Dr. Vitale Directs Hand Specialty Conference

ONS hand and wrist surgeon Dr. Mark Vitale served as co-director with Dr. Alex Shin, director of the Mayo Clinic hand surgery fellowship, for the 2017 Mayo Clinic Hand Surgery Conference, which was held at the main campus of the Mayo Clinic in Rochester, MN from May 11th to 13th..

Dr. Vitale and Dr. Shin coordinated and moderated several discussions, symposia and debates among the annual gathering of national hand surgery specialists.  Some topics that were discussed included wide awake hand surgery, new research into causes of carpal tunnel syndrome, advances in nerve reconstruction in the hand and upper extremity, and new methods of scapholunate ligament reconstruction of the wrist.

The conference welcomed guest keynote speaker, Dr. Peter Stern, former chairman of the Department of Orthopaedic Surgery at the University of Cincinnati, and speaker Dr. Ed Athanasian, a Mayo Clinic alumni and renowned specialist in hand and upper extremity tumor reconstruction at Memorial Sloan Kettering.

Dr. Vitale, a 2012 graduate of the Mayo Clinic Fellowship in Hand and Microsurgery, remarked, “This conference was a special opportunity for me to give something back to the very place where I was fortunate to train to be a hand surgeon.  It provided a valuable forum for hand surgeons from around the country to discuss advances, research and observations to further our field of expertise. I think we are all excited to move forward in building similar programs in the future.”

Skier’s Thumb

You don’t have to be a skier to suffer skier’s thumb, according to hand, wrist and elbow specialist David Wei, MD at ONS.

Along with other skiing-related injuries such as concussions, torn knee ligaments and shoulder dislocations, injuries to a skier’s thumb are one of the most common conditions Dr. Wei and the other specialists at the ONS Hand & Upper Extremity Center see during ski season.

While not as serious or debilitating as the other skiing calamities, skier’s thumb can be extremely painful and can limit the ability to perform many common daily tasks such as grasping or opening jars, pinching your fingers to pick up something or writing with a pen.  And it’s a stubborn injury. It can take 4 – 6 weeks to heal and sometimes longer.


Skier’s thumb occurs when one of the two main ligaments that support the thumb, the ulnar collateral ligament, is abruptly stretched beyond its limits. It is typically referred to as skier’s thumb because it commonly results when a skier falls with an outstretched hand while holding a ski pole. But, this condition can occur in other contact sports where the thumb is vulnerable to injury, such as football, rugby, or lacrosse. Most often, the ligament is strained when the thumb is jammed backwards and out to the side, but strains can occur on any side of the thumb.  Although skier’s thumb is typically caused by a single accident, repetitive gripping and twisting motions can create a painful chronic condition.


The most common symptoms of skier’s thumb include swelling, throbbing pain, and decreased range of motion. Bruising can appear a few days after the incident.

  • Pain is at the base of the thumb, usually at the side of the web space between the thumb and index finger

  • Swelling is usually at the base of the thumb

  • Pain, weakness or difficulty gripping using the thumb and index finger

  • Bruising along the inside of the thumb

  • Pain moving the thumb


Moderate, partial ligament injuries may be managed with ice compression, anti-inflammatory medication and immobilization using a splint.  However, Dr. Wei, notes, “If the thumb is unstable during physical exam, an MRI can help determine if a special lesion, known as a Stener lesion, is present.  If this is the case, surgery may then be required for proper healing of the ligament and stability of the joint.”  Surgery may also be necessary if the ligament suffered a complete tear and is very unstable.

During recovery from this injury, either with nonoperative or operative treatment, a certified hand therapists may be called in to help rebuild strength and mobility to the thumb.


There is no single precaution that can be taken to prevent thumb injury. For skiers, many experts suggest keeping the hands outside of the straps at the top of the poles so that the poles are easy to drop during a fall.




Solutions for Hand, Wrist and Elbow Pain

Tips to manage chronic hand, wrist and elbow pain.

Chronic upper extremity pain affects as much as 20% of the population at any given time and can lead to significant disability and time away from work and activities. It can originate anywhere from the neck to the fingertips and can have a wide range of underlying causes from nerve compression and ligament injury to degenerative arthritis. Learn about common causes of hand, wrist and elbow pain, ways to lower your risk of developing it, and strategies to keep the pain under control at this informative discussion by ONS orthopedic surgeon, Matt Cantlon, MD, a specialist in upper extremity conditions. There will be time for audience questions following the presentation.  Free.  Registration required. Call 203.863.4277 or register online at greenwichhospital.org

Ready for Spring Sports?


Foot and ankle, hand and wrist injury prevention tips by orthopedics specialists

When: February 25, 2015 at 6:30 p.m.
Where: Noble Auditorium, Greenwich Hospital
Speakers: Mark Yakavonis, MD, MMS, Mark Vitale, MD, and Paddle and Tennis Professional Patrick Hirscht

If golf or racket sports are in your plans for the spring you will want to hear tips from fellowship trained orthopedic foot and ankle specialist Mark Yakavonis, MD, MMS and fellowship trained hand/wrist/elbow specialist Mark Vitale, MD, MPH who will discuss common injuries seen in golf and racket sports. Special guest and local tennis pro Patrick Hirscht will also speak. Learn about common injuries, and how to choose footwear, braces and exercises to prevent injury and play your best; whether it’s the foot, hand, wrist or elbow, they’re all at risk for injury when you’re active. Dr. Yakavonis and Dr. Vitale will discuss nonsurgical and surgical treatments, along with ailments particular to racket sports. You will have the opportunity to ask questions at the conclusion of the talk. The program is free and open to the public. Registration Requested. Call (203) 863-4277 or register online at www.greenhosp.org.


ONS Orthopedic Surgeon and Hand Specialist, Mark Vitale, MD Presents at 69th Annual American Society for Surgery of the Hand (ASSH)

Dr Vitale Portrait -sm web
Mark Vitale, MD

September 19, 2014, ONS orthopedic hand surgeon Dr. Mark Vitale traveled to Boston at the 69th annual American Society for Surgery of the Hand (ASSH), the premier annual hand surgery meeting where the nation’s leading hand surgeons gather to present new research and techniques for the care of hand, wrist, nerve and upper extremity problems.

Dr. Vitale presented two of the conferences’ 84 podium presentations to the community of hand surgeons in the U.S. and abroad. One of his presentations entitled, “Intra-articular fractures of the sigmoid notch of the distal radius: an analysis of progression to distal radioulnar joint arthritis and impact on upper extremity function in surgically treated fractures,” was a study that looked at fractures of one of the understudied joints of the wrist. This study will help surgeons guide treatment of these fractures to optimize wrist function in surgically treated fractures.

Traditional treatments for thumb arthritis involve removing the arthritic bone in the wrist called the trapezium which forms a joint with the base of the thumb and then using part of a patient’s own tendon to reconstruct the thumb. Dr. Vitale’s research revealed that the results with this more traditional “trapeziectomy” surgery are excellent and time tested.21

Dr. Vitale Speaking at the ASSH His second presentation, “A comparison of pyrolytic carbon hemiarthrioplasty versus Thompson suspensionplasty in the treatment of trapezial metacarpal arthritis,” was a study that compared a traditional treatment for thumb arthritis with a new pyrocarbon joint replacement for the thumb.

Pyrolytic carbon joint replacement is a synthetