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Orthopaedic Surgeon (Dr Duncan McGuire) - Trading Hours of Practice

Monday – Friday, 8:00 – 16:30
Saturday and Sunday, Closed

Orthopaedic Surgeon (Dr Duncan McGuire) - Practice Address

Mediclinic Cape Town, Room H122
21 Hof Street, Oranjezicht

Dr Duncan McGuire

Orthopaedic and Specialist Upper Limb Surgeon

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From pre-operative care to improved quality of life

Dedicated to quality care

Orthopaedic Surgeon (Dr Duncan McGuire) - Dedicated Treatment

Treatment

Prioritising conservative treatments to alleviate the need for surgery.

Orthopaedic Surgeon (Dr Duncan McGuire) - Speedy Recovery

Recovery

Utilising the latest evidence-based treatment methods for speedy recovery.

Orthopaedic Surgeon (Dr Duncan McGuire) - Dedicated to patient care

Patient Dedication

Comitting time and energy thoroughout the patient journey.

Orthopaedic Surgeon (Dr Duncan McGuire) - Providing individualised care

CARE

Providing individualised care for in-hospital and recovering patients.

Orthopaedic and Specialist Upper Limb Surgeon
MBCHB (Wits), FC Orth (SA), MMed Orth (UCT)

Dr Duncan McGuire

As an orthopaedic and specialist upper limb surgeon, Dr McGuire treats conditions of the hand, wrist, elbow and shoulder. This includes chronic degenerative conditions, overuse injuries and acute trauma. He also has a special interest in peripheral nerve and brachial plexus surgery, including obstetric brachial plexus injuries in babies. His surgical skills include a broad spectrum of open surgery, minimally invasive surgery, arthroscopy and joint replacement surgery.

Dr McGuire’s private practice is based at Mediclinic Cape Town, and he also works in the public sector as a consultant in the Hand Surgery Unit at Groote Schuur Hospital in Cape Town. He is affiliated with the University of Cape Town and is involved in teaching medical students and registrars who are specializing in orthopaedic and plastic surgery. Because of his academic affiliations and teaching commitments, he has to stay up to date with the latest evidence based medicine.

Dr McGuire has helped countless patients claim back quality of life with his expertise, by providing his patients with the best possible medical care within both the private and public healtcare sectors.

Medical
Training

Dr McGuire studied medicine at The University of the Witwatersrand.  He then specialised in orthopaedic surgery at the University of Cape Town, Groote Schuur Hospital and Red Cross Children’s Hospital.

Furthering his orthopaedic training, he then completed a fellowship in upper limb surgery in Australia.

Special Interests
and Skils

Dr McGuire specialises in treating conditions of the hand, wrist, elbow and shoulder. This includes chronic degenerative conditions, overuse injuries and acute trauma. He also has a special interest in peripheral nerve surgery and brachial plexus surgery, including obstetric brachial plexus injuries in newborn babies.

His surgical skills include a broad spectrum of open surgery, minimally invasive surgery, arthroscopy and joint replacement surgery.

Mission and
Philosophy

Dr McGuire strives to offer individualised expert care, utilising the latest evidence-based treatment methods.

With a focus on conservative (non-operative) treatment, relief of symptoms are often possible without the need for surgery.

Awards and
Associations

Dr McGuire is on the executive committee of the South African Society for Surgery of the Hand, a member of the Shoulder and Elbow Society of South Africa and a member of the South African Orthopaedic Association.

He is the section editor for “Hand Surgery” for the South African Orthopaedic Journal. In 2011 he was awarded the Edelstein medal for being the top candidate in the country in the orthopaedic final specialist exams.

Professional
Staff

Our friendly and professional staff are committed to assisting you on your road to recovery. You are not a number, but a person we want to help.

Research and Publications

Dr McGuire has been extensively involved in the field of research, having authored many peer-reviewed scientific articles and written many textbook chapters.

Click here to view the list of publications.

Affordable
Rates

Affordable rates for both private and medical aid patients, which range from R700 for a first consultation, R500 for a follow-up consultation and R200 for an injection.

Medical Aid and
Private Patients

Dr McGuire operates on medical aid and private patients at both Mediclinic Cape Town and Intercare Century City Day Hospital.

