Triangular Fibrocartilage Complex Tear: Orthopedic Plano

by Administrator 26. October 2016 08:15

The Triangular Fibrocartilage Complex (TFCC) Tear is a complex structure between the ends of the small carpal bones and the ulna (in the wrist). It provides stability to the forearm bones (radius and ulna). When this structure gets injured or torn, it results in Triangular Fibrocartilage Complex (TFCC) Tear.

There are two main types of TFCC Tears:

  • Type 1 Tears: These are called Traumatic tears and occur due to excessive use of hand or force applied.
  • Type 2 Tears: Wear and tear of cartilage takes place with the progression of the age.


  • Degenerative changes.
  • Power drill injuries.
  • Fall on an outstretched hand
  • Excessive use of badminton racquet or a cricket bat.


  • Pain in the ulna which increases by performing any physical activity
  • Swelling in the wrist
  • Weakness
  • Clicking sound produced while moving the wrist
  • Low hand grip


An orthopedic doctor may conduct physical examination of the wrist and analyze the symptoms experienced by the patient. An X-ray test may be conducted to check for any fracture or dislocation in the wrist. The doctor may even recommend an MRI test which may help to visualize the enlarged image of the injury. Wrist arthrography may also be performed to determine the severity of the condition.


Non-Surgical Treatment Options

  • Splint: The doctor may recommend wearing a splint to immobilize the joint and promote healing. The wrist may be immobilized for 4-6 weeks depending on the extent of damage.
  • Medication: Anti-inflammatory medications may be prescribed by the doctor to reduce swelling. Cortisone injections may be administered in case of severe pain.  
  • Physical Therapy:  Certain exercises may be suggested by the doctor to provide strength and flexibility to the wrist joint. These exercises may also help to improve the range of motion of the wrist joint.
  • Rest: Adequate rest must be provided to the affected area. Activities that strain the wrist joint must be avoided.

Surgical Treatment

If non-surgical treatment fails to provide relief, a surgery may be recommended. The doctor may make small incisions to clean the torn edges and remove damaged tissues in the wrist joint. Tears can also be repaired through sutures.


TFCC tear can take a long time to recover, ranging from 8 to 12 weeks.

Dr. Knoll is a hand surgeon in Frisco, TX providing effective treatment for Triangular Fibrocartilage Complex (TFCC) Tear. To schedule an appointment, you can call at (214) 618 - 5502.

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Kienbock’s Disease: Orthopedic Treatment In Frisco

by Administrator 25. April 2016 10:47

The wrist is made up of eight carpal bones-one of which is the lunate bone. Any damage or loss of blood supply to this bone is termed as Kienbock’s Disease. Also known as Lunatomalacia or Avascular Necrosis of the Lunate, the condition is characterized by severe pain, swelling and difficulty in wrist movement. In severe stages, it may affect the adjacent bones within the wrist joint. It can be categorized into four stages:

  • Stage 1 – At this stage, there may be a disruption in blood supply to the lunate. However, an X-ray may not show any signs of damage.
  • Stage 2 – The bone may become hard and dense, a condition known as Sclerosis. X-ray results may reveal the damage caused to the bone. 
  • Stage 3 – In this, the affected bone may begin to collapse and break into several pieces, causing the surrounding bones to dislocate.
  • Stage 4 – The lunate is completely collapsed during this stage and the other wrist bones may also weaken, leading to the development of Arthritis.


  • Loss of arterial supply to the lunate
  • Damage to the venous drainage of the lunate
  • Short length of the adjoining ulnar bone
  • Trauma to the wrist, such as during a car accident
  • Repetitive stress
  • Medical conditions such as Sickel Cell Anemia, Gout, Cerebral Palsy, Lupus etc.


  • Swollen wrist
  • Pain
  • Stiffness
  • Clicking sound in the wrist
  • Weakening grip strength
  • Tenderness to touch
  • Restricted range of motion, particularly during upward movement of the wrist


  • The doctor may recommend wearing a brace or splint to restrict the movement of the wrist.
  • Giving complete rest to the wrist and avoiding any movements that may trigger pain.
  • Anti-inflammatory medications may be prescribed to ease pain and reduce swelling.

