Conditions Treated

Learn about conditions treated by Dr. Berschback.

Wrist Fractures

A broken wrist, or a wrist fracture, can happen for a variety of reason.  A wrist can break during a sports injury, a vehicle crash or when falling or slipping on an outstretched hand.  The wrist is a complex joint made up of bones, ligaments and muscles and a fracture should be looked at by an orthopedic doctor.  If untreated with a cast, medication, ice or arthroscopic surgery, a broken wrist could lead to ongoing stiffness, osteoarthritis or circulation problems.  Sometimes it can be difficult to know if you have a broken wrist or a wrist sprain.  See below for common symptoms of a fractured wrist.

Wrist Fracture Symptoms

  • Severe pain and swelling
  • Tenderness and bruising
  • Bent or deformed wrist
  • Wrist, hand or finger stiffness

Treating Wrist Fractures

Different wrist fractures may be treated in different ways such as a split, cast, medication, icing or arthroscopy.  Dr. Berschback, a board certified orthopedic surgeon in Eau Claire, will help find the right treatment for your fracture.  Treatment methods for helping a broken wrist heal may include a splint or cast to demobilize the injured area and allow the fractured bone(s) to align.  Pain medications, icing the injured area and elevating the wrist may also ease pain and swelling during the recovery process.  Other methods for treating a broken wrist may include therapy and/or arthroscopic wrist surgery Arthroscopy is a minimally invasive procedure where your surgeon is able to look inside the joint using small instruments and treat the problem area.

Tennis Elbow

Tennis elbow, or lateral epicondylitis, is an inflammation of tendons that may be damaged from overuse. Unsurprisingly, it is often caused by overuse in sports such as tennis or other racquet sports; however, there are several other activities that may also put you at risk. Repeating the same motions over and over again can lead to damage, creating an inflammation of the tendons that join your forearm muscles, and the pain associated with it.

Treating Tennis Elbow

There are many treatment options for tennis elbow, aimed at reducing pain and ultimately recovering from the condition. Your primary doctor, physical therapist, and orthopedic surgeon will work together to decide on and provide the most effective care for you. 80-95% of patients with tennis elbow symptoms will recover without surgery. Non-surgical remedies include:

  • Rest
  • Anti-inflammatory medicines
  • Physical therapy
  • Brace
  • Steroid injections

If your symptoms do not improve in 6-12 months, your doctor may recommend surgery. The right type of surgery will depend on the severity of your injury, your personal needs, and your general health. Talk with your doctor to decide on the right surgical approach for you:

  • Open surgery – This is the most common surgical treatment for tennis elbow. It is an outpatient surgery and rarely requires an overnight stay.
  • Arthroscopic surgery – Using miniature instruments and creating small incisions, tennis elbow can also be repaired with arthroscopic, out-patient surgery.

After surgery, your arm may be immobilized with a splint. Splints are often only necessary for about a week, and will be removed after that. After the splint is taken off, you may begin exercises aimed at restoring strength and flexibility.

Tennis elbow surgery has been found successful in 80-90% of patients; however, a loss of strength in the elbow is not uncommon.

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Rotator Cuff Tears

Rotator cuff tears are common among adults. It is a major cause of pain and weakness in the shoulder. Daily activities will become limited, such as combing your hair or getting dressed. These activities may be difficult and very painful to do on a daily basis.

Your shoulder is a ball-and-socket joint. Your arm is kept in your shoulder socket by your rotator cuff. The rotator cuff helps to lift and rotate your arm. When your rotator cuff endures a tear, the tendon no longer attaches to the shoulder. Torn tendons typically begin by fraying, and as damage progresses, rotator cuffs can tear completely.

There are several factors that may contribute to a rotator cuff tear:

  • Repetitive stress – Repeating the same motions over and over again creates stress on your rotator cuff muscles and tendons.
  • Lack of blood supply – Without a good blood supply, the human body’s ability to repair damage to the tendons is weakened.
  • Bone spurs – Bone overgrowth is likely to happen as we age, and the spurs rub on the rotator cuff tendon. This will weaken the tendon over time, making it more likely to tear.

