Xiaflex for Dupuytren's Disease

Xiaflex is used to treat cords that form in Dupuytren's Disease in the hand. Xiaflex injection on day one  is followed a day later by manipulation to break the cord and fully extend the finger. Fast forward if you wish to see the manipulation at 3:30.

XIAFLEX® (collagenase clostridium histolyticum) is a prescription medicine used to treat adult patients with Dupuytren's contracture when a "cord" can be felt. Over time, the thickening of this cord in your hand can cause one or more fingers to bend toward your palm, so that you cannot straighten them. XIAFLEX should be injected into the cord by a healthcare provider who is experienced in injection procedures of the hand and treating people with Dupuytren's contracture. XIAFLEX helps "break" the cord that is causing the finger to be bent.

Important Safety Information

XIAFLEX can cause serious side effects, including:

• Tendon or ligament damage. Receiving an injection of XIAFLEX may cause damage to a tendon or ligament in your hand and cause it to break or weaken. This could require surgery to fix the damaged tendon or ligament. Call your healthcare provider right away if you have trouble bending your injected finger (towards the wrist) after the swelling goes down or you have problems using your treated hand after your follow-up visit.
• Nerve injury or other serious injury of the hand. Call your healthcare provider if you get numbness, tingling, or increased pain in your treated finger or hand after your injection or after your follow-up visit.
• Allergic Reactions. Allergic reactions can happen in people who have received an injection of XIAFLEX because it contains foreign proteins. Call your healthcare provider right away if you have any of these symptoms of an allergic reaction after an injection of XIAFLEX: hives; swollen face; breathing trouble; or chest pain.

Before receiving XIAFLEX, tell your healthcare provider if you have had an allergic reaction to a previous XIAFLEX injection, or have a bleeding problem or any other medical conditions. Tell your healthcare provider about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Be sure to tell them if you use blood thinners such as aspirin, clopidogrel (Plavix®), prasugrel hydrochloride (Effient®), or warfarin sodium (Coumadin®).
Common side effects with XIAFLEX include: swelling of the injection site or the hand, bleeding or bruising at the injection site; and pain or tenderness of the injection site or the hand, swelling of the lymph nodes (glands) in the elbow or underarm, itching, breaks in the skin, redness or warmth of the skin, and pain in the underarm.
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Pumpkin Carving Dangers

Hand Surgeons Warn of Pumpkin Carving Dangers

from ASSH (American Society for Surgery of the Hand)

Use caution during the Halloween season, and take steps to prevent hand injuries when carving.

“Every Halloween season we see four or five patients—both adults and children—who come into our office with severe injuries to their hands and fingers,” says Jeffrey Wint, MD, an ASSH member from The Hand Center of Western Massachusetts, Springfield, MA. “Treatment can often run three to four months from the time of surgery through rehabilitation.”

To prevent hand injuries, the ASSH suggests the following safety tips

Carve at a Clean, Dry, Well-lit Area

Wash and thoroughly dry all of the tools that you will use to carve the pumpkin: carving tools, knife, cutting surface, and your hands. Any moisture on your tools, hands, or table can cause slipping that can lead to injuries.

Always Have Adult Supervision

“All too often we see adolescent patients with injuries because adults feel the kids are responsible enough to be left on their own,” says Wint. “Even though the carving may be going great, it only takes a second for an injury to occur.”

Leave the Carving to Adults

Never let children do the carving. Wint suggests letting kids draw a pattern on the pumpkin and have them be responsible for cleaning out the inside pulp and seeds. When the adults do start cutting, they should always cut away from themselves and cut in small, controlled strokes.

Sharper is not Better

“A sharper knife is not necessarily better because it often becomes wedged in the thicker part of the pumpkin, requiring force to remove it,” says Wint. “An injury can occur if your hand is in the wrong place when the knife finally dislodges from the thick skin of the pumpkin. Injuries are also sustained when the knife slips and comes out the other side of the pumpkin where your hand may be holding it steady.”

Use a Pumpkin Carving Kit

Special pumpkin carving kits are available in stores and include small serrated pumpkin saws that work better because they are less likely to get stuck in the thick pumpkin tissue. “If they do get jammed and then wedged free, they are not sharp enough to cause a deep, penetrating cut,” says Wint.

Help for a pumpkin carving injury

Should you cut your finger or hand, bleeding from minor cuts will often stop on their own by applying direct pressure to the wound with a clean cloth. If continuous pressure does not slow or stop the bleeding after 15 minutes, an emergency room visit may be required.