Patients with Stage 4 Kienbock’s Disease may require surgery. The wrist specialist may recommend any of the following procedures:

  • Revascularization: This involves removing a portion of a bone along with the blood vessels and inserting into the lunate to augment or restore blood supply.
  • Joint Leveling: It may be performed if there is a difference in lengths of the forearm bones. The surgeon may either insert a bone graft to increase the length or remove a section of the bone to shorten it. 
  • Fusion: Joining the surrounding wrist bones, either partially or completely, may help to decrease pressure on the lunate.
  • Arthroplasty: In this procedure, the lunate is replaced with an artificial implant to help the patient find relief from the symptoms.


  • Avoid trauma to the wrist
  • Seek proper and timely of the wrist conditions that may cause Kienbock’s Disease, such as Septic Emboli or Sickle Cell Disease.

Dr. Knoll is a Frisco, TX based hand and wrist surgeon providing comprehensive treatment for Kienbock’s Disease. To schedule an appointment, you can call at (214) 618 – 5502.

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De Quervain’s Tendonitis: Orthopedic Carrollton

by Administrator 26. October 2015 14:07

De Quervain’s Tendonitis, also known as Washerwoman's Sprain is a medical condition which involves inflammation of the tendons around the base of the thumb. These tendons run through a tunnel made up of soft tissues which swells and narrows the tunnel. Swelling of the tendons may lead to pain while doing any hand or wrist movement.  People involved in activities that require repetitive hand and wrist movement have more chances to develop this condition.


  • Overuse of the thumb
  • High-impact blow to the thumb
  • Repetitive clutching
  • Rheumatoid Arthritis
  • Racquet sports
  • Activities such as gardening
  • Women can get it just after pregnancy


  • Pain along the back of the thumb
  • Pain that resonates from the thumb up to the forearm
  • Difficulty in moving the thumb
  • Hurting sensation, particularly when grasping things
  • Inflammation and pain side of the wrist


An orthopedic doctor may conduct Finkelstein test to confirm the presence of De Quervain. He may ask the patient to make a fist with thumb placed in his palm. While turning the wrist outwards, the tendons get pulled and stretched. If this test is painful then a patient suffers from this condition.


  • Splint: A doctor may advise to wear a splint to prevent thumb and wrist movement. All activities that worsen this condition have to be completely stopped.
  • Ice pack: Ice packs can be applied to the affected area at regular intervals as it may help in eliminating pain and swelling.
  • Medication: Anti-inflammatory medicines such as ibuprofen or naproxen, as prescribed by doctor, can be administered to reduce tenderness. Steroids can also be given if the pain is unbearable.
  • Avoiding strenuous activities: A doctor may suggest reducing the activities that cause pain and swelling as it may relieve the symptoms.
  • Corticosteroids: Corticosteroids injection may be recommended by a doctor to provide relief from pain and swelling.
  • Exercise: Certain exercises may be recommended by the doctor so as to strengthen the thumb and wrist. These help in the healing process by reducing pain and improving health of the patient.
  • Surgery: When a patient does not respond to non-surgical treatments, the doctor may recommend surgery.

If you are suffering from De Quervain’s Tendonits, consult Dr. Knoll. The orthopedic doctor specializes in treating a wide range of wrist and hand conditions. To schedule an appointment, call at (214) 618 -5502 or visit 5757 Warren Parkway Suite 180, Frisco, Texas 75034.

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Orthopedic Treatment For Writer's Cramp

by Administrator 16. July 2015 07:18

Writer’s Cramp, also known as Mogigraphia, is a condition that involves involuntary and sudden cramping of the intrinsic muscles of the hand. It is caused due to excessive writing and other repetitive tasks involving the hand. As it is a task-specific focal dystonia of the hand, the pain and symptoms are limited to the hand, and are caused due to specific tasks. It is not a common condition and is more prone to men.

