By Alexander Germanis
In the toolbox of the human anatomy, the wrists, hands, and fingers are the screwdrivers, wrenches, pliers, and even hammers. In short, they are meant to tackle just about every job. Even the best tools break or wear out, and the flesh-and-bone set can’t just be replaced with a purchase from the hardware store.
That’s where the skilled tools — both literal and metaphorical — of orthopedic surgeons are put to work — surgeons like Dr. Jerry Oakey of McLean County Orthopedics. Specializing in hand, wrist, and elbow orthopedic surgery, Dr. Oakey utilizes a unique set of skills, know-how, and instrumentation to repair the human toolset.
A lot can go wrong with a set of tools that is in constant use: torn ligaments, broken bones, necrosis, and the seemingly omnipresent carpal tunnel syndrome — the last of which is the most common ailment Dr. Oakey treats.
Most people have heard of carpal tunnel but few know what it is. Described simply, the median nerve and tendons controlling the fingers pass through a tunnel comprised of bone and ligament at the base of the hand. When swelling of the tendons occur, pressure builds up in this narrow passage, choking off the nerve and collapsing blood vessels on the outside. Tingling and numbness is common. In worse cases, the muscle can actually die.
Carpal tunnel is just one example of what can happen in what Dr. Oakey describes as the “tight system” of the human hand and wrist. With 27 bones and an interwoven network of tendons, muscles, and ligaments, the area leaves little room for error.
With more complex procedures, like fractures to the first joint of the finger and lacerations to the tendons, the need for tight work within that “tight system” is paramount. “Injuries of [those types] are challenging to treat,” Dr. Oakey explains. “You need to [make] repairs… in a very strong nature so you can get the fingers moving to avoid scar tissue, but you also have to minimize the bulk of that repair.”
So, a delicate balance must always be kept — a balance between the strength of the repair and the minimizing of scar tissue. Thankfully, since the advent of arthroscopy, this balance is kept with much better regularity than ever before.
Utilizing tools such as 2.7mm arthroscopes and suture lassoes unique to his specialty, Dr. Oakey can make repairs to the wrist joint, clean out and repair torn ligaments, and shave away partially torn pieces of cartilage. “[All of these repairs] can be done very successfully through the scope,” Dr. Oakey ensures, “whereas previously, that was done in an ‘open’ or where you cut through the joint itself.”
Arthroscopy isn’t only better for the patient, it also makes the surgeon’s work easier. “The instrumentation we have is all designed for small-portal arthroscopic surgery,” Dr. Oakey continues. “[With non-minimally invasive surgery] it’s very difficult sometimes to get around the bone because you just don’t have the same visualization you have with an arthroscope.”
It doesn’t stop with arthroscopy. Other methods and tools have been or are being developed to ensure the proper functioning of the human toolset. Lock plates obviate the need for setting a cast, and removed arthritic bone can be replaced using a patient’s own tissue.
Much of these already existing methods and equipment — as well as the special skills necessary to work well within the tight systems of the hand, wrist, and elbow areas — require a little something extra in an orthopedic surgeon to make sure the work is done right and the patient can get back to living life.
“That’s why I did an extra year of training in hand surgery,” Dr. Oakey assuages. “So, I did five years in orthopedics and I did a one year fellowship in hand/upper extremity surgery for that very reason.”
Such information inspires confidence, especially where the complex instrument of the human hand is concerned. Although the hand may not have changed over the years, the tools and abilities in the surgeon’s trade have evolved considerably in order to keep the human toolset in good repair for the years to come.
For more information on any type of orthopedic problem or injury, contact McLean County Orthopedics, 309-663-6461 or visit them online at www.McleanCountyOrthopedics.com. Their new office is located at 1111 Trinity Lane in Bloomington.
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