Hand and upper limb surgery

Wide range of orthopaedic services

Click on the condition for more information

Orthopaedic Surgeon (Dr Duncan McGuire) - Hand Surgery

HAND

Dupuytren’s Disease

Dupuytren’s disease or Dupuyten’s contracture is a strange condition that results in a thickening of the tissues and skin in the palm of the hand. The onset is usually later in life and more common in men. It may have a hereditary cause.

The thickening of the palmar tissue can result in the development of cords, which can cause the fingers to bend in towards the palm. The ring and little fingers are most commonly involved. In some cases the disease is very mild and doesn’t progress much. In other cases severe contractures can develop where the fingers cannot be straightened or opened.

There is unfortunately no permanent cure as this is a genetic disease, but surgery can make the contractures much better. Fortunately most cases are mild and need no treatment. Surgery is indicated if the contractures of the fingers interfere with function. Surgery can be through an open procedure to remove the thickened tissue and cords, or through a minimally invasive approach using a needle to cut the cords. The treatment of choice depends on multiple factors which your doctor will discuss with you.

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Ganglion Cysts

A ganglion is a lump most commonly found around the wrist and hand.  It is a fluid-filled sac that originates from and usually communicates with a joint.  The most common place for a ganglion is on the back of the wrist.  They may be small or large and are usually painless.  Often the smaller ganglions tend to be more symptomatic.  Small ganglions on the back of the wrist may cause pain when bending the wrist fully backwards, for example when doing push-ups.

Treatment may not be necessary as ganglions are harmless and can go away by themselves.  Certain ganglions may disappear after aspirating the contents with a needle and syringe, although the recurrence rate is fairly high.  Persistent ganglions and painful ganglions may be removed surgically if required.  If you have a lump around the wrist and hand and are in doubt about the diagnosis, then it is best that you have it checked out by your doctor.

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Hand Fractures

There are many bones in the hand.  The finger bones include the metacarpals and phalanges, and they are commonly broken as a result of blunt trauma.  

A particularly common fracture is called a “Boxer’s fracture”.  This is a fracture of the metacarpal of the little finger and occurs at the time of a punch.  The vast majority do not need surgery and can be treated in a splint.  The indications for surgery would include malrotation, or severe angulation and displacement.  

There is a huge variety of different types of fractures in the hand.  Again most of these do not need surgery and do well with splinting and rehabilitation.  A common complication of hand injuries and fractures is stiffness, so hand therapy plays an important role in treatment.

If you have a fracture of one of the bones in the hand it should be assessed by your doctor and a decision made as to whether splinting or surgery is required.

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Hand Infections

Any part of the hand can get infected and this requires urgent treatment. Symptoms of a hand infection include pain, swelling, redness and warmth. Early infections usually respond well to antibiotics. If not treated early, an infection may develop into an abscess, which is then resistant to antibiotics as it contains pus. If this occurs the pus will need to be drained.

Infections can also quickly spread to other parts of the hand and up the forearm, particularly in people who are diabetic or immunocompromised. If you think you have a hand infection it is vital you see a doctor as soon as possible.

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Tendon Injuries

Tendons are an integral part of the function of the hand. They connect the muscles to the bones and allow you to flex and extend the fingers and wrist. Tendon injuries can occur as a result of a blunt or sharp mechanism.

If a laceration to a hand is deep enough it can cause a tendon injury. If a tendon is cut, then one is unable to flex or extend the fingers or the wrist. This requires urgent surgical repair of the tendon, followed by rehabilitation.

You can also sustain a tendon injury without a laceration. A blunt injury to a fingertip can result in a tendon pulling off the bone. This would present as an inability to flex or extend the finger. Common terms for these injuries are a “Jersey Finger” or a “Mallet Finger”. Some of these injuries may be amenable to conservative treatment with splinting. Others may require surgical repair.

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Orthopaedic Surgeon (Dr Duncan McGuire) - Finger or thumb surgery

Finger and thumb

Arthritis of the Fingers and Thumb

Arthritis can affect all joints in the body. It is a common cause of pain and stiffness. In the hand, the most common joints involved are the base of the thumb and the small joints of the fingers. Arthritis can often be asymptomatic and only result in thickening and mild deformity of the joints. In these cases, no treatment is required. If arthritis becomes painful then treatment is indicated.

