C. Noel Henley, MD | Hand Wrist Elbow Surgeon, Fayetteville, Arkansas

Thumb Pain – Four Common Causes

Dr. Henley — Thu, 02 Feb 2012 05:09:19 +0000

painful thumb

If your thumb hurts and you didn’t jam it or injure it in a specific way, this article may help you diagnose the problem.

The four most common causes of thumb pain are:

Thumb arthritis
Trigger thumb
Thumb Tendonitis
Carpal tunnel syndrome

Click here to read the full article on the four most common causes of thumb pain.

Dr. Henley on The Jon Williams Show – 104.9 The X – Hand Injury

Dr. Henley — Mon, 30 Jan 2012 03:17:05 +0000

Dr. Henley and Jon Williams – 104.9 the X

Recently I appeared on Jon Williams’ show to talk with Jon about his hand injury.

Click the image below to start listening!

Taurine – What You Should Know Before Putting It In Your Body

Dr. Henley — Tue, 10 Jan 2012 16:34:34 +0000

energy drinks with taurine

You’ve seen it on cans, bottles, and packages – if you’ve eaten or drunk stuff with taurine in it, find out what your body uses it for. If you’ve wondered what it is and haven’t tried it, this article will make you a more informed consumer.

Introduction – learning about taurine

If you’re wondering about a substance called taurine and what it does, then this article will provide the answers. You’ll find out what taurine is and learn about its basic functions in the body. I’ll describe some of the benefits of taurine and point you to some products and ways to incorporate taurine into your diet.

After reading this article, you’ll have a better understanding of taurine and its functions and benefits.

What is taurine?

Taurine is an important amino acid that cirulates in the bloodstream and is not put into the building blocks of proteins like other amino acids. It’s found in several important places in the body, including heart, or cardiac tissue.

You’ll see taurine in multivitamin ingredients and as a component of energy drinks like Red Bull and Monster (see the pictures with this article!).

Benefits of taurine in the body

Taurine supports the development of the nervous system. This includes brain, spinal cord, and nerves. One critical role of taurine is to protect and nourish rods, which are a part of normal eye function, especially in low light environments (you’ve probably heard of rods and cones).

Scientific studies have also demonstrated the anti-inflammatory and immune system supporting effects of taurine. In fact, animal studies show that a lack of dietary taurine leads to abnormal development of the immune system and nervous system.

Energy drinks like Red Bull and Monster Energy contain taurine, along with other substances like caffeine.

red bull energy drink with taurine

Where to get taurine

Dietary supplementation with taurine may improve athletic performance and mental proficiency and function may improve when combined with caffeine consumption.

Other foods that contain taurine include shellfish, meat, seafood, dairy, eggs, and poultry. So vegans and vegetarians may not receive any taurine from food sources. In people with normal kidney function, any excess taurine not used by your body passes through the kidneys and eliminated in the urine.

Conclusion

Since taurine is found in high concentrations in heart cells and infection-fighting white blood cells, we know that it has many important effects and benefits in the body. Now when you see that ingredient listed on the can of energy drink you’re about to guzzle, you’ll know more about the amino acid taurine and some of its benefits and functions.

Carpal Tunnel Cross Section Image

Dr. Henley — Sun, 08 Jan 2012 12:53:59 +0000

cross section of the carpal tunnel

This is a combination drawing/photograph I made to illustrate the cross sectional anatomy of the carpal tunnel.

Carpal tunnel cross sectional image

This is looking at your right hand stretched away from you. The hand is in a palm-up position. I’ve colored the tunnel itself WHITE – this is where the problem is. Muscles are colored red.

Nerves in the carpal tunnel cross section image

I’ve colored the two nerves yellow. The one on the right is the median nerve, the main nerve compressed or pinched in carpal tunnel syndrome.

On the left is the ulnar nerve.

The median nerve supplies sensation to the fingers on the thumb (or radial) side of the hand, including thumb, index, middle, and half of the ring finger.

The ulnar nerve is not involved in carpal tunnel syndrome and supplies sensation to the pinky finger (or small finger) and the half of the ring finger on the pinky side.

The flexor tendons in the cross sectional drawing

The small circles around the large median nerve are the nine flexor tendons of the hand. These flex (or bend) the fingers and thumb into a fist.

Each tendon has a lining called a tenosynovium, which can get swollen and compress the median nerve. You can imagine that if all nine were swollen, there wouldn’t be much space left for the nerve! The drawing actually exaggerates how much space there is in the tunnel – it’s very tight in there under normal situations – worse in carpal tunnel syndrome.

Carpal bones – the “floor” of the carpal tunnel in the drawing

The four carpal bones are the large, irregularly shaped objects at the bottom of the drawing.

