Typical Orthopaedic Surgeries

• What Is Arthroscopy?
  
  This is a surgery done through tiny incisions ("poke holes") about ½” each. A tiny telescope-like device attached to a camera is inserted and allows the physician to see the inside of joints. The arthroscopy allows the physician to see a magnification up to 40 times. Small biters, shavers, and other tools can be use to clean up or repair tears in menisci, ligaments, etc. Using arthroscopy, the physician can often see more detail than with open surgery. The small incisions through muscle causes less pain than larger ones and provides a quicker rehabilitation after surgery.
   
• What is a Rotator Cuff Repair?
  
  The rotator cuff (see above) is reattached to the upper arm bone (the humerus). This is most often done with stitches attached to plastic, or metal tacks, or screws. The tacks or screws are placed in the bone and the stitch is placed through the torn part of the rotator cuff so the rotator cuff is now attached again to the bone. Patients with this condition are usually in a sling for about 4 weeks and cannot do any lifting for about 6 weeks.
   
• What is ACL Reconstruction?
  
  A variety of tissues/structures can be used to reconstruct/replace the ACL. The most common are the patellar tendon in the front of knee and the hamstring tendons in the back of the knee. Your own tendon (autograft) or one from a cadaver (allograft) can be used. Your body essentially uses these tendons as "scaffolds" to show it where to "grow" a new ligament. First, blood vessels grow in and then new ligament cells follow. That is why when autograft is used, the new "ligament" is actually the weakest from 4 to 6 months after surgery, when the blood vessels and the cells are still "growing." When an allograft is used, it takes longer for blood vessels and the cells to start growing- sometimes years. Usually, a long leg hinged brace is used for the first 6 weeks and crutches for the first 2 to 4 weeks. Physical therapy is an important part of the recovery process and is started immediately. Dr. Dunbar typically allows patients to start a running program around 4 months after surgery, start light sports at 6 months, and return to full sports around 8 to 9 months after surgery.
   
• What is Open Repair of Ankle Fractures?
  
  There are three malleoli in the ankle, which are the prominences (or bumps) you see on the inside and outside of the ankle. The one on the inside is the medial malleolis which is part of the tibia or shin bone, while the one on the outside is the lateral malleolis and is part of the fibula or smaller bone in the leg. The posterior malleolis is a bump on the back of the tibia or shinbone but you cannot see it from the outside.
  
  Ankle fractures almost always involve the ankle joint. If the bone is out of place and heals without the joint surface being smooth, it can act like sandpaper and wear away the cartilage, thus leading to arthritis. That is why surgery is often done for ankle fractures. A thin plate and screws are often used on the lateral malleolis (fibula), and screws and pins are usually used to fix the medial malleolis. The posterior malleolis may or may not require a screw to fix it. After surgery you may be in a splint, a cast or a fracture boot.
  
  One of the other advantages of surgery for an ankle fracture is that you can usually start moving the ankle sooner. This may help prevent stiffness during the recovery process.
   
• About Wrist Fractures
  
  Wrist fractures can be treated in a variety of ways depending on whether they are "in place" or "out of place," and whether they involve the joint. Fractures that are completely "in place" are usually treated with a cast or brace. Fractures that are "out of place" or involve the joint may require manipulating the bone back into place. Successfully holding the bone in place may require a cast, pins, plate and screws or an external fixator. An external fixator is a device in which pins are placed through the skin and through the bone at places away from the fracture. Bars connect the pins and keep traction across the fracture which keeps the bone from collapsing back out of place. While this may look odd or scary, it actually helps in the same way as if the doctor were walking around with you trying to keep the fracture in place while holding the bone.
   
• What is Carpal Tunnel Syndrome?
  
  In this procedure, the top of the tunnel is opened up to release the pressure on the tendon and nerve. This allows the nerve to shrink back to its normal size. Depending on how much damage has already been done to the nerve, you may or may not have all of your symptoms go away. Pain usually goes away right away, but full feeling and strength may never return. The surgery is done as an outpatient and often with just a local anesthetic.
   
• What is "Trigger Finger" Release?
  
   In this surgery the pulley is cut and allowed to heal in a more opened-up position like a "drawbridge." (This is also like letting out the waistband of those shrunken jeans!) This is usually done as an outpatient procedure and often with a local anesthetic.

If you have a specific question that is not addressed here, please send us an email at contact@docdunbar.com

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