Treating Rotator Cuff Tears

About half of patients will respond to non-surgical treatment to relieve shoulder pain without rotator cuff surgery; however, shoulder strength is not likely to improve without surgery. Many popular non-surgical treatment options include:

  • Rest
  • Avoid activities that induce shoulder pain
  • Anti-inflammatory medication
  • Physical therapy and other strengthening exercises
  • Steroid injections

Your doctor may recommend rotator cuff surgery if you continue to experience shoulder pain. If your symptoms last longer than 6-12 months, or if you have significant weakness and loss of function, your doctor may also recommend rotator cuff surgery options. Your orthopedic surgeon will discuss the best procedure to meet your needs.

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Osteoarthritis of the Shoulder

Osteoarthritis is wear and tear of the shoulder joint. Over time, the smooth cartilage that cushions the bone cracks and thins. This leads to the bones in the joint rubbing together. This causes shoulder pain and inflammation, and the roughened bone may create growths called bone spurs. The joint becomes very stiff and painful and may “catch” when it moves. There are a variety of treatments that can be used to help address and heal your shoulder pain, most of which do not include surgery. The earlier you start treatment, the sooner you can enjoy your life again, free of shoulder pain.

Treatment for Osteoarthritis of the Shoulder

Imaging tests help to look inside the shoulder and rule out other possible problems. You may have one or more of the following tests:

  • X-rays
  • Ultrasound
  • CT Scan
  • MRI
  • Arthrograms

You may also have a combination of the most common treatment options:

  • Active rest
  • Icing and heat
  • Medication
  • Injection therapy
  • Exercise

Based on the evaluation of your shoulder joint, you may have several surgical options for treatment:

  • Arthroscopy
  • Shoulder replacement, in extreme cases

You will discuss these options with your surgeon and together you will decide on the best surgical, or non-surgical, treatment option for you. Replacement surgery is often very successful and may offer the best option for relieving your shoulder pain.

 

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome is a condition brought on by increased pressure in your wrist. Essentially, it is a pinched nerve at the wrist. Carpal Tunnel Syndrome symptoms may include: numbness, tingling, and pain in the arm, hand, and fingers. The numbness and tingling usually occur in the thumb, index, middle, and ring fingers. Some patients may notice a weaker grip, occasional clumsiness, and a tendency to drop things. In severe cases of carpal tunnel syndrome, sensation may be permanently lost and the muscles at the base of the thumb slowly shrink, causing difficulty with pinching.

Carpal Tunnel Syndrome Treatment

Carpal Tunnel Syndrome symptoms may be treated and relieved without surgery. Treatment of Carpal Tunnel Syndrome can include wearing wrist splints, which will keep the wrist in a straight position and may help reduce pressure on the nerve. A steroid injection into the carpal tunnel may help relieve swelling around the nerve. If Carpal Tunnel symptoms do not improve, surgery may be needed to make more room for the nerve. To decrease the pressure on the nerve, the ligament that forms on the top of the tunnel will be cut. The goal of carpal tunnel release surgery is to free the ligament, allowing more room for the nerve in the carpal tunnel. To learn more about Carpal Tunnel Syndrome treatment with Dr. Berschback, click here.

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Extensor Tendon Injuries

Extensor tendons are located on the back of the hand and fingers, directly on the bone. The extensor tendons in your hand allow you to straighten your fingers and thumb, and they are attached to the muscles in your forearm. Because extensor tendons are just under the skin, even a minor cut could injure them. After an injury to the extensor tendon, straightening one or more joints becomes difficult. To return use to the joints and tendons, treatment will be necessary.