Transverse carpal ligament – what gets cut in carpal tunnel surgery

I’ve put a star on top of the transverse carpal ligament.

The tissue layer on top of the tendons and the large median nerve is a strong, thick ligament called the transverse carpal ligament (just means the ligament than runs across between carpal bones).

This ligament is what I cut in the carpal tunnel surgery, that relieves pressure on the nerve and lets the compressed nerve heal.

Jay Cutler’s Thumb Fracture, Surgery, and Rehabilitation

Dr. Henley — Thu, 24 Nov 2011 20:53:07 +0000

Jay Cutler’s thumb fracture was most likely a displaced break in one of the three bones that make up the thumb. His total time off the field could be as long as eight weeks.

The bones and joints of the thumb are critical for the normal function of the human hand, so any thumb fracture is more serious than a “regular” finger fracture, as a general rule.

The nature Jay Cutler’s thumb injury

The exact fracture type is unknown, so I’m speculating here for the most part – fair warning.

The injury happened when Jay fell onto his outstretched hand, which probably created a violent stretching of the thumb away from the fingers and palm.

This injury can tear ligaments or break bones.

Sometimes if the pieces of broken bone are lined up perfectly next to each other or it’s just a hairline break, the bone may be strong enough in about 4 weeks.

Since we know Jay had surgery by Dr. Viola in Vail, Colorado, I’m guessing that the fractured pieces were moved away from each other (displaced), which usually requires surgery to fix.

Interestingly, hand surgeons in Vail treat a lot of skier’s thumb injuries – slightly different than the type of fracture Jay allegedly had, but it happens the same way when a skier falls on his outstretched hand.

Jay Cutler’s injury may be a Bennett’s fracture

Some reports state that Jay had a Bennett’s fracture. This is a broken metacarpal bone in the thumb, where the thumb joins up with the wrist.

It involves a break right into the most important joint in the hand – the basilar thumb joint – a common place for arthritis to develop later in life.

Surgery can involve putting pins in through the skin as the surgeon holds the thumb fracture in place. This would leave pins either sticking out of the skin or cut below the skin level. The patient usually wears a splint or cast over the pins when this happens.

x-ray of a pinned Bennett's fracture

Another type of surgery involves putting a plate or screws inside the thumb, on the bone, through an incision. This may let the patient move the thumb sooner, but is more invasive, and may not necessarily let the athlete return to play any sooner.

x-ray of a Bennett's fracture screw repair

Why Cutler’s return to play may be longer than six weeks

A broken bone heals in about six weeks. However, patients need about two or three weeks of intensive rehabilitation therapy to regain flexibility and strength after the bone heals. Therefore, Jay may not be back on the field for eight weeks or so, depending on his pain level, flexibility, and confidence with the hand.

Another surgeon’s explanation of Jay’s thumb injury and rehab

In this video, Dr. Mark Cohen, a hand surgeon in Chicago and member of the American Society for Surgery of the Hand, gives us his opinion about Jay Cutler’s injury and potential recovery.

The Right Way To Wash Your Hands

Dr. Henley — Tue, 25 Oct 2011 11:46:01 +0000

The right way to wash your hands

As a hand specialist I often get asked general hand health questions like, What is the right way to wash my hands?

Here’s a quick summary of the Dos and Don’ts of proper hand washing techniques.

People don’t take hand washing seriously – I’m sure you have the same experience as me in the bathroom, where people tend to splash a little water on their hands, wipe them off, and run out the door. Yikes.

Why is hand washing so important?

Frequent and proper hand washing is critical for avoiding illness and preventing the spread of germs, like bacteria and viruses.

Hospital patients get millions of infections each year in the United States. In the hospital, infections can be especially dangerous.

The most common way infections are transferred from person to person is on the hands!

There is substantial evidence that hand hygiene reduces the incidence of infections.

In recent studies healthcare-associated infection rates were lower when antiseptic handwashing was performed by health care workers and went down when people followed hand washing rules more closely.

Hand hygiene

Hand hygiene is a general term that applies to either handwashing, antiseptic handwash, alcohol-based handrub, or surgical hand hygiene/antisepsis (when a doctor scrubs before surgery).

Handwashing

Handwashing refers to washing hands with plain soap and water. Handwashing with soap and water remains a sensible strategy for hand hygiene in non-healthcare settings and is recommended by CDC and other experts.

How to know which one to use

If you have visible dirt or some sort of goo or mess on your hands, use soap and water.

If you can’t see any dirt, you can use hand hygiene techniques.

