Dr Neil Kruger

15/06/2023

🗣️ 𝐀𝐍𝐍𝐎𝐔𝐍𝐂𝐄𝐌𝐄𝐍𝐓
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21/06/2021

“Over the course of the coming year we will be running weekly informative videos on various hand and upper limb conditions. Each video contains information on the relevant anatomy, predisposing factors and optimal management of each condition. We hope these are of value to you in better understanding your problem.” Dr Neil Kruger.

ARTIFICIAL FINGER JOINT REPLACEMENT
The hands are made up of 27 bones, which are grouped into carpals, metacarpals and phalanges. Each bone is separated by the articular cartilage, which helps in a smooth gliding movement of the fingers. Arthritis develops when the cartilage wears-out, resulting in pain, stiffness and inflammation in the joints. Arthritis can affect any joint in the body, but the most commonly affected joints are the small joints of the fingers.

Finger joints are essential for many activities, and arthritis in this area can cause significant joint damage and deformity. Artificial finger joint replacement is a surgical procedure that involves the removal of an arthritic or damaged finger joint and replacement with an artificial prosthesis.

Diagnosis

Your doctor diagnoses arthritis of the finger joint after reviewing your medical history, performing a physical examination, and obtaining X-rays. Additionally, blood tests may also be ordered to confirm the presence of rheumatoid arthritis.

Indications

Artificial finger joint replacement is indicated for patients with arthritis of the fingers. Finger joint replacement is considered if other treatment options fail to relieve the pain and disability.

The surgery is usually reserved for older patients who do not perform heavy labor activities. Finger replacement implants are not appropriate for younger, more active patients as the implants may loosen or wear out over time.

For an Appointment with Dr. Neil Kruger, or further information on this video / procedure please contact us on:
☎️ 074 810 0564 (Appointments & WhatsApp)
💻 www.drneilkruger.com
📩 info@drneilkruger.com

Click on the link to view the high quality Artificial Finger Joint Replacement video provided by Your Practice Online. We provide medical videos for medical professionals to educate their patients.

07/06/2021

“Over the course of the coming year we will be running weekly informative videos on various hand and upper limb conditions. Each video contains information on the relevant anatomy, predisposing factors and optimal management of each condition. We hope these are of value to you in better understanding your problem.”
Dr Neil Kruger.

DUPUYTRENS CONTRACTURE
Dupuytrens is a disease that originates from the Scandinavian peninsula, the so-called Viking disease. It is a progressive hand deformity that affects a layer of tissue that lies under the skin of your palm causing cords and nodules which lead to flexion contractures of the joints of the fingers, and an inability to open one’s hand completely. It is twice as common in men, and also starts at a younger age. The incidence also increases with increasing age. Mostly it is a painless, but the nodules may occasionally be sensitive, especially if in weight bearing areas of the palm.

In rare cases there is an aggressive form of the disease which occurs in younger patients and may affect the under-surface of their feet, the back of their hands or even their ge****ls.
Earlier onset disease is usually more aggressive and has a higher recurrence rate. Dupuytrens is diagnosed at the consultation and does not require any ancillary tests. There are thick cords in the palm and fingers. These cords will occasionally wrap around and displace the nerves supplying the fingers, so there may be some subtle numbness or tingling in the hand or fingers affected.

🧰 Management 🧰
Non-operative-:
Non-operative measures such as stretching exercises or night extension splinting will not slow the progression of the disease. There is some evidence that radiotherapy may slow the progression of the disease, but this is mostly reserved for younger patients who present with early disease.

Operative-:
Surgery is indicated if the flexion contractures of the digits are impacting the patient’s daily activities. Surgical options to treat the disease are patient specific, as certain techniques are more appropriate for certain types of Dupuytren contracture.

Need More Information?
🔽Please click the link below & for our website🔽
https://drneilkruger.com/dupuytrens-contracture/

For an Appointment with Dr. Neil Kruger, or further information on this video / procedure please contact us on:

☎️ 074 810 0564 (Appointments & WhatsApp)
💻 www.drneilkruger.com
📩 info@drneilkruger.com

Click on the link to view the high quality Dupuytrens Contracture video provided by Your Practice Online. We provide medical videos for medical professionals to educate their patients.