Pumpkin Carving Dangers

Hand Surgeons Warn of Pumpkin Carving Dangers

from ASSH (American Society for Surgery of the Hand)

Use caution during the Halloween season, and take steps to prevent hand injuries when carving.
“Every Halloween season we see four or five patients—both adults and children—who come into our office with severe injuries to their hands and fingers,” says Jeffrey Wint, MD, an ASSH member from The Hand Center of Western Massachusetts, Springfield, MA. “Treatment can often run three to four months from the time of surgery through rehabilitation.”

To prevent hand injuries, the ASSH suggests the following safety tips

Carve at a Clean, Dry, Well-lit Area
Wash and thoroughly dry all of the tools that you will use to carve the pumpkin: carving tools, knife, cutting surface, and your hands. Any moisture on your tools, hands, or table can cause slipping that can lead to injuries.
Always Have Adult Supervision
“All too often we see adolescent patients with injuries because adults feel the kids are responsible enough to be left on their own,” says Wint. “Even though the carving may be going great, it only takes a second for an injury to occur.”
Leave the Carving to Adults
Never let children do the carving. Wint suggests letting kids draw a pattern on the pumpkin and have them be responsible for cleaning out the inside pulp and seeds. When the adults do start cutting, they should always cut away from themselves and cut in small, controlled strokes.
Sharper is not Better
“A sharper knife is not necessarily better because it often becomes wedged in the thicker part of the pumpkin, requiring force to remove it,” says Wint. “An injury can occur if your hand is in the wrong place when the knife finally dislodges from the thick skin of the pumpkin. Injuries are also sustained when the knife slips and comes out the other side of the pumpkin where your hand may be holding it steady.”
Use a Pumpkin Carving Kit
Special pumpkin carving kits are available in stores and include small serrated pumpkin saws that work better because they are less likely to get stuck in the thick pumpkin tissue. “If they do get jammed and then wedged free, they are not sharp enough to cause a deep, penetrating cut,” says Wint.
Help for a pumpkin carving injury
Should you cut your finger or hand, bleeding from minor cuts will often stop on their own by applying direct pressure to the wound with a clean cloth. If continuous pressure does not slow or stop the bleeding after 15 minutes, an emergency room visit may be required.

ENTEROVIRUS D68

Enterovirus D68 prevention, symptoms and Treatment. We have taken the liberty of reposting this from Baystate Children's Hospital. Please show this to family, friends and relatives.

Why choose us for Hand and Wrist and Upper Extremity Surgery?

Dr Wint, Wintman and Martin ( L to R)

If you choose the hand center, you will always be seen by one of our highly skilled Hand surgeons at every visit. 

Here at The Hand Center of Western Massachusetts our physicians provide the individual attention and care that you need. 

We've seen it before

We strive to work closely with our patients and their families, other medical professionals, employers and insurance carriers to provide you with needed care. We know that the path to recovery from minor to major injuries can be a difficult one. Our highly specialized physicians and caring staff are interestedin your success. If you have a question or problem while treating with us,  we want to hear about it.

For example , at Baystate Medical Center our hand and wrist surgery experience for our three surgeons combined is well  over  25 years as hand surgeons who have taken Emergency call for  acute problems and the most severe injuries. For overall experience with hand surgery we have even more combined years than that!  This give our surgeons and our office staff a high level of  wisdom and experience  that is put to work for you. If it involves the hand and wrist and upper extremity our surgeons and  staff have seen it before. Whether we evaluate you in one of our three offices in Springfield, Ware or Enfield or go to any one of the locations where we do surgery, this experience follows. 

Well Respected in the Community

All of our hand surgeons have been awarded recognition by their peers and patients for their work. Including several patient portals and  physician rating websites. Each has won awards from these sites for several years. Ask your friend, relatives and  your primary care provider about us. Chances are  they know of someone we have taken care of in the past.

It's What we do

At The Hand Center of Western Massachusetts, we care for the hand, upper extremity, and shoulder, including fractures, tendonitis, lacerations, nerve compression, carpal tunnel, arthritis, and workerscompensation injuries, just to name a few. Our Hand and Upper Extremity Surgeons are consideredby many  in the community to be the premier source for care of these areas including bone, joint, tendon and nerve problems.

Our specialists diagnose and treat injuries and diseases of the hand and wrist and upper extremity  in adults and children.

