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What You Need To Know About Dupuytren’s Contracture
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What You Need To Know About Dupuytren’s Contracture

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What You Need To Know About Dupuytren’s Contracture

A Dupuytren’s contracture is the result of thickening fascia beneath the skin of the palm most often near the pinky and ring fingers. Over time the skin at the base of an affected finger will become thicker before finally creating a knot and dimple appearance. A knot formation is indicative of the fascia thickening aspect of Dupuytren’s. Fascia is a layer of tissue between the skin and muscle layers that help anchor down your skin. Otherwise, the skin on your palm could be manipulated much like the skin on the back of your hand. As the fascia tightens into a knot like structure, the tightened skin and fascia cause the fingers to become progressively flexed, making extending the fingers difficult. Unlike a similarly presenting problem, trigger finger, Dupuytren’s does not involve any tendons. Although there is no known cause of Dupuytren’s, there are several risk factors: • Gender: The prevalence is greater in men than women • Ancestral Descent: People from Northern European or Scandinavian descent are most likely to develop the condition • Age: Likelihood increase with age • Alcohol & Tobacco Use: People who smoke and drink more regularly are more likely to present with the [...]

SilverOrtho2022-05-23T18:43:37-07:00Uncategorized|

Myths of Orthopedic Surgery

Orthopedic Myths and Frequently Asked Questions “I can eat breakfast since my surgery isn't until this afternoon.” Do I really have to skip breakfast before surgery? Our policy is that you are unable to eat after midnight the night before your surgery with us. We have this policy to protect you, as the patient, from aspiration during surgery. In addition, if we needed to move you up in the schedule, due to a cancelation or simply running ahead of time, it is important that you have not ate or drank anything since midnight. Patient safety is of utmost importance to us; therefore, we don’t ask you to skip breakfast just for fun, it is vital to follow these instructions to help ensure you have the best possible outcome. “I always drink coffee in the morning, one cup won't hurt me.” Can I drink coffee before surgery? No! You cannot drink coffee before surgery. Due to the increased risks associated with eating or drinking anything after midnight the night before surgery, we ask that you refrain from your morning cup of joe too. No eating or drinking includes no water, no coffee, no gum, no candy, no breath mints, nothing at all. Kind [...]

SilverOrtho2023-01-16T18:19:55-08:00Uncategorized|

Orthopedic Myths – Knuckle Cracking, Surgery Misconceptions, and More

#1: “Total joint replacements are only for the elderly.” There is no age prerequisite to total joint replacements. While the rate of receiving a total joint replacement is great for ages 64-85, younger adults are more frequently receiving total joint replacements every year. In fact, one study analyzed the trend of knee replacements done in adults aged 45-64 over a ten year period ending in 2014 and saw a 188% increase in total knee replacements in that population over ten years. However, it’s best to keep in mind that the younger one is and the longer that person lives, the more likely they are to need a revision or replacement of their prosthetic. Studies show that 85% of total knee replacements last 20 years and that around 10% of patients will need a revision at some point. #2: “Cracking knuckles causes arthritis.” No one can definitively say that cracking knuckles causes arthritis. In fact, studies have shown no difference in the prevalence of arthritis between those who crack and do not crack their knuckles. On the contrary, some anecdotal accounts have stated that cracking their knuckles has resulted in some cartilage damage and one study looking at the side effects of knuckle [...]

SilverOrtho2018-07-25T22:08:22-07:00Uncategorized|

MRI’s Explained – Open vs. Closed Operating Systems

Magnetic resonance imaging (MRI) didn’t start as the technology we now commonly know. Researchers Felix Bloch and Edward Purcell first discovered the magnetic resonance phenomena in 1946 and later harnessed the abilities of magnetic resonance to analyze chemicals, leading to their Nobel Prize in 1952. Later on, scientists discovered the same technique could be used to visualize different human tissues. By 1973, aided by the rapid technological progression of computers, researchers developed the MRI that we now use today. Then, in 2003, the MRI led to another Nobel Prize, this time awarded to researchers Paul Lauterbur and Peter Mansfield for developing MRI as a diagnostic tool. What is an MRI? An MRI uses a strong magnetic field and directs the field at a specific area of the object or person of interest. As the magnetic field enters different tissues and fluids within the body, hydrogen atoms become excited similarly to how a smaller magnet becomes excited as a larger magnet inches closer. Depending on the tissue or fluid that the hydrogen atoms are in, the atoms return to a resting state at different rates as the magnetic field is turned on and off several times. This allows a computer to analyze the [...]

