1. Wear a shirt one size bigger and wear it over the sling. This will prevent you from using the arm. If you wear a button-up shirt, then you can leave one button open so your hand sticks out.

2. Wear your pants one size bigger and leave them buttoned/zippered so you can pull them on each time or wear a pair of drawstring pants (sweat pant style).

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Using the thumb or the index finger supported with the middle finger, rub rapidly back and forth across the tendon with as much pressure as tolerated. The tendon is located on the lateral epicondyle, and you must be on the most sensitive spot in order for this to be effective. Goal: 5 minutes.

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Surgery will take place at our outpatient surgery center, (ASC), on a Wednesday. You will be placed into a well padded splint and ace wrap after your surgery to allow for swelling. Leave this on until your first post-op appointment in the clinic 9-12 days later.

At your first post-op appointment the splint will be cut off in the cast room by one of our technicians. Your foot/leg will be cleaned up and the stitches removed at this time. Dr. Vieth will look at your incision and make sure everything is healing well. You will be put into a cast or boot at this appointment. You will follow up in approximately three weeks. You will need to remain *protective weight-bearing until that appointment.

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Fusion of your great toe (big toe) with the metatarsal. This is performed due to severe arthritis of the great toe that has failed conservative treatment. Severe arthritis of this joint is called hallux rigidus.

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Joint fusion of the tibia, fibula, and talus (the specific bones entailed in this procedure may vary depending on your specific arthritic problems in this joint area). This procedure is most likely warranted due to severe arthritis in this joint that causes severe pain that has failed all other conservative treatment.

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You are scheduled for a Thumb Arthroplasty. The procedure is performed in patients with advanced basilar thumb arthritis. It is intended to alleviate pain in the thumb and improve function. Pinching or grasping causes severe pain in the thumb. The joint is removed and a tendon is used to reconstruct the joint.

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You are scheduled for a Trigger Finger Release. The procedure is performed to alleviate locking or triggering of your finger. The swollen tendon catches as it glides under the pulley or sheath. The sheath over the tendon is released allowing normal motion of the finger. The swelling in the tendon will improve over the first few weeks following surgery.

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You are scheduled for Carpal Tunnel Release. The procedure is performed to relieve pressure on one of the major nerves to the hand, the median nerve. The nerve may be compressed as it passes through the carpal tunnel which is formed by the bones of the wrist and the transverse carpal ligament. By transecting the transverse carpal ligament, pressure on the nerve is relieved.
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Replacing the worn out ball and socket joint of the hip with a metal stem/ball and socket. This is done to relieve the pain associated with arthritis of the hip. These components are fixed to your body with bone ingrowth or cement fixation. The type of fixation is determined by your bone quality, activity level, and weight. The procedure is done as an inpatient requiring a hospital stay of 2 to 4 days. The procedure takes approximately 60 to 90 minutes to perform. It is done through an incision which is as small as possible to allow adequate visualization for your surgery. A walker or crutches are used for approximately 2 to 4 weeks, then a cane for 1 to 3 weeks. Ninety to 95 percent of patients are happy with the results after surgery.

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The ACL or Anterior Cruciate Ligament is one of the major ligaments in your knee. Injury to this ligament can cause instability and recurrent giving way episodes, which could injure other important structures in your knee. Often the original injury of an ACL coincides with injury to the meniscus cartilage.  Surgical treatment of an ACL tear involves reconstructing the ligament to restore stability of the knee.  The tissue used to replace the ACL is usually borrowed from another part of your knee, (or donated tissue could be used.) The most commonly used tissue is a portion of your hamstring tendons. The operation is carried out with the aid of an arthroscope, which allows your surgeon to see the entire knee through very small incisions. A slightly longer incision will be made to obtain the tissue or graft that is used to reconstruct the ligament. Tunnels are made in the bones on either side of the knee joint and the tissue grafts are anchored on each bone. The anchoring devices utilized are left in on a permanent basis.

