Paul Tavakolian, M.D - Hand, Wrist, and Elbow Orthopedic Surgeon

Just received an advanced copy of my new book chapter going into print this month. Thanks to all the authors that made this book so valuable and meaningful.
Texas Orthopedic Specialists

🇺🇸 Remembering those who lost their lives, those who stepped up to serve, and the countless sacrifices made in the days, months, and years after the attacks.
🇺🇸Hoping we can honor those lost on 9/11 by living each day like Sept 12th, where there is no gender, race, or political side. Where the only thing that matters is each other. America first and forever.

Texas Orthopedic Specialists | Orthopedic Surgeon Keller, Fort Worth TX Texas Orthopedic Specialists is committed to providing the highest quality orthopedic care in North Texas. Our mission is to treat our patients with dignity, respect, courtesy, and compassion.

Lunchtime clinic visits by my favorite Good Boy, Dakota. Should we make Dakota the official Hand & Upper Extremity team mascot?
Texas Orthopedic SpecialistsHolly Bassham

Nothing like Friday Night Lights during Texas High school football season. Proud of these guys for always fighting hard. Wishing all athletes a healthy injury-free season. L. D. Bell High School Texas Orthopedic Specialists

Not only are some of our patients elite athletes, they are also some of the most thoughtful people I get the privilege of treating. This young athlete brought me this beautiful hand drawing depicting his family's Maori and Polynesian heritage. The Maori people are the indigenous people to mainland New Zealand, where I got to spend invaluable time doing Orthopedic Trauma and Upper Extremity Surgery along with learning about this beautiful culture and amazing people. Feeling very grateful on days like today.

Texas Orthopedic Specialists

Feeling blessed to work with the most amazing people that I can call my friends. Thank you to Jeremy Roberson and all the staff at Bear Creek Surgery Center for always being so amazing inside and outside the operating room.

Some problems are best addressed with two hand surgeon brains! Dr. Drury and I often times tackle complex surgeries as a team to get the best result for patients.

Staying up to date on advanced techniques for complex wrist problems and working with Arthrex with their wrist arthroscopy systems. Always thankful to work with the most innovative and advanced team for solutions for our patient's needs.

Texas Orthopedic Specialists

Not only do we have the best patients in the world, but sometimes they are also world-class expert bagel makers. Thank you to Lenore's Handmade Bagel Company for the DELICIOUS batch!

Congrats and shoutout to my Texas Longhorns for winning the Big 12 Basketball Championship title and the #3 seed during Selection Sunday!

As March Madness approaches, we discuss injuries common to basketball. Basketball injuries are common, particularly those of the hand, wrist, and elbow. This is largely because of the intense repetition of passing, catching and shooting players do in practice and games.

The hands, wrists, and elbows see a lot of action and take a beating. In today’s post we discuss some of the most common hand, wrist, and elbow injuries that occur when playing basketball.

1. Fractured Fingers/Hands
An impact to the hand is common in basketball when players collide, during a fall, or when catching the basketball.
At one point or another, every basketball player will experience a jammed finger - generally a simple sprain or injury to a ligament in the finger. However, a more serious impact may result in the fracture of the bones in the finger or even the hand. Although the bones in the fingers and hands are quite small, a fracture can throw the whole hand out of alignment, making even basic tasks difficult and painful.

Treatment: In the majority of cases, the bones can be realigned without surgery and placed in a splint or cast while the fracture heals. Splints or casts can be worn anywhere from three to six weeks, depending on the severity of the break and how quickly it heals. In some cases, surgery might be needed to realign the bones appropriately and screws, pins, or wire may be needed to hold the bones in position.

2. Elbow Bursitis
Elbow bursitis refers to inflammation or irritation of the elbow bursa, which are slippery, thin sacs that cushion the soft tissues and bones. Elbow bursitis may be caused by infection, repetitive activity, or an injury to the elbow bursa. Bursitis causes the elbow to swell, and fluid collects in the bursa. Bending the elbow can become painful as the swelling increases.

Treatment: Most of the time, elbow bursitis is first treated with non-surgical options. Cortisone injections or anti-inflammatory medications may be recommended to help with swelling and pain.

The fluid may be aspirated from the elbow with a needle. If the bursitis does not improve without surgery, the entire bursa may have to be surgically removed. The bursa will usually grow back after several months and function as it once did.

Los Angeles Clipper Blake Griffin has had to deal with bursitis over the course of his career, and has his elbow aspirated regularly.

3. Elbow Tendonitis
Elbow tendonitis is an injury from overuse that can occur in basketball players as the result of passing, shooting, and dribbling the ball. With elbow tendonitis, tendons that attach the forearm muscles to the elbow become swollen and inflamed, causing elbow pain. Symptoms usually begin as minor pain that gradually gets more severe.

Treatment: Typically, elbow tendonitis can be successfully treated without surgical intervention. Surgery is only recommended if symptoms do not improve with nonsurgical treatment. Nonsurgical treatment includes physical therapy, anti-inflammatory medications, and rest. Sometimes, a brace may be recommended, and cortisone injections may be given to relieve inflammation. If surgery is necessary, it can frequently be done arthroscopically, which allows for a faster recovery time than traditional open surgery.

4. Wrist Sprains
Wrist sprains happen when a ligament is torn or stretched, typically when the wrist is forcefully bent. Wrist sprains can happen if a player falls on the court while their hand is outstretched. A sprain may be minor, where the ligaments are simply stretched, or more intense, where the ligaments are torn – partially or completely.