Depending on the joint involved, first-line treatment may involve splinting and possibly a corticosteroid injection. When conservative treatment fails and pain interferes with function, then surgery is indicated. Depending on the joint, this may involve a cleanout of the joint, joint fusion or a joint replacement.

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Mucoid Cysts of the Fingers

A mucoid cyst is a ganglion that arises around one of the small joints on the back of the fingers or thumb. It is a fluid-filled cyst that originates from the joint. The cyst usually indicates that the joint has arthritis in it. The cyst forms because there are small bits of bone that form around an arthritic joint called osteophytes. An osteophyte then causes a small hole in the joint capsule and allows fluid to escape which forms the cyst.

The cysts are usually painless but pressure effects from the cyst can cause abnormal nail growth. The cysts can get repeatedly knocked and burst. Occasionally when this happens the cyst can get infected and cause problems. They can get quite large as well and be a cosmetic concern.

Indications for treatment would be if they are cosmetically unsightly or if they get infected. Treatment involves surgery to remove the cyst and the small osteophyte that caused it in the first place. It is a relatively small operation and can be done under local or general anaesthetic as a day procedure.

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Mallet Finger

A mallet finger injury occurs after a blunt injury to a fingertip. Typically someone knocks their finger when trying to grab something. This results in sudden flexion of the fingertip and causes the extensor tendon to pull off. The tendon either pulls directly off the bone, or a piece of bone breaks off with it. When a piece of bone breaks off as well it is called a mallet fracture.

The appearance of a mallet finger is one where the joint nearest the tip of the finger stays in a bent position, and it is not possible to straighten it. Most of these can be treated conservatively in a splint which should be worn full time for 6-8 weeks. Occasionally if a large piece of bone has pulled off, or if it slips out of joint then surgery may be required.

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Trigger Finger or Trigger Thumb

Trigger finger or trigger thumb is a common condition. The flexor tendon that bends the finger or thumb enters a tunnel at the base of the digit. The tunnel that it enters is called a pulley system. The first pulley in the pulley system is called the A1 pulley. The A1 pulley can become thickened and inflamed, and this results in a “catching” of the tendon as it glides through the pulley system. This causes the finger or thumb to get “stuck” in a certain position. With a little force, the finger or thumb then has to be straightened out. This is usually painful but not always. There is often a tender nodule at the base of the thumb or finger, which represents the thickened A1 pulley.

Treatment is initially conservative and the majority of these cases get better without surgery. This involves a corticosteroid injection around the A1 pulley which allows the flexor tendon to glide freely through the tunnel. Sometimes the injection doesn’t cure the condition and it wears off after weeks or months and another injection is required. If conservative treatment does not work, then a small operation can be done to release the A1 pulley which then allows the tendon to glide freely. This can be done under local or general anaesthetic and is usually a day procedure.

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Orthopaedic Surgeon (Dr Duncan McGuire) - Elbow surgery

Elbow

Biceps Tendon Injuries and Ruptures

The biceps is one of the main muscles that bend the elbow. The biceps muscle is attached to the humerus above the elbow and the biceps tendon joins onto the radius below the elbow. A rupture of the biceps tendon occurs when the tendon pulls off the radius. This usually happens when catching a falling object or when lifting something heavy.

When it occurs there is often an audible “pop” as it ruptures. This is accompanied by sudden pain and the biceps shortens as the tendon pulls off the bone and comes to lie above the elbow. The biceps contracts into a ball and is referred to as a “Popeye muscle”. Occasionally there is a partial tendon injury where some tendon is still attached to the bone. When this happens the muscle usually does not change shape.

Once the tendon pulls away from the bone it cannot heal itself. Repair of the injury requires surgery to reattach the tendon onto the bone. This restores the shape of the muscle and the strength back to normal. If this occurs in someone who is very low demand and sedentary, surgery may not be required, but there will be persistent weakness and the shape of the muscle will remain shortened.

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Cubital Tunnel Syndrome

Cubital tunnel syndrome is a compressive neuropathy of the ulnar nerve as it passes behind the elbow. The ulnar nerve runs through a small tunnel at the back of the elbow. This tunnel can become narrowed and result in compression of the ulnar nerve. The ulnar nerve supplies feeling to the ring and little fingers and supplies the small muscles of the hand.

