General Practitioners

• Osteoporosis
• Warts
• Arthritis
  The MP joints are less often affected by arthritic conditions than the smaller joints in the hand or the joint where the thumb joins the wrist (CMC). The most common arthritic condition affecting the MP joints is rheumatoid arthritis. In this situation, the joint lining (synovium) produces chemical factors that inflame and destroy the cartilage and soft tissue, such as ligaments and tendons. The end result is that the joint surfaces are destroyed and the fingers drift into a characteristic ulnar-deviated position, in which they point towards the little finger (see Figure 2 ).
• Fibromyalgia
  The time for healing is variable as no two people are alike and no one heals exactly the same. However most feel comfortable doing light activities UNSPLINTED and UNPROTECTED that require palm pressure in 1-2 weeks and very heavy activities at 4 -5 weeks. Those with lighter sedentary jobs can often go back sooner. Those with very heavy jobs may take longer. Some with office positions even go back to work in the time period between having the opposite hand done. The minimum that most people take off from work is a few days. Of course, other conditions such as arthritis, tendonitis and fibromyalgia may delay comfort after surgery.
• Primary Care
  If your regular doctor has recommended that you take prophylactic antibiotics before surgery because of joint replacement, heart disease, or other medical problems, it is appropriate to take that type of medicine before this procedure. You'll need to make arrangements with your primary care physician to obtain prescriptions for these types of medicines prior to your procedure. If you take aspirin, vitamin E, or blood thinners such as coumadin, or have any questions about your medications; please check with the Hand Center before your scheduled appointment.
• Emergency Care
  These are some questions we are frequently asked regarding hand and wrist injuries that need urgent care.
• Immunizations

Gynecologists

• Pregnancy

Neurologists

• Carpal Tunnel Syndrome
  About The Hand Center - Surgery for hand fractures, tendonitis, nerve compression, and carpal tunnel - The Hand Center of Western Massachusetts

Endocrinologist

• Diabetes Care
• Thyroid

Radiologist

• Ultrasound
  To make the diagnosis, the doctor will examine the child and probably use X-rays to determine whether a growth plate fracture occurred. Occasionally, the doctor may request other diagnostic tests, such as magnetic resonance imaging (MRI), computed tomography (CT), or ultrasound.
• MRI
  Scaphoid fractures are most commonly diagnosed by x-rays of the wrist. However, when the fracture is not displaced, x-rays taken early (first week) may appear negative. A non-displaced scaphoid fracture could thus be incorrectly diagnosed as a “sprain.†Therefore a patient who has significant tenderness directly over the scaphoid bone (which is located in the hollow at the thumb side of the wrist, or “snuffbox†) should be suspected of having a scaphoid fracture and be splinted (see Figure 2). An X-ray a couple of weeks later may then more clearly reveal the fracture. In questionable cases, MRI scan or bone scan may be used to help diagnose an acute scaphoid fracture. CT scanning is also very useful, especially to assess the fracture configuration. Until a definitive diagnosis is made, the patient should remain splinted to prevent movement of a possible fracture.
• X-Rays
• Computed Tomography
  Examination and x-rays are needed so that your doctor can tell if there is a fracture and assess the position of the bones, in order to help determine the treatment. Occasionally a CT scan may be helpful to get better detail of the fracture fragments. In addition to the bone, ligaments (the structures that hold the bones together), tendons, muscles, and nerves may be injured as well when the wrist is broken. These injuries may need to be treated in addition to the fracture. Whenever the bone protrudes through the skin, it is important to receive immediate care to minimize the risk of bony infection. When numbness in the fingers is present, it implies that the nerves have been injured.

