Typical Orthopaedic Surgeries
- What Is Arthroscopy?
This is a surgery done through tiny incisions ("poke holes") about ˝”
each. A tiny telescope-like device attached to a camera is inserted and
allows the physician to see the inside of joints. The arthroscopy allows
the physician to see a magnification up to 40 times. Small biters,
shavers, and other tools can be use to clean up or repair tears in
menisci, ligaments, etc. Using arthroscopy, the physician can often see
more detail than with open surgery. The small incisions through muscle
causes less pain than larger ones and provides a quicker rehabilitation
- What is a Rotator Cuff Repair?
The rotator cuff (see above) is reattached to the upper arm bone (the
humerus). This is most often done with stitches attached to plastic, or
metal tacks, or screws. The tacks or screws are placed in the bone and
the stitch is placed through the torn part of the rotator cuff so the
rotator cuff is now attached again to the bone. Patients with this
condition are usually in a sling for about 4 weeks and cannot do any
lifting for about 6 weeks.
- What is ACL Reconstruction?
A variety of tissues/structures can be used to reconstruct/replace the
ACL. The most common are the patellar tendon in the front of knee and
the hamstring tendons in the back of the knee. Your own tendon (autograft)
or one from a cadaver (allograft) can be used. Your body essentially
uses these tendons as "scaffolds" to show it where to "grow" a new
ligament. First, blood vessels grow in and then new ligament cells
follow. That is why when autograft is used, the new "ligament" is
actually the weakest from 4 to 6 months after surgery, when the blood
vessels and the cells are still "growing." When an allograft is used, it
takes longer for blood vessels and the cells to start growing- sometimes
years. Usually, a long leg hinged brace is used for the first 6 weeks
and crutches for the first 2 to 4 weeks. Physical therapy is an
important part of the recovery process and is started immediately. Dr.
Dunbar typically allows patients to start a running program around 4
months after surgery, start light sports at 6 months, and return to full
sports around 8 to 9 months after surgery.
- What is Open Repair of Ankle Fractures?
There are three malleoli in the ankle, which are the prominences (or
bumps) you see on the inside and outside of the ankle. The one on the
inside is the medial malleolis which is part of the tibia or shin bone,
while the one on the outside is the lateral malleolis and is part of the
fibula or smaller bone in the leg. The posterior malleolis is a bump on
the back of the tibia or shinbone but you cannot see it from the
Ankle fractures almost always involve the ankle joint. If the bone is
out of place and heals without the joint surface being smooth, it can
act like sandpaper and wear away the cartilage, thus leading to
arthritis. That is why surgery is often done for ankle fractures. A thin
plate and screws are often used on the lateral malleolis (fibula), and
screws and pins are usually used to fix the medial malleolis. The
posterior malleolis may or may not require a screw to fix it. After
surgery you may be in a splint, a cast or a fracture boot.
One of the other advantages of surgery for an ankle fracture is that you
can usually start moving the ankle sooner. This may help prevent
stiffness during the recovery process.
- About Wrist Fractures
Wrist fractures can be treated in a variety of ways depending on whether
they are "in place" or "out of place," and whether they involve the
joint. Fractures that are completely "in place" are usually treated with
a cast or brace. Fractures that are "out of place" or involve the joint
may require manipulating the bone back into place. Successfully holding
the bone in place may require a cast, pins, plate and screws or an
external fixator. An external fixator is a device in which pins are
placed through the skin and through the bone at places away from the
fracture. Bars connect the pins and keep traction across the fracture
which keeps the bone from collapsing back out of place. While this may
look odd or scary, it actually helps in the same way as if the doctor
were walking around with you trying to keep the fracture in place while
holding the bone.
- What is Carpal Tunnel Syndrome?
In this procedure, the top of the tunnel is opened up to release the
pressure on the tendon and nerve. This allows the nerve to shrink back
to its normal size. Depending on how much damage has already been done
to the nerve, you may or may not have all of your symptoms go away. Pain
usually goes away right away, but full feeling and strength may never
return. The surgery is done as an outpatient and often with just a local
- What is "Trigger Finger" Release?
In this surgery the pulley is cut and allowed to heal in a more
opened-up position like a "drawbridge." (This is also like letting out
the waistband of those shrunken jeans!) This is usually done as an
outpatient procedure and often with a local anesthetic.
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