SilverOrtho2019-06-18T16:27:21-07:00Uncategorized|

Dr. Dujela Chapter on Evidence Based Bunion Surgery

Click to read Dr. Dujela's Chapter on Evidence Based Bunion Surgery

SilverOrtho2018-07-25T21:56:07-07:00Uncategorized|

Frozen shoulder: from freezing to thawing, a guide to repossessing your shoulder

If you’ve experienced shoulder pain, you know it can be one of the most debilitating forms of pain. A painful shoulder can make everyday tasks like picking up a cup to sleeping seem impossible. The dull toothache feeling of chronic inflammation in a shoulder is enough to make just about anyone go mad. Sometimes, as ongoing shoulder pain prevents someone from using his or her shoulder, the condition can turn into a disease called frozen shoulder. Women Adults of 40-60 years of age Those with diabetes Frozen shoulder most often occurs in a 3-step process.* Freezing (6 weeks– 9 months): This phase begins with progressing tightness in the shoulder capsule as the tendons that comprise the shoulder movers become more stiff, scar tissue forms, and the amount of synovial fluid(lubricant for your shoulder joint) decreases. The freezing stage is typically the most painful stage. Frozen (4-6 months): The shoulder capsule is extremely tight making daily activities very difficult. However, the pain experienced in the “freezing” stage is less severe. Thawing (6 months – 2 years): The stiffness and pain in the shoulder slowly recede as daily activities become easier to complete. As you can tell, recovery from a frozen shoulder is no [...]

SilverOrtho2019-06-18T16:28:55-07:00Uncategorized|

Washington Orthopaedic Center – Patient Reviews

General Reviews - Everyone has been great. Every phone call email and visit has made me feel valued as a client. I'm not sure if I can explain it clearly. Each person I have encountered has shown this and has made sure all of my needs were met. Just simply amazing! Customer service must be a priority and a value! - All staff were professional and friendly to both me and my family. - I have received the best care - I'm quite pleased with the progress! - Great staff! - The MA Kelsey Moorecraft did a wonderful job today first time I have had her at an appointment here. Keith R Birchard M.D. Reviews - I was happy with the whole procedure and with the results - Truly a professional! Throughout my care dating back to June Dr. Birchard discussed all options clearly and included me in decisions. I have never felt so involved in my care. He has set the bar very high for all others. - Thank you did excellent - Got us in quickly Michael D Dujela D.P.M. Reviews - Dr. Dujela has performed both of my ankle fusions and I have been very happy with his care [...]

SilverOrtho2019-06-12T20:59:59-07:00Uncategorized|

What You Need to Know About ACL Tear & Repair

For athletes and “wanna-be” athletes alike, an anterior cruciate ligament (ACL) tear is one of the most feared injuries one can sustain. More common in females than males, and commonly seen in sports requiring quick changes of direction, the ACL is typically torn as an athlete plants their foot on the ground with an extended leg and rotates internally. Accidents involving falling from some height with an extended knee can also results in an ACL tear. The initial injury may be accompanied by a “snap” or “pop,” but often doesn’t keep an athlete from walking off the field under their own weight. In fact, some people may go an extended period of time, months to years, with lingering knee pain only to find out they actually tore their ACL long ago. Unlike other areas of the body that have self-repairing tissue, an ACL tear will not repair itself. Thus, the only corrective treatment for a torn ACL is found through surgery. While the only real fix for an ACL tear lies within surgery, chances are you will get three different answers from three different orthopedic surgeons if you ask each of them how they repair an ACL. From the angles that surgeons [...]

SilverOrtho2018-08-21T17:49:15-07:00Uncategorized|

Life Can Be A Pain In The… Foot?

A guide to fixing the base of your big toe: 1st MTP arthrodesis Life can be a pain in the foot, and trust me, you’ll quickly realize how much a painful foot can control your life once it really starts hurting. For some, myself included, it’s flat feet that lead to a host of complications, while for others the pain started when a weight was dropped on their foot. A common issue is found at the base of your big toe, officially called the first metatarsal-phalangeal joint. Whether the pain at the 1st MTP joint is caused by a foot deformity, chronically wearing bad footwear, or from an acute injury, the pain can be significantly detrimental to one’s quality of life due to the natural push off from the big toe during activities like walking and running What causes the pain? No matter the origin of the pain, acute or gradual, the eventual chronic pain is caused by the wearing down of cartilage between the two bones that form the MTP joint. The lack of cartilage leads to inflammation in the joint, osteophytes (small bones fragments) that grind inside the joint, and the development of arthritis in and around the joint, which [...]

SilverOrtho2018-08-21T17:51:22-07:00Uncategorized|

Have a Chronically Dislocating Kneecap? We Can Fix That!

Anyone can dislocate his or her kneecap, or patella, given enough torque. Young, old, muscle bound, or lean, it doesn’t matter much. The real difference maker is your anatomy. If you, or someone you know, have a chronically shifting patella, know that there is a safe and secure way to fix your knee and that Washington Orthopaedic Center has providers with years of experience doing just that. The knee joint primarily consists of three bones, the femur, tibia, and the patella. The fibula is more or less along for the ride here. The femur has two large condyles on either side of the knee, which is what you feel when you palpate the sides of your knees, and in between the condyles lies a groove called a trochlea. Naturally, the patella glides in the trochlea as the knee flexes and extends, fixed in the middle by the two opposing condyles. This is where things get interesting. With enough internal rotation under pressure with a knee flexed between 20 and 40 degrees, the patella can slip out of the trochlea. For the most part, anyone with average knee anatomy won’t ever experience his or her patella shifting outside normal position. However, people exhibiting [...]

SilverOrtho2020-12-28T19:11:40-08:00Uncategorized|