hospital emergency rooms, and also receive requests from other clinics, walk-in centers, and emergency rooms in the western Connecticut region for help with traumatic injuries to the hand, wrist, elbow and shoulder. Our staff are ready and able to manage all forms of accidents and traumatic injuries including emergent surgery, fracture reduction, splinting, wound management, and emergency surgical intervention when needed.
Our surgeons and Hand Therapists have extensive experience in caring for children's hand and arm injuries, including congenital deformities. Our goal for the care of children is the same as for all our patients: we consider all treatment options, including conservative treatments, with a goal of optimal recovery in the shortest period of time.
Since the Center opened, our team has worked with injured children and their parents to help get their children back to sports and other activities as quickly as possible. Our specialized team of Hand Therapists make custom (and often removable) splints for many injuries that allow children to shower, bathe or swim while wearing their splint.
Christian L., of Southbury, pictured here with his Mom, is a member of our "both arms" club. He broke his right arm in 2000 and his left arm in 2004. His family chose The Hand to Shoulder Center for his care on both occasions and also when his sister broke her arm in 2006.
Sports related injuries are common among all active people, including both children and adults. The Hand to Shoulder Center has cared for many sports-related injuries from minor finger breaks to complex fracture-dislocations. Common sports-related injuries include sprains, dislocations, fractures, tendon/ligament/muscle strain, over-use injuries like tennis or golfer's elbow, shoulder bursitis, and rotator cuff injuries.
Our surgeons approach all sports-related injuries in a conservative fashion, working up a ladder of treatment that may include rest, splinting, anti-inflammatory medication, hand therapy services, steroid injections, and surgery.
Second Opinions and IMEs
Our patients can trust that our Center has an extensive experience base in the care of upper extremity injuries. Many patients, insurance companies, Worker's Compensation case managers, and attorneys turn to us for second opinions and Independent Medical Exams (IMEs) for patients from around the State of Connecticut. Additional information on insurance coverage and costs for these services can be obtained by contacting our billing office.
On-site Radiology and X-ray
Like many Hand Surgeons, we use a "mini-C arm fluoroscan" machine in our office for both still and moving x-ray images of the hand and wrist. These images allow our physicians to get very specific x-ray shots of the small and complex bones in this part of the body. Some patients may need to be sent to an off-site facility for larger joint images, such as the shoulder.
For patients who have had their x-rays taken elsewhere, we ask that you call our office to see if we can access these images through the internet in our office, or if we will require you to bring them at the time of your appointment.
Hand Therapists are either licensed occupational or physical therapists who have a special interest in and advanced training in rehabilitation of the hand and upper extremity. Hand Therapists have specialized training in hand and arm mobility and function, wound management, custom splinting, and the evaluation and modification of activities of daily living to help restore independent functioning to our patients. Our therapists are all board certified in Occupational Therapy and have a combined over 60 years of hand therapy treatment experience. Our therapists are either eligible for or are already certified in hand therapy by the Hand Therapy Certification Commission.
Custom Splinting and Casting
Casting and splinting techniques have changed a lot over time. Where plaster was once the only option for a cast, there are now many fiberglass and plastic-based materials that can be used to fabricate standard and custom casts and splints.
Traditional casts can be a bummer, especially for active kids. The custom splints we make at The Hand to Shoulder Center are often used in place of casts and give our patients more comfort and freedom while they are healing.
Typically a cast is made into a solid piece that completely immobilizes the injured area, and requires a cast saw to remove. Splints can frequently be utilized in place of casts. Whether they are removable or not, splints add a great deal of patient-specific flexibility including the use of hinges, tension wires and springs that can be adjusted as an injury heals.
Our physicians and Hand Therapists are all trained for the unique and specialized casting and splinting techniques required by the hand and arm injured patient.
One of the many specialized services offered by our Hand Therapy Department is ergonomic assessments. An in office review of a person's work space, home activities and ADL's is performed to determine optimal body positioning and function. Typical outcomes of these evaluations include suggestions for correct seat positioning/posture and computer/keyboard placement to allow the arms of the worker to be best positioned to limit potential injury from repetitive tasks. Other examples may include specialized or modified items such as eating utensils, garden tools, door knobs, key or card holders to improve function and reduce joint or muscle strain.