Premier/Crozer-Keystone Physician Spotlight: David Zelouf, M.D.

David S. Zelouf, M.D., is a board-certified, fellowship-trained hand and orthopedic surgeon with the Philadelphia Hand Center. He is on the medical staff of Taylor Hospital as part of an alliance between the Philadelphia Hand Center and Premier Orthopaedics and Sports Medicine Associates.

Dr. Zelouf earned his medical degree at Albert Einstein College of Medicine of Yeshiva University in Bronx, New York, where he also completed his general surgery internship. He completed a clinical residency in orthopedic surgery at the Hospital for Joint Disease Orthopedic Institute in New York, and a postgraduate fellowship in hand, wrist, elbow and microsurgery at Tufts University in Boston, Mass.

Dr. Zelouf routinely gives community-based presentations and enjoys being able to educate and provide this service to the public. The following information is based on a recent presentation, “Common Disorders of the Hand, Wrist and Elbow,” that he gave at a local library.

“The cause of hand, wrist and elbow problems can usually be found with the help of X-rays, a bone scan, an MRI, a CT scan, an EMG or blood work,” Dr. Zelouf explains. “After I meet with a patient, discuss their medical history and perform a physical examination of the problem area, I may recommend further testing.”

Hand, wrist and elbow problems are most commonly caused by tendonitis/tenosynovitis (the inflammation of a tendon and its covering), carpal tunnel syndrome (an entrapment of the nerves at the wrist), arthritis, ganglion cysts, infection or Dupuytren’s disease (a condition where knots of tissue form under the skin of the palm, eventually forming a thick cord that can pull one or more of your fingers into a bent position). 

 “If a patient has tendonitis or tenosynovitis, they may complain of pain in the palm of the hand, fingers, wrist or elbow,” Dr. Zelouf adds. “De Quervain’s disease―which is tenosynovitis of the wrist―and tennis elbow are common tendon disorders. Trigger finger is another common form of tenosynovitis. For this, and other tendon disorders, splints, physical therapy and steroid injections are likely forms of treatment.” Surgery is at times necessary as well. 

Carpal tunnel syndrome, which is most common in women 40-60 years old, is caused by pressure on a nerve that runs through the carpal tunnel. Common symptoms of carpal tunnel syndrome include pain, numbness and tingling of the hand. Generally, carpal tunnel syndrome treatment begins with splints and medication, and can include task or equipment modifications. If symptoms persist, injection or surgical release of the carpal canal may be recommended.

Osteoarthritis is the most commonly encountered form of arthritis, and can affect all joints of the hand, including the base of the thumb at the wrist. Treatment for osteoarthritis includes anti-inflammatory medications, splinting, and the occasional cortisone injection. Surgery may also be required if other treatments fail to relieve symptoms.

“Ganglion cysts are the most common soft-tissue, benign (non-cancerous) tumor of the hand and wrist,” Dr. Zelouf says. “These fluid-filled cysts are usually attached to underlying joint capsules or tendons.” Most commonly, observation is recommended. For painful ganglion cysts, surgical removal can be performed.

Paronychia, the most common hand infection, affects the skin around the fingernail. These, and other hand infections, are treated with antibiotics. Surgery may be necessary if a collection of pus is present with the infection.

Patients suffering from Dupuytren’s disease usually have symptoms like the development of thick tissue under the skin in the palm of the hand, finger(s) being pulled forward and decrease in hand function. Surgery may be necessary for more severe cases; however, a new form of treatment using an injected enzyme may also be effective. While surgery may increase the mobility of the finger(s), it does not correct the underlying disease process.

“Most hand, wrist and elbow disorders can be treated non-operatively with a combination of splints, therapy and injections,” Dr. Zelouf adds. “Post-traumatic problems and infections should be referred early to ensure that timely care is instituted.”

Dr. Zelouf is on the medical staff at Taylor Hospital. He has office locations at Taylor Hospital and in King of Prussia. For appointments or referrals, please call 1-800-971-4263.