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NHRMC Newsletter

In This Issue
Thumb Arthritis
NHRMC Room Service
 
Procedure for Thumb Arthritis Suffers

What is thumb arthritis and who develops it?
Thumb arthritis, also called basal joint arthritis, occurs when the cartilage in the joint at the base of the thumb begins to wear out from normal use affecting the nearby bones. Specifically, with the deterioration of cartilage between the two carpal, or wrist, bones sitting on either side of the joint, these bones begin to rub against each other, often resulting in pain, stiffness and arthritis.

Thumb arthritis is most common in women over 40 (1 in 4 develops it); however, men develop it, too (about 1 in 12). Thumb arthritis can cause severe, debilitating hand pain, making simple household tasks like turning door knobs and opening jars difficult.

How is it treated?
A variety of treatments exist for thumb arthritis, including splints, medications and injections. However, surgery may sometimes be necessary when other treatments fail. One surgical procedure for thumb arthritis with proven results is Ligament Reconstruction and Tendon Interposition, or LRTI.

How does LRTI work?
After an incision in the lower forearm, the trapezium bone is taken out and arthritic joint removed. To stabilize the area created by the excised bone, the tendon behind the joint is attached to the index metacarpal, or long bone found within the hand at the base of the index finger. This constitutes the “ligament reconstruction” portion of the procedure and ensures “pinching” and “grabbing” stability in the thumb.

Final steps of the procedure can vary, but one common approach is “balling” the ends of the remaining
tendon to fill the open space created by the excised trapezium – this constitutes the “tendon interposition” portion of the surgery. Most LRTI procedures are outpatient procedures, which means patients return home the same day. Following the procedure, the thumb is immobilized for up to six weeks, and most patients regain good thumb function within three months.

What the experts say:
“It’s a great, effective procedure for patients suffering from thumb arthritis,” said Richard Moore, MD, an orthopedic surgeon in Wilmington specializing in hand and upper-extremity surgery. “And there’s good long term follow up on the efficacy of the procedure. The procedure restores function and mobility and dramatically reduces pain. Overall, it has a very high success rate."

“The LRTI procedure is very successful at decreasing and relieving pain symptoms and re-establishing functional pinch and grip,” said Richard Bahner, MD, an orthopedic surgeon in Wilmington specializing in hand and upper-extremity surgery. “Overall strength to the thumb will return after a rehabilitation program.”

As to the future of treating patients with thumb arthritis and similar conditions, Dr. Bahner says: “Minimally invasive arthroscopic procedures and specialized joint injections look to be promising.”

“LRTI is an excellent surgery which has withstood the test of time,” said Derrick Hickey, MD, an orthopedic surgeon in Wilmington specializing in hand, elbow and shoulder surgery. The hand surgical literature unequivocally supports the LRTI arthroplasty. Thumb stability, pain relief, and improvement in strength are expected outcomes.” Adds Dr. Hickey: “Recent trends in hand surgery attempt to retain the trapezium bone. A hand surgeon can tell you if you are a candidate for these newer procedures.”

What patients say:
“LRTI is a great procedure that has transformed my life,” said 70-year-old Wilmington resident Bruce Anderson, who has had the procedure performed on both thumbs by Dr. Bahner. “I used to have to take medication every day to help with the pain and arthritis, but now I take nothing. The procedure has allowed me to return to my favorite pastimes like fishing and golf. I would recommend the procedure to anyone and everyone with this condition.”

Where in the region can I get this procedure?
At NHRMC’s Cape Fear Hospital, an orthopedic dedicated hospital with expertly trained orthopedic surgeons.

For information on this procedure and others offered at NHRMC’s Cape Fear Hosptial, an orthopedic- dedicated hospital, visit nhrmc.org/orthopedics.

Room Service Enhances Patient Experience

If you thought room service was the stuff of high-end hotels and elegant, ivy-covered inns, think again! On July 29, New Hanover Regional Medical Center’s Cape Fear Hospital rolled out its room service operations, an initiative long in the making meant to further enhance the patient experience at NHRMC. “It’s all about serving the patient and making the patient stay more convenient and more meaningful,” said Tony DeSanctis, NHRMC’s Director of Food Services.

How it works
When patients are hungry, they dial “TO GO,” a number specific to food services, and submit their breakfast, lunch or dinner orders. Orders are based on an extensive, bed-side menu that includes everything from soups and sandwiches to pork loin, chicken and pot roast entrees. Patients may dial room service direct from their rooms from 6:30 a.m. to 9 p.m.

And room service isn’t just for those who know about it. “It’s how we now serve all meals to all patients … so all patients order through room service," said DeSanctis. “That way patients get to express their preferences and are greeted with a meal made to their specifications.” Meals usually arrive within 45 minutes, some earlier, he said.

Menu choices are also sensitive to patient conditions. Patients with diabetes or those just out of surgery, for example, have a menu specific to their needs. And patients can eat anytime they want, skirting traditional meal times.

“For patients who don’t eat breakfast, lunch or dinner at traditional times, there’s the opportunity to order when they feel like it … thus our room service slogan of ‘Patients can have what they want, when they want it,’” DeSanctis said.

DeSanctis said room service would be available at NHRMC’s main campus sometime late 2009 or early 2010 after main campus kitchen renovations are complete.

The Buzz About Room Service
Cape Fear Hospital nursing assistant Amanda Ansbach says patients have reacted “positively” and with “overwhelming enthusiasm” about the recent room service implementation.

“It’s a great new addition to the quality services we already provide here at Cape Fear,” Ansbach said. “Patients are just so excited because of the food choices and options they have. It’s been non-stop chatter.”

“It was so refreshing to see they offered room service,” said Wallace resident Sam Meale, a recent patient at Cape Fear. “You don’t see that kind of amenity offered much in the hospital setting.” And as for food and service: “It couldn’t be better – the food is great, and the staff are a class operation,” he said.

For patients unable to order because of their condition, nurses and the patients’ families often help in the selection process, said Ansbach. “Every patient is included.”

Ansbach said room service also makes good financial and environmental sense.

“Because patients get what they want and are more likely to eat it, there’s less waste,” she said. “And that’s good for our environment.”

Ansbach said she and her colleagues were some of room service’s first taste testers.

“The food was great, we loved it!” she said.

With great pleasure, Ansbach even revealed some of the menu’s many sweet temptations: “There’s even milkshakes on the menu, can you believe it?”

If you or a loved-one is a patient at Cape Fear Hospital, NHRMC Food Services would like to introduce you to its new room service amenity. Patients in the hospital please dial extension 8646 to begin your room service experience.

 

 
 

Thumb arthritis
– which most commonly affects women over 40, but can affect anyone - occurs when the cartilage in the joint
at the base of the thumb
begins to wear out.

RTI Terms:

Basal joint arthritis – potentially debilitating arthritis at the base of the thumb.

Cartilage – Cartilage is a type of connective tissue that provides a cushioning effect in joints.

Trapezium – The trapezium bone is a carpal bone in the wrist.

Tendon – A tendon is a tough band of fibrous connective tissue that usually connects muscle to bone.

LRTI – a highly successful orthopedic procedure for thumb arthritis that enables patient to return to pain-free, fully functional use of the thumb
and hand.


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Mission:
New Hanover Regional Medical Center is a team-centered, value-focused, teaching provider of quality health care to all in need of its services.

Vision:
To be the best provider of comprehensive health services rendered with value, dignity, and respect.

 

 


 
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