Dr. McClellan is Fellowship Trained in Hand Surgery
Dr. McClellan is an renowned innovator in Hand Surgery
Dr McClellan led the innovation team to a break through device for amputees around the country. Fingy 3D is a revolutionary product for amputees to access and afford a functional prothetic. Fingy3D won Innovation of the year at the American Society of Plastic Surgeons in 2023.
Read more about Fingy 3D by clicking the picture or visit www.fingy3d.com
Dr. McClellan led the team that created a Hand Surgery simulator to help doctors in training prepare to operate on patients. The trainer which was studied and published at Stanford University was demonstrated to be a superior training tool for residents and medical student.
Dr. McClellan has developed a very informative website dedicated to hand surgery education for patients and professionals. This information is created by hand surgeons for patients to better understand their conditions. The site provides clear explanations, diagram's, pictures, and videos of surgeries to prepare for their procedures. Click the picture to see more or visit www.Hand411.com
Basilar Thumb (CMC) Arthritis
Arthritis is a condition that affects joints, ultimately resulting in wearing out of the protective cartilage joint surface. In the thumb, the most common site for arthritis to develop is in the basal joint at the base of the thumb — also known as the thumb carpometacarpal (CMC) joint.
Smooth cartilage covers the ends of the bones. It enables the bones to glide easily in the joint. Without it, bones rub against each other, causing friction and damage. Osteoarthritis occurs when the cartilage begins to wear away, typically due to age and use.
The basal joint at the base of the thumb — or thumb CMC joint — is located near the wrist and at the fleshy part of the thumb. It enables the thumb to swivel, pivot, and pinch so that you can grip things in your hand. This joint is highly vulnerable to arthritis as people age.
Arthritis of the base of the thumb is more common in women than in men, and usually occurs after 40 years of age.
For more information visit Dr. McClellan's Hand Surgery site Hand411.com
FAT GRAFTING for Basilar Thumb Arthritis
The typical surgery for CMC Arthritis is called LRTI (Ligament Reconstruction Tendon Interposition) or Hematoma Arthroplasty. The arthroplasty can be very painful and is quite invasive. Dr. McClellan does perform this surgery, however he has developed and popularized fat grafting to the thumb as an early alternative to arthroplasty. As you can read in the abstract below Fat Grafting to the base of the thumb can significantly improve symptoms with little down time and little pain. A simple surgery and splinting for 2 weeks following the surgery by Dr. McClellan has seen a significant improvement in pain and symptoms without the more invasive surgery.
Patient 1
You can see in these before and after X-rays; after the fat is injected into the joint space the spacing between the bones improves. Dr. McClellan has performed this procedure for years and the success rate and satisfaction is very high.
Patient 2
Carpal Tunnel
Carpal tunnel syndrome occurs when the median nerve of the hand is compressed within the transverse carpal ligament at the wrist. The median nerve provides sensation to part of your hand and fingers. The carpal tunnel is the area in your wrist where the median nerve and many tendons traverse your wrist and go into your hand. It is a narrow and tight tunnel which is why carpal tunnel syndrome can happen so easily – any swelling in this area can pinch the nerve causing pain, numbness, tingling, or weakness.
For more information visit Dr. McClellan's Hand Surgery site Hand411.com
Watch a video where Dr. McClellan discusses whats in the carpal tunnel and how a Carpal Tunnel Release can help you fell better.
Click the picture to watch a video where Dr. McClellan performs a carpal tunnel release.
Trigger Finger
Trigger finger is also known as stenosing tenosynovitis. This occurs when one of your fingers or your thumb gets stuck in a bent position and then straightens with a snap. This is like a trigger being pulled and released. In severe cases, your finger may become locked in a bent position. Trigger finger is more common in your dominant hand, and most often affects your thumb or your middle or ring finger. In addition, more than one finger may be affected, and both hands might be involved.
This condition is often painful and is caused by a narrowing of the sheath that surrounds the tendon in the affected finger. People who are most susceptible include those whose work or hobbies require repetitive gripping actions. Trigger finger is also more common in diabetics and women.
