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Doctor Q&A for Dr. Andrew Bronstein

A 33-year-old male asked:
Dr. Andrew Bronstein
Hand Surgery 36 years experience
Healing: The improvement is encouraging and a step away from surgery. As long as immobilization and or injection(s) up to three have improved the condition than surgery is not warranted. The tfcc can be considered healed when asymptomatic. If rarely painful, fully functional, then surgery is not warranted regardless of MRI finding. 30% of people older than 30 have mris with tfcc changes w/o injury.
A female asked:
Dr. Andrew Bronstein
Hand Surgery 36 years experience
Test / Surgery: If no studies done, a routine x-ray followed by a triple arthogram with or without mri. If confirms clinical findings then an arthroscopic evaluation and debridement (shaving) vs. Repair should be entertained. It sounds like in your situation, that conservative care has been exhausted.
A 26-year-old male asked:
Dr. Andrew Bronstein
Hand Surgery 36 years experience
X-ray, less pain: The typical way to follow a fractured forearm is by taking serial x-rays (over sequential weeks) and eventual less pain followed by greater function.
A 26-year-old male asked:
Dr. Andrew Bronstein
Hand Surgery 36 years experience
Yes: After confirmed healing on x-ray and re-gaining range of motion through home exercise and/or therapy.
A 42-year-old member asked:
Dr. Andrew Bronstein
Hand Surgery 36 years experience
Depends: Typically all fractures require immobilization. If a closed fracture, non-displaced then typically splinting/casting. If displaced then closed versus surgical reduction of the fracture with or without pins/plates/screws followed by a period of immobilization. If the bone punctured through the skin, definite surgery to wash then fix.
A 24-year-old male asked:
Dr. Andrew Bronstein
Hand Surgery 36 years experience
Yes: Depending on the severity of the deformity and fracture, and level of function, a decision can be made to immobilize it until healed again, or to remove the hardware and re-address the fracture surgically. Often with malunions this requires cutting the bone, re-setting and fixing it and probable augmentation with bone graft and immobilization.
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A 26-year-old male asked:
Dr. Andrew Bronstein
Hand Surgery 36 years experience
Update x-ray, Yes: Changing casts monthly is typically routine. Also typical is to obtain regular x-rays to chart the healing process. When in doubt, x-ray before cast removal.
A 24-year-old female asked:
Dr. Andrew Bronstein
Hand Surgery 36 years experience
Minimal: Assuming minimal to no displacement of the fracture fragments (aka buckle fracture), typically these fractures heal within 4-6 weeks in this age group.
A 29-year-old female asked:
Dr. Andrew Bronstein
Hand Surgery 36 years experience
Tendintis vs. CTS: Both diagnoses, dequervain's tendinitis and carpal tunnel syndrome can be seen in "new" moms. Dequervain's is more common with pain at the wrist below the thumb. It can be painful with breastfeeding due to sustained posture. Carpal tunnel would be associated with pain, numbness noted when awakening. It also can be caused by extreme wrist posture while breast feeding. Both can respond to splints.
A 44-year-old member asked:
Dr. Andrew Bronstein
Hand Surgery 36 years experience
Depends: Depends on the severity of the "crack." if it is a confirmed non-displaced fracture, then typically it would be immobilized 4-6 weeks with confirmed healing on x-ray to come out of the splint.
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