Surgeons

• General Surgery
  He is Board Certified in Orthopaedic Surgery and has a Certificate of Added Qualifications in Surgery of the Hand. Dr. Wintman attended Wesleyan University graduating with high honors in Molecular Biology and Biochemistry. He completed his medical education at Harvard Medical School in 1991. He interned in general surgery at the Brigham and Women's Hospital followed by a residency in Orthopaedic Surgery at the Harvard Combined Program working at Massachusetts General Hospital, Brigham and Women's Hospital and Children's Hospital in Boston. Following this training he was an Orthopaedic Trauma attending and Chief Resident at Brigham and Women's Hospital. In 1997, Dr. Wintman went on to complete a Hand and Upper Extremity Surgery Fellowship in Pittsburgh, Pennsylvania. He is currently licensed in Massachusetts and Connecticut.
• Orthopedics
  Hand and Wrist Injuries and Conditions - Orthopedics Surgeons Western Mass - Wrist and Hand Problems - Endoscopic Release - The Hand Center of Western Massachusetts
• Arthroscopy
  Patients with advanced disease or who fail non-surgical treatment may be candidates for surgical reconstruction. A variety of surgical techniques are available that can successfully reduce or eliminate pain. Surgical procedures vary and may include a combination of removal of arthritic bone and joint reconstruction, joint fusion, bone realignment, capsulodesis, tendon transfers, ligament reconstruction, release of contractures and even arthroscopy in very rare select cases. A consultation with your hand surgeon can help decide the best option for you.
• Pinched Nerve
  Carpal tunnel syndrome (CTS) is a condition brought on by increased pressure on the median nerve at the wrist. In effect, it is a pinched nerve at the wrist. Symptoms may include numbness, tingling, and pain in the arm, hand, and fingers. There is a space in the wrist called the carpal tunnel where the median nerve and nine tendons pass from the forearm into the hand (see Figure 1 ). Carpal tunnel syndrome happens when pressure builds up from swelling in this tunnel and puts pressure on the nerve. When the pressure from the swelling becomes great enough to disturb the way the nerve works, numbness, tingling, and pain may be felt in the hand and fingers (see Figure 2 ).
• Joint Replacement
  Patients with severe joint destruction may benefit from either a joint fusion or joint replacement. The thumb functions very well after an MP joint fusion. In the fingers, however, the loss of motion can be very disabling and joint replacement is usually preferred. Classically, replacement with silastic hinged implants has resulted in reasonable pain relief and function (see Figure 4 ). Silastic implants have been particularly successful in older, more sedentary patients with low demand on the use of their hands. More recent types of implants that try to replicate the joint surface may offer benefits to younger individuals and patients with more active, vigorous lifestyles.
• Hand Surgery
  Hand and Wrist Injuries and Conditions - Hand Surgeons Western Mass - Wrist and Hand Problems - Hand Surgery - The Hand Center of Western Massachusetts
• Orthopedic Surgery
  Dr. Wint and Dr. Wintman have Subspecialty Certificates in Surgery of the Hand, are board certifed in Orthopedic Surgery and participate in Maintenance of Certification.
• Arthroscopy
  Other fractures may need surgery to properly set the bone and/or to stabilize it. Fractures may be stabilized with pins, screws, plates, rods, or external fixation (Figure 2). Plates and screws that can be placed through an incision on the bottom or top of the wrist are often used to hold the bone fragments in place and may allow early use of the hand and wrist. These implants are buried inside the wrist and usually do not require removal. External fixation is a method in which a frame outside the body is attached to pins which have been placed in the bone above and below the fracture site, in effect keeping it in traction until the bone heals. Sometimes arthroscopy is used in the evaluation and treatment of wrist fractures. Your hand surgeon will determine which treatment is the most appropriate in your individual case.
• Reconstructive Surgery
  Recovery time varies considerably, depending on the severity of the injury, associated injuries, and other factors as noted previously. It is not unusual for maximal recovery from a wrist fracture to take several months. Some patients may have residual stiffness or aching. If the surface of the joint was badly injured, arthritis may develop. On occasion, additional treatment or reconstructive surgery may be needed.

Plastic Surgeons

• Plastic Surgery
  The examination for the Subspecialty Certificate in Surgery of the Hand (formerly CAQ Hand) is developed and administered by the Joint Committee on Surgery of the Hand of the American Boards of Orthopaedic Surgery, Plastic Surgery and Surgery.

Dermatologists

• Cyst
• Frostbite
  €¢ Too much exposure to ice water can lead to frostbite or hypothermia and injury. Never bathe in an ice bath without supervision.
• Lesions
  X-rays are usually taken to make sure the bones of the thumb and hand are not fractured. Sometimes "stress" X-rays are also used. Your doctor will then examine the thumb to determine whether the ligament is torn. If the ligament is partially torn, it is usually treated in a cast or splint. Radial collateral ligament injuries are frequently treated this way as well. The end of a completely torn ulnar collateral ligament often gets trapped behind a tendon. This "trapping" of the ligament in the edge of the aponeurosis is known as a Stener Lesion. Complete ulnar collateral ligament tears are most commonly treated with surgery to repair the ligament. The presence or absence of a Stener Lesion is at times used to determine whether surgery is needed but typically complete lesions or ligament tears require surgery. Sometimes the remaining ligament tissue is of poor quality and the ligament must be reconstructed with a tendon or ligament graft. A partial strain that does not require referral can be treated with either a thumb spica cast or a gamekeeper's thumb splint for four to six weeks. Active range of motion exercise is started at three to four weeks, with gradual return to full activity.
• Skin Care
  It is easiest to shower with the splint on, covering it with a bag, and then removing the splint for skin care.
• Psoriasis
  Less commonly, other conditions can produce pain, deformity, and motion loss. Previous injuries can result in a gradual loss of joint cartilage (post-traumatic arthritis) with progressive pain and stiffness. Similar findings are seen with osteoarthritis. Post-traumatic and osteo-arthritis most commonly affect the thumb, index, and middle fingers, and the degree of deformity is often much less severe than in rheumatoid arthrosis. Gout, psoriasis, and infection are other less common causes of MP joint arthritis.
• Burns

Physical Therapists

• Sports Medicine
  Hand Surgeons are often called upon to treat sports injuries. Dr Wint is a member of ISSPORTH, the International Society for Sport Traumatology of the Hand an organization whose mission is focused upon sports specific injuries of the hand and wrist. ISSPORTH recognizes that there is a need
• Physical Therapy
  Modification in activities and learning to use the shoulder in a safer, more comfortable manner is important. Proper lifting technique is also emphasized. Physical therapy may help improve mobility and strengthen shoulder muscles. Anti-inflammatory medications and cortisone injections are used for both relieving pain and decreasing inflammation.
• Tennis Elbow
• Shoulder Pain