From Collarbones to Carpal Tunnel Syndrome (CTS)



Since summer is upon us and mountain bike “season is open” let’s start with the clavicle because it’s the 1st bone in the body to form (at 5 wks) and the last bone the body to finish developing (at 20-25 wks). It is one of the most common bones to break, accounting for 5% of all fractures and nearly 1/2 of all the fractures involving the shoulder area. Typically, the clavicle breaks in the middle. Until recently, clavicle fractures, other than fractures at the very end of the bone, have been treated conservatively with a sling, a figure-of-eight, or some type of immobilization. With “the tincture of time” they typically heal 95% of the time. The Canadian Orthopedic Trauma Society data suggests operative treatment may provide for improved outcomes. There has been a general trend toward surgical fixation or Open Reduction & Internal Fixation (ORIF) of clavicle fractures. Healing in the surgical group occurred at an average of 12 weeks faster than with non-operative treatment (16 vs. 28 wks). That’s impressive. Fractures, like people, are unique, each with their own personality, and must be treated individually and with the utmost respect. I make sure that each person’s care is individualized. Over time, we will be able to determine which approach is the ”better“ approach.

Carpal Tunnel Syndrome (CTS)

With regard to carpal tunnel syndrome (CTS), it is one of the most common disorders of the upper extremity, affecting up to 1 out of 10 Americans. More than 3.1 million Americans of sought treatment for carpal tunnel syndrome and over half-million surgical procedures are performed annually to help patients who have carpal tunnel syndrome. Patients with carpal tunnel syndrome describe numbness, tingling, pain in the thumb index & middle fingers, wrist, or forearm, which is often worse at night. An “electric shock–like“ feeling is common. CTS increases with age, during pregnancy, and in people with diabetes, rheumatoid arthritis, and thyroid disease. CTS has been associated with typing and computer data entry. I think of CTS as a “packaging problem” – “too much stuff” compressing the median nerve. Conservative measures include splinting, medication, & activity modification. Acupuncture, electrical stimulation, massage therapy, magnets, water pills, and nutritional supplements have all been used but have not been shown to be beneficial in the treatment of CTS. When conservative measures fail, releasing the pressure relieves the symptoms.

The Advantage device allows for simple, painless, & reliable diagnosis of carpal tunnel syndrome using sophisticated sensors & computer technology. Diagnosis is something we can do right here in Hailey at my office. Don’t let hand pain keep you up at night.

You can count on getting up-to-date answers to all of your orthopedic questions at Hailey Orthopedics & Sports Medicine. Ride hard, wear your helmet, and call for numbness, tingling, or hand pain that just will not quit.

Enjoy summer, spread compassion!