31/05/2021

“Over the course of the coming year we will be running weekly informative videos on various hand and upper limb conditions. Each video contains information on the relevant anatomy, predisposing factors and optimal management of each condition. We hope these are of value to you in better understanding your problem.”
Dr Neil Kruger.

BASE OF THUMB ARTHRITIS (Thumb Arthroplasty)
Degenerative arthritis – osteoarthritis – at the base of the thumb is extremely common and age related. It might appear as a dull ache at the base of your thumb for many years with exacerbations of the pain when you load the thumb in pinching or opening a jar.
This degeneration starts at the primary joint of the thumb, but spreads to the adjacent joints due to the abnormal subsequent loading of these joints. Joint cartilage regeneration is not possible – once it is worn away it is does not regenerate.
This degeneration also places more stress on the surrounding ligaments and they struggle to contain the joint, so the thumb can’t be maintained in its position to complete tasks and may appear unsightly. The base of the thumb appears squared off and cannot extend away from the palm.

🧰 Management 🧰
All management is aimed at providing sustained symptomatic relief and is personally tailored according to what the individual patient’s concerns are.
Read more about the management options, please click through to our website here
🔽https://drneilkruger.com/base-of-thumb-arthrtitis-carpo-metacarpal-joint-cmcj-osteoarthritis/🔽

For an Appointment with Dr. Neil Kruger, or further information on this video / procedure please contact us on:
☎️ 074 810 0564 (Appointments & WhatsApp)
💻 www.drneilkruger.com
📩 info@drneilkruger.com

Click on the link to view the high quality Thumb Arthroplasty video provided by Your Practice Online. We provide medical videos for medical professionals to educate their patients.

31/05/2021

“Over the course of the coming year we will be running weekly informative videos on various hand and upper limb conditions. Each video contains information on the relevant anatomy, predisposing factors and optimal management of each condition. We hope these are of value to you in better understanding your problem.”
Dr Neil Kruger.

GANGLION CYST REMOVAL
Cysts or swellings around the hand and wrist are extremely common and may be troublesome if interfering with daily activities or become unsightly if they grow very large. The most common swelling is found on the back side of the wrist and is a simple ganglion.

They may vary in size from barely visible, to large troublesome swellings that won’t go away. They may also get bigger and then smaller again. They may occur in multiple locations, but when occurring on the palmar surface of the wrist they may be troublesome, as they may cause intermittent symptoms related to compression of arteries or nerves, and it is advisable to seek specialist opinion if these are troubling you.

🧰 Management 🧰
Dorsal ganglions-:
In some cases these may resorb on their own, so doing nothing is an option. Most patients however wish to have something done about it, and needle aspiration performed under local anaesthetic can be performed. The recurrence rates of aspiration are high, as more than one in two recur.
If managed surgically, open surgical removal is effective over 90% of the time. The key to the surgery is to remove the stalk in its entirety.
An attractive alternative to open surgery is through removing the ganglion from the inside of the wrist through a wrist arthroscope. This makes two small keyholes at the back of the wrist and the ganglion is removed under direct vision.

Volar ganglions -:
These are often very close to the radial artery and should not be aspirated. If there is any concern regarding the lesion, it should have a formal excision biopsy in theatre by an experienced surgeon who has done these before.

For an Appointment with Dr. Neil Kruger, or further information on this video / procedure please contact us on:

☎️ 074 810 0564 (Appointments & WhatsApp)
💻 www.drneilkruger.com
📩 info@drneilkruger.com

Click on the link to view the high quality Ganglion Cyst Removal video provided by Your Practice Online. We provide medical videos for medical professionals to educate their patients.

31/05/2021

“Over the course of the coming year we will be running weekly informative videos on various hand and upper limb conditions. Each video contains information on the relevant anatomy, predisposing factors and optimal management of each condition. We hope these are of value to you in better understanding your problem.”
Dr Neil Kruger.

