Hand Surgery in the Minimally Invasive Style

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On a typical day I get up at 6 or 6:30 a.m. I shower and read the paper and have a big breakfast of yogurt, an apple and some kind of bread, plus a cup of coffee and orange juice. Then I leave for one of my three offices.


I live in Marina del Rey and my commute takes 30 to 45 minutes. In the car I usually just try to collect my thoughts about what I have to do that day. I reach work by 7:30 a.m. and review patient charts to refresh my memory.


I see all types of cases every day. They range from fingertip crush injuries and carpal tunnel syndrome to finger and wrist fractures. I use medication, injections or surgery to treat them.


Then there are cases we call “cold trauma” that don’t need to go to surgery right away, so they can wait.


I see people of all ages, from all kinds of occupations. But the clinic is known for treating professional athletes. We treat pretty much most of the L.A. Clippers, Lakers, Kings and Dodgers.


People think we get paid a lot more to treat professional athletes. But the compensation is the same as any ordinary workers’ compensation. Even though we try not to treat them differently, we feel this unspoken pressure with them. We have to be in constant contact with their trainers and there is the media factor also. I always keep in mind that this is their livelihood and they want to get back on the field as soon as possible.


The year I studied at Stanford was a great surgical experience. I learned orthopedic surgery, and I also learned to respect soft tissues, like skin, when I learned plastic surgery techniques.


Arthroscopic surgery is my specialty. It is well known for the shoulder and knee, but is a relative newcomer to the wrist. Where other surgeons would make big incisions into the skin and palm of the hand, I use very minimally invasive surgery techniques. I make a small incision of about one centimeter in the skin and insert an instrument with a blade and a camera. This way I can see the ligament that needs to be worked on without making an incision in the palm of the patient’s hand.


There is a learning curve to this method and many surgeons believe it is not worth the risk, but with enough experience, I know it is safe. If it is impossible to do it this way I resort to open incision.


I love doing surgery and that’s the highlight of my week. I see patients in the mornings and perform surgeries all afternoon for about three days a week.


I see wrist factures that have not healed in the proper position. Those require a lot more thinking and planning prior to surgery. I open up the wrist with a large incision and put in some bone graft from another bone and put a large screw in to try to get it to mend. Sometimes fractures heal but in the wrong position. Then I re-cut the bone and put a plate and screw arrangement with the bone graft and try to accelerate healing.


I love patient interaction. I love speaking with patients and I am often guilty of taking longer than I should to get to know them.


I normally get done with surgery around 5 or 6 p.m., and I do my dictations and operative reports after that.


In the evenings I spend time with my wife. She is an attorney. She also works rather long days so we try to keep our evenings free.


I try to stay away from fried food and don’t eat too much. When we cook at home we use a lot of vegetables.


I go to the gym as often as possible. I also play the violin and I do that once in a while when I want to unwind.





As told to Aarthi Sivaraman


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Dr. Steven S. Shin



Orthopedic Surgeon

Kerlan-Jobe Orthopedic Clinic


Regular Reading:

Journal of Hand Surgery


Favorite Food:

Tofu


College Major:

Economics and biology


Teaching:

Clinical instructor at USC’s Keck School of Medicine


Recent Training:

Hand and upper limb fellowship at Stanford University School of Medicine


Family Business:

His grandfather, father and most of his uncles are doctors

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