Your hands, wrists and elbows play an important role in the way you care for yourself, help others and participate in activities. To do these things, these upper extremities depend on a complex system of tendons, muscles, skin, nerves, joints, arteries and ligaments (see Hand Anatomy). An orthopedic hand surgeon with a specialty in hand surgery is trained specifically to care for problems that occur with these structures in both adults and children.
To become a hand specialist, an orthopedic surgeon must undergo special training known as a hand surgery fellowship, which includes intensive study of the hands, wrist and elbow. This fellowship occurs after medical school and a multiyear residency in orthopedic surgery. Upon completion of these thorough training programs and examinations, the orthopedic surgeon is awarded board certification in Surgery of the Hand.
Modern techniques of arthroscopic surgery, microsurgery, Carpal Tunnel Surgery, and platelet rich plasma are becoming increasingly important to the hand surgeon. Arthroscopically assisted surgical techniques are applicable not only to the wrist and elbow, but also to the small joints of the hand. Dr. Pruzansky is one of the few physicians in the country to have board certifications in both Hand Surgery and Orthopaedic Sports Medicine—a combination that enables him to expertly diagnose and treat both professional and weekend athletes who rely on upper extremity strength and dexterity to perform at the highest level possible. In addition, a hand surgery specialist works in concert with both occupational and physical therapists and pays close attention to ergonomic stresses a patient may experience at home or work that might contribute to problems with structures in the hand, wrists, elbows and shoulders.
Hand and Upper Extremity Sports Medicine
The goal of sports medicine of the hand and upper extremities is the prevention and successful treatment of athletic injuries. This is an ever-increasing challenge for the orthopedic surgeon. As athletes—both professional and amateur—acquire more skill and greater training, the hand and upper extremity sports medicine specialist must develop increasingly sophisticated treatments to maintain fitness and prevent injuries. Treating upper extremity problems often requires evaluating the core and legs because of their interdependency in motion and mobility – the kinetic chain. Dr. Pruzansky is one of the few physicians in the country to have board certifications in both Hand Surgery and Orthopaedic Sports Medicine (2.1% worldwide, July 2015).
Today, more than ever, an injured athlete can look forward to a speedy recovery thanks to a team of specialists that includes a hand surgeon also trained in orthopedic sports medicine, a certified athletic trainer and a physical therapist. Coupled with the latest techniques in rapid rehabilitation, arthroscopic surgery and occupational therapy, this team can help prevent further injury and enable the athlete to perform at his or her highest level.
Minimally Invasive Surgery
Minimally Invasive Surgery includes arthroscopic surgery of the wrist, elbow, and shoulder, as well as some of the small joints of the hand. Endoscopic surgery is so named because the tiny surgical scope and instruments are used in anatomic spaces outside of the joints, such as the carpal tunnel. Use of cutting edge techniques with small, precisely located incisions to treat finger, hand, wrist and elbow disorders, generally leads to a quicker and less painful recovery then conventional surgery.
Rapid Rehabilitation signifies maximizing recovery in the shortest safe period of time, utilizing the newest techniques to restore function, strength, coordination and sensation. The concept and practice of Rapid Mobilization is applied to joints, tendons, muscles and ligaments to accelerate tissue remodeling, sharpen proprioception, and to reduce joint adhesions and athletic deconditioning. Working with physical and occupational therapists, Dr. Pruzansky himself, directly supervises the exercise and splinting programs, progressing the patient in their rehabilitation by evaluating each person, individually. During these meetings each patient has their questions addressed, their progress noted, and their rehabilitation program updated. Sport-specific exercises are introduced at the appropriate stage in the patient’s recovery.