Facts about hand hygiene (non-soap and water)

alcohol-based handrub is better than handwashing at killing bacteria
Alcohol-based handrubs are less damaging to the skin than soap and water.
Alcohol-based handrubs may be a better option than traditional handwashing with plain soap and water or antiseptic
handwash because they require less time, act faster, and irritate hands less often.
These handrubs are easier to get to than finding a sink (more accessible)

Hand hygiene technique

When decontaminating hands with an alcohol-based handrub, apply product to palm of one hand and rub hands together, covering all surfaces of hands and fingers, until hands are dry.

Handwashing technique

When washing hands with soap and water, wet hands first with warm water, apply a nickel or quarter-sized amount of soap, and rub hands together for at least 15 seconds (sing Jingle Bells twice in your head to spend enough time), covering all surfaces of the hands and fingers.

Rinse hands with water, dry thoroughly with a disposable towel, and use the towel to turn off the faucet and open the door, if needed.

When to clean your hands

After:

you cook with raw meat or other raw foods
using the toilet
changing diapers
touching a pet or other animal
blowing your nose, coughing, or sneezing into your hands
touching a sick family member
dealing with garbage or other contaminated material – even shoes

Before:

you prepare food
you eat
treating cuts, scrapes or giving medicine
touching a sick family member
removing or putting in contact lenses

Reasons Why Your Doctor Runs Late

Dr. Henley — Fri, 09 Sep 2011 14:58:41 +0000

When doctors run late in the office, it’s a frustrating experience for patients. It may surprise you to learn that we’re frustrated, too! I was featured in a recent article on the website EveryDayHealth.com commenting on this issue.

In this multi-part article, Lexi Petronis has collected several comments from doctors about real reasons why your doctor’s running late in the office.

My comments are here, on the seventh page of the article.

Dried Plums – A Natural Way to Reverse Bone Loss and Osteoporosis

Dr. Henley — Wed, 24 Aug 2011 11:55:05 +0000

dried plums may reverse bone loss

Are you looking for natural ways to boost your body’s bone-building capacity?

The answer may be inside a dried, wrinkled fruit…

Natural treatments for osteoporosis

Bone loss accelerates after menopause, which puts millions of American women at risk for hip, spine, and wrist fractures.

More women are looking for ways to modify their lifestyle and diet to prevent bone loss. Drug treatment can have side effects and be very expensive over the long term.

A new study on prune therapy for bone loss

Researchers at Florida State University recently conducted a study which found that patients who ate prunes had a higher bone density than other patients in the study.

The study was conducted by Dr. Arjmandi, a faculty member of the department of nutrition, food and exercise sciences. His previous research demonstrated bone-boosting effects of dried plums in a rat model.

Arjmandi’s goal is to isolate the compounds responsible for the bone building effect and create a supplemental solution for the treatment of osteoporosis.

How dried plums work to reverse bone loss

In multiple studies, the researchers found that dried plums result in the following effects:

increased bone density
decreased bone turnover (natural variation of bone density)
restoration of strong bone structure
reversal of bone loss that occurs during bedrest
increased blood markers of bone formation

In the recently performed clinical study on postmenopausal women, patients ate 9 or 10 prunes per day, supplemented with vitamin D and calcium.

For more information on this research

These links contain more information on prune research and osteoporosis (bone loss).

http://www.ncbi.nlm.nih.gov/pubmed/21736808

http://fsu.edu/news/2007/01/11/osteoporosis.study/

Adding Bone Strength with Simple Diet Changes

Dr. Henley — Mon, 08 Aug 2011 12:35:05 +0000

slice-o-cheese

Making some simple changes in food selection is one way to get more calcium and stronger bones. Here are some food substitution ideas for you to consider.

You’ve heard that bone health and avoiding osteoporosis is important – try a few of these diet options to give yourself a bone health advantage!

Try adding milk to soups and hot cereals

Substituting milk for water in cream soups and tomato soups enhances flavor and adds calcium. Cooked cereals are also thicker and creamier when you use milk.

Fortified versus non-fortified cereals

Whether you’re adding them to yogurt or eating them with milk, check the nutritional label on the box to see if your cereal is fortified or not. These fortified cereals often contain additional calcium and vitamin D.

Raw spinach instead of other salad lettuce and greens

Dairy food calcium is absorbed by your body most efficiently, but spinach contains more calcium than most other lettuces and salad greens.

Reduced fat cheese instead of regular cheese

In addition to the side benefit of fewer fat calories, the reduced-fat cheeses generally contain the same amount of calcium as their fattier counterparts.

Preventing Warm Weather Injuries – Tips for Parents

Dr. Henley — Thu, 21 Jul 2011 19:56:42 +0000

Warmer weather means more outdoor activities for kids. This guide will give you some concrete tips you can use right now to protect your kids and avoid injury during the warm weather season.

