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A Patients Story: Jon A.

James J. Creighton, Jr.

Jon’s x-ray shows the nail polish glass still in his arm.

On March 6, 2015, 7-year-old Jon A. had decided it would be fun to set up an obstacle course in his house around 10 p.m., which basically meant he was jumping from one piece of furniture to the next.  He was on the recliner jumping to the inn table where there was a fingernail polish bottle sitting. He missed the table with his body falling to the floor between the table and the chair but his arm came down on the fingernail polish bottle, busting the bottle into pieces. A large piece of the bottle severed the FDP, FDS, FCU tendons; the palmaris, the median, ulnar, ulnar sensory nerve; and ulnar artery. A piece of the broken bottle was still in his arm.

“When we heard the screams we knew something was really wrong and we found Jon with our oldest daughter trying to get him to us, blood everywhere and pumping out fast.  My husband who is a PA got him to the sink so he could try to see what was going on and yelled at me to call 911 and I knew then if he was panicked then it wasn’t good.  Brandon was able to get the bleeding stopped before the medics arrived thankfully.” said Jon’s mother Amber.

The medics tried to assess Jon but if pressure was removed the bleeding resumed. They had no idea the glass was still in his arm until he got to St. Johns Hospital in Anderson where they did an x-ray. So while the pressure applied to the arm had to happen to keep Jon from loosing too much blood it may have also contributed to the extent of the laceration to the internal structures. The physician at Johns Hospital assessed him and decided he needed to go on to Peyton Manning Children’s Hospital in Indianapolis for surgery.

They drove Jon to the Peyton Manning Children’s Hospital and the intake nurse from the Indiana Hand to Shoulder Center was there waiting to assess Jon when we arrived to see if they needed to go straight to surgery or wait until the morning. With the extent of the injury they decided they needed to operate as soon as possible.

“The staff in the emergency room at Peyton Manning Children’s Hospital as well as the surgical staff were great with Jon and two very nervous parents. Dr. James J. Creighton, Jr.  took Jon into surgery around 3:30a.m., Brandon and I set in the surgical waiting room for what seemed like FOREVER.” said Amber

Jon after surgery with James J. Creighton, Jr.

Jon after surgery with James J. Creighton, Jr.

Dr. Creighton came out around 6:30 to tell the parents the extent of Jon’s injuries, which was much worse than they originally anticipated. The broken glass had to be removed as well as the fingernail polish before Dr. Creighton could even begin to repair all the arteries, nerves and ligaments.

“Dr. Creighton was very frank with us when he came to talk to us. Not making any promises on what kind of recovery Jon would have. We didn’t know if he would have recurring infections after surgery due to the fingernail polish, we didn’t know if he would have ever have normal function in his hand or any at all. Because he not only severed the ulnar nerve, he also partially severed the median nerve which controls your intrinsic muscles and the intrinsic muscles control the individual movement of the fingers. In the grand scheme of things this injury could have cost Jon his life, we knew we had already been given that blessing. But we did grieve for the things we knew Jon, who loves baseball, basketball, football, and all things little boys love may have to give up.” said Amber.

After recovery they spent two nights at Peyton Manning Children’s Hospital for them to administer pain medication and antibiotics. Jon went home with a huge cast and orders to come back in 10 days to remove his sutures and to get recast. Jon’s family had planned a spring break trip and left the day after Jon’s sutures came out. He was placed in a removable cast which was okay to get wet on vacation.

James J. Creighton, Jr

Jon getting his stitches out and enjoying Spring Break vacation

Jon started therapy with Barb in Anderson as soon as the family got back from spring break and continued therapy twice a week from April-August, then went to once a week in August-September where he was released after meeting all his therapy goals.

“Barb was so good with Jon, and he loved her.  She made him work hard but was very encouraging to him.”

Throughout the therapy sessions Jon had lots of different casts and splints to target one area of rehab or another. When Jon started his therapy with Barb his grip strength in his Left hand was 4lbs, 5 months later in September his grip strength was 20lbs. His progress was impressive.

“Jon saw Dr. Creighton monthly and He is so good with Jon, making sure he knew the importance of continuing to work to regain his strength and movement. Dr. Creighton was also impressed by the progress Jon was making.” said Amber

Jon was very guarded with his Left arm for a very long time and wouldn’t use it. Dr. Creighton assured the family that when he got the feeling back in his hand he would use it like he used to, and now he does.

“There are now times where I forget the accident happened because He is a normal boy, doing normal things, who just happens to have a really cool scar.  We can never give enough thanks to everyone who played a role in Jon’s treatment and recovery.  Dr. Creighton had a BIG challenge that night and he rose up like a superstar.  We are so thankful for him and his staff at the Indiana Hand to Shoulder Center. Plus the nurses and staff on the recovery floor after surgery, who were also wonderful and the multiple prayers that were said for our boy not only that night but all through his recovery.” said Amber

“While Jon will always have to be mindful to keep the scar tissue stretched as long as he continues to grow to make sure he doesn’t have retraction of his muscles and hand he is one blessed little boy who is back to enjoying all the things he could do before his injury.  He is just wrapping up his first season of tackle football, where he plays maybe a little more guarded, and his Dad and I are a little more nervous than we would have been prior to his injury.  But he plays center where he guards the biggest opponents and snaps the ball to the quarterback, and no one would ever know that just 6 months ago we weren’t sure Jon would ever have use of that hand.  We will continue to see Dr. Creighton once a year until Jon stops growing to be sure he is progressing as he should.  And we look forward to those visits to thank Dr. Creighton and remind him of the difference he has made in our lives.”

James J. Creighton, Jr. with Jon.

James J. Creighton, Jr. with Jon.

Jon's note to Dr. James J. Creighton, Jr.