The two basic types of Writer’s Cramp are:

  • Simple: When suffering with simple Writer’s Cramp, the person only faces difficulty with one specific task such as writing or typing.
  • Dystonic: In this condition the symptoms are present when the person performs any activity with the hand such as shaving, eating, washing or applying make-up.


  • Excessive muscular or motor activity
  • Using faulty writing technique
  • Excessive writing
  • Activities such as typing
  • Injury to the hand
  • Genetics
  • Ruptured Intervertebral Disc
  • Defective blood vessels
  • Tumors of the brain
  • Stroke


  • Pain contractions
  • Chronic sustained pain
  • Inability to write
  • Changes in handwriting
  • Difficulty in carrying out occupational tasks such as typing, writing, playing instruments, etc
  • Excessive abnormal movement of the elbow and wrist
  • Difficulty with coordination of the hand
  • Shaking or twitching of hand while writing
  • Deformity


In order to diagnose the condition the orthopedic surgeon may physically examine your hand. He may discuss the symptoms, nature of any injury and past medical history of the patient. The orthopedic doctor may recommend certain imaging test such as MRI, Electromyography, etc. to determine the extent of the condition.


The condition often resolves spontaneously but there are chances of recurrence if you return to repetitive tasks that led to the condition. The orthopedic surgeon may prescribe certain medicines to offer relief from the symptoms. The doctor can also recommend physiotherapy to regain flexibility and strength in the hand. The physiotherapist can help by offering an exercise program that helps the patient stretch the hands and avoid spasms. Surgery is also effective but is only prescribed in extreme cases. Release surgery is used to decompress the affected nerve in the wrist, hand or elbow. It is a minimal invasive surgery, which involves a short recovery time.

Making significant behavioral and ergonomic changes can prevent writer’s cramp. You should limit the working hours, take regular breaks, use alternate devices for transcription such as dictation, speech-to-text recognition software, etc. and change the way you grip a pen.

For complete diagnosis and treatment of Writer's Cramp, consult Dr. Knoll. To schedule an appointment with the hand surgeon, call at (214) 618-5502.

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Mallet Finger: Orthopedic Treatment In Frisco, TX

by Administrator 20. May 2015 13:19

Mallet Finger, also known as baseball finger, is an injury to the outermost joint of the finger that is responsible for making the tip of the finger bend towards the palm. It is caused by damage to the tendon, causing severe pain and swelling. It is a common sports injury but can also occur due to minor accidents.


Mallet Finger generally occurs while playing sport activities involving a ball, like baseball or basketball. When the ball hits the tip of an outstretched finger the tendons of the outermost joint of the finger swell up, leading to Mallet Finger. It can also be caused when any hard object hits the finger or cut with a sharp object like a knife.

Risk Factors

People with less flexibility or concurrent sprains in their fingers and sportspersons involved in sports with a ball are prone to suffer from this condition.


  • Pain and swelling
  • Bent finger
  • Redness and numbness
  • Tenderness
  • Blood clots under nail
  • Inability to extend the finger
  • A popping sound at the time of injury


The orthopedic surgeon physically examines the injured finger to determine the extent of pain, redness and swelling. He may also diagnose the severity of the condition and the movement possible by bending the finger. The doctor may recommend an X-Ray to check if the injury involves any broken bones. Accordingly, he devises a treatment plan to treat the condition.


Non-surgical treatment:

  • Ice: Applying an ice pack can be advised to reduce swelling and pain.
  • Splints: Wearing a splint to keep the injured finger in a straight position can help to heal the injury. The doctor advises on the duration that the splint needs to be worn, as it depends on the severity of the condition.
  • Exercises: The doctor may also advise certain exercises to improve motion and resume flexibility in the finger.
  • Medication: The orthopedic surgeon can also recommend anti-inflammatory medications to reduce pain and swelling.

Surgical treatment:

In severe cases, if the non-surgical methods do not provide relief, the surgeon may recommend surgery. The surgical procedure is usually followed by physiotherapy and it is advised that you visit the orthopedic surgeon regularly for check ups.

