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Hand & Upper Extremity

OrthoWilmington offers comprehensive care for a range of hand and upper extremity conditions, from treatment of carpal tunnel syndrome to complex reconstruction in arthritic and traumatic cases.

Our medical team includes physicians who are fellowship trained in hand, upper extremity and microvascular surgery, as well as total joint replacement of the shoulder. These advanced skills place them among the area’s leading specialists in hand surgery.

Additionally our physical therapy centers employ several Certified Hand Therapists with excellent credentials and years of experience.

Hand Therapy

A bit of a misnomer, hand therapy extends to include rehabilitation of the wrist, elbow and shoulder girdle. The specialty is actually a blend of occupational and physical therapy, concentrating on the function of the entire upper extremity. Hand therapies are aimed at preventing dysfunction, as well as restoring function and reversing the progression of disease.

Conditions Treated

  • Traumatic injuries, including fractures, sprains, dislocations and lacerations
  • Arthritis—osteo-, rheumatoid, inflammatory and post-traumatic
  • Carpal tunnel syndrome
  • Ganglion cysts
  • Dupuytren’s Contracture
  • Poor circulation, numbness, tingling and nerve problems
  • Work-related injuries
  • Recreational and sports-related injuries
  • Athletic injuries, including ligament, tendon and cartilage issues
  • Bursitis/tendonitis
  • Rotator cuff tears of all sizes

Advanced techniques utilized by our surgeons:

  • Total shoulder replacement
  • Arthroscopic shoulder stabilization
  • Arthroscopic rotator cuff repair
  • Arthroscopic biceps tenodesis
  • Arthroscopic labral repair
  • Total shoulder arthroplasty
  • Hemiarthroplasty
  • HemiCap partial humeral resurfacing (for segmental avascular necrosis)
  • Reverse total shoulder arthroplasty
  • Hemiarthroplasty combined with meniscal interposition glenoid resurfacing for younger patients with shoulder arthritis
Hand and Upper Extremity Physicians
About Hand and Upper Extremity Problems

A common cause of injury to an arm or leg can be trauma, where a bone in the arm or leg is fractured from a fall, contact with another object, or in a car accident.

Most fractures, thankfully, can be “reduced” or “set” so that over time, with immobilization, such as provided by a cast or sling, the fracture will heal and the strength and function of the bone and body part can be fully restored. 

dr bahner examination of patient wilmington north carolina, extremity center north carolina

Richard S. Bahner, MD
Fellowship-Trained in Hand and Upper Extremity

When an injury occurs to an arm or leg during sports activity, a sports medicine specialist may be involved in your care, because the goal of an athlete is to return to their previous performance level. A sports medicine orientation emphasizes reconditioning and rehabilitation, along with prevention, and even training related to proper body mechanics and form for that particular sport.

For example, a common upper extremity problem related to tennis is tennis elbow and rotator cuff problems in the shoulder. Both injuries can involve tears to ligaments around the elbow, and cartilage in 

the shoulder. Repairing this damage is the first issue by the orthopedic surgeon. The second issue is helping the patient so they don’t repeat the same injury continually. Injuries to the shoulder and elbow often relate to incorrect tennis strokes, or “overuse” syndrome from too much practice or playing time on the court.

As part of the recovery from the initial injury, the sports medicine specialists at OrthoWilmington in Wilmington, North Carolina may involve therapists who will help the patient strengthen the muscles and ligaments needed in the sport, and look at the form and body mechanics used.

A person can lower their risk of injuries to the arm or leg by addressing the following areas:

Technique & form — If you use the correct technique, you achieve power correctly rather than through counter productive and excessive body movements and torque. An incorrect swing in tennis, often indicates that the person is relying only on the arm to hit the ball, rather than transfer of body weight and uncoiling the trunk correctly.

Failure to warm up and cool down – warming up and cooling down is extremely important to reduce the risk of muscle and joint injuries. Warming up will not only help avoid injury but will also improve performance.

Stress fractures — Repetitive stressful motion on a leg or arm can over time create a painful stress fracture. In a leg, this can include a spiral fracture where the crack in the bone resembles a spiral staircase. These can be difficult injuries to recover from.

Overuse syndrome — Your body needs recovery time between events. This is common problem with Spring training in baseball, where teen athletes throw for three hours straight in practice sessions, only to tear a rotator cuff, or create a ligament strain in the elbow.

Recurrent injury — Many times people never fully give themselves time to recover from an earlier strain or sprain, and this can lead to similar strain in the future.


Disclaimer: Where pictures of patients are displayed, the patients of OrthoWilmington have consented to have their picture in this website for the purpose of patient education.