We offer a wide range of services from initial consultations to non-surgical and minimally invasive treatments, to complex reconstructions for the most difficult of  hand, wrist and upper extremity problems.  

The Hand Center is devoted to the care of the Hand, Upper Extremity and Shoulder. Our staff wants to provide you with a high quality of care. We are committed to successfully returning you to your daily work and leisure activities.

Doctors Wint, Wintman, and Martin are fellowship trained hand surgeons. Doctors Wint and Wintman

are trained and Board Certified in Orthopaedic surgery of the hand. Dr. Martin is trained in plastic surgery, and is Board Certified. All three physicians have added qualifications in Surgery of the Hand, which is awarded after additional requirements of training, practice experience   and  ongoing Maintenance of certification.

Our physicians have surgical privileges at Baystate Medical Center, Pioneer Valley Surgicenter,

Mercy Medical Center, Baystate Mary Lane Hospital, Cooley Dickinson Hospital. Noble Hospital, and Johnson Memorial Medical Center.

PREVENT FIREWORKS AND FIRECRACKER INJURY

Be safe this fourth of July , enjoy yourself and prevent

Firecracker or Fireworks Injuries from occurring.

According to the Consumer Product Safety Commission, national losses involving fireworks amount to 3 deaths and 10,527 injuries annually.Hand and finger injuries are the most common and account for 32 percent of all injuries. Head and eye injuries occur with about the same frequency, equaling 19 and 18 percent of total injuries.

A review of firework mishaps shows a variety of factors contribute to the typical mishap. Most pre-school age victims are injured by fireworks ignited by someone else, while older children who are injured are usually lighting the fireworks themselves. Children under age five are commonly hurt by rocket-type fireworks; small firecrackers and ground spinners injure the majority of children between the ages of 5 and 14. Most of the injuries associated with large, illegal firecrackers such as M-80's are to older teenagers or adults.

Hand Surgeons Agree: Leave Fireworks to the Professionals

The American Society for Surgery of the Hand (ASSH) has urged the public to leave fireworks in the hands of the professionals.
According to the U.S. Consumer Product Safety Commission, 38% of all reported fireworks-related injuries from June 22-July 22, 2001, were to fingers, hands, and arms. These injuries included burns, lacerations, fractures, and traumatic amputation.
Of the finger, hand, and arm injuries, the majority of injuries were caused from accidents involving firecrackers, bottle rockets, and sparklers— the three firework-types most often used in a backyard environment. Accidents involving firecrackers, bottle rockets, and hand-held sparklers totaled 57% of all firework injuries (source: American Pyrotechnic Association).
One solution that has been offered by the ASSH to individuals is to attend public fireworks displays, which are monitored for safety by a local fire department, rather than setting off fireworks near or around the home.

The following precautions should be taken when attending a public fireworks display:

• Obey safety barriers and ushers.
• Stay back a minimum of 500 feet from the launching site.
• Resist the temptation to pick up firework debris when the display is over. The debris may still be hot, or in some cases, the debris might be “live” and could still explode.
• Never give children hand-held sparklers. Sparklers cause 10% of all firework injuries (source: American Pyrotechnics Association)—and were associated with the most injuries to children under 5 years of age. (source: U.S. Consumer Product Safety Commission)

The Hand Center of Western Massachusetts agrees -- keep your hands safe this fourth of July. Enjoy the day and leave fireworks to the professionals

Portions Copyright © American Society for Surgery of the Hand 2008.

Modified/adapted altered by www.handctr.com from assh.org

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SPRING TIME reminder: LAWNMOWER SAFETY

help us to promote

Lawnmower Safety

These Injuries can be devastating to the hand ...or any part of the body that is involved.

• 22% of injuries involve the hand, fingers or wrist.  25% of which result in amputation

• Lawnmowers should be considered potentially lethal in the hands of children.

• Children under age 6 should be inside when the lawn is being mowed.

• Children under age 12 should not be allowed to go near a power lawnmower and should be at least 16 before using a riding mower.

• Safety training is essential always.