Symptoms include numbness and pins and needles of the hand, particularly the ring and little fingers. In advanced cases the hand becomes weak and the muscles can waste away. Symptoms are exacerbated by bending of the elbow for prolonged periods of time, and with leaning on the elbow.

In mild cases, activity modification can help. This involves avoiding bending the elbow for prolonged periods, and avoiding leaning on the elbow. If this fails then surgery may be required, which involves releasing the nerve in the tight tunnel at the back of the elbow. Sometimes the nerve may need to be moved out of the tunnel to the front side of the elbow to allow the nerve to “cut the corner” and reduce tension on it when bending the elbow.

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Olecranon Fractures

The elbow joint is made up of three bones; the humerus which is the upper arm bone, and the radius and ulna which are the two forearm bones. There are many different types of fractures that can occur around the elbow. Radial head fractures are common and discussed previously.

Another fairly common fracture is an olecranon fracture. The olecranon is the top part of the ulna or the point of the elbow. If an olecranon fracture is not displaced it can be managed in a cast or splint. The triceps muscle attaches onto the olecranon and sometimes this causes the fracture to displace. If this occurs then there will be a gap in the joint and surgery will be required to reduce and fix the fracture.

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Radial Head Fractures

The radius is one of the two forearm bones and the radial head is the upper part of the radius that forms the elbow joint. The radial head is shaped like a disc and allows the forearm to rotate. When falling onto an outstretched hand a radial head fracture can occur. Symptoms are swelling and pain around the elbow, particularly when rotating the forearm.

If a fracture occurs it is usually just a crack or a small piece that breaks off. The majority of these don’t need surgery and can be treated in a sling. Occasionally if a large piece has broken off or if the fracture displaces and results in a step in the joint, then surgery may be required to reduce and fix the broken piece. Sometimes the broken piece causes a block to the rotation of the forearm. If this occurs then surgery will also be required.

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Supracondylar Elbow Fractures

Fractures of the lower end of the humerus are fairly uncommon in adults. They are usually high energy injuries and usually require surgery. In children, however, it is quite a common area to break and usually occurs as a result of a fall.

In children, it is referred to as a “Supracondylar fracture”. If these are undisplaced or minimally displaced they can be treated in a cast. If they are displaced they will need to be pushed straight and held in position with pins. The pins are then removed after a few weeks. Results are very good as children’s bones heal very well and very quickly.

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Tennis Elbow

This is a very common condition and results in pain on the outside of the elbow, which is aggravated by activity. Tennis elbow is tendonitis involving the muscles that bend the wrist backwards (extensor muscles). It may start spontaneously, be due to overuse or be caused by an injury.

It presents with tenderness around the bony prominence on the outside of the elbow, which is where the tendonitis is. There is also pain with the use of the hand and wrist, which often results in weakness as well.

Most cases of tennis elbow respond well to conservative management. This consists of rehabilitation involving stretching and eccentric muscle strengthening. Corticosteroid injections can speed up recovery. Bracing and dry needling can give relief as well. Those that do not get better with a course of conservative management may need surgery. This involves a small operation to remove the tendonitis which is done as a day procedure.

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Orthopaedic Surgeon (Dr Duncan McGuire) - Wrist surgery

Wrist

Cubital Tunnel Syndrome

Cubital tunnel syndrome is a compressive neuropathy of the ulnar nerve as it passes behind the elbow. The ulnar nerve runs through a small tunnel at the back of the elbow. This tunnel can become narrowed and result in compression of the ulnar nerve. The ulnar nerve supplies feeling to the ring and little fingers and supplies the small muscles of the hand.

Symptoms include numbness and pins and needles of the hand, particularly the ring and little fingers. In advanced cases the hand becomes weak and the muscles can waste away. Symptoms are exacerbated by bending of the elbow for prolonged periods of time, and with leaning on the elbow.

In mild cases, activity modification can help. This involves avoiding bending the elbow for prolonged periods, and avoiding leaning on the elbow. If this fails then surgery may be required, which involves releasing the nerve in the tight tunnel at the back of the elbow. Sometimes the nerve may need to be moved out of the tunnel to the front side of the elbow to allow the nerve to “cut the corner” and reduce tension on it when bending the elbow.

