Dr. George Edwards III of Raleigh Hand Center passed the American Board of Orthopedic Surgery examination. He is officially board-certified in orthopedics. Congratulations Dr. Edwards!

The cost of medical care has increased significantly in the United States in recent years. Due to changes in health insurance plans, many patients are now responsible for paying a larger portion of the cost associated with the treatment they receive. Raleigh Hand Center physicians are aware of the financial burden of medical expenses for patients and strive to reduce costs in several ways.

The Raleigh Hand Center has been committed to providing high-quality and cost-effective treatment for many years. Since the founding of the Center, Raleigh Hand has remained an independent practice in the community. Independent physician practices have been shown to be less expensive than hospital-owned practices in recent studies.

Cost-effective treatment begins with providing appropriate, evidence-based medical care to patients. Conservative treatment options are emphasized at Raleigh Hand; surgery is recommended only when necessary. MRIs, CT scans, and other expensive tests are only ordered when required for treatment. Additionally, Raleigh Hand Center offers same day and next day appointments for patients with urgent problems, which reduces the need for costly emergency room visits. The physicians are also on-call 24/7 to help triage emergency cases from doctors’ offices, urgent cares, and emergency rooms to expedite patient treatment.

Raleigh Hand Center physicians perform the majority of their outpatient surgeries at Capital City Surgery Center, which charges a much lower facility fee than local-area hospitals. Additionally, the price of equipment and implants used during surgery has been negotiated with manufacturers to keep costs down.  Many hand procedures can be performed using local anesthesia only, avoiding the anesthesiologist’s fee. Raleigh Hand Center physicians maintain a low infection rate and low complication rate, reducing the need for secondary surgeries or additional treatment.  Less-invasive surgery is available in many cases, allowing patients a more rapid return to their work and livelihood.

Raleigh Hand Center physicians have been listed as preferred providers by several insurance companies by providing high-quality care at a low cost. 

Cubital tunnel syndrome is a common cause of numbness, tingling and pain in the small and ring fingers. For many patients, this condition feels like “hitting the funny bone”. Some cases can result in hand weakness, poor dexterity and loss of muscle tone. Please watch this video by the American Society for Surgery of the Hand regarding diagnosis and treatment of this common condition. Raleigh Hand Center physicians treat cubital tunnel syndrome with conservative treatment as well as surgery if needed.

What is a shoulder SLAP lesion?

A SLAP lesion is an injury in the shoulder that is characterized by a tear of the labrum and long head of the biceps tendon insertion (see image below).  SLAP stands for Superior Labrum from Anterior to Posterior, which signifies the location of the labrum injury at the top of the shoulder joint and the direction of the tear running from front to back that is typical for this type of injury.

What are the signs of a SLAP lesion?

Pain is the most common symptom and is often a vague discomfort deep within the shoulder that is aggravated with overhead activity, throwing, lifting, or holding the arm out in front of the body.  Occasionally, with larger tears, mechanical symptoms of popping or clicking with shoulder motion are noted.

What causes a SLAP lesion?

A SLAP lesion typically occurs in overhead athletes such as baseball pitchers, volleyball and tennis players, but can happen with work related injuries, falls or overuse conditions as well.   A sudden forceful exertion of the shoulder can cause the biceps tendon to detach the labrum from where it attaches to the shoulder, or repetitive small injuries can lead to an overuse type of injury with gradual onset of pain over time.   Depending on the severity of the injury, the SLAP lesion can either be a partial injury with fraying of the labral attachment, or a complete tear with displacement of the tissues.  An MRI is often required to diagnose and determine the severity of the SLAP lesion.

What are the treatment options? 

Many SLAP lesions respond favorably to nonsurgical treatment with anti-inflammatory medication, corticosteroid injection and a therapy program. Conservative treatment is typically the first line of treatment.  Occasionally, surgery is required to address the SLAP lesion in cases that fail to respond to nonsurgical treatment, especially for more severe, complete tears.  The particular surgical procedure depends on the type of tear and the health and activity level of the patient.  Some SLAP injuries are amenable to arthroscopic repair by reattaching the labrum to the glenoid with suture anchors.  Alternatively, in certain situations a biceps tenodesis procedure can have excellent results as well.  Biceps tenodesis involves detaching the biceps tendon from the labrum and reinserting the biceps further down on the humerus outside of the shoulder joint.  Regardless of the type of surgery performed, a period of shoulder immobilization with a sling is required followed by a rehabilitation program with gradual return to work and sports.

If you have signs or symptoms of a SLAP lesion, feel free to call our office to schedule an appointment with one of our fellowship trained Orthopaedic hand and upper extremity surgeons that specialize in both the non-surgical and surgical treatments of shoulder pathology.

article by Dr. George S. Edwards, III

What is frozen shoulder?

Frozen shoulder, also called “adhesive capsulitis,” is an inflammatory condition of the shoulder that results in tightening of the shoulder capsular ligaments.  This results in a stiff and often painful shoulder and can make it difficult to perform normal activities of daily living.

What are the signs of frozen shoulder?

Pain and stiffness are the hallmark signs of a frozen shoulder and most commonly there is a loss of external rotation range of motion.  A frozen shoulder typically goes through three stages of symptoms that last for a variable period of time.  Stage I (Freezing Stage) is the first stage and is the most painful. There is a progressive loss of motion in the first stage that can last from 6 weeks to 9 months.  Stage II (Frozen) is characterized by a plateau of the pain and stiffness and can last from 4 to 12 months, or more.  Stage III (Thawing) is characterized by decreasing pain with a gradual return of motion and can last from 1 to 4 years without treatment.  Although frozen shoulder usually resolves on its own with time, permanent stiffness is possible. 

What causes frozen shoulder?

Frozen shoulder is often caused by an injury to the shoulder that leads to an inflammatory reaction and the resultant tightening of the shoulder capsule and ligaments.  It can also result from an injury elsewhere in the arm or hand if the arm is immobilized for a long period of time.  Other medical conditions are associated with frozen shoulder, but the relationship is not entirely clear.  These associated medical conditions include diabetes, respiratory/lung problems, adrenal disease, thyroid problems, recent chest surgery, and an extended hospitalization.  Regardless of the original cause, the synovial lining of the shoulder joint thickens, and the capsular ligaments contract, limiting the range of motion of the shoulder.

What are the treatment options?

Most cases of frozen shoulder can be successfully treated with anti-inflammatory medicines, a corticosteroid injection and a therapy program.  The medication and injection help to decrease the pain and inflammation, and the therapy helps restore range of motion.  Occasionally for severe cases, if these methods fail to resolve the frozen shoulder, a manipulation of the shoulder under anesthesia and/or surgery may be required to release the tight capsule/ligaments in the shoulder.  The surgery is typically performed arthroscopically with small incisions in a minimally invasive manner.

If you have signs or symptoms of frozen shoulder feel free to call our office to schedule an appointment with one of our fellowship trained Orthopaedic hand and upper extremity surgeons that specialize in both the non-surgical and surgical treatments of hand, wrist, elbow, and shoulder problems.

Article by Dr. George S. Edwards, III.