As team physician for the University of Virginia athletics department, Dr. Bobby Chhabra builds on a breadth of experience in caring for injured athletes. Also chair of the orthopaedics department with the University of Virginia Health System, Dr. Bobby Chhabra offers particular expertise in conditions related to the upper extremities. Valgus extension overload, also known as pitcher's elbow, is a common upper-extremity injury in throwing athletes. The condition occurs because the motion of throwing causes the humerus, located in the upper arm, to rub against the tip and fossa of the olecranon bone. The same forces also cause a stretching of the ulnar collateral ligament, also known as the medial collateral ligament. In time, this movement leads to a wearing away of the cartilage that protects the olecranon. In the absence of cartilage, the exposed olecranon begins to develop abnormal growths known as bone spurs. The condition typically presents with pain or swelling around the elbow area. In addition, athletes may develop weakness of grip and a loss of power or control in the throw. Damage may also manifest as a weakened grip and numbness in the fourth and fifth fingers.
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A surgeon with expertise in procedures of the hands, wrists, and elbows, Dr. Bobby Chhabra chairs the Department of Orthopaedics and serves as professor of orthopedic surgery at the University of Virginia. In preparation for his medical career, Dr. Bobby Chhabra completed his fellowship in hand, microvascular, and congenital hand surgery at the Hand Center of San Antonio. According to researchers, 22.5 of every 10,000 babies born exhibit upper limb anomalies. The formation of the hand in utero is extremely complex and can be influenced by a variety of factors, including genetics and environmental contaminants. Some of the most common congenital hand deformities include polydactylism, a condition in which an infant is born with additional fingers. Only in rare cases are the extra fingers fully functional. Doctors usually treat polydactylism by removing the extra digit or digits. Radial club hand, another congenital deformity, causes a curved and shortened forearm as well as a stunted or absent thumb. Children with the condition may experience difficulty carrying out activities that necessitate the use of both hands. As an endowed chair of orthopedic surgery in the University of Virginia Health System, Dr. Bobby Chhabra contributes his talents to the organization's Primary Care Sports Medicine Program. Dr. Bobby Chhabra has also written and presented extensively on surgical interventions for wrist, hand, and finger injuries in athletes. In a healthy hand, finger and thumb movements are initiated by muscles in the wrist. Contraction of these muscles causes a pull on the flexor and extensor tendons, which tug on attached bones to allow the fingers to bend or straighten. Injury to these tendons can render finger joints useless and are particularly common in contact sports, in which players' fingers can become caught on others' uniforms and become stretched beyond their endurance. Similarly, rock climbing and other activities that demand excessive hand strength may also cause excessive outward pressure of the fingers that in turn can tear the tendon. When a tendon tears, the severed parts slide away from each other as a result of lost tension in the tendon sheath. This makes it impossible for the tendon to heal independently and prompts the need for surgical intervention. Such intervention involves suturing the tendon to reattach the severed pieces and facilitate any other reconnections. It is typically most successful when it occurs within seven to 10 days following the injury. Dr. Bobby Chhabra, Chair of the Department of Orthopaedic Surgery at the University of Virginia Health System, has extensive experience in surgically treating the full spectrum of upper-extremity diseases and injuries. Dr. Bobby Chhabra frequently sees patients with arthritis of the elbow and offers several treatments. Cartilage at the end of bones provides cushioning so that the bones can move fluidly past each other at joints. Osteoarthritis occurs when the cartilage is destroyed, causing the bones to rub together. This condition can occur because of injury to a joint or from simple age-related wear and tear. Another type of arthritis, rheumatoid arthritis, causes inflammation in the joint linings, which can destroy the cartilage and bones as well as the soft tissues that cushion them. Arthritis in the elbow often causes difficulties in bending or straightening the elbow, and the joint can become stiff and lock up. Pain and swelling in the elbows may also occur. A diagnosis of arthritis can usually be made by assessing the symptoms and taking standard X-rays, which will typically show narrowing of the joint or loose, bony pieces in the joint. Rest, physical therapy, and corticosteroid injections can help alleviate symptoms, but some patients need surgery. Arthroscopic surgery is an outpatient procedure that is performed by inserting small instruments through several small incisions around the joint to remove loose, diseased, or damaged tissues. When wear or damage to the joint surfaces is too extensive, the physician may need to replace the joint completely. As professor of orthopaedic surgery within the University of Virginia Health System, Dr. Bobby Chhabra draws on extensive experience in surgical correction of congenital hand abnormalities. Dr. Bobby Chhabra completed his fellowship in hand, microvascular, and congenital hand surgery at the Hand Center of San Antonio and has since been selected as one of the “Best Doctors in America” multiple times.