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De Quervain’s Tenosynovitis

De Quervain’s tenosynovitis is a condition where the tendons that extend the thumb become inflamed as they pass through a tunnel on the side of the wrist. Symptoms are pain around the thumb side of the wrist which is exacerbated by movement. It may be caused by overuse. It is also quite common in pregnancy and in women with newborn babies.

Treatment is initially conservative with activity modification and corticosteroid injection. The majority of cases get better with this treatment. The few that don’t get better can be cured with a small operation to release the tendons. The operation can be done under local or general anaesthetic and is usually a day procedure.

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Ganglion Cysts

A ganglion is a lump most commonly found around the wrist and hand. It is a fluid-filled sac that originates from and usually communicates with a joint. The most common place for a ganglion is on the back of the wrist. They may be small or large and are usually painless. Often the smaller ganglions tend to be more symptomatic. Small ganglions on the back of the wrist may cause pain when bending the wrist fully backwards, for example when doing push-ups.

Treatment may not be necessary as ganglions are harmless and can go away by themselves. Certain ganglions may disappear after aspirating the contents with a needle and syringe, although the recurrence rate is fairly high. Persistent ganglions and painful ganglions may be removed surgically if required. If you have a lump around the wrist and hand and are in doubt about the diagnosis, then it is best that you have it checked out by your doctor.

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Scaphoid Fractures

The scaphoid is one of the small bones in the wrist and is found at the base of the thumb. It may be fractured when falling onto an outstretched hand. Pain is experienced on the thumb side of the wrist, especially with movement. Because the scaphoid is one of many bones in the wrist, it may not be that painful and may be confused with a wrist sprain.

Diagnosis requires x-rays which unfortunately may not always show the fracture straight away. They may need to be repeated after 2 weeks or alternatively a CT or MRI scan may be done. Once diagnosed, treatment depends on the type of fracture and whether it is stable or unstable and displaced or undisplaced. Some may be treated conservatively in a brace or cast. Others may need surgical fixation with a screw, usually if the fracture is displaced or unstable.

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Tendonitis

There are many tendons that flex and extend the fingers and wrist. Due to overuse or an injury, these tendons can become inflamed and result in tendonitis. This results in pain when doing certain movements and activities.

Tendonitis is almost always successfully treated with conservative methods. This involves activity modification, stretching, eccentric exercises and possibly a corticosteroid injection. Surgery is rarely required. If required, it is usually a small operation to remove the tendonitis.

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Wrist Fractures

Distal radius fractures are very common. The radius is one of the forearm bones and the distal radius is the part of the radius at the wrist. The mechanism of injury is a fall onto an outstretched hand. It is a common fracture in people with osteoporosis. In younger patients, common causes are a fall from a height or a fall from a bicycle or motorbike.

Symptoms are acute pain and swelling around the wrist. There may be a visible deformity if the fracture is displaced. Treatment mostly depends on whether the fracture is displaced or not. Undisplaced fractures can usually be treated in a brace or cast. If the fracture is displaced then it may require either manipulation and cast, or surgical fixation with a plate, screws or a wire.

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Orthopaedic Surgeon (Dr Duncan McGuire) - Shoulder surgery

Shoulder

Rotator Cuff Tears and Tendonitis

The shoulder is a very complex ball and socket joint which allows for a very large range of motion in all directions. The rotator cuff is the main muscle complex that moves the shoulder. The rotator cuff is made up of four muscles – supraspinatus, infraspinatus, subscapularis and teres minor. The rotator cuff muscles originate from the shoulder blade or scapula. The muscle then becomes tendon, and the tendon attaches onto the greater tuberosity which is the top part of the humerus bone. The bone right on the top of the shoulder is called the acromion.

When lifting your arm sideways or forwards, the greater tuberosity of the humerus comes into close contact with the acromion. When this happens the rotator cuff tendons can be pinched between the greater tuberosity and the acromion. This is called impingement. There is a shock-absorbing cushion on the top of the rotator cuff tendons which protects them against this. This structure is called a bursa. Occasionally with injury or overuse, this bursa can become inflamed which is called bursitis.