Signs and symptoms can vary in severity and often include the following:
• A popping or clicking sensation when moving your finger
• Finger stiffness, especially in the morning
• Finger locking or catching in a bent position
• Tenderness or a nodule at the base of the affected finger
For more information visit Dr. McClellan's Hand Surgery site Hand411.com
Ganglion Cyst - Volar wrist
Ganglion cysts commonly occur near the radial artery in the wrist. They may occur following a trauma, usually to an outstretched hand, that causes a small tear in the joint capsule. Due to the tear, joint fluid escapes and the body builds a small shell around the fluid, forming the ganglion cyst. 75% of volar ganglion cysts occur in women, with most cases being between the ages of 20 to 40 years. Volar ganglion cysts are sometimes referred to as “Bible” cysts because treatment used to consist of smashing them with a Bible to make them rupture. However, this method is not performed anymore because it can lead to further damage and possible recurrence of the cyst (so don’t try this at home).
There are a number of different types of ganglion cysts. Patients can get these in the joints on the fingers, on the tendon sheath on the finger, and also on the dorsal part of the wrist.
For more information visit Dr. McClellan's Hand Surgery site Hand411.com
Click the picture to watch a video where Dr. McClellan performs a volar ganglion cyst excision.
Cubital Tunnel
Cubital tunnel syndrome is a condition brought on by increased pressure on the ulnar nerve at the elbow. The ulnar nerve is one of the major nerves to the hand and provides both motor and sensory innervation to the hand. There is a bone on the inner portion of the elbow (medial epicondyle) the ulnar nerve passes behind. This site is commonly called the “funny bone”. At this site, the ulnar nerve lies directly next to the bone and is susceptible to pressure. When the pressure on the nerve becomes great enough to disturb the way the nerve works, then numbness, tingling, and pain may be felt in the elbow, forearm, hand, and/or fingers.
Cubital tunnel syndrome symptoms usually include pain, numbness, and/or tingling. The numbness or tingling most often occurs in the ring and little fingers. The symptoms are usually felt when there is pressure on the nerve, such as sitting with the elbow on an arm rest, or with repetitive elbow bending and straightening. Often symptoms will be felt when the elbow is held in a bent position for a period of time, such as when holding the phone, or while sleeping. Some patients may notice weakness while pinching, occasional clumsiness, and/or a tendency to drop things. In severe cases, sensation may be lost and the muscles in the hand may lose bulk and strength.
For more information visit Dr. McClellan's Hand Surgery site Hand411.com
Click the picture to watch Dr. McClellan perform a cubital tunnel release and discuss the anatomy.
Dupuytren's contracture
Dupuytren’s contracture is a rare hand deformity in which the connective tissue under the skin of your palm, called the superficial palmar fascia, tightens, contracts, and toughens. The reason this occurs remains unknown however its more common in people of Northern European descent. (The same fascia tightness can also occur on the feet and is called Ledderhosen Disease). Eventually, your fingers are drawn down into a bent position. The affected fingers can’t be straightened and it makes using your hand very difficult. Many people come into Dr. McClellan’s office complaining of “bumps in the palm”, “difficulty putting on gloves” or “loss or hand function”.
Dupuytren’s contracture happens when the fascia, or layer of tissue under the skin, of the palm shrinks and pulls your skin and fingers down. There is no known cause for Dupuytren’s contracture; however, it is most common in people that have Northern European or Scandinavian ancestry. Because it seems to be genetically predisposed to happen in individuals, it often runs in families. It is also associated with smoking, drinking, and certain medical conditions like diabetes, thyroid problems, and seizures. It occurs most often in older individuals.
For more information visit Dr. McClellan's Hand Surgery site Hand411.com
Click the picture to watch Dr. McClellan perform a Dupuytren's Fasciectomy and discuss the anatomy.
Syndactyly
Syndactyly is a joining or webbing of fingers or toes. It can be simple, in which only skin is joined, or complex, in which there is bone involvement. Complete syndactyly involves the digit all the way to the nail folds, while incomplete syndactyly does not, although the web depth is more distal than usual. Finally, complicated syndactyly can have involvement of muscles, tendons, bones, joints, and neurovascular bundles (1).
Syndactyly is a congenital failure of differentiation. For simple syndactyly, the cause is likely a failure of programmed cell death to remove the skin webbing which is normally present during development. The cause of more complex syndactyly is less clear. Syndactyly is associated with several autosomal dominant syndromes, including Apert syndrome.
Surgical correction of the digits can be performed, and often requires the use of skin grafts. A congenital simple syndactyly is typically released at 1 year of age or older (1). However, certain types of complex syndactyly may need to be released earlier, or corrected in stages. Digits on the edges of the hand, such as the thumb, must be separated when the child is a few months old (2). The primary goal of surgery is to create opposable digits that increase function of the hand. If joints are unstable, the skin connections may be preserved to keep the digits stable and functional.
For more information visit Dr. McClellan's Hand Surgery site Hand411.com