Jon’s note to Dr. James J. Creighton, Jr.

James J. Creighton, Jr, the indiana hand to shoulder center

Jon is now back playing all the sports he loves so much.

Cell Phone Elbow

cell phone elbow, cubital tunnelSmartphones and tablets have changed the way we live our lives, but they can also can cause some medical issues.  Cell phone elbow occurs when patients experience tingling or numbness in their ring and pinkie fingers. Cubital tunnel syndrome or cell phone elbow is similar to carpal tunnel syndrome in that compression of a nerve results in tingling or numbness within the hand. Carpal tunnel syndrome creates numbness in the thumb, index, and middle fingers from pressure on the median nerve in the wrist, while in cubital tunnel syndrome, it is the ulnar nerve being pinched with the site of compression occuring behind the elbow.

Bending the elbow for long periods of time like when using a cell phone, sleeping with your elbows bent, or keeping your elbow on an armrest for too long can cause cubital tunnel syndrome. Although symptoms may not be immediate, these positions can aggravate the problem and progressively irritate the nerve.

Nonoperative treatments should be used first and include anti-inflammatory medications, elbow pads, splints, and avoidance of problem positions. But, if numbness is becoming constant or the hand has become weak, then nerve damage may have occurred surgical treatments should be considered.

Surgery for cubital tunnel syndrome, like carpal tunnel syndrome, involves making more room for the nerve so that the blood flow can be restored. In the elbow, this is often accomplished with simply releasing the tight tissue passing over the nerve. In some cases, when the nerve has lost its elasticity, or when it is unstable in its groove, the nerve may need to be moved to the front of the elbow (this is called a transposition.)

Please visit our pages on cubital tunnel syndrome and carpal tunnel syndrome for more information.

Pumpkin Carving Safety Tips

pumpkin carving hand safety

pumpkin carving hand safety

Halloween is a fun holiday for the whole family to enjoy. Carving pumpkins has become as big a part of Halloween as Trick-or-Treating. Each year during the fall season, the Indiana Hand to Shoulder Center’s surgeons treat many adults and children who suffer from severe hand and finger injuries due to careless pumpkin carving activities. These injuries range from simple lacerations to more severe tendon and nerve injuries that can require extensive surgery to repair and may also result in a permanent loss of hand function. Most injuries result from knives slipping in an individual’s hand resulting in laceration to digital nerves and flexor or extensor tendons. A knife with to much applied pressure can also suddenly slice or puncture through a pumpkin resulting in a stab wound to the other hand which has been supporting or holding the pumpkin. Have a safe Halloween by following these tips.

  • Adults, not children, should always perform the pumpkin carving.
  • Never let children play with knives or pumpkin carving tools.
  • Allow the children to draw the pattern on the pumpkin and clean the seeds out of the inside of the pumpkin.
  • Utilize pumpkin carving kits. A serrated pumpkin saw is safer to use than a sharp knife. A large and very sharp knife is not the best tool to use to carve.
  • Prepare a clean, dry surface for carving. Any moisture on your hands, tools or table can cause slipping that can lead to injuries.
  • Thoroughly wash and dry hands and all carving tools before starting.
  • When you start your cutting, always cut away from yourself and cut in small controlled strokes.
  • If an injury occurs apply pressure to the wound with a clean cloth. If the pressure does not stop the bleeding after 15 minutes an emergency room visit may be required.

Hand Care 2016 Dates

The Hand Care 2016 conference in Indianapolis, Indiana will be held on April 15-17, 2016.  More information on registration will be available soon.

Ladder Safety

With the Fall months upon us the leafs are changing colors and falling to the ground. Many home owners will be raking and cleaning the leaves out of their yards and gutters. One of the tools used for this is the ladder. Ladders are very useful tools, but if not properly used you can hurt yourself. The most common injuries are dislocations and sprains, followed by fractures and open wounds. These injuries are typically severe and complicated secondary to the high degree of energy the body absorbs from a fall from a like this. Here are some helpful tips to use this fall.

  • Always inspect the ladder before use. Check for loose screws or damage.
  • Place ladder on a even surface.
  • Do not use the top step on the ladder.
  • Always maintain a 3-point contact (two hands and a foot or two feet and a hand) on the ladder when climbing and always face the ladder.
  • Do not extend the center of your body’s torso past either side rail of the ladder. Over-reaching or leaning to far to one side when you are on a ladder could make you lose your balance and fall.
  • Ladders should be set up at a 4:1 angle (1 ft out from the base for every 4 ft of rise)
  • Use the right ladder for the job. Extension ladders are ideal for use outdoors to reach high places like gutters on the roof.
  • Be sure all locks are properly engaged on the extension ladder before use.

If you would like further information Werner Ladders has provided a great “Ladder Safety Tips” brochure on their website. It is full of helpful illustrations and diagrams. Please visit their website and download the PDF file at http://www.wernerladder.com/catalog/files/rc310.pdf

2015-16 Fellowship Class

2015-16-fellows-social-media

2014-15 Fellowship Class Completes Year of Specialized Training

indiana hand to shoulder center fellowshipToday is the last day for the Indiana Hand to Shoulder 2014-15 Fellowship class. They have completed a year of specialized training in the upper extremity and will be joining practices around the country. Here is where they will be practicing:

Michael Brody, MD – Loyola Univ. in Maywood, IL
Christina Endress, MD – Troy Orthopaedics in Troy, MI
Tobias Mann, MD – ORA Orthopedics in Bettendorf, IA
Santosh Mathen, MD – Plainview, NY
Cameron Schick, MD – Bellevue Bone & Joint Clinic in Bellevue, WA
Chad Turner, MD – Rockwood Clinic in Spokane, WA
Justin Walker, MD – Georgia Physicians Group in Braselton, GA

Good Luck in the future.