The term “congenital hand abnormality” refers to a malformation of the hand that develops while a fetus is in utero. The American Society for Surgery of the Hand has approved classification of these abnormalities into seven categories. The first, problems in development of the parts, indicates the premature cessation of a body part’s development. This may include underdevelopment of the hand or finger bones on either the thumb or little finger side of the hand. Other malformations include fusion of the fingers, also known as syndactyly, which is caused by cells (tissue and/or bone) failing to differentiate in utero. Contractures of the hand, which is another instance of a failure of the hand to separate, is a condition that, due to problems with muscle or skin, causes one or more digits to curl into the palm, unable to extend. Additional common abnormalities include duplication of digits, underdevelopment of one or more fingers, and the abnormally large growth of a digit. Ring constriction, when a band of tissue grows around a digit or arm, may also lead to deformities and can be associated with other structural issues such as clubfoot or cleft palate. The cause of ring constriction remains unknown. A board-certified orthopedic surgeon, Dr. Bobby Chhabra has focused on hand, wrist, and elbow surgery, with an emphasis on sports-related injuries and congenital hand issues. Dr. Bobby Chhabra currently holds positions as an educator, physician, researcher, and athletics department surgery consultant with the University of Virginia (UVA) and the UVA Health System.
In a recent press release, the UVA Health System announced that the University of Virginia Medical Center garnered a 2014-15 Consumer Choice Award, based on the results of a national survey. The survey investigated consumers’ perceptions of health care quality and reputation by gathering insights from more than 290,000 households around the country. Presented by the National Research Corp. (NRC), the Consumer Choice Award recognizes the leading hospitals in the nation after they are identified by consumers and then evaluated and ranked according to their Core Based Statistical Areas. The CEO of UVA Medical Center noted that the award is a testament to the hospital’s commitment to delivering high-quality care and reflects patients’ positive experiences and feedback. Knowledgeable in the field of orthopaedic medicine, Dr. Bobby Chhabra teaches on the subject and is also an administrator in the sports medicine and orthopaedic field. One of Bobby Chhabra’s areas of focus is sprains of the wrist.
A wrist sprain is a type of ligament injury. Therefore, the injury affects the connective tissues that link one bone to the next. A common sports injury, a wrist sprain generally results when a ligament is torn or stretched. Because a number of ligaments act to support the wrist, any sprain that occurs may be rated mild, moderate, or severe. The degree of severity then depends on the extent of the injury. Grade one wrist sprains are mild and generally happen when a ligament is merely overstretched. Moderate or grade two sprains are denoted by partial tearing of the affected ligament or ligaments. The patient may also complain about some loss of functioning. Severe or grade three sprains happen when the ligament is entirely torn. These types of injuries generally necessitate surgery. An avulsion fracture, characterized by a chipped bone, is usually considered a grade three injury. Symptoms of a wrist sprain include pain at the outset, wrist swelling, pain while moving the wrist, bruising, tenderness, and a popping sensation. The patient may also feel some warmth around the wrist itself. While some wrist strains may present very little in the way of swelling, it does not mean that the injury is not severe. A crucial ligament may have been torn, and this can result in eventual stiffness and pain if the injury is not addressed. Therefore, it is important to have the wrist carefully examined whenever any injury occurs. Since 2002, Dr. Bobby Chhabra has served as a member of the University of Virginia (UVA) faculty and UVA Health system, concentrating his work on hand, wrist, and elbow trauma; arthritis; and surgery for congenital hand abnormalities. Currently the chair of the UVA Department of Orthopaedics, Dr. Bobby Chhabra was inducted as a fellow of the American Orthopaedic Association (AOA) in 2008. The longest-standing orthopaedic organization in the world, the AOA operates several programs, such as Own the Bone, with the mission of advancing leadership and best practices in the science of orthopaedics.
