Medical doctor Bobby Chhabra is a professor and the chair of orthopedic surgery at the University of Virginia School of Medicine. A physician in the orthopedic hand and upper extremity division of the school, Bobby Chhabra supports the division’s Hand and Upper Extremity Fellowship.
The Hand and Upper Extremity Fellowship is offered every year to two surgeons-in-training with a goal to prepare them for compassionate and responsible practice on all pathologies affecting the hand, shoulder, elbow, and wrist. The fellowship also encourages the surgeons-in-training to give back by advancing the specialty through continuous involvement in scientific research and long-term practice.
The fellowship lasts one year, from August 1 to July 31. Training focuses on congenital, sports-related, and injury-related pathologies of the hand and upper extremities. Fellows work together with the university’s four orthopedic hand and upper extremity faculty on a rotating basis. They also get an opportunity to work with plastic surgeons to gain experience in caring for wounds and transferring free tissue. At the end of the program, fellows will have gained experience on how to diagnose, manage, and surgically treat disorders of the upper extremities.
Bobby Chhabra, an orthopaedic hand surgeon, has been a member of the University of Virginia Health System since 2002. Hand surgeons such as Bobby Chhabra often perform a surgery called resection arthroplasty to reduce pain and restore function to arthritic thumbs.
In a resection arthroplasty, the surgeon removes a bone from the base of the thumb and replaces it with a small amount of tendon material. This tissue serves the same purpose as the bone but prevents joint surfaces from rubbing together and causing pain.
The surgery takes about 90 minutes and can be performed under local or general anesthetic. Afterward, the thumb is bandaged and splinted to keep it in a natural position as it heals.
Patients must schedule a follow-up appointment after about a week, and stitches will usually be removed two weeks later. If a pin was used to protect the joint, the pin is removed a few weeks afterward. A full recovery takes about four months.
Dr. Bobby Chhabra has extensive leadership experience in orthopaedic surgery, practicing within the University of Virginia (UVA) Health System. Serving as UVA Athletics team physician, Dr. Bobby Chhabra has knowledge spanning hand, tendon, and upper extremity injuries.
Tendon injuries include those involving the biceps, a muscle that inhabits the front of the upper arms. The biceps attaches to the shoulder bones through a pair of tendons and is also attached at the elbow to the radius bone through a single tendon.
Associated with overuse and repetitive motion, biceps tendonitis often occurs among athletes who swim or play tennis, baseball, or golf. Occurring either at the elbow or the shoulder, it may be accompanied by rotator cuff tendonitis.
While painful, this type of tendonitis usually can be resolved through a combination of therapies that include cold packs and nonsteroidal anti-inflammatory drugs, such as ibuprofen and aspirin. A common recommendation is extended rest, free from heavy lifting and the repetitive motion that caused the injury. Over time, a full range of motion and pain-free movement should be attained.
In serious cases, surgery may be recommended, with the tendon lining opened and the inflammatory tissue taken out. In addition, tears in the tendon are identified and repaired.
Dr. Bobby Chhabra, endowed chair of orthopaedic surgery at the University of Virginia Health System, specializes in surgeries of the hand and upper extremities. Focused particularly on the correction of congenital hand deformities, Dr. Bobby Chhabra has received media attention for his success in the use of digit pollicization.
When a child is born without a thumb, the process of pollicization may allow surgeons to re-place the index finger so that the body can use that digit as a thumb. The procedure most often occurs when the child is between 1 and 2 years old, and naturally developing the ability to manipulate the hand.
The procedure requires the surgeon to shorten one of the bones that make up the index finger. This creates a digit that is similar in length to a natural thumb. The surgeon then shifts the index finger, without amputation, into position.
Most children are able to leave the hospital the day after surgery, though the repositioned thumb will not begin to function until the surgical site has begun to heal. This typically happens after approximately four weeks. Over the course of the next few months, an occupational therapist helps the child to use the thumb, which typically develops full range of motion by the 12th week after surgery.
As University of Virginia’s (UVA) Department of Orthopedics chairman, Dr. Bobby Chhabra oversees a full range of surgical procedures in his orthopaedic department. Dr. Bobby Chhabra’s departments work was recognized late last year, when the Becker’s Hospital Review selected UVA Orthopedics as one of its “100 Hospitals with Great Orthopedic Programs 2016.”
As defined by Becker’s, all hospitals on the list have amassed a long-term reputation for excellence in orthopedic care, as well as received recognition in diverse quarters, from accrediting organizations to publications. Dr. Chhabra described feeling honored in having his UVA team recognized for this accomplishment.
With its “high-performing” rating in U.S. News and World Report’s 2016-2017 “Best Hospitals” guide, UVA also achieved distinction for its hip and knee replacement capabilities. The department placed in the top 10 percentile in its area of specialization and is recognized by the BlueCross BlueShield as a Blue Distinction Center.
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.
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.
An 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.