DE QUERVAIN'S TENOSYNOVITIS
De Quervain’s is a narrowing of two tendons that control movement of the thumb due to repetitive thumb movement which causes friction, irritation and swelling. In certain patients one of the tendons run in a sub-sheath and these patients are predisposed to De Quervain’s.
While afflicting a wide range of people, it is more common in women older than 50, or those who have recently given birth. Interestingly the condition is now sometimes reported in teenagers due to repetitive thumb movements when using smart phones.
Clinically the pain is felt at a precise point on the thumb side of the wrist and may be very painful and disabling.

Any movement pulling the thumb and/or wrist to the little finger side may be exquisitely painful. The diagnosis is clinical and usually there is no need for special investigations.

🧰 Management 🧰
Patients respond well to conservative management with avoidance of precipitating movements (often a splint is helpful in this, but splints have not been shown to alter the course of the disease), oral analgesics and anti-inflammatories. If a steroid injection is required, 8 in 10 patients respond well. It is worth noting though that repeat injections in the region discolour the skin permanently and cause tissue degeneration.

Surgical release involves a small incision over the wrist, completely releasing the narrowed pulley through which the tendons pass. This may be done under local or general anaesthetic, depending on the patient’s needs.

Many patients feel better within a week or two following surgery, but full rehabilitation may take 6 weeks to 3 months. The wrist is splinted for a week post surgery and the key to recovery is to keep the thumb tendons gently gliding in the newly released tunnel.

Therapy will include scar and swelling management, wrist and thumb range of movement and strengthening with and occupational hand therapist

For an Appointment with Dr. Neil Kruger, or further information on this video / procedure please contact us on:

☎️ 074 810 0564 (Appointments & WhatsApp)
💻 www.drneilkruger.com
📩 info@drneilkruger.com

The muscles and bones of the hand are connected by thick flexible tissue called tendons. Tendons are covered by a thin soft sheath of tissue known as synovium. Extensor pollicis brevis and abductor pollicis longus are two tendons located on the thumb side of the wrist. Inflammation and swelling of t...

17/05/2021

“Over the course of the coming year we will be running weekly informative videos on various hand and upper limb conditions. Each video contains information on the relevant anatomy, predisposing factors and optimal management of each condition. We hope these are of value to you in better understanding your problem.” Dr Neil Kruger.

ENDOSCOPIC CARPAL TUNNEL SURGERY

Endoscopic carpal tunnel release surgery is a minimally invasive approach to treat carpal tunnel syndrome. Special tissues known as synovium surround and lubricate the flexor tendons in your wrist, allowing smooth movement of the fingers. Carpal Tunnel Syndrome occurs when the synovium swells, narrowing the limited space within the tunnel, and pinches the median nerve over time.

For an Appointment with Dr. Neil Kruger, or further information on this video / procedure please contact us on:
☎️ 074 810 0564 (Appointments & WhatsApp)
💻 www.drneilkruger.com
📩 info@drneilkruger.com

Click on the link to view the high quality Endoscopic Carpal Tunnel Surgery video provided by Your Practice Online. We provide medical videos for medical professionals to educate their patients.

16/05/2021

“Over the course of the coming year we will be running weekly informative videos on various hand and upper limb conditions. Each video contains information on the relevant anatomy, predisposing factors and optimal management of each condition. We hope these are of value to you in better understanding your problem.” Dr Neil Kruger.

MINI-OPEN CARPAL TUNNEL RELEASE SURGERY

The carpal tunnel is a narrow passageway on the palm side of your wrist. Small wrist bones known as carpals form the bottom and sides of your carpal tunnel and a strong band of connecting tissue, known as the transverse carpal ligament, covers the top of the carpal tunnel.

The carpel tunnel houses the flexor tendons, that allow you to bend your fingers, and the median nerve, which provides sensation to most of your fingers and hand.

Disease Overview~
Special tissues known as synovium surround and lubricate the flexor tendons in your wrist, allowing smooth movement of the fingers. Carpal Tunnel Syndrome occurs when the synovium swells narrowing the limited space within the tunnel and pinches the median nerve over time. The transverse carpal ligament can also become tight narrowing the carpal tunnel space and putting pressure on the median nerve.

