We rely on our hands every day, but arthritis, trauma and repetitive movements can take its toll, leading to debilitating pain and stiffness. Our team of specialty-trained hand surgeons, hand-certified therapists and staff work together to improve function, reduce pain and get you back to doing the things you love.
Widely respected for our hand and wrist expertise, Panorama Orthopedics serves as a trauma referral center for hand and wrist injuries.
Our doctors see the toughest cases and are experienced in everything from carpal tunnel syndrome and arthritis to hand surgery for complex fractures and revision surgery. Additionally, Panorama diagnoses and treats a wide variety of traumatic, inflammatory, arthritic and overuse disorders. Other commonly encountered problems include trigger finger, tennis elbow, ganglion cysts and tendonitis.
Our doctors are considered leaders in their field, having undergone extensive training to treat the most complex cases.
After discussing different options, our physicians will design customized treatment plans based on your individual needs. We use non-surgical/conservative treatments when appropriate. In fact, many patients can be helped through rest, bracing, ice, medication, injections or physical therapy. When surgery is necessary, it is done at facilities that specialize only in orthopedics, Golden Ridge Surgery Center, South Denver Surgery Center and OrthoColorado Hospital.
Services offered at Panorama Orthopedics across Denver and the Front Range area include:
finger surgery
small joint arthroscopy
minimally invasive techniques
carpal tunnel surgery
Micro surgery and nerve reconstruction
Wrist Fractures - A Common Colorado Injury
A broken wrist (also called a fractured wrist) is a very common injury and it can happen to anyone at any age, although aging individuals with thinning bones (osteoporosis) are most often at risk. We see patients for fractures caused by everything from mountain biking and snowboarding to slipping on ice or falling from a ladder. Breaks often occur when people extend a hand backwards or forwards to catch a fall. There’s even an acronym for that – FOOSH or falling on an outstretched hand.
An X-ray can usually confirm whether or not your wrist is broken or simply sprained. The most common symptoms of a fracture include severe ongoing pain, swelling near the wrist, tenderness, stiffness, numbness and an inability to move your wrist or thumb. In some cases, the fracture results in an obvious deformity such as a bent wrist. Although there are many different types of fractures, the treatment depends upon whether or not the fracture is non-displaced or displaced.
Non-displaced fracture: refers to a break in which the bones stay in their original position. These types of fractures are most often treated with a cast to keep the bones stable as they heal.
During treatment, patients need to be monitored closely with X-rays (usually every two weeks) to ensure the fracture hasn’t shifted. (If the break does shift, your doctor may recommend surgery.)
Generally, it takes six weeks for the bones to knit together before the cast is removed. After eight to ten weeks, patients can return to all of their normal activities, including more extreme sports such as snowboarding, mountain biking and rock climbing. Within three months, the wrist generally regains its full strength and within six months it should feel normal again.
Displaced fracture: refers to a break in which the bones have shifted out of place. These types of fractures often require surgery to reposition the bones so your wrist heals straight. In the vast majority of cases, surgery involves making an incision on the palm side of the wrist, aligning the bones and then fixing them in place with an ultra-thin plate secured with tiny surgical screws. Surgery typically takes about an hour to an hour and a half and doesn’t require an overnight stay. The plate won’t trigger airport security systems and is undetectable under your skin. The plate is not typically removed once the bone has healed because it’s not worth the increased health risk or added cost to the patient. Surgery follows the same general healing timeline as casting, which is six weeks to heal, three months to regain full strength and six months for the wrist to feel normal again. In extreme injuries, such as those sustained in a car accident, your wrist may always feel slightly different.
For both types of fractures, we advise that patients only use the injured hand for light activities while healing (no lifting items over five pounds) and that they take 500 mg. of vitamin C for fifty days to support soft tissue healing. Fortunately, with wrist fractures, most individuals are able to regain full use and range of motion in their hand once the healing is complete.
Sara Gets Back to Life after a Broken Wrist
Dr. Froelich Discusses Trigger Finger
Carpal Tunnel
Carpal tunnel syndrome is one of the most common conditions we treat. This condition occurs when tissues swell in the wrist, putting pressure on an important nerve that controls feeling in parts of the hand. The carpal tunnel is the narrow structure in the wrist through which this nerve and important tendons pass into the hand and fingers.
