Jordan pysz / iFoundMyDoctor.com
Dr. Farino spent the first 10 years of his career in Bradenton before moving north, then to Sarasota. A decade later, he’s back, now with Manatee Physician Alliance.
Manatee Physician Alliance, an affiliate of Manatee Memorial Hospital, recently welcomed a new doctor to its growing team of healthcare providers. His name is Gregory Farino, MD. He is a fellowship-trained, board-certified orthopedic surgeon who specializes in hand and wrist reconstruction. Florida Health Care News sat down with Dr. Farino to discuss his practice.
Q: Welcome to Florida. Tell us a little about yourself and what prompted the decision to move here.
A: So, I’m originally from Pennsylvania, and I went to medical school in Philadelphia at Temple University, did my residency at Penn State University in Hershey and then did a fellowship in hand surgery at the University of Pittsburgh. I am now in my 20th year in practice, and I actually practiced in Bradenton for the first 10 years of my career. After that, I went to Indianapolis and worked with a group on the south side of the city for two years, but during that time, I realized I didn’t like the cold weather anymore, so I came back to the Sarasota/Manatee community. Now I’m with Manatee Physician Alliance.
Q: What will your role be with Manatee Physician Alliance?
A: I’ll be working at a Manatee Physician Alliance location that’s about a half a mile from Manatee Memorial Hospital. It is an orthopedic practice, where I will see patients with hand and wrist issues, pathology, fractures, arthritis, trigger fingers, carpal tunnel, that kind of stuff. I’m going to function for the most part the way I have functioned when I’ve been in group practice because we have other doctors who will take care of issues with knees, hips, shoulders and other areas.
Q: Why hand and wrist surgery?
A: I do hands for a bunch of reasons. First, during residency, you get a little experience with everything. You do joint replacements, sports medicine and the spine, and I gravitated toward hands because it’s a little more detailed. I find there’s a lot more variability in the kinds of things you can take care of with hands. I have days where I might do 10 different surgeries because there’s a lot of different types of pathology in the hand. And I like things where there’s a lot of variety to them. I’ve always been fascinated by hands because they are the only part of the body that is exposed almost all the time, that everyone sees almost all the time, and that we can look at and see ourselves almost all the time. In order to see your own face, you have to look in the mirror, but you can always look at your hands, and because of that people do take care of them and represent them in different ways, whether it’s with jewelry or other forms of decoration such as painting their nails. I’ve always found it interesting, the attachment people have to their hands, which are an extension of our minds. We communicate through our hands, shake hands, hold hands. And yes, we can live without them, but so many tasks such as cooking, manual labor, and playing a musical instrument are executed through the function of the hands, and helping people maintain that functionality seemed to be a rather important thing to me.
Q: What is the most common injury to the hand that patients present with, if there is one?
A: Most of the patients I see come in for what we call trigger finger. It’s tendonitis within the flexor tendons in the fingers or thumb, and what happens is a person will bend a finger or multiple fingers, and if the fingers lock or get stuck in flexion, that’s trigger finger. Now, some people come in with trigger fingers that don’t trigger. They just have pain, or they can’t fully bend the fingers. Another common problem is carpal tunnel syndrome and, of course, arthritis, particularly in the thumb. I would say that at least 40 to 50 percent of the patients I see come in with one of those issues. As for injuries, I would say that broken wrists are the most common. And that’s because when people fall, they typically put their hands out to break the fall and wind up breaking their wrist. We get that a lot with kids and post-menopausal women.
Q: What are the some of the more common treatments for those ailments? Let’s start with trigger finger.
A: With trigger finger, it’s typically the middle finger and thumb that are most affected, and one of two things typically happen there: either the tendon gets swollen or the anatomic tunnels that it goes through will thicken up. When that happens, it’s like trying to drive a 9-foot bus through an 8-foot tunnel. The tendon just doesn’t fit and so it gets stuck. To correct that, the first thing we do normally is try an injection of cortisone. I would say that injection works about 80 percent of the time, and the patient never comes back. With those who do come back – it can be two months later or two years later that they come back – and if the problem keeps occurring, then there is a surgery we can do to fix it. It’s a very straightforward 10-minute procedure in which we go in and cut the first part of the tunnel, and that basically cures that trigger finger*.
Jordan pysz / iFoundMyDoctor.com
Dr. Gregory Farino
Q: What’s the remedy for carpal tunnel syndrome, and is that more prevalent now because of the increased use in computer keyboards?
A: That’s definitely a factor, but we do so many repetitive things with our hands that it can be a problem even for people who don’t regularly use a computer keyboard. I have older patients who come in and say, How am I getting carpal tunnel? I don’t really do anything with my hands.
The answer is, as we get older, the anatomic space – those tunnels – narrow, and as they narrow, the fingers will start getting tingly or the hand will fall asleep. It happens a lot of times when people sleep at night because they bend their wrist while they’re sleeping and that can narrow the tunnel.
And for those who are doing a lot of word processing on the computer, they get carpal tunnel because their tendons get swollen from the repetition. No matter the cause, the remedy is often a brace or therapy, but those things tend to provide only temporary relief. After that, you’re usually looking at surgery where the surgeon goes in and essentially opens those tunnels and makes them bigger again. The good news is that typically takes care of it. The problem could recur, but that’s usually 20 or 30 years down the road.
Q: And how do you treat arthritis of the hands and wrist?
A: The place where we most often find arthritis in the hands is the base joint of the thumb. That’s the joint that gives your thumb the ability to oppose all of the other fingers. Every year, I see 500 to 600 patients who have problems with that joint alone, but the good news is that an injection or occasional injections of a local anesthetic and steroids usually takes care of that. You can also put a splint on it, but I find a splint to be very hit or miss. Finally, you can do a joint replacement where we go in and replace the bone with a tendon from the patient’s wrist. That’s called an interpositional arthroplasty. It doesn’t work very well in most joints, but it works great in the thumb.
Q: Let’s get away from the office for a moment. What are your hobbies?
A: I guess I’m a little bit of a nerd because I like to read, and I mostly read a lot of history, especially ancient Greek and Roman history. I play the piano a little bit but not terribly well. Other than that, I just do general fitness type of stuff. I work out, too, but nothing crazy. I’m not running marathons or triathlons. I’m not that crazy, but just general stuff. Thanks for your time and good luck in the new position. Thanks. I’m looking forward to this next chapter in my life and taking care of whomever I can in the area.
*Individual results may vary.
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