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Replacing the worn out surfaces of the end of the thigh bone (femur) and top of the shin bone (tibia) and undersurface of the kneecap (patella) with metal and polyethylene (hard plastic) bearing surfaces. We use both fixed-bearing and mobile-bearing prostheses to maximize motion and longevity. This is done to relieve the pain associated with arthritis of the knee. This requires an inpatient hospital stay of 2 to 4 days. The procedure takes approximately 60 to 90 minutes to perform. A system of specific instruments, along with the use of computer-assisted techniques, are used to insure correct placement and alignment of your prosthesis. The implants are fixed to your bones with bone cement. Ninety to 95 percent of patients are happy with their procedure.

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Basic information about this procedure: You are scheduled for an arthroscopic surgery to remove torn meniscus and/or cartilage tissues from your knee. For this surgery, most people “go to sleep completely” during surgery with a general anesthetic. Surgery with a spinal anesthetic is also an option. Three small incisions are made to allow special instruments, including a fiber-optic camera, to be placed into your knee. Sterile saline (saltwater) is brought into the knee joint continuously with tubing to provide a clear view for the surgeon. Torn parts of the meniscus and/or damaged cartilage on the bone surfaces are carefully removed with special arthroscopic instruments. The end result is a knee lined with smooth and stable tissues rather than rough, torn, and unstable edges. The actual surgery time is usually about 30 minutes, but if extensive work is needed, the procedure may last slightly longer. At the end of the surgery, local anesthesia medication is injected into the knee and reduces pain for about 10 to 12 hours after surgery. This explains why patients often note that their pain is not severe at first, then worse the day after surgery.

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How long does the surgical procedure take and what exactly is done?

The actual surgery time is usually about 30 minutes. If extensive work is needed, the procedure may last up to 45 minutes. Most people "go to sleep completely" during surgery with a general anesthetic. Some have surgery with a spinal anesthetic.

Three or four small incisions are made to allow special instruments, including a fiber-optic camera, to be placed into your knee. Sterile saline (salt water) is brought into the knee joint continuously with tubing to provide a clear view for the surgeon. Torn parts of the meniscus and/or damaged cartilage on the bone surfaces are carefully removed with special arthroscopic instruments. The end result is a knee lined with smooth and stable tissues rather than rough edges.

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The rotator cuff is a group of muscles and tendons that attach to the bones of the shoulder joint. The tendons are located at the top of the shoulder between the ball of the shoulder joint (humeral head) and the shoulder cap (acromion). These tendons can be irritated by injury or overuse resulting in a problem called rotator cuff tendinitis.

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The rotator cuff is a group of four tendons that help to move and stabilize the shoulder. Rotator cuff tears are a common cause of shoulder pain and disability. Rotator cuff tendons tears can occur as the result of injury (falls or heavy lifting) or as the result of "wear and tear" and aging changes that significantly weaken the tendons thus placing them at increased risk for injury.

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Try these spine stretches, designed for your lower extremity. Proceed until you feel a mild tension, and then relax. You should hold a sustained stretch for 10 to 30 seconds.

• No bouncing while doing these stretches
• You should not experience pain while doing these stretches
• Breathe slowly and gently, but do not hold your breath, while attempting these stretches.

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Try a few spine stretches, specifically designed for your upper extremity. Proceed only until you feel a mild tension. Then relax. Try to hold the sustained stretch for about 10 to 30 seconds.

• No bouncing while trying a stretch
• You should not feel pain when trying these stretches
• Breathe slowly and naturally, but do not hold your breath during these stretches.

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Nearly 70-percent of people respond favorably to epidural spinal injections. However, each patient’s experience may vary. For some patients, pain relief is immediate. Others may take up to two weeks following a spinal injection to experience relief. If necessary, spinal injections may be repeated in a series of three.

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You are scheduled for Wrist Fracture Reduction and Fixation. Fractures of the wrist usually refer to injuries of the end of the radius bone and/or the ulna. The radius forms the major joint surface of the wrist. Different fractures may be treated in many different ways. Some can be treated with casting only while others may require surgery. The surgery usually involves setting the fracture fragments and fixing them with pins or a plate and screws while they heal.
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