MORE RESOURCES:

ASSH LAWNMOWER SAFETY

Keep Your Hands Safe: Follow Lawnmower Safety Tips

Each year, more than 74,000 small children, adolescents and adults are injured by rotary, hand and riding power mowers due to improper handling. The American Society for Surgery of the Hand would like to provide you with patient information to help you avoid these injuries.
Kinetics of Rotary Power LawnmowersKinetic energy (motion) imparted by a standard rotary blade is comparable to the energy generated by dropping a 21-pound weight from a height of 100 feet or is equal to three times the muzzle energy of a .357 Magnum pistol. Blade speed can eject a piece of wire or an object at speeds up to 100 miles per hour.
Injury Profile
Adults 25-64 years
Children under age five
22% involve wrist, hand or finger
14% involve foot, ankle or toes
25% of all hand and foot injuries result in amputation
Deaths occurred in children under six years of age
Common Injury Patterns

• Direct contact with rotating or jammed blade
• Serious avulsion (tearing/separating) injuries to soft tissue and bones
• Gross contamination from contact with grass and soil harboring pathogens
• Injuries requiring multiple staged surgeries to cleanse wounds and provide soft tissue coverage (to regenerate healthy tissue/skin)

Common Weather Conditions

• Wet grass
• Damp ground

Other Causes of Injury

• Passengers (adult/child) on riding mowers or in cart towed behind mower
• Mower being pulled backward
• Sloping lawn mowed by power mower up and down slope, instead of across
• Sloping lawn mowed by riding mower across slope, instead of up and down
• Wearing sandals or open-toed shoes
• Operator attempts to unclog blades with hand or foot

Lawnmowers are safe if used properly.
Remember the following:

• Read your mower's instruction manual prior to use.
• DO NOT REMOVE safety devices or guards on switches.
• NEVER insert hands or feet into the mower to remove grass or debris. Even with the motor turned off, the blade remains engaged.
• ALWAYS use a stick or broom handle to remove any obstruction.
• NEVER cut grass when it is wet or when the ground is damp.
• NEVER allow a child to operate the mower at any time or be in the area to be mowed.
• NEVER allow passengers, other than the operator, on riding mowers.
• Keep your mower in good working order with sharp blades.
• DO NOT DRINK before or while using your lawnmower.
• Wear protective boots, goggles, gloves and long pants.
• Do not operate the lawnmower while barefoot.
• Be cautious when mowing hills or slopes.

REMEMBER — SAFETY FIRST AT ALL TIMES!
Copyright © American Society for Surgery of the Hand 2009.

2008 AAOS Position Statement taken from AAOS website by www.handctr.com 

Power Lawnmower Safety.
This Position Statement was developed as an educational tool based on the opinion of the authors. It is not a product
of a systematic review. Readers are encouraged to consider the information presented and reach their own
conclusions.
More than 210,000 people – including approximately 16,000 children - were treated in doctors’ offices, clinics and
emergency rooms for lawnmower-related injuries in 2007, according to the U.S. Consumer Product Safety
Commission. Lawnmower injuries often result in partial or complete amputation of both lower and upper extremities.
The American Academy of Orthopaedic Surgeons believes that the great majority of these injuries are
preventable. The Academy recommends the following safety guidelines when using lawnmower
equipment.

Never let children operate lawnmowers. Keep kids 15 years of age and younger away when lawnmowers are in use.

Children should not be in the yard while the lawn is being mowed.

No riders other than the operator, regardless of age, should be allowed on a riding mower.

Be sure the motor has been turned off before inspecting or repairing power lawnmower equipment.

Do not tamper with safety release switches.

Keep lawnmowers in good working order with sharp blades.

Remove stones, toys and other objects from the lawn before you start mowing.

Wear protective gloves, goggles, boots and long pants when you use lawnmowers. Never mow barefoot or in
sandals.

Use caution when mowing hills and slopes. Mow across with a push mower; mow up and down with a riding
mower. Do not cut wet grass.

Be sure the motor is off before inspecting or repairing lawnmower equipment.

Read the instruction manual before using a lawnmower.

Be sober (i.e., don’t drink and mow.)

Do not remove safety devices, shield or guards on switches, and keep hands and feet away from moving parts.

Stay away from the engine cowling, as it can become very hot and burn unprotected flesh.

Add fuel before starting the engine, not when it is running or hot.

Use a stick or broom handle (not your hands or feet) to remove debris in lawnmowers or snowblowers.

Do not leave a lawnmower unattended when it is running. If you must walk away from the machine, shut off the
engine.

March 1998. Revised December 2008 American Academy of Orthopaedic Surgeons.
This material may not be modified without the express written permission of the American Academy of Orthopaedic
Surgeons .
Position Statement 1142
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LINKS:

Lawn Mower-Related Injuries to Children:Committee on Injury and Poison Prevention

Mowing the Lawn Can Be a Dangerous Chore