Abhishek Julka MD

Rheumatoid arthritis disease can affects the hands disproportionately. This video demonstrates my patient who underwent a wrist fusion, ulna resection, tendon transfers, carpal tunnel release, and multiple revision joint replacements with life changing improvement.@OSUWexMed

@myorthodoc @txsportsdoc Couldn’t agree with you more. Joint replacement is such a serious and incredibly life changing operation. Should be valued much more than it is.

@txsportsdoc I feel bad for my joint replacement colleagues. I think they are feeling it more than everyone else. it’s no surprise that joint replacement has become a volume business. It’s a little sad actually.

We are seriously considering no longer participating in the Medicare program with the looming cuts in Jan. How many of my colleagues will do the same? At some point it doesn’t make financial sense to continue. It’s just math.

@txsportsdoc @robgraymd @NuelleSportsMD @ChrisTuckerMD @zilberfarb @FixnBones @H2O_SportsMD @SportsSurgeryNY Knotless anchor, generally no cautery of vessels, one small longitudinal anterior incision. Minimal clearing of tuberosity .

How you fixing your distal biceps these days? Routinely clipping or cauterizing recurrent branch? Clear off radial tuberosity or simply drill and place preferred fixation? @robgraymd @NuelleSportsMD @ChrisTuckerMD @zilberfarb @FixnBones @H2O_SportsMD @SportsSurgeryNY

Love hearing from our patients. A previous bad experience is a great opportunity for our team to show patients just how different we truly are.

@Plexusorthoexam Well done. Non op treatment and pinning (never simple, requires effort and experience) is great to see. We need to get on board in the US with the rest of the world . Not every fracture needs a volar plate. 👏

Sequence of Kapandji intrafocal pinning for a case of distal radius fracture with intra-articular extension. #orthotwitter #Orthopedics #handsurgery #congenitalhand

Just a few days after Dupuytren’s contracture release this patient demonstrates one of my favorite sites, a hand FLAT on a table.@HandSociety @HandSurgeryAssn

I pride myself in recognizing subtleties in CMC arthroplasty. One that I try my best to address is the ability of the thumb to spread away from the rest of the hand. This allows appropriate grasp and particularly is needed for hobbies like Piano amongst others. @HandSociety

Nothing better than 2 week post surgery dupuytrens patient with a straight finger for the first time in years. 100 deg PIP and 45 deg MCP contracture resolved. #dupuytren

This patient suffered for over five years with a hand deformity that was painful and non-functional. Thankfully she was a great candidate for silicone joint replacements and re-balancing of her hand musculature. Only a few weeks from surgery and already pain-free and recovering.

Can you guess which hand recently had surgery?  Here we have a incredibly hard-working mechanic just four weeks after a large reconstructive wrist operation on the left side clearly still working extremely hard but only using his right hand.

@TheKDesai I have done both. I LOVE 4 individuals. It makes retraction much easier and much less dissection in general. This allows me to do the surgery with minimal assistance and in a very efficient manner. I see retraction as trauma. Less the better.

@JulkaDr Great result! How do you feel about the 4 individual longitudinal incisions vs one long transverse?

We love our Rhuematoid Arthritis patients at JIS Orthopedics. Please check out this before and after (6 weeks after surgery).

@jnqh4mbd96 Held up by a suture construct ( I have a technique I described and published) as well as a small tendon. It does a fantastic job but there are subtleties to the technique. If you can check out @ajulkamd on instagram.

@JulkaDr Thanks for the clarification. Just need to ask, if there's no pin there, what holds the thumb up? Please excuse my anatomical ignorance!

Why does my thumb constantly ache?      It could be thumb CMC joint or Basilar joint arthritis.       Before and after from one of my favorite operations.

Muscle and dexterity loss around the hand can be significantly limiting. It is often NOT related to normal aging. Please check out this video to learn about the warning signs of severe cubital tunnel syndrome.

@jnqh4mbd96 I do not use a pin which is what I think you are referring to. I have only used pins on revision or re do operations.

@JulkaDr Do you wire the thumb in place after removing the trapezium?

Keys to our success with CMC Arthroplasty: 🔹Atraumatic technique. Minimal bleeding. Minimal tourniquet time 🔹Glue closure which allows warm showers at 3 days (great for early mobilization) 🔹 Simple exercises

Rheumatoid arthritis can be crippling to the hands…but does not have to be. At JIS Orthopedics Hand Center we have solutions .

When should I get a second opinion?     Second opinions are never a bad idea. Anytime the patient feels uncomfortable with a treatment plan or has a complex situation we openly recommend considering another opinion. Before and After of a complex hand contracture surgery.

Our New Albany office treating all disorders of the hand, wrist, elbow and peripheral nerve is ready to go. We are now in our 3rd week and have received great positive feedback from our patients and the community.

Love hearing from our patients. This patient is 8 weeks post thumb arthritis surgery, endoscopic carpal tunnel release and trigger thumb release. #handsurgeon #thumbarthritis