Orthopedics
Orthopedics (also called orthopedic surgery) is a medical specialty that focuses on injuries and diseases of the musculoskeletal system of your body.
Orthopedics deals with prevention and treatment of the diseases related to the movement system.
This complex system, which includes your bones, joints, ligaments, tendons, muscles, and nerves, allows you to move, work and be active.
If you suffer from knee pain, hip, elbow or joint problems, this is the right place for you.
At Rotim Polyclinic, you can undergo an examination by a specialist orthopedist and traumatologist, as well as radiological (MRI, ultrasound) and laboratory tests.
With the extension of the average lifespan, we are increasingly dealing with the resolution of diseases resulting from aging, osteoporosis, and surgical treatment of injuries – traffic, professional, or sports-related.
In addition to diagnostics and therapies, we also provide counseling services on the installation of artificial joints such as hips or knees and procedures like ligament reconstruction.
OSTEOARTHRITIS OF THE HAND SMALL JOINTS
Osteoarthritis is a common rheumatic disease of chronic and progressive course characterized primarily by changes in joint cartilage. Osteoarthritis can affect all the joints of the hand and wrist, but is most common in the area of the finger base joints. Changes in the joints usually lead to finger deformity and limited function or, in the advanced stage, loss of finger function as well as injuries and tendon ruptures.
The clinical picture is dominated by pain, stiffness of the joints, restricted and limited mobility of the joint, sensitivity to touch and movement and thickening in the form of nodules on the joints. Changed joints can be replaced with artificial joints that enable better mobility and reduce pain, although they can never functionally replace real joints.
OSTEOARTHRITIS IN THE AREA OF THE WRIST
Arthritis of the wrist is a degenerative disease characterized by the loss of joint cartilage and narrowing of the joint space. These changes are accompanied by severe pain. It is common in people with rheumatoid arthritis or as a consequence of frequent injuries. In addition to inflammatory changes, there is destruction of joint surfaces resulting in contracture of the joint capsule, instability of the joint and atrophy of the surrounding muscles.
Following all these changes, the function of the wrist is impaired, reducing the mobility and strength of the wrist. Crepitus or “crunching” in the joint during movement often occurs. Ultimately, the disease can result in the joint becoming thickened and deformed.
OSTEOARTHRITIS OF THE BASE OF THE THUMB JOINT
The base of the thumb joint (saddle joint) allows for great joint mobility, but it is also prone to early onset of arthritic changes and instability. The described change is manifested by pain and difficulty in carrying out daily functions of the thumb. There are periods when the pain decreases, but in the long term it leads to progression of pain and instability of the joint and consequential loss of thumb function.
Most surgical procedures are performed under regional anesthesia and are a one-day surgical procedure.
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, advice on the installation of an artificial hip joint, sports injuries); diseases and injuries of the knee (inflammatory and degenerative diseases and injuries and fractures, advice on the installation of an artificial knee joint, sports injuries, acute and chronic instability, ligament ruptures); diseases and injuries of the ankle and foot (inflammatory and degenerative diseases, injuries and fractures of the ankle and foot, treatment of foot deformities – hallux valgus and rigidus, digitus flexus and flat foot, degenerative Achilles tendon disease, Haglund’s heel).
DUPUYTREN'S CONTRACTURE
A condition that occurs due to thickening of tissue in the palm. It is usually painless, but progressively limits the mobility of the fingers and bends them towards the palm. The affected fingers cannot be fully straightened, which can make everyday activities such as putting hands in pockets, putting on gloves or shaking hands difficult.
Dupuytren’s contracture mainly affects the two fingers furthest from the thumb. The surgical procedure removes the changed tissue in the palm and restores finger mobility, depending on the stage and duration of the disease.
GANGLION CYSTS
A ganglion or a hygroma is a cyst that originates from the tissue that lines the joints and tendons. There is excessive accumulation of synovial fluid, which is otherwise a necessary fluid that lubricates joints and tendons, facilitating joint movement and reducing friction that can lead to joint structure damage. It most commonly appears on the wrist, but can also develop in other places, such as knees, ankles or feet.
It is a benign formation that usually does not cause problems, but can sometimes cause other symptoms or be a sign of early osteoarthritis of the wrist joint and the joints of the hand. Although they can sometimes disappear spontaneously, most often it requires removal by puncture or surgical procedure.
TENDON INJURIES
Most tendon injuries (tendons are fibrous tissues that connect muscles to bones in the human body) are a result of gradual wear and tear of the tendon due to excessive use or aging. Anyone can have a tendon injury, but people who repeatedly perform the same movements in their work, sport or daily activities are more likely to damage the tendon compared to others. Tendon injury can occur suddenly or develop over a longer period of time.
As a result of tendon rupture, it becomes impossible to move the affected finger or joint, so operative treatment for tendon reconstruction is required as soon as possible.
INJURIES OF THE HAND AND WRIST LIGAMENTS
The most common cause of these injuries is trauma, and they manifest as loss of function and instability of the joints, which in most cases require operative treatment. Disorders of the wrist ligaments cause various forms of instability, and there are numerous complex classifications for them.
Most surgical procedures are performed under regional anesthesia and require hospitalization of up to 3 days. Resumption of movement depends on the type of injury and treatment.
HAND AND WRIST BONE FRACTURES
Fractures in the hand region show swelling, hematoma, tenderness, limited mobility, deformation of the hand or fingers, and overlapping of the fingers when forming a fist. Injuries to the wrist may refer to bone fractures, either of the distal part of the forearm bones or the carpal area, ruptures of partial or complete ligament structures, or strains and ruptures of the muscle-tendon structures of the wrist.
Injuries to the wrist are common in children and the elderly population who are at a higher risk of falls, and they are also common in contact sports. Operative treatment is necessary in case of loss of function and deformity, which allows an earlier start of physical therapy and better final functional outcome.
CARPAL TUNNEL SYNDROME
The carpal tunnel syndrome is caused by pressure on the median nerve in the carpal tunnel. The carpal tunnel is a narrow passage surrounded by bones and ligaments on the palm of the hand. The aforementioned nerve controls movement and feeling of the thumb and movements of all fingers except the little finger of the hand. When the median nerve is compressed, symptoms may include numbness, tingling, burning sensations, weakness in the hand. Patients often have difficulty holding things in their hand.
Numbness and pain occur in the area of the thumb to the middle of the ring finger on the palm side. The nerve is released from pressure by surgically cutting the carpal tunnel ligament.
TRIGGER FINGER
In this condition, the finger usually moves normally but remains stuck when the fist is completely clenched. It occurs due to thickening of the finger tendon that becomes trapped in the tunnel at the base of the finger, usually during an inflammatory process. In severe cases of this condition, the finger may remain permanently bent. Sometimes, the finger can be straightened with the help of the other hand, and a specific sound, “a click”, can be heard, after which the change was named.
Symptoms of trigger finger can be mild or severe, and include stiffness of the finger, a popping sensation during movement, sensitivity to touch, formation of a lump on the palm, finger being stuck in a bent position that suddenly straightens, finger being stuck in a bent position that cannot be straightened. In a certain number of cases, application of steroid injection helps, and in surgical treatment, the tunnel in which the tendon lies is opened, and the tendon is released.
The orthopedic team approaches each patient individually.
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