Recognizing studies that have shown 80% of fragility fracture patients receive inadequate care, AOA established Own the Bone to facilitate the delivery of osteoporosis treatment to these patients and prevent the recurrence of fractures. Through Own the Bone, AOA advises healthcare institutions on the implementation of a fracture liaison service. The program utilizes an Internet-based patient registry with which a care coordinator identifies postfracture patients over the age of 50 at risk for osteoporosis. The coordinator can then refer these patients to a primary care physician, orthopaedic surgeon, or osteoporosis specialist for proper diagnosis and treatment. In addition to the online registry, Own the Bone employs a set of 10 prevention measures to mitigate the impact of osteoporosis and prevent fractures. As those who have previously incurred fractures are at an increased risk for future fractures, these measures seek to change physician and patient behavior in the wake of an initial fragility fracture. Physicians are encouraged to regard fragility fractures as a teachable moment through which they can educate their patients and ensure subsequent care. AOA established Own the Bone in 2009, and the program has since been put into action in private practice offices, hospitals, and medical centers in 44 states. Bobby Chhabra, M.D. currently serves as a professor of orthopedic surgery and plastic surgery as well as division head of hand and upper-extremity surgery at the University of Virginia Health System. With over a decade of experience in performing hand and wrist surgery, Dr. Bobby Chhabra has treated patients with a wide array of bone injuries, including scaphoid fracture.
The scaphoid is a small bone in the wrist that is located at the base of the thumb at the point where the wrist bends. The most common cause of a scaphoid fracture is a fall in which the person catches himself with an outstretched hand. The pain from a scaphoid fracture may range from minor to severe, and it is often accompanied by swelling. Many people who experience minimal symptoms may mistake the injury for a sprain and not seek medical treatment. However, without proper treatment, the bone may fail to heal, and some of the bone fragments may die because of inadequate blood supply. Non-displaced fractures of the scaphoid may respond well to stabilization with a cast that covers the hand and forearm. If the fracture is closer to the thumb, it usually has enough blood supply to heal properly with a cast. Scaphoid fractures that are displaced or occur closer to the forearm may not have enough blood supply and could require surgery, which involves reconnecting the bone pieces with screws. A bone graft may also be performed at the time of surgery to promote healing. A graduate of the University of Virginia School of Medicine, Bobby Chhabra, M.D. completed much of his postgraduate training at the same institution, and now heads up the division of hand and upper-extremity surgery at the University of Virginia Health System. During his extensive career, Dr. Bobby Chhabra has handled the most complex conditions affecting the hands and wrists as well as simple injuries such as wrist sprains.
The bones of the body are connected by bands of tissue called ligaments. When a ligament is stretched, partially torn, or completely torn, the injury is called a sprain. Wrist sprains typically occur when a person tries to break a fall with an outstretched hand, and they are among the most common types of sprains during sports as well as everyday activities. Depending on the severity of the sprain, the injured person may experience mild symptoms or severe pain, swelling, bruising, tenderness, and popping sensations in the wrist. A doctor’s examination can determine the whether the sprain is minor or severe. This workup includes a physical exam, X-rays, and possibly an MRI or CT scan. For a mild sprain, the patient will be instructed on the RICE protocol, which involves resting the wrist for 48 hours, icing the injury, compressing the wrist with a bandage to reduce swelling, and frequently elevating the wrist above the heart. The use of a stabilizing splint may also be advised. More severe ligament tears may require surgery to reconnect the ligament to the bone. |
AuthorAn orthopedic surgeon with a specialization in hand and upper extremity surgery, Bobby Chhabra currently splits his time between various teaching and clinical responsibilities at the University of Virginia. Archives
May 2017
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