If you have suffered a finger/fingertip injury, Dr. Knoll in Frisco, TX. To schedule an appointment with the wrist doctor, call at (214) 618 - 5502.

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Orthopedic Treatment For Hand Fractures

by Administrator 21. April 2015 11:39

A severe or forceful blow to the hand can cause a hand fracture. The hand has multiple small and large joints that allow the hand to bend, straighten, rotate and move side-by-side. If a hand fracture is not treated on time, it can lead to temporary and permanent disability.


  • Falling on an outstretched hand
  • Forceful injury
  • Fall from height
  • Collision or car accident
  • Osteoporosis
  • Injury during sports or work related injuries
  • Stress fractures that occurs due to repeated overuse


  • Pain that worsens when you move the hand
  • Tenderness
  • Swelling
  • Bruising
  • Inability to hold or grab objects
  • Abnormal bump or any deformity
  • Numbness
  • Weakness
  • Bone that moves out of place


During physical examination, the orthopedic surgeon checks the injury to confirm a fracture. He carefully examines the symptoms, looks for any signs of damages to nerves, blood vessels and tendons. The doctor may also ask about the patients medical history and prescribe imaging tests such as X-ray, CT scan, MRI, or bone scan to identify any bone and tissue injuries in the hand.


The orthopedic surgeon devises the treatment plan depending on the extent and nature of the injury. If the injury is not severe, then the doctor may recommend non-surgical treatment of the Hand Fracture. This may involve using braces, cast or a splint to stabilize the hand and limit the motion of the hand. The surgeon may strap or tape the fracture fingers to the finger next to it, as this will decrease stiffness and limit motion. In order to reduce pain and swelling, the doctor often prescribes certain non-steroidal anti-inflammation medicines and antibiotics.

However if the injury is severe and non surgical methods fail to provide relief, surgery may be recommended. Post surgery the surgeon may prescribe physiotherapy to strengthen your hand with the help of stretching and strengthening exercises.

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Orthopedic Treatment For Trigger Finger

by Administrator 22. September 2014 08:53

Trigger Finger is a common ailment that causes the fingers to snap and get stuck in the palm. It is a form of tendinitis involving the hand and occurs mostly in the thumb, middle and ring finger. People suffering from this condition complain of the finger stuck in the palm when they wake up. The term “Trigger Finger” is named so because of the snapping sensation that occurs when the finger is straightened. Due to inflammation, the normal gliding action of the tendons is affected, which causes the joint to freeze. This condition is most common in diabetics and women.


  • Trigger Fingers are sometimes associated with medical conditions such as rheumatoid arthritis, diabetes and gout.
  • It can also be caused due to local trauma to the palm or base of the finger.
  • Activities that strain the hand can also cause this condition.


  • Stiffness in fingers, particularly in morning
  • Popping or clicking sensation when the finger is moved
  • Tenderness in the affected finger
  • Pain when the finger is straightened
  • Finger catches or locks in a bent position
  • It might affect one or more fingers and sometimes both hands


The treatment for Trigger Finger is aimed at eliminating the catching or locking to allow for free movement without any discomfort. Resting the finger by wearing a splint is helpful in relieving the pain. Anti-inflammatory medications, physical therapy and finger exercises help in reducing the pain. However, the most common treatment is injecting steroids into the tendon sheath. Generally, two injections are needed to resolve the problem.
If the problem still persists, surgery may be required. In this, the opening of tunnel is widened so that the tendon is able to slide through it easily. Local anesthesia is used to numb the hand and a small incision is needed to perform the surgery.

Though some people can move their hands immediately after surgery, there can be soreness in the hand which can be reduced by raising the hand above heart level. Complete recovery can be expected within a few weeks and it might take some months for the stiffness and swelling to go away.

For complete diagnosis and treatment of Trigger Finger, visit Dr. Knoll in Frisco, TX. The hand surgeon is specialized in treating all conditions of fingers and providing comprehensive care to the patients. To schedule an appointment, you can call at (214) 618-5502.