Extensor Tendon Treatment

Treating extensor tendon injuries may differ based on the nature of the injury. For instance, a cut that splits the tendon may require stitches, while jamming injuries are typically treated with a splint. If your hand doctor recommends a splint, the splint should be worn as the doctor directs, at all times, until the tendon is fully healed. In some instances, a pin is placed through the bone as an internal splint to complement the external splint.

Osteoarthritis of the Hand

Osteoarthritis is a degenerative joint disease. When the cartilage covering the bone surfaces of your hand wears out, you will experience stiffness, swelling, and pain. Osteoarthritis in the hand can develop in four main areas:

  • The Base of the Thumb
  • The Fingertip End Joint
  • The Middle Joint of a Finger
  • The Wrist

Osteoarthritis in the hand may cause deep, aching pain, and it may make it seemingly difficult to complete daily tasks, such as turning keys or opening jars. Osteoarthritis in the wrist may cause pain, swelling, and stiffness.

Treating Osteoarthritis of the Hand

To treat osteoarthritis of the hand, anti-inflammatory medication may relieve pain. Finger or wrist splints, as well as soft sleeves, may help relieve pain at night or for selected activities. It is important to maintain motion and continue using your hand as much as possible. Hand therapy is helpful in order to regain range of motion and to keep the joints limber. Surgery is not typically recommended; however, it becomes an option when the patient has too much pain or too little function. Joint fusion may be used to relieve pain by fusing the bones on each side of the joint are fused together, eliminating motion from the joint. Joint reconstruction is another surgical option, in which the joint surface is removed. This eliminates the bone-to-bone contact that causes pain. Which treatment option is used will depend on the joint(s) involved, your activities and needs, and what your hand surgeon believes is the most appropriate for you.

Rheumatoid Arthritis of the Hand

Rheumatoid arthritis affects the synovial tissue of your hand, or the cells that normally lubricate the joints. It most commonly affects the wrist and finger knuckles. Rheumatoid arthritis of the hand causes the joint tissue lining to become inflamed and swollen, resulting in a sausage-shaped finger. The swelling may stretch the cartilage and bone, and the tissue may stretch the surrounding ligaments. This will result in visual deformity and overall instability.

Treating Rheumatoid Arthritis of the Hand

Rheumatoid arthritis of the hand inflames the tendons and joints in your hand. Medications can be prescribed to decrease the inflammation, as well as reduce pain. They may even slow the progression of the disease. Several new disease-modifying treatment medications may also help suppress the body’s immune system to reduce pain and inflammation. To help relieve pain and protect your joints, you may be referred to a hand therapist for exercises and instruction on how to use your hand in alternate ways that are not as painful.

In some Rheumatoid arthritis cases, preventative surgery is recommended and may include: removing nodules and releasing pressure on tendons. If a tendon has ruptured, your hand surgeon will be able to repair it with a tendon transfer or graft. Surgery to treat the joints in the hand that are affected by rheumatoid arthritis include: joint replacements, removal of the inflamed joint linings, and possibly removal of the damaged bone. Your hand surgeon will help you decide on the most effective and necessary treatment option.

Flexor Tendon Injuries

Flexor muscles in the hand allow the finger to bend, or flex. These muscles move the fingers though tendons that connect to muscles to the bone. Deep cuts to the inside of the wrist, hand, or fingers, may injure the flexor tendons, as well as the nerves and blood vessels. Although the injury may look like a simple cut on the outside, the damage is actually much more complex on the inside. Tendons act like rubber bands, and when they are cut, the ends pull away from each other and the joints cannot bend on their own. If the tendon has not been cut through completely, the finger may still be able to bend but can cause pain, or eventually tear completely.

Treating Flexor Tendon Injuries

Flexor tendons are made up of living cells. Healing begins if the cut ends of the tendon can be brought back together in the cells of the inside of the tendon, as well as the tissue outside of the tendon. Typically the cut ends of a flexor tendon will separate, and in this case surgery is necessary in order to heal. Your hand surgeon will advise on how soon after the injury surgery is needed. After surgery the tendon may either need to be protected from movement altogether, or begin on a very limited movement program. Hand therapy is sometimes necessary in order to regain full range of motion. Healing after a flexor tendon injury may take up to three months after the surgery.