Bursitis and impingement are very common. Typically this results in pain when lifting the arm above the horizontal or when reaching behind you. Often you are unable to sleep on that side at night. Management is always conservative, to begin with and the vast majority get better without any surgery. Conservative management involves rehabilitation with a physiotherapist, and usually a corticosteroid injection. Usually with a period of rehabilitation, and an injection or two, the pain resolves.

When bursitis or impingement is more chronic, or if someone has degenerative rotator cuff tendons, this can progress to a partial tear or a complete tear. Partial rotator cuff tendon tears are usually treated in the same way as bursitis or impingement, usually with good results. If there is a full-thickness or complete rotator cuff tear, the tendon pulls away from the bone and cannot heal itself. In low demand or sedentary individuals, this can be managed with rehab and corticosteroid injections. In someone more active and higher demand, surgery is recommended to reattach the tendon.

If a rotator cuff repair is required this can be done arthroscopically (key-hole surgery). In this procedure, a small camera is placed inside the joint and the tendon repaired through small skin incisions. The advantages of this technique are that there are virtually no scars, and rehabilitation is quicker and easier. The recovery is still quite long from this surgery though and requires a lot of physiotherapy.

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Acromioclavicular (AC) Joint Injuries

The acromioclavicular or AC joint is where the collar bone (clavicle) meets the acromion on the outer part of the shoulder. Injury to this joint usually occurs when falling off a bicycle or motorbike, or in contact sports such as rugby. There are varying grades of injury ranging from a sprain to complete dislocation. Fortunately, most of these injuries do not need surgery.

There are five grades of injury. Grades 1 and 2 do not need surgery and can be treated in a sling. Grades 4 and 5 do need surgery as the collar bone is completely displaced and unstable. Grade 3 is a grey area where some of these can be treated without surgery, whereas others do need surgery. Usually, a trial of conservative treatment in a sling should be offered to grade 3 injuries, and only if there is minimal improvement after 1-2 weeks then surgery can be considered. Dr McGuire is very conservative in his approach to treating these injuries.

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Shoulder Instability and Dislocations

The shoulder is a very mobile ball and socket joint. Because the shoulder has such a large range of motion, it sacrifices stability and is therefore prone to dislocations. Dislocation usually occurs while playing contact sports or falling off a bicycle or motorbike. If a dislocation occurs the shoulder needs to be put back in the joint as soon as possible. This usually needs to be done in a casualty unit by a doctor under sedation. After the shoulder is back in the joint it should be placed in a sling.

Following a dislocation, there is a risk of ongoing instability. This risk is reduced the older someone is at the time of the dislocation. You should be assessed by an orthopaedic surgeon after a dislocation to ensure there is no persistent instability. If there is then you may need surgery. Surgery may take the form of an arthroscopic procedure (keyhole surgery) called a Bankart or labral repair, or an open bony procedure called a Latarjet.

Another potential complication of a shoulder dislocation is a rotator cuff tear. The rotator cuff is the muscles that lift up and rotate the shoulder. When the shoulder dislocates the rotator cuff tendons can tear off their attachment onto the shoulder. If this occurs you will require surgery to reattach the tendons otherwise you will be left with permanent weakness of the shoulder.

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Clavicle Fractures

The clavicle or “collar bone” is one of the bones that link the shoulder to the rest of the skeleton. Clavicle fractures are fairly common. They usually occur as a result of a fall, often off a bicycle or motorbike. If the fracture is undisplaced or minimally displaced then it can be treated non-operatively in a sling.

With more high energy injuries the fracture can displace. When this occurs the two ends of the bone lose their connection to each other and overlap. If this happens then surgery is recommended to restore the length and alignment of the clavicle. Surgery usually involves fixing the fracture with a plate and screws.

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Orthopaedic Surgeon (Dr Duncan McGuire) - Nerve surgery

Nerve

Peripheral Nerve Injuries

A peripheral nerve injury is a devastating injury. Nerves supply feeling and allow muscles to work. If a nerve is cut, you will lose the feeling to the particular area of skin that the nerve supplies, and the muscles that the nerve supplies will be paralysed resulting in loss of function and weakness. A peripheral nerve injury usually occurs due to a deep laceration. The three main nerves that supply the arm and hand are the median, ulnar and radial nerves.