The number one priority

Your top priority as a parent and authority is to find a balance between protection and fun for your kids’ activities. This takes practice, but no one can force you or show you instantly how to do this. You know your children best!

Provide adequate supervision

Be an educated parent. Learn about the risks of your child’s activities and supervise accordingly. Adequate supervision is the most important factor here. If your children are playing in their own fenced-in backyard, they may need less supervision than on a crowded playground with unfamiliar equipment and other children. Even though you can’t prevent all injuries, you can respond quicker if you are nearby.

Teach your children to play safely and respect others

Teaching kids to play safely is half the battle – if they know some basic rules of safety and decent behavior, a lot of disasters can be prevented. For example, kids are notoriously creative – they’ll invent new and more hazardous ways to use outdoor equipment, so supervision is also critical. Teach them how to watch out for dangerous situations. For instance, they should learn not to run in front of swings on the playground to prevent collisions.

Get helmets and protective gear for your kids

Bone injuries are bad enough, but preventing brain injury is even more important. Helmets should be worn during activities that involve high speeds or the potential to lose your balance – biking, in-line skating, water sports. Elbow guards and pads may also help protect against fractures and skin injury.

Keep your child hydrated

Make sure they’re drinking plenty of water when playing in the heat. Plan ahead and put full water bottles and ice in a small cooler before your trip to the park – even if it’s for a couple of hours. Give your child plenty of time to adjust to high heat or humidity and encourage frequent breaks on the hottest days. Stopping every 20 minutes or so for a drink break is a good plan.

Avoid trampolines

Children under 6yo should not use them; they do not have the coordination or strength to avoid injury. Only one kid at a time should be jumping and adults should be present at all times. If you get on the trampoline with the child, do not jump. Don’t be lulled into a false sense of security by trampoline safety nets or enclosures.

Tips on playground safety

avoid playgrounds with hard surfaces like concrete, asphalt, or hard packed soil
look for surfaces covered with wood chips, mulch, or shredded rubber
several parks have equipment designed for different age groups. make sure your child is playing on the appropriate equipment for their age and skill level
make sure you can clearly see your child on the playground and that your kids know where you will be during playtime. you should be able to find each other quickly if an injury occurs
there should be adult supervision at all times
check the playground and equipment for obvious broken pieces or large objects that may be a tripping hazard

Be sure sports equipment fits your child

If your child plays organized sports, helmets and other protective gear may be used. The best solution is to buy your own, so you know it fits well. Otherwise be sure the shared helmets and protective gear fits your child and that he knows how to put it on appropriately. For example, ask your kid’s baseball coach to let him or her try on the three team batting helmets. One may fit better than the others, and the child should learn to ask for that one each time if possible.

Stretch and warm up before athletic activity

Stretching and warming up before sports or athletic activity may help prevent strains and sprains, the most common injuries in kids during warm weather. Good warm up exercises include jogging, running in place, or jumping jacks.

What to do immediately after an injury

Call 911 if your child is not responding, not moving, or obviously severely injured.

For injuries to legs or arms, use the RICE treatment method to stop swelling, pain and stiffness.

Rest: Stop moving the injured part. Stop using it for at least 48 hours. Trying to keep playing with a damaged body part may cause further injury. Splints and braces help with this, so if you have one that fits, use it to stop the motion of an injured joint. Your doctor can advise you when it’s safe to start moving again.
Ice: Put an ice pack on the injured area for 15 to 20 minutes at a time, four or five times per day for the first few days. Pad the ice pack with a thin towel to avoid freezing the skin. You can use a Ziploc bag filled with ice, or even a bag of frozen peas.
Compression: Ace wraps can be used to provide some light compression to a swollen, injured body part. Don’t wrap it too tight or it will cut off blood flow completely. Wrap the injured part from distal (near the toes or fingers) to proximal (away from the toes and fingers) without pulling the wrap tightly with each turn.
Elevation: This is probably the most important step and is the hardest to do. Keep the injured body part elevated higher than your heart during as much of the day and night as possible. Any amount of elevation is better than nothing, but if you keep it above the heart, the swelling will flow downhill and improve motion, pain, and stiffness.

Know who to call if your child is injured

Most serious injuries are recognized quickly, so the chances of getting a quick diagnosis and treatment are high. Other injuries can be subtle but still cause problems in the future.

The most common injuries among children are sprains, strains, and fractures. These involve ligaments, joints, and bones. Orthopaedic surgeons are experts in treating these injuries, whether they need surgery or not.

One of the most common situations we’re happy to see is a worried mom who “just wants to make sure nothing serious is going on”.

If your child has an injury to an arm or leg, make an appointment with one of our bone and joint experts as soon as possible. Peace of mind for parents is something we provide every day.

image: http://www.everystockphoto.com/photographer.php?photographer_id=298