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Hand Surgery in the Digital Age

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LEXINGTON The technological advances made throughout the past decade that we now enjoy in our day-to-day lives have been nothing short of amazing. The same can be said for the medical field, especially with regard to orthopedic surgery. Technological advances such as small joint arthroscopy, bone/suture anchors, and low-profile implants allow for more minimally-invasive procedures that in turn result in a quicker and more predictable return of function following surgical procedures.

“For example, 30 years ago, patients were admitted to the hospital the night before and after a carpal tunnel release. Today, this same routine has become a short, outpatient procedure. In addition, new developments, such as endoscopic carpal tunnel release, offer the potential advantage of a faster return to normal activity and work,” says Brandon Devers, MD, orthopedic hand surgeon and Lexington Clinic’s newest physician. “Advances in arthroscopic equipment and bone/suture anchors now allow for arthroscopic treatment of several wrist, elbow, and small joint conditions using minimally-invasive techniques. More low-profile plate and screw configurations now enable us to better stabilize hand fractures while minimizing damage to the surrounding soft tissues. This in turn allows us to be more aggressive with patient rehab in order to avoid adhesion formation and subsequent post-operative stiffness, which is a hand surgeon’s worst enemy.”

Advancements have not been limited to surgical procedures, but extend to nonoperative medical management as well. For example, collagenase injections now allow surgeons to inject Dupuytren’s cords within the hand and fingers and perform in-office manipulations to break these cords and straighten the previously flexed digits. This offers the potential to avoid a large open surgical procedure that can result in significant scar formation.

Devers, who joins Lexington Clinic Orthopedics – Sports Medicine Center and specializes in hand surgery, completed fellowship training in orthopedic surgery of the hand and upper extremity at the University of Cincinnati, a residency in orthopedic surgery at Vanderbilt University Medical Center, and received his medical degree from Baylor College of Medicine. He says he is fortunate to have received this training and education during a time period of exponential growth in medical technology and development and plans to use this training and experience to offer patients the most up-to-date treatment measures for hand and upper extremity conditions.

“Not only have I had the good fortune to receive my training during a time period marked by incredible growth and development in medical practice and technology, but I have also had the privilege of training under incredible surgeons and mentors at both Vanderbilt and Cincinnati. I am extremely humbled by the opportunity I had to complete my hand surgery fellowship under the guidance of world renowned orthopedic hand surgeon Dr. Peter Stern. I look forward to integrating all that he and many others have taught me over the years and using my experience with modern medical technology to provide the most comprehensive care for my patients as possible,” says Devers. “My goal is to get the patient back to their pre-injury activity level and work, while minimizing post-operative pain and complications. I believe that utilizing treatments such as endoscopic carpal tunnel release, arthroscopy, and low-profile fracture fixation will help me towards this end.”

However, it is necessary that physicians be cautious about embracing new technological advancements at the expense of abandoning established practices and procedures that have a proven track record with regard to patient outcome. At Lexington Clinic Hand Surgery the providers, Devers, along with Stephen C. Umansky, MD, and Michelle Derbin, PA-C, work to not only treat patients with the most up-to-date technology available, but also streamline and standardize all procedures, from the most complex of surgeries to daily office routines.

“It is imperative to make well-informed decisions based upon the evidence-based medicine available in the literature, and in turn relay that information to the patient. To that end, it is important to involve the patient in their medical decision making. I believe that it is my job to explain the various options available for the care of a specific condition, including the risk and benefits of each potential treatment course, and then to help patients make the decision that is right for them based upon this information,” says Devers. “I am excited to work alongside Dr. Umansky and Michelle and continue to grow the orthopedic hand practice, as well as manage a variety of conditions, regardless of their complexity. I am proud to be a part of this practice, and in turn, the well-respected Lexington Clinic Orthopedics – Sports Medicine Center, which has established a tradition of excellence within the community it serves.”