Shoulder-Elbow-Hand

Shoulder-Elbow-Hand Pictures, stories, updates and lots of information about problems affecting the upper limb and solutions to those problems.

Any idea what this is? It started off as olercanon bursitis until a well meaning GP decided to aspirate it. It’s now nec...
29/10/2019

Any idea what this is?

It started off as olercanon bursitis until a well meaning GP decided to aspirate it.

It’s now necrotising fasciitis.

So the simple message is: don’t aspirate these. It doesn’t matter how much you are tempted or how much pressure the patient puts you under or how many you’ve done with no problems. Just say no.

They nearly always resolve over time or can be removed surgically if the patient really wants rid of it.

Arthritis of the base of the thumb is a common and very painful condition that makes simple daily activities difficult t...
06/06/2019

Arthritis of the base of the thumb is a common and very painful condition that makes simple daily activities difficult to carry out. If pain persists after activity modification, use of splints and injections then surgery becomes a good option. The traditional procedure is a trapeziumectomy which does work well in terms of pain reduction but doesn’t always restore normal movement and function. A new generation of CMCJ replacements seem to answer all the problems and provide excellent results. So that’s what I’ve started to do and, so far, so good.

19/02/2019

Arthritis at the base of the thumb is not only painful but it really interferes with function making the simplest activities very difficult if not impossible. If straight forward measures like splints, anti-inflammatoires and steroid injections don’t calm it down, then you would probably benefit from surgery. Traditionally that was a trapeziumectomy where the whole worn out bone was removed and while it is good at reducing pain, it doesn’t really give you back normal thumb function.

So today I went to visit Dr Tanguy Mraovic at The Catalan Hand Institute to learn how to do an operation that replaces the joint which gets rid of the pain and gives you back a pretty normal thumb.

If this might apply to you then get in touch to discuss having a new thumb joint.

I am starting Saturday afternoon clinics in Brentford. So if anyone needs their shoulder or elbow sorted out then contac...
07/02/2019

I am starting Saturday afternoon clinics in Brentford. So if anyone needs their shoulder or elbow sorted out then contact my office on 01483776494 to make an appointment. Also offering very competitively priced selfpay surgery for Carpal Tunnel, Trigger Finger and Ganglion excision as well as PRP injections for Tennis and Golfers Elbow.

03/11/2018

Carpal Tunnel Syndrome is a very common condition that can make life pretty miserable and simple activities very difficult. Surgery for this condition is being more and more tightly rationed and difficult to access. I am now offering that life improving surgery at The Syon Clinic in Brentford at the best price you will find in and around London. Just turn up and have it done and lose those awful pins and needles and numbness and pain. Contact my office on enquiries@lu-lu.co.uk for prices and dates.

Painful lump over the acromion. I’ve never seen that before and was a bit anxious as to what it was. The patient present...
08/10/2018

Painful lump over the acromion. I’ve never seen that before and was a bit anxious as to what it was. The patient presented with classic tendonitis impingement. The scan shows a bipartite acromion with significant ostéophytes with the subacromial ones causing the impingement.

25/08/2018

Oh - and the band is called Softer Still. Worth a listen!!

It’s all too easy to solicit glowing testimonials on the rash of doctor rating sites - you just ask the ones who’ve done...
25/08/2018

It’s all too easy to solicit glowing testimonials on the rash of doctor rating sites - you just ask the ones who’ve done well to get online and write a few lines about how wonderful you are. But it means so much more to get something like this out of the blue and especially when it’s had such an effect on that persons lifestyle. As a doctor the tendency is to fixate on the things that don’t go according to plan so a little praise means an awful lot.

I don’t like to chop and change the implants I use but I have often struggled when using radial head replacements. Today...
01/08/2018

I don’t like to chop and change the implants I use but I have often struggled when using radial head replacements. Today I used the one from Acumed and was really pleased with it. Easy to use with an excellent range of sizes and, most importantly, instruments clearly designed by a surgeon who has done this sort of case may times and knows just how difficult it can be. So a happy surgeon and that usually means a happy patient.

So how do you choose your surgeon? Do you check out their results (how well the patients did, how low the infection rate...
05/07/2018

So how do you choose your surgeon? Do you check out their results (how well the patients did, how low the infection rate is etc) which are objective measures or do you go on personal recommendation or patient reviews on websites which are subjective opinions? And would you not think the two would correlate?

Apparently not.

Maybe patients do better if they like their surgeon or have a rapport with them? Or maybe that relationship masks or overrides any problems they might have which, if they didn’t like their surgeon, they may have complained more about.

Got to love the ‘art’ of medicine that gilds the science.

This level of medical AI linked to the inevitable advances in genetic engineering (which is what is actually going to cu...
28/06/2018

This level of medical AI linked to the inevitable advances in genetic engineering (which is what is actually going to cure everything) means it won’t be long before we are looking back at what we think of as our modern level of brilliance only to realise we are barbarians.

So how do you treat a primary traumatic anterior dislocation in a 48 year old? What he doesn’t need is surgery - and tha...
21/06/2018

So how do you treat a primary traumatic anterior dislocation in a 48 year old? What he doesn’t need is surgery - and that’s hard for a surgeon to admit! - unless it comes out again or feels wobbly. But how long in the sling? A week is probably enough. What can he do now? Mobilise in Safe Zone A (basically working at desk level). He will have access to the best physios to advise and supervise. But maybe wear the sling during matches as punching the air is the sort of movement that could easily cause another dislocation.

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