Hands-on medicine

Photograph by Bob Rozycki

Versatile, tireless, swift and nimble, our two hands are vital assets to daily existence.

Working alone or in tandem, they are sensitive enough to perform delicate surgery, strong enough to lift heavy objects and dexterous enough to thread a needle, button clothes, tie shoelaces, type on a keyboard or manipulate a computer mouse endlessly, along with hundreds of other functions.

Beverly Guo, an orthopedic surgeon specializing in hands with University Orthopaedics P.C. of Hawthorne, has had a fascination with these two extremities since first studying anatomy in medical school.

“Since I was a little girl, I was always interested in seeing how things work,” she says. “I also wanted to do something to help people. Once I got to medical school, I found the hands very interesting. They are a wonderful balance of bones, muscle and tendons and can do amazing things.”

Structurally, the hands are the most intricate components of the body, with much “machinery” packed into a small space.

Healing hands

“I love orthopedics as a specialty, because you can actually make this work better and see lots of positive outcomes,” Guo says. “You need your hands for everything you do, so it is very satisfying to be able to give people back the use of these vital parts of the body.”

Guo says our hands are marvels of construction.

Under the palm, there are five cylinder-shaped metacarpal bones, which extend from the wrist area to the knuckles. From the metacarpals rise the finger bones – 14 joined, flexible phalanges. The bridges between the forearms and the hands are the wrists, each of which has a collection of small bones fitted closely together containing strong ligaments. All in all, the wrists and hands contain 27 bones and dozens of muscles, tendons and ligaments.

Guo says her approach to making her patients’ hands better is very “can-do.”

“I love my specialty, because I can examine a hand with a problem, figure out the mechanics and see exactly what needs to be done to make it better. I think this is a characteristic shared by most surgeons – that’s why we are in that specialty. We like getting direct and immediate results.”

The hands work so well and so tirelessly, she says, that we often take them for granted.

“But when something goes wrong, it has a big impact on your daily life.” Even a relatively minor injury to one digit can affect the functioning of the entire hand and breaking a thumb can really limit what you are able to do.”

Try taping two of your fingers together to see what Guo means. “I tell this to patients and if they try it, they are amazed at how limited the usefulness of the hands becomes. And if, for example, you have a broken thumb, you cannot even turn a doorknob.”

Guo says the number one problem patients present to her in her practice is carpal tunnel syndrome.

“Carpal tunnel syndrome is on the increase because of repetitive movements in digital technology. It is basically a compression of a nerve in the wrist that produces numbness, pain and trouble sleeping at night. The good news is that it is an easy thing to repair – surgery followed by wearing of a splint – and then you can move on.”

Arthritis is another common problem among Guo’s patients. “There are surgical techniques where the pain caused by bone rubbing against bone can be alleviated by putting tendons in the needed places in between the bones of the hand,” she says. “The patient’s own tendons are used for this. Arthritis can also be treated by injections, steroids and splinting.”

Trigger finger is another condition Guo sees often in her practice. This is a condition that limits finger movement,” she says. “When a patient tries to straighten a finger, it will lock into place staying in a bent position.”

Trigger finger is usually caused by an inflamed or swollen tendon in the finger. The condition should be treated by a hand surgeon.

Guo also sees her share of hand injuries and is expert at repairs. “When you have a serious injury, always see a hand surgeon rather than a general practitioner,” she says. “We can make a quick and accurate diagnosis and get you on the road to healing.”

Although hands are mostly taken for granted because they are so versatile and reliable, Guo says it makes sense to be aware of anything that seems amiss. “Ongoing numbness, swelling, tingling, pain – anything that bothers you deserves a visit to a hand surgeon,” she says. “We need to be aware of our bodies and respond when something seems wrong.”

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