Treatment: The majority of wrist sprains can be treated non-surgical interventions, although surgery may be required if the ligament is completely torn. Nonsurgical options for a wrist sprain often include anti-inflammatory medications and immobilization with a splint. The RICE (Rest, Ice, Compression, and Elevation) method is also frequently recommended for wrist sprains.

5. Mallet Finger - Mallet finger is one of the most common injures in basketball players. It occurs when the ball strikes the end of an extended finger causing forceful bending of the last finger joint (DIP joint) and rupture or tearing of the extensor tendon, which is attached to the finger bone. Injured finger becomes painful and swollen at the DIP joint and the tip of the finger feels and looks stuck in a bent position. If not treated in a timely fashion, the injury can lead to permanent deformity and discomfort.
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6. Jammed Finger - When a basketball hits the finger "head on" while the finger is fully extended, collateral finger ligaments can tear or rupture, usually at the middle knuckle joint of a finger (PIP joint). In addition, the collateral ligament can tear at its attachment at the volar plate (thick ligament on the palm side of the joint) and middle phalanx. These injuries are frequently accompanied by avulsion fractures, which occur when a piece of bone is torn away by a tendon or a ligament. It is important to evaluate the jammed finger quickly as the avulsion fractures indicate major ligament or tendon injury and can lead to significant long-term pain and stiffness if not treated appropriately.

7. Volar Plate Injury - One of the most common injuries to the PIP joint occurs on the palm side of the finger joint to a thick ligament known as the volar plate (Figure 1). Any injury that causes hyperextension (backward bending) can result in a tear of the volar plate with or without an avulsion fracture.

8. Central Slip Extensor Tendon Injury - Center slip extensor tendon injury is highly common injury in basketball players. It occurs when the PIP joint is forcibly flexed while actively extended. Another cause of the central slip tears is the volar (palm-side) dislocation of the PIP joint. In either case, if the injury is not treated in a timely fashion, the affected finger will develop a Boutonniere deformity.

9. The PIP joint and the MP joint (knuckle joint) dislocation - All dislocated joints need to be immediately evaluated to assess for tendon, ligament, and bone injury. Although the dislocated joint can often be reduced on the basketball court, any joint that cannot be reduced is considered an emergency.
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Texas Longhorns

On this first day of MLB Spring Training (Go Rangers), we recognize all our awesome baseball and softball athletes as they continue with their seasons and head toward their playoff months.

Elbow health is an important consideration to longevity in playing and an emphasis must be placed at an early age on preseason conditioning, proper throwing mechanics and proper warm up exercises.

Overhand throwing places extremely high stresses on the elbow. In baseball pitchers and other throwing athletes, these high stresses are repeated many times and can lead to serious overuse injury.
Unlike an acute injury that results from a fall or collision with another player, an overuse injury occurs gradually over time. In many cases, overuse injuries develop when an athletic movement is repeated often during single periods of play, and when these periods of play — games, practices — are so frequent that the body does not have enough time to rest and heal.
Although throwing injuries in the elbow most commonly occur in pitchers, they can be seen in any athlete who participates in repetitive overhand throwing.

Treatment for throwing injuries in the elbow usually begins with a short period of rest. Other treatment options may include:
- Physical therapy
- Change of position
- Anti-inflammatory medications
- Longer periods of rest
- Platelet rich plasma (PRP) therapy is also being used as a non-surgical treatment

Our philosophy is to first try all appropriate nonsurgical methods to increase mobility and function. If these methods do not achieve the desired results then, and only then, is surgery considered.

If you or someone in your family has suffered an elbow injury, Texas Orthopedic Specialist has some of the most advanced sports medicine program in the area. We use a multi-disciplinary approach to ensure the most innovative treatment for all sports-related injuries.

Texas Orthopedic Specialists L.D. Bell Blue Raider Baseball Texas Rangers

Wishing everyone safety and warmth as this historic winter weather makes its way into the metroplex over the next few days. Hoping everyone can stay indoors and off the roadways.

Hand, wrist, and elbow injuries are common with winter weather. Here are some tips for preventing falling on ice and snow:

1) Select proper footwear. No single shoe sole material is perfect under all conditions, however, footwear with rubber or neoprene composite soles provides better traction on ice and snow than leather or plastic.

2) Walk consciously. Be alert to the possibility that you could quickly slip on an unseen patch of ice. Avoid the temptation to run to catch a bus or beat traffic when crossing a street. You can test your travel path by sliding your shoe or boot on it to see if it is slick.

3) Walk cautiously. Your arms help keep you balanced, so keep hands out of pockets and avoid carrying heavy loads that may cause you to become off balance.

4) Walk “small.” Avoid an erect, marching posture. Look to see ahead of where you step. When you step on icy areas, take short, shuffling steps, curl your toes under and walk as flatfooted as possible. Spread your feet our slightly like a penguin. Walking like a penguin on ice increases your center of gravity.

5) Many injuries occur when entering or exiting a vehicle. Be particularly careful and hold onto you vehicle to help support yourself.

6) Be sure you remove snow immediately, before it becomes packed down and turns to ice. Pay special attention to your porch stoops, steps, sidewalk and driveway by applying ice melt. This is the best way to prevent the formation of ice patches.

Shout out to my L.D. Bell Women's Basketball team for another dominating season as District 3-6A Champions and the 3-peat! Wishing you all a successful and injury-free post-season run!! LD Bell Lady Raiders Basketball L. D. Bell High School

Assembling The Avengers in clinic can be lots of fun. Our patients often times get creative with their casts.

Happy MLK Day to everyone from Texas Orthopedic Specialists!