Today, I helped interview the 2021-2022 class for Baylor College of Medicine's hand surgery fellowship. The applicants were extremely qualified. It seems that it gets more competitive every year. It's nice to be reminded of the bright people that give up their youth to get extra training so they can be masters of their craft. It's also a great privelege that I can help train the next wave of hand surgeons.
Sports injuries occur frequently. While many are just "sprains", one should not overlook the injuries as they can become chronic injuries with negative longterm outcomes. In our wrist, for instance, we have many ligaments that control the fine movement between the various wrist bones (carpal bones). One of the most important is the scapholunate ligament, which can be injured when one forcibly lands on his/her wrist.
I was recently board certified by the American Board of Orthopedic Surgeons (ABOS) after passing the Part II of my exam. The Part I of the exam is taken shortly after residency and involves 275 questions on various topics in orthopedic surgery. After passing this test, an orthopedic surgeon becomes board eligible and may be offered to take Part II of the exam.
Skier's thumb, which sometimes is termed Gamekeeper's thumb (for a chronic injury), is an injury to the ulnar collateral ligament (UCL) of the thumb. Essentially, the thumb will typically be pulled "outwards" away from the small finger. This causes significant pain on the inside of the thumb. Sprains or tears without retraction can sometimes be treated with a splint or a brace for 4-6 weeks. However, there are times when the ligament itself will be displaced, and sometimes even trapped above a structure called the adductor aponeurosis. When this happens, it's called a Stener lesion, and surgical repair is indicated.
Carpal tunnel syndrome is a condition that causes numbness and tingling in the hand. Predominantly, it affects the thumb, index, middle and part of the ring finger. It is caused by constriction around a nerve called the median nerve in the wrist area. While we always strive to treat the condition non-operatively with changes to our activities, nighttime wrist bracing, and anti-inflammatories, there are times when we have to operate to get symptom relief.