Signs & Symptoms~
Some of the common symptoms associated with Carpal Tunnel Syndrome include.
📍Numbness and tingling in the thumb, index, and middle fingers.
📍Pain and burning in the hand and wrist that may radiate up the arm to the
elbow.
📍Decreased sensation and weakness in the hand with diminished grip
strength.
📍Worsening of symptoms at night.

For an Appointment with Dr. Neil Kruger, or further information on this video / procedure please contact us on:
☎️ 074 810 0564 (Appointments & WhatsApp)
💻 www.drneilkruger.com
📩 info@drneilkruger.com

The carpal tunnel is a narrow passageway on the palm side of your wrist. Small wrist bones known as carpals form the bottom and sides of your carpal tunnel and a strong band of connecting tissue, known as the transverse carpal ligament, covers the top of the carpal tunnel.

16/05/2021

“Over the course of the coming year we will be running weekly informative videos on various hand and upper limb conditions. Each video contains information on the relevant anatomy, predisposing factors and optimal management of each condition. We hope these are of value to you in better understanding your problem.” Dr Neil Kruger.

OPEN CARPAL TUNNEL RELEASE SURGERY
The carpal tunnel is a narrow passage on the palm side of your wrist. Small wrist bones known as carpals form the bottom and sides of your carpal tunnel and a strong band of connecting tissue, known as the transverse carpal ligament, covers the top of the carpal tunnel.
The carpal tunnel houses the flexor tendons, that allow you to bend your fingers, and the median nerve that provides sensation to most of your fingers and hand.

Disease overview~
Special tissues known as synovium surround and lubricate the flexor tendons in your wrist, allowing smooth movement of the fingers. Carpal Tunnel Syndrome occurs when the synovium swells narrowing the limited space within the tunnel and pinches the median nerve over time. The transverse carpal ligament can also become tight narrowing the carpal tunnel space and putting pressure on the median nerve.

Signs & symptoms~
Some of the common symptoms associated with Carpal Tunnel Syndrome include:
📍Numbness and tingling in the thumb, index, and middle fingers
📍Pain and burning in the hand and wrist that may radiate up the arm to the
elbow.
📍Decreased sensation and weakness in the hand with diminished grip
strength.
📍Worsening of symptoms at night.

For an Appointment with Dr. Neil Kruger, or further information on this video / procedure please contact us on:
☎️ 074 810 0564 (Appointments & WhatsApp)
💻 www.drneilkruger.com
📩 info@drneilkruger.com

The carpal tunnel is a narrow passageway on the palm side of your wrist.Small wrist bones known as carpals form the bottom and sides of your carpal tunnel and a strong band of connecting tissue, known as the transverse carpal ligament, covers the top of the carpal tunnel.

26/04/2021

“Over the course of the coming year we will be running weekly informative videos on various hand and upper limb conditions. Each video contains information on the relevant anatomy, predisposing factors and optimal management of each condition. We hope these are of value to you in better understanding your problem.” Dr Neil Kruger.

TRIGGER FINGER
The ability to bend the fingers is governed by supportive tendons that connect muscles to the bones of the fingers.
The tendons run along the length of the bone and are kept in place at intervals by tunnels of ligaments called pulleys.
When the fingers bend or are straightened, a slippery coating called tenosynovium helps the tendons smoothly glide through the ligaments with reduced friction.
Inflammation in the tenosynovium leads to a condition called trigger finger, also known as stenosing tenosynovitis or flexor tendonitis, where one of the fingers or thumb of the hand is caught in a bent position.

For an Appointment with Dr. Neil Kruger, or further information on this video / procedure please contact us on:
☎️ 074 810 0564 (Appointments & WhatsApp)
💻 www.drneilkruger.com
📩 info@drneilkruger.com

Click on the link to view the high quality Trigger Finger video provided by Your Practice Online. We provide medical videos for medical professionals to educate their patients.