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Wrist Fractures: Causes, Symptoms & Treatment

by Administrator 21. July 2014 12:44

The wrist is one of the most important joints of the body as it gives the hand and fingers most of their functionality and range of motion. It is a strong and flexible joint which allows us to do a lot of everyday things. Any injury to the wrist can be a serious deterrent and curb our lifestyle to a significant degree. A case of wrist fracture can be seriously debilitating and needs immediate orthopedic treatment so that affected people can get back the full functionality of their wrist and get back to normal life as fast as possible. Commonly, the term wrist fracture refers to a fracture at the terminal point of the long radius bone in the arm. Except for that, it might also be used to refer to any fracture in one of the either carpal bones or the ulna.


There can be myriad factors that cause a wrist fracture. Most often, wrist fracture is a result of sustaining impact damage. People who encounter falls from a height or face accidents such as automobile accidents are most likely to sustain a wrist fracture. Wrist fracture is also commonly seen in people who indulge in certain kinds of sports which require heavy use of the hand and might give rise to situations where the wrist has to face an unusual strain. Sports like rollerblading and snowboarding top the list of activities which can be a major cause of wrist fracture. Age related problems like osteoarthritis can make the wrist joint weak, thereby making it more vulnerable to injuries and more susceptible to sustain fracture.


The symptoms faced by people affected with wrist fracture are more or less similar, irrespective of the nature of the fracture. The degree might vary with the severity of the fracture but the basic symptoms have been seen to be similar. Severe pain in the wrist and adjoining areas can be accompanied with marked inflammation and redness. Also, the wrist bone can seem to be visually deformed in case of severe injuries. There is also significant loss of strength and range of motion in the wrist joint in cases of a wrist fracture.


Orthopedic treatment for wrist fracture commences with the correct identification of the location and the extent of the fracture. Once that has been ascertained, treatment can consist of immobilization, rest and the use of pain medication for normal cases. For serious fractures, corrective surgery is usually the only option.

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Arthritis Of The Hand

by Administrator 20. November 2013 13:30

Arthritis is an autoimmune disease that is associated with chronic inflammation and pain the affected joint. The disease can affect people of all ages and is characterized by alternate periods of flares and remissions. Being a chronic disease, it usually lasts for years, with long periods when the patient experiences no symptoms. In some cases, arthritis of the hand can result in a damage of the cartilage, bones, and ligaments, and ultimately deformity of the joints. This form of arthritis can be severely debilitating, causing difficulty in performing everyday activities.

Arthritis of the hand or the wrist can have multiple causes as listed below:

  • It is believed that some people can be genetically predisposed to getting arthritis.
  • Being an autoimmune disorder, it can be triggered by certain infections that cause the activation of the immune system.
  • Worn out or damaged cartilage- This could be caused by disease or trauma, and results in a limited range of motion in the joint.
  • The excessive production of synovial fluid in the body as an attempt to make up for the lost cartilage results in inflammation.
  • It is important to visit an orthopedic doctor if you experience pain or inflammation in the hand. If left untreated, the bones eventually lose their shape, resulting in further limiting of motion.

The symptoms of arthritis of the hand come and go depending on the extent of tissue inflammation. Some of the major symptoms of arthritis include:

  • Fatigue
  • Loss of energy
  • Lack of appetite
  • Low grade fever
  • Muscle and joint aches
  • Stiffness in the knuckles, especially upon waking up in the morning
  • Redness, swelling, warmth, and tenderness around the joints in the hands during periods of flares.


  • Non-surgical treatment involves the use of anti-inflammatory drugs, steroid injections, and splinting.
  • This treatment cannot reverse the joint damage that has already occurred, but can help to treat symptoms.
  • When these options fail to provide relief, it is advisable to visit a hand surgeon, who can perform surgery to provide long-term pain relief and help restore function. It is important to visit an experienced surgeon in Frisco, who shall carefully evaluate your case before suggesting the most suitable surgical option for you.
  • Once the surgery is performed, you shall be referred to a trained hand therapist who will help to maximize your post-operative recovery.

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