Laceration of peripheral nerves require surgical repair. This involves microsurgery and is done with magnification, special instruments and very small stitches. If you do have a peripheral nerve injury you should ensure that your surgeon has been trained in microsurgical techniques.

The recovery of nerves after repair is very seldom complete. Feeling usually does come back but recovery of strength is less predictable. There is usually some weakness that persists. It does depend though on the particular nerve that is injured though. Recovery is a very long process and may take months to years.

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Brachial Plexus Injuries

The brachial plexus is a complex of nerves that are formed as the spinal nerves exit the spinal cord at the neck. All the nerves that supply the arm originate from the brachial plexus. Injuries to the brachial plexus are devastating and can result in a completely paralysed arm. Injuries are either due to a sharp mechanism (stab) or a blunt mechanism (e.g., motorbike accident).

Sharp injuries require urgent surgery to repair the cut nerves. This involves microsurgery and is done with magnification, special instruments and very small stitches. Recovery takes very long and is virtually never complete. Depending on the extent of the initial injury there will likely be persistent weakness and loss of function.

Blunt injuries have a wide spectrum of injury. Sometimes the nerves are just bruised and can recover spontaneously over weeks or months. This is called a neuropraxia. With a more severe injury, the nerves can rupture or pull out of the spinal cord. Unlike a sharp injury, the nerves cannot be repaired in this situation because there is either a gap when they rupture, or there is nothing to repair them to if they pull out of the spinal cord. Various specialist techniques are required here to reconstruct the injury, including nerve transfers and nerve grafting. Again full recovery is not likely here.

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Positive feedback from our patients

Testimonials

It’s always the word of mouth that’s the best advice when it comes to choosing a doctor you can trust.

Orthopaedic Surgeon (Dr Duncan McGuire) - Patient Testimonials 

Dr McGuire performed surgery on my fractured right wrist in April 2016. Upon arriving back in the USA, I consulted a top orthopaedic surgeon before continuing my physiotherapy and

I quote his remarks: “Excellent surgery, I could not have performed a better job!”

Thank you Dr McGuire for a job well done!

Belinda Egesdal

Orthopaedic Surgeon (Dr Duncan McGuire) - Patient Testimonials 

I had a very badly broken wrist sustained while mountain biking on a Saturday morning. Dr McGuire was the only wrist specialist that I could get hold of in just about the whole of Cape Town that could operate on my wrist the next day. He did an excellent job, despite the fact that it was a bad break. Six months later, my wrist is right as rain with only a small, snake-shaped scare left as evidence of my misfortune.

Margarethe Visser

Orthopaedic Surgeon (Dr Duncan McGuire) - Patient Testimonials 

Thank you for ensuring my recent operation was a great success. I regained the use of my arm very quickly after the surgery and hardly felt any pain. Being so frightened before the consultation, your calm demeanour put me right at ease. It’s good to know that there are such excellent orthopaedic surgeons in our country.

Cirkine Coetsee 

Frequently asked questions from our patients

Questions

Have a quick browse through our frequently asked questions to find out more about how Dr McGuire can help you onto the road to recovery.

Is Dr McGuire a specialist for hands, fingers, elbows or shoulders?

Yes, Dr McGuire is a Super Specialist for the upper limb, from fingers to shoulders.

Is he likely to want to operate on me?

Not necessarily, Dr McGuire is a conservative surgeon and will discuss treatment options with you, and decide what would be best for you and your situation. 

I would like to make an appointment, when is the soonest the doctor can see me?

Okay sure, let’s see what we can do for you.  Most patients are able to be seen the same week.

I need to see the doctor today because I’ve broken my hand, finger, elbow or shoulder. What time can I come in?

Emergency appointment slots are kept open for such cases if Dr McGuire is consulting that day.  If not, then the secretary will liaise with Dr McGuire to try and make a plan for the patient to be seen that day, or if that is not possible then the next day. 

Do I need to go for an x-ray or scan before seeing the doctor?

No – Dr McGuire will need to see you first and examine you before deciding if you need to have an x-ray or scan.

Send us a message and we’ll get back to you

Contact Us

Orthopaedic Surgeon (Dr Duncan McGuire) - Trading Hours

Monday – Friday, 8:00 – 16:30
Saturday and Sunday, Closed