Specialties

Dr. Carroll treats hand problems, upper extremity problems, general orthopedic issues and rehabilitation. 

Hand Surgery

Anatomy, complexity and perhaps art are some of the words that define Hand Surgery. Issues can range from trauma and replantation of amputated digits to simple laceration care to nerve and tendon injuries to tendonitis, trigger finger and Dupuytren's disease where the fingers curl into the palm. Education and rehablitation are essential components of allowing for optimal function. Surgery is a follow up to conservative care in many cases where the non-operative care is not succesful. No problem is too small to have a patient centered discussion and arrive at a solution to promote function and patient autonomy.

Hand Fracture Fixation

Many hand fractures can be treated with splints or casts. In 3 to 6 weeks, many of these fractues will heal but will require 6 to 8 weeks or more of rehabilitation to regain motion and function. Fractures with poor reduction (out of place) may require surgical fixation and repair with wires, pins, plates and screws that are placed in an outpatient operating room. Injuries to the thumb and finger joints can require surgical fixation when displaced to restore smooth joint gliding surfaces and minimize the risk of arthritis and loss of function. Post surgical care follows for dressings and splints for a total of 6 to 8 weeks. Therapy will ustilised for 2 to 4 months to regain motion and strength. Swelling may take 6+ months to fully resolve. A good outcome can be expected with return to many functions in 2 to 3 months. Pins may require removal 6 weeks after placement. Many plates and screws are not removed and if necessary (due to discomfort or tendon interference) removal can be done at 6 to 12 months post placement under a regional or local anesthetic in an outpatient setting.

Wrist, Elbow, Shoulder and Knee Arthroscopy

Many orthopedic conditions do not require surgical care. In those that necesssitate surgical care, minimally invasive techniqus can be utilised. Small incisions can be employed with video guidance. Cartilage tears and joint pathology can be diagnosed and treated without significant soft tissue invasion and shorter recovery. Outpatient regional anesthesia can be used with less impact on the patient. Early rehabilitation may be appropriate as well. We will consider arthroscopic care and minimally invasive care where it it is apropriate and optimal for upper extremity and knee injuries. Appropriate referral for hip and complex knee issues will be considered as well.

Carpal Tunnel Release and Cubital Tunnel Release

Numbness and tingling in the thumb, index, long and ring finger can be carpal tunnel syndrome. This condition is due to compression of the median nerve at the wrist. The ulnar nerve at the medial elbow (funny bone) may become compressed and cause similar symptoms in the ring and small fingers. Splinting and therapy may allow for resolution. Nerve conduction/ EMG studies may be necessary to evaluate the median nerve at the wrist (carpal tunnel syndrome) and the ulnar nerve at the elbow (cubital tunnel syndrome). Minimally invasive techniques can be utilised where non- surgical care is not succesful. Therapy may follow for 6 to 12 weeks. A good outcome is probable with return to life activities over 3 months or earlier.

Dupuytren's Hand Care

As we mature, a small segment of the population develop lumps and cords in their palms. These will need to be evaluated as the changes could be a cyst or something more difficult. Over time, the cords can contract and pull our fingers into our palms. Contractures can occur to the metacarpophlangeal (first) joint, the proximal interphalangeal (second) joint and even the distal interphalangeal (end) joint of our fingers. Some contractures will be slow to advance but others can continue to pull and interfere with function. Non-operative and operative care could be indicated and helpful to allow one to remain active. At times a surgical release and excison of diseased tissue as an outpatient can be performed. That combined with post surgical wound care, splinting and therapy can allow for better function. The condition will need to be followed as there is a risk of some form of recurrence over time (up to 50%). Left untreated the condition can advance and limit hand function. Judicious care can improve the quality of life for those with this degenerative and often inherited condition.