The hand, German philosopher Immanuel Kant once noted, is the “visible part of the brain.” Our hands do reflect and carry out many of our thoughts, feelings and imaginings, whether it’s driving a car, hammering a nail, writing a letter, painting a picture or holding another’s hand.
Most people, though, don’t consciously think that much about their hands—until they stop working properly or start hurting. Fortunately, patients in need of a little help with their hands can turn to a pair of top-notch hand surgery specialists at Sentara Martha Jefferson Orthopedic Services.
Hand surgeons Steve Hoover, MD, and Michael Potter, MD, have received the specialized training and rigorous certifications needed to diagnose and provide effective surgical and nonsurgical treatment of various conditions affecting the hand, the wrist and even the elbow.
Following are the stories of two patients who lost use of one or both hands, but have been able to regain full functioning after undergoing hand surgery and treatment at Sentara Martha Jefferson.
After the Fall: Back on the Bike
Kyle DeTuncq knew he was riding a little too fast when, one day in August 2016, his dirt bike bounced down into a dry creek bed marred by deep ditches and slopes. “I dropped off on one side of the path and tried to get the front wheel up, but instead I lost control,” the 28-year-old Charlottesville native recalls of the incident in the backwoods of Afton Mountain. “I went off the bike sideways at about 20-30 miles per hour, and I put my arm out to break my fall.”
In doing so, he broke two bones in his wrist and tore the labrum tissue surrounding his shoulder joint.
Seeing the X-rays in the Emergency Department (ED) at Sentara Martha Jefferson, DeTuncq knew he was in trouble. “You don’t realize all the simple things you do in life that you really need both hands for—like tying your shoes, buttoning your shirt and brushing your teeth—until you can’t use them,” he says. “And, of course, I knew that for a while I wouldn’t be able to do the things I really enjoy, like riding my bike, lifting weights and playing football.”
Added to those concerns, DeTuncq works full time as a project manager for a local homebuilder, which involves a lot of typing and sometimes requires him to step in and help out at construction sites.
Though the ED doctors were confident that DeTuncq’s shoulder injury would heal on its own, the fractures in the wrist would likely require surgery. DeTuncq was immediately referred to Dr. Hoover. “He told me it was a violent break, but he was confident that he could get me back to 90-100 percent mobility,” DeTuncq recalls.
After his evaluation, DeTuncq was eager to get on with the surgery. “I felt pretty good after I met with Dr. Hoover. Then when I was getting ready for surgery, the anesthesiologist told me that Dr. Hoover had done her hand surgery, so I was pretty confident that everything was going to be OK.”
The surgery involved fixing his scaphoid with a screw and piecing the radius back together with a screw and plate. DeTuncq was then fitted with a hard cast and some additional soft bandaging and sent home.
“The cast kept my hand immobile for about a week. Within three weeks, I was able to do most of my normal activities again,” he says, noting that Dr. Hoover sent him to physical therapy to further ensure a proper and speedy recovery. “I was back to 100 percent pretty quickly.”
DeTuncq elected to have his plate removed several months after his initial surgery to avoid any future issues.
“He recommended that I go ahead and have the second surgery because I was so young and active, and because I had healed so quickly from the first injury,” DeTuncq says. “So we went ahead and did that in January. That healed up quickly as well, and there was absolutely no pain. It was incredible.”
DeTuncq is fully back to his regular life, lifting weights, playing football and racing his dirt bike out in the woods. He won’t promise that he’ll always be completely careful on the bike, but he does know this for sure: “If this kind of thing ever happens again, I’m definitely going back to Dr. Hoover.”
Carpal Tunnel: Easy Come, Easy Go
For Andrew Koerper, the pain in his wrists and forearms started subtly, but quickly became intense. “It would go shooting up both arms, and it was horrendous,” says the 36-year-old, a manager at a Panera Bread restaurant in Charlottesville. “I had previously torn the anterior cruciate ligament in my knee playing football, but this actually felt worse.”
The crisis couldn’t have come at a more difficult time for him. It was just before Thanksgiving 2016, and Andrew and his wife, Cristelle, who were already parents to a 4-year-old daughter, had just welcomed a baby boy. Andrew, though, was suddenly struggling to do his regular job, and he wasn’t able to help out his wife around the house like he normally would. Cristelle, who works as director of catering at the C&O Restaurant, was also gearing up for the holiday party season—a time when she would normally need Andrew’s support, helping with setup, arranging flowers, and building and painting signs in his workshop. Due to the condition of his hands, however, Andrew wasn’t able to assist much in those endeavors, either.
“I didn’t have the normal strength in my grip,” Andrew recalls, noting that the pain would wake him up continually at night, and forced him to sleep sitting up. “The dexterity in my hands and fingers was just not there, so even cutting bread was very difficult. And opening a bottle of wine? I just couldn’t do it. I’d pick it up and start, but then I’d just set it down and walk away.”
One night while cooking dinner, Andrew dropped a skillet. “What if the skillet had been one of the kids?” he thought out loud.
That fear finally inspired him to go see his primary care doctor, who diagnosed Andrew with carpal tunnel syndrome, a nerve disorder that often results from too much repetitive use of the hands. She put him on Prednisone, an anti-inflammatory medication, and referred him to Dr. Potter.
During the initial visit, Dr. Potter examined Andrew’s hands and had him squeeze and pick up a few items, and then provided his prognosis: “OK, when do you want to do surgery?” he asked Andrew.
Taken aback by the speedy evaluation, Andrew responded: “Wait. … What? That quick?”
Dr. Potter was matter of fact about Andrew’s condition. As Andrew remembers: “He was like, ‘Well, you can keep taking medication, and we can do a whole bunch more tests just to reconfirm that, yes, surgery is the only option—or we can just do the surgery and fix it.”
Andrew agreed to move forward as soon as possible. “I appreciated Dr. Potter’s frankness, because I don’t like being a patient,” he notes. “To be honest, I just wanted the pain to go away.”
The surgery on Andrew’s left hand, which involved cutting the ligament pressing on the median nerve that runs through the narrow carpal tunnel in the wrist, was performed on an outpatient basis using a local anesthetic. The entire procedure took just 30 minutes from start to finish. Andrew drove himself home with a few simple instructions: Keep the bandage dry and clean, and don’t lift anything heavier than a gallon of milk.
“Within a week, I had most of my dexterity and hand abilities back, and within a month it was like I had never had a problem,” Andrew says.
When he went back to Dr. Potter for a follow-up, the pain in the other hand also had subsided, despite the fact that Andrew had forgotten to take his pain medicine. So Dr. Potter canceled the second surgery.
“And again, I was like: ‘Wait. … What?’” Andrew says, laughing. “Dr. Potter told me: ‘Well, if it’s not hurting, I’m not going to operate for no reason. Let’s just see how things go, and if something changes, call me.’ He was so straightforward about everything.”
Now, Andrew is once again helping to care for the couple’s children, cooking dinner most nights and doing all the little extras for his wife’s catering events.
Everything has gone so well, in fact, that Andrew has already recommended Dr. Potter to a co-worker who is also suffering with carpal tunnel pain. “I told her: ‘When you’re ready to get surgery, go talk to Dr. Potter,’” he explains. “‘Actually, don’t wait to go talk to him. He’s great, and you’ll be really happy you did.’”