Orthopedics deals with the prevention and treatment of diseases of the locomotor system. If you suffer from knee pain, problems with hips, elbows or joints, this is the right place for you. At the Rotim Clinic, you can be examined by an orthopedist or traumatologist, and have radiological (X-ray, CT, MRI) and laboratory tests performed. With the increase in average life expectancy, we increasingly deal with the treatment of diseases caused by aging and osteoporosis, and surgical treatment of injuries: traffic, professional or sports injuries. In addition to diagnostics and therapies, we also provide counseling on the implantation of artificial joints such as the hips or knees, and procedures such as ligament reconstruction.
Arthrosis is a common rheumatic disease with a chronic and progressive course, which is primarily characterized by changes in the articular cartilage. Arthrosis can affect all hand joints and the wrist but it is most common in the area of the finger base joints. The changes in the joints most often lead to deformity of the fingers and limitation of function or, in an advanced stage, loss of finger function. Injuries to and disruption of the tendon of the fingers may also occur. The clinical picture is dominated by pain, joint stiffness, difficult and limited joint mobility, sensitivity to touch and movement, and thickening in the form of nodules on the joints. The altered joints can be replaced by artificial joints that allow better mobility and reduce pain, although they can never functionally replace real joints.
ARTHROSIS OF THE WRIST
Arthrosis of the wrist is a degenerative disease characterized by loss of articular cartilage and narrowing of the joint area. These changes are accompanied by severe pain. Arthrosis of the wrist is common in people with rheumatoid arthritis or as a consequence of frequent injuries. Inflammatory changes lead to the destruction of joint surfaces, which results in shrinkage of the joint capsule, joint instability and atrophy of the surrounding muscles. As a result of all these changes, the function of the wrist is impaired, and mobility and strength of the wrist are reduced. Crepitus or “creaking” in the joint often occurs during movement. Ultimately, the disease can result in the joint becoming thickened and deformed.
ARTHROSIS – The joint of the thumb base (saddle joint)
The joint of the thumb base (saddle joint) enables great mobility of the joint but is also prone to early onset of arthrosis-related changes and instability. The described change is manifested through pain and difficulty performing daily functions of the thumb. There are periods when the pain decreases, but in the long run there is a progression of pain and joint instability and a consequential loss of thumb function. Most surgeries are performed under regional anesthesia as one-day surgeries.
DISEASES AND INJURIES OF THE LOWER EXTREMITIES
Diseases and injuries of the lower extremities include diseases and injuries of the hip (inflammatory and degenerative diseases, injuries and fractures, consultation on hip joint replacement surgery, sports injuries); diseases and injuries of the knee (inflammatory and degenerative diseases, injuries and fractures, consultation on knee joint replacement surgery, sports injuries, acute and chronic instability, ligament ruptures); diseases and injuries of the ankles and feet (inflammatory and degenerative diseases, injuries and fractures of the ankles and feet, treatment of foot deformities – hallux valgus and rigidus, claw toe and lowered foot, degenerative diseases of the Achilles tendon, Haglund’s deformity).
Dupuytren’s contracture is a condition caused by thickening of the tissue in the palm area. It is usually painless, but it progressively limits the mobility of fingers and bends them towards the palm. The affected fingers cannot be completely straightened, which can make everyday activities such as putting one’s hands in pockets, putting on gloves or shaking hands difficult. Dupuytren’s contracture mainly affects the two fingers furthest from the thumb. Surgery removes the altered tissue of the palm and restores finger mobility, depending on the stage and duration of the disease..
GANGLION OR HYGROMA
A ganglion or hygroma is a cyst that forms from the tissues that line the joints and tendons. There is an excessive accumulation of synovial fluid, an otherwise necessary fluid that lubricates the joints and tendons, thus facilitating joint movements and reducing friction that can lead to damage to joint structures. It most commonly occurs on the wrist, but can also occur in other places, such as the knees, ankles, or feet. It is a benign formation that usually does not cause problems but can sometimes trigger other symptoms or be a sign of early osteoarthritis of the wrist joint. Although ganglions can sometimes disappear spontaneously, most of the time a removal by puncture or surgery is required.
Most tendon injuries (tendon is a fibrous tissue that connects muscles to the bones in the human body) are a result of gradual tendon wear due to overuse or aging. Anyone can injure a tendon, but the people who repeat the same movements in their work, sports, or daily activities are more likely to damage a tendon than other people. Tendon injury can occur suddenly or over a long period of time. As a result of tendon rupture, it is impossible to move the injured finger or joint, and surgical treatment is needed as soon as possible to reconstruct the tendon.
INJURIES TO THE HAND LIGAMENTS AND WRIST
Injuries to the hand ligaments and wrist most often occur as a result of injuries and are manifested by loss of function and joint instability, which in most cases requires surgical treatment. In wrist ligament ruptures, various forms of instability occur and there are numerous and complex divisions and classifications. Most surgeries are performed under regional anesthesia and require hospitalization for up to 3 days, and exercise begins as early as possible depending on the type of injury and type of treatment.
FRACTURES IN THE AREA OF THE HAND
Fractures in the area of the hand are manifested by the appearance of swelling, hematoma, pain, limited mobility, deformity of the hand or fingers, and overlapping fingers during fist formation. Injuries to the wrist may involve bones fractures (of either the distal part of forearm bones or the carpal region), ruptures (partial or complete) of ligament structures, or sprains and ruptures of the muscle and tendon structures of the wrist. Wrist injuries are common in children and the elderly population at a higher risk of falls and are also common in contact sports. In the case of loss of function and deformity, surgical treatment is required, which enables an earlier start of physical therapy and load, and a better final functional outcome.
THE CARPAL TUNNEL SYNDROME
The carpal tunnel syndrome occurs when pressure is applied to the median nerve in the area of the carpal tunnel. The carpal tunnel is a narrow passageway surrounded by bones and ligaments on the palm of the hand. The aforementioned nerve controls the movement and feeling of the thumb and the movements of all the fingers except the little finger. When the median nerve is compressed, the symptoms may include numbness, tingling, and weakness in the hand. The patients often have trouble holding things in their hands. The tingling and pain occur in the thumb and in the half of the ring finger on the side of the palm. An operation relieves the nerve of pressure by cutting the carpal tunnel ligament.
Trigger finger – in this condition, the finger most often moves normally, but remains locked in a bent position when the fingers are bent. It occurs due to thickening of the finger tendon that remains stuck in the tunnel at the base of the finger, most often during an inflammatory process. In severe cases, the finger may remain permanently in a bent position. Sometimes, the finger can be straightened using the other hand. The symptoms of trigger finger can be mild or severe, and they include: numbness of the finger, a feeling of cracking (skipping) during movement, sensitivity to touch or appearance of a lump on the palm, finger getting stuck in a bent position that straightens immediately, finger getting stuck in a bent position that cannot be straightened. In a certain number of cases application of steroid injections helps, and during surgical treatment a tunnel in which the tendon lies is opened and the tendon is released.