If you are experiencing a painful “pins and needles” sensation or numbness, it’s important not to ignore the symptoms. Nighttime splinting may be all that is needed to relieve pressure on the median nerve and prevent the condition from progressing.
For more advanced cases, additional treatment options include splinting or bracing during certain daytime activities, anti-inflammatory medications or corticosteroid injections. Carpal tunnel release surgery may be necessary in severe or long-standing cases of carpal tunnel syndrome to prevent permanent nerve damage.
Our physicians are experienced in advanced options for hand surgery, including minimally invasive techniques and arthroscopic approaches, which result in less pain and a faster recovery. For example, Panorama patients undergoing surgery for carpal tunnel release experience greater than a 90 percent reduction in pain.
When A Hand Surgeon Treats The Elbow
Patients with Elbow injuries are often left wondering who will best treat their condition. Many elbow injuries are treated by sports medicine doctors, but there are times where you may see a hand surgeon for the treatment of an elbow conditions as well.
Dr Sameer Lodha is one of Panorama’s expert hand surgeons, but he also routinely performs complicated elbow surgeries.
His expertise as a hand surgeon, as well as his specialized training in the wrist and elbow, helps enable him to deliver successful outcomes to patients suffering from elbow pain.
“Hand surgeons have experience with nerve anatomy and are comfortable operating around the complicated neurovascular structure of the elbow,” Dr. Lodha said. “More and more, the elbow is coming into the hand surgeon’s sphere of treatment.”
Dr. Lodha commonly treats elbow patients for cubital tunnel syndrome, which occurs when one of the main nerves in the arm, the ulnar nerve, becomes compressed and impairs hand function.
“Elbow pathology is extremely complicated, and the main concern is always the risk of injury to nerves and arteries that cross the elbow,” Dr. Lodha said. “We see a tremendous volume of elbow surgeries because people recognize the level of experience we have treating this very difficult joint.”
The team of highly specialized orthopedic surgeons at Panorama Orthopedics & Spine Center in metro Denver addresses the full range of conditions that affect the elbow, including fractures, tendon ruptures, ligament injuries, and arthritis. In fact, Panorama’s Dr. David Schneider is amongst the surgeons performing the most elbow replacements in the Rocky Mountain Region.
“An impaired elbow is debilitating for patients,” Dr. Lodha said. “The elbow is essential in positioning the hand in space; people with limited motion, pain or instability in the elbow struggle to do even basic tasks that most of us take for granted, like feeding ourselves. Within Panorama, we are fortunate to have experts who specialize in different areas of elbow treatment so we can direct patients to the best person and get them the treatment they need.”
Thumb Arthritis - A Common Problem
Does it hurt your hand to open a jar? Or grab your car keys? You could be suffering from thumb arthritis. Thumb arthritis happens when cartilage wears away from the joint at the base of the thumb. It can cause severe pain and swelling. It can also impact strength and range of motion.
Thumb arthritis is very common – it’s one of the top three conditions we treat at Panorama Orthopedics. And for no clear reason, women are six times more likely than men to experience the condition. Because they are at greater risk than men, women should be aware of the condition and watch for signs of pain, especially if they are over 50 or post-menopausal.
Thumb arthritis can be caused by an injury to the base of the thumb, a fracture, or dislocation of the joint. It can also be caused by rheumatoid arthritis or lupus. In most cases, the cause of arthritis is unknown.
What are the treatment options? If you’re experiencing discomfort in your hand or thumb, the first step is to talk to your primary care doctor. He or she can assess your pain and adjust any medication you may be on if needed. From there, your doctor may place your hand in a splint, or prescribe anti-inflammatory medication or physical therapy.
Injections and surgery. If these defenses do not work, it may be time to visit a hand specialist. This doctor may recommend a clinical steroid injection in the joint or joints that are in pain. These injections are low-risk and can provide pain relief for up to three to six months.
A final option for how to treat thumb arthritis is surgery. While there are many different surgical interventions, most involve removing the tiny bone that is causing the inflammation. People who undergo surgery often report pain relief, along with improved strength and range of motion.
Hand Pain and Numbness from Ulnar Nerve Entrapment