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Hand Fractures

No two hand fractures are alike. A broken hand can range from a tiny hairline crack in the bone, to a bone that has broken through the skin. A fracture can occur anywhere in your hand, and it can affect how your entire hand moves. Hand fractures can cause pain, throbbing, swelling, and in some cases, limited hand and finger mobility.

Treating Hand Fractures

Fractured bones start to heal on their own right away. A treatment process called reduction also assists in the healing process that repositions your bones. The goal is to get them as close as possible to how they were before the hand fracture. Both splints and casts limit the movement in your finger or arm to keep your fracture in the best position for healing. A pin, screw, or plate also helps keep the bone(s) stable and in place as it heals. Healing can take about 6 weeks.

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Mallet Finger (Softball Finger)

Mallet finger is a common extensor tendon injury. Mallet finger, or softball finger, refers to the end joint of a finger where the tendon has been separated or cut from the bone. This injury results in a fingertip that cannot straighten. Whether the injury stemmed from a cut or a jam to the finger, a splint is typically necessary in order to treat mallet finger. The splint is used to keep the tip of the finger straight until fully healed. Mallet finger injuries can take four to eight weeks to heal completely.

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Thumb Sprains

A sprain is an injury, typically caused by a wrench or twist, to a ligament. Thumb sprains occur when the thumb is jammed, or in an extreme position, causing a sprain injury. Sprains make moving the thumb very painful, and may include swelling and/or bruising. The most common thumb sprain injures the ulnar collateral ligament, also called “Skier’s Thumb.” It is called this because it typically occurs when a skier falls and bends their thumb in an extreme position. The ulnar collateral ligament may also be jammed when falling on the ground or onto something hard. The radial collateral ligament may also be injured, but it’s less common.

Treating Thumb Sprains

To ensure that the thumb is not fractured, your hand doctor will take X-rays of the thumb and hand. If the bones are not broken, your doctor will examine whether or not the ligament is torn. If the ligament in the thumb is partially torn, the injury will require a splint or cast in order to heal. If the ligament tissue is of poor quality, the ligament may need to be reconstructed. If arthritis is present, joint fusion may be necessary. Some patients may benefit from cortisone injections or surgery. Your hand surgeon will determine the best course of action in treating your thumb sprain(s).

Arthritis in Hands

Arthritis literally means “inflamed joint.” Normally a joint consists of two smooth, cartilage-covered bone surfaces that fit together and move smoothly against one another. Arthritis results when these smooth surfaces become irregular and don’t fit well together anymore–they wear out. Often, arthritis symptoms are gradual. For questions about arthritis in hands treatment in Eau Claire, contact Dr. Berschback today.

 

Hand arthritis symptoms include:

  • Joint pain in fingers, thumb or wrist
  • Finger stiffness or swelling
  • Loss of motion  in hand joints or muscles
  • Growth of bony bumps around joints

Each hand has 19 bones, plus 8 small bones, and the two forearm bones that form the wrist. Arthritis in hands can be both painful and disabling. The most common forms of arthritis of the hand are osteoarthritis, post-traumatic arthritis (after an injury), and rheumatoid arthritis.

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Arthritis of the Thumb

In a normal joint, cartilage covers the end of the bones to serve as a shock absorber to allow smooth, pain-free movement. In osteoarthritis the cartilage layer wears out. This produces direct contact between the bones and produces pain and deformity. One of the most common joints to develop osteoarthritis in the hand is the base of the thumb. The thumb basal joint, also known as the carpometacarpal joint, is a saddle-shaped joint that is formed by a small bone of the wrist and the first bone of the thumb. Pressure and movement, such as twisting, will produce pain at the joint in the form of a grinding sensation.

