When you have a job title like "adventure supervisor," you don't want anything, like
gravity or a serious hand injury, to get you down.

Seriously, how can you expect to teach young campers the finer points of repelling off a

30-foot climbing wall, or zooming down a "zip line," with a cast on your arm?

This wasn't a question to which Marilyn Sherwood wanted to discover the answer. So

when the city resident and summer camp supervisor broke her wrist on Christmas Eve

2007, she was very interested in learning about what alternatives there might be to

spending months in a cast - followed by many more months of rebuilding the strength in

her arm.

"I'm climbing walls and high wires. I can't have a hand injury slow me down," she said.

Given TUH's excellent reputation for orthopaedic surgery, Sherwood made an appointment.
There, hand surgeon Asif Ilyas, MD, Director of the new Temple Hand Center, explained

that there may be a better way to repair her wrist than a traditional cast.

After an examination, Ilyas confirmed that Sherwood had suffered a distal radial fracture.

One of the most common wrist injuries, it often happens when a person attempts to break

a fall with their hand, which is exactly how the accident happened.

"I was teaching a 5-year-old how to ice skate," she said. "She fell, and then I fell. I remember

breaking the fall with my right hand. Then, I remember seeing stars."

Ilyas explained that while her injury was a common one, she wasn't necessarily doomed

to a cast.

"We discussed operative and nonoperative interventions," said Ilyas. "Non-operative would

mean a cast for about six weeks, with, possibly, another six weeks of therapy afterward. The
second option was operative. Surgery would allow anatomic restoration of the fracture to its

pre-fracture state. Titanium plates and screws would be used deep within the bone to keep

everything secure. The recovery and rehabilitation time for this is dramatically shorter."

Sherwood opted for the surgery, which took place on a Friday. By Monday, she was back to

her day job as a high school teacher in Center City.

This summer, she was back in action at Pinemere Camp in Stroudesburg, Pa., ascending

telephone poles and climbing rock walls. In the off-season, she even gets out to a Center

City rock climbing gym from time to time.

"I'm back to doing everything now," said Sherwood. "This has been wonderful."

 

 

 

Helping patients like Sherwood regain optimal functioning so they can get back to their life

as soon as possible is central to the mission of the Temple Hand Center, which provides

comprehensive care for disorders of the hand, wrist, elbow, and arm for everyone - from

children to adults.

To facilitate this goal and to offer patients a central location where they can obtain the full

complement of these services, the Hand Center recently opened a new, state-of-the-art

office on the fifth floor of the Boyer Pavilion.

The Center, which opened in December, encompasses four high-tech orthopaedic exam

rooms, equipped with digital X-ray technology that enables doctors to illustrate diagnoses

via cutting-edge 3-D renderings. The space also includes an expansive 2,000 sq. ft. physical

therapy gym that covers the entire spectrum of physical therapy modalities.

Ilyas, who returned to Temple after completing a surgical fellowship at Harvard, serves as

Director, and shares surgical duties with Joseph Thoder, MD, Chairman of Orthopaedic

Surgery and Sports Medicine. Their efforts are aided by Albert Weiss, MD, a non-operative

hand surgeon who brings years of experience in the care and management of disorders of
the hand and upper extremity.

For all the new technology and equipment, Thoder says the idea of the Hand Center

transcends physical surroundings and high-tech gadgets. The challenge has been
establishing the right surgical team and support staff - physical therapists, occupational
therapists, athletic trainers, and rehabilitation physicians - who would work together to

promote excellent, seamless patient care.

"The center has grown because of the talent and temperament of the people who work

here," said Thoder. "They are essential to the Hand Center because patients know that

whomever they see, they will be treated with the same level of compassion and quality.

The new Hand Center takes the reputation we have built and gives it a physical
location."

While this patient-centered reputation wasn't built overnight, it's the reason why the Hand

Center continues to attract new patients like Sherwood, and retain longtime patients like

Claire Coleman, who has a relationship with Temple that spans decades.

 

 

 

Nearly 20 years ago, Coleman's wrists collapsed due to complications of rheumatoid arthritis.

Her fingers had pulled to one side, making it difficult to even pick up a glass of water. A
very active person with a life full of hobbies and a family to care for, the Bucks County
resident began searching for a surgeon who could help.

By word of mouth, she was referred to the Orthopaedics program at Temple and, specifically,

to Thoder. She said she was amazed to learn that he could actually "rebuild" her hands after

they had been ravaged by rheumatoid arthritis.

Rheumatoid arthritis can destroy the cartilage in the wrist bones, causing pain and loss of

motion. This can also cause the tendons to slip off the knuckle, resulting in what is called

ulnar drift, which pulls the fingers to one side of the hand, making it difficult to close the hand

or grasp objects. In 1990, Thoder rebuilt Coleman's wrists with titanium implants and then

transferred the tendons of each finger to the adjacent finger to pull the fingers back to their
normal position - in a procedure called intrinsic transfer.

After surgery, the mended hand must "mature" in a special splint that allows it to heal and

retrains the fingers to stay straight. Extensive physical therapy follows to help ease patients

back into the full use of their hands.

This year, Thoder rebuilt Coleman's hands for the second time. Eighteen years was an
amazingly good lifespan for her artificial joints, which typically last 10 to 15 years.

For Coleman, 69, who had her last surgery in September, it's great to get back to
doing what she loves - which is essentially ... everything. Whether it's gardening, her
book club, church group, or spending time with family and friends, there's not much
time for sitting around - especially now with two her "new" hands.

 

Looking back, Coleman says she is glad she choose Temple those many years ago, when she

put the fate of her hands in the hands of Thoder, who was then a young surgeon just out of

fellowship.

"My friends joked, 'You sure you want to go with him? He just graduated high school.' Yes,"

she replied. There was something about his nature that put her at ease. It was the way he

took the time to explain everything so she would understand. "It made me feel like he was the

right man for the job," she said.

Obviously, her instincts were right.
 

-- Steven Bates