TRUITT RQGERS
Having surgery is an important decision and coordinating the care for recovery can involve a team of health care professionals. Hand and upper extremity surgery represents a highly specialized field of orthopedic surgery, requiring an extra level of dedication to care for your needs among a team of the surgeon, assistants, and therapists, just to name a few. And since not all problems of the upper extremity are limited to the hand (many problems extend upward to the elbow, the shoulder, and even the upper back), this can further drive the complexity of coordinating care among multiple surgeons, physiatrists, nonoperative physicians, and neurologists as well.
The Hand to Shoulder Center was formed to create a unified practice, completely devoted to upper extremity problems from the fingertip to the shoulder, all to better serve patients. From in-house therapy services to on-site imaging and in-office procedures, the center is designed to treat patients of all ages with any orthopedic condition from the fingertip to the shoulder. One of the many advantages you will find at the center is the ability to have an office-based procedure. As surgical techniques have become more refined, developing a responsive and caring environment for delivering surgical care has become possible in the office setting.
stuart sandlin
In-Office Surgery (WALANT Technique)
By performing surgery in our state-of-the-art in-office procedure rooms, we eliminate unnecessary fees, decreasing the cost to the patient while maintaining the highest standard of care. Several common hand surgeries can be done this way, many times with improved outcomes over traditional methods.
Classic techniques for hand and wrist surgery involve placing a tourniquet on the arm to maintain a bloodless surgical field. While good for visualization, this causes severe discomfort for patients, so sedation or general anesthesia must be used. By using a technique called WALANT (Wide Awake Local Anesthesia No Tourniquet), we can perform the same or better-quality surgery without a tourniquet, resulting in a much more comfortable experience for the patient — all without sedation or general anesthesia.
We are firm believers this technique has benefits for the patient and health care. It does require surgeons to learn new techniques and takes valuable time and effort to set up, which are some of the reasons we have seen a slow adoption in the U.S. We have this set up specifically to improve care for our patients, our top priority. A main advantage is that patients can actively participate in the procedure when needed, which is especially helpful during tendon repairs, tendon transfers, and trigger fingers. Formal anesthesia monitoring and the hospital setting are not needed, which eliminates the majority of overall surgery cost. Patients can also leave immediately after the procedure since there is no nausea or other negative side effects from the local numbing medicine.
How WALANT is performed: Local anesthesia is accomplished with a combination medication of diluted lidocaine and epinephrine, which is injected into the planned area of the surgery. Once injected, there is a brief waiting period for the medicine to reach maximum effect, which improves our surgery visualization. This medicine provides up to four hours of local anesthesia (numbness). Most patients say they experience less discomfort than a single IV placement.
Major Advantages for Our Patients:
- No nausea
- No mind-altering medications
- You can drive yourself
- You can eat and drink before the procedure
- You can take all your normal medicines
- You get more time to talk with your surgeon
- Lower overall cost
Read more at handtoshouldertexas.com/in-office-procedures
The Hand to Shoulder Center
We are four orthopedic surgeons who all completed additional subspecialty fellowship training in the upper extremity. With this unique combination of surgeons, we can treat virtually any pathology from the fingertips to the shoulder: all ages, any broken bone, any sports injury, accident, new or chronic pain, all types of arthritis, replace or fuse any joint, accept patients without insurance, and can offer expert second opinions when needed. We came together to offer an improvement in patient care from the status quo. With all of us working together, we can offer same-day or next-day appointments to better serve you when you need it most. We offer several modalities in-office to avoid unnecessary travel or additional appointments, which is especially important for our patients during this pandemic. This includes x-rays, physical therapy, occupational therapy, certified hand therapy, primary care physicians, internal medicine doctors, and even in-office surgeries all in one safe stand-alone building, The Hand to Shoulder Center. Call 817-420-9238 for an appointment today.
Learn more at handtoshouldertexas.com.
TRUITT RQGERS