Treatment of Arthritis of the Thumb

Thumb Arthritis will usually respond to non-surgical care. Medication, splinting, and limited cortisone injections may help alleviate pain. Patients with advanced disease or who fail non-surgical treatment may be candidates for surgical reconstruction. Surgical procedures include removal of arthritic bone and joint reconstruction (arthroplasty), joint fusion, bone realignment, and arthroscopy in some cases. A consultation with your hand surgeon will help decide the best option for you.

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Boutonnière Deformity

Boutonnière deformity is a common extensor tendon injury. Boutonnière deformity is a condition resulting from a cut or tear in the tendon of the middle joint of your finger. This prevents your finger from straightening and requires a splint. Splinting the middle joint of an injured finger is necessary in order to treat boutonnière deformity. Stitches are needed occasionally, when the tendon has been cut or torn. If the deformity is not treated, the finger may become more bent and stiffen to this position permanently. Typically, splints should be worn for four to eight weeks, or to the length your hand doctor recommends.

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De Quervain’s Tenosynovitis

De Quervain’s Tenosynovitis induces painful tendons along the thumb side of the wrist. In De Quervain syndrome, the tendon tunnel runs narrow, due to the thickening of the soft tissues. Motion in the hand and thumb causes pain, especially with grasping or twisting motions. Some patients describe the pain as inflammation; however, studies show that De Quervain syndrome is not inflammatory. Pain caused by de Quervain syndrome can affect patients of all ages and is especially common in new mothers. Symptoms develop four to eight weeks after delivery, due to possible changes in hormones and swelling.

Treating De Quervain’s Tenosynovitis Eau Claire

Treatments for De Quervain’s Tenosynovitis may vary, based on the severity of the pain associated with it. Treatments that may relieve symptoms temporarily include splinting the thumb and wrist, as well as Tylenol or aspirin-type medications. Treatments that may alter the course of the disease include steroid injections and, in extreme cases, surgery. Surgery allows the tunnel to become open which allows more room for the tendons.

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Dupuytren’s Contracture

Dupuytren’s Contracture is a condition resulting in loss of range of motion. It is an abnormal thickening in the ring and pinky fingers that is typically inherited. This disease is often painless, but it can restrict movement and decrease ability to straighten the fingers. Your hand surgeon can help restore motion by repairing, removing, or replacing the tissue causing the contracture.

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Ganglion Cyst of the Wrist and Hand

Ganglion cysts are lumps within the hand and wrist that occur adjacent to joints or tendons. They are fairly common and often resemble a water balloon on a stalk, filled with clear fluid or gel. Ganglion Cyst of the Wrist and Hand may change in size or disappear completely, and they may or may not be painful. They are not cancerous and will not spread; however, some people form multiple cysts in multiple locations. Ganglion cysts are usually oval or round and may be soft or firm. The cause of these cysts is unknown, although they may form in the presence of joint or tendon irritation. They occur in patients of all ages.

Treatment of Ganglion Cyst

Treatment is often non-surgical, because the cysts can frequently disappear spontaneously. If the ganglion cyst becomes painful or limits activity, there are several treatment options available. The use of splints and anti-inflammatory medication can be prescribed. An aspiration can be performed to remove the fluid from the cyst and decompress it. Aspiration is a very simple and common procedure, but recurrence of the cyst is common. If non-surgical options fail to provide relief, surgical alternatives are available. Surgery involves removing the cyst, along with a portion of the joint capsule or tendon sheath. Surgical treatment is generally successful, although cysts may reappear. Your hand surgeon will discuss available treatment options and determine the best option for you.

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Trigger Finger

Trigger finger is a type of tenosynovitis. Tenosynovitis is an inflammation of the tendons in the finger or the thumb, limiting a finger’s ability to bend or straighten. It can be caused by repeatedly grasping an object. When a tendon is swollen, it tends to “lock” in a bent, or trigger, position. A pop or catching sensation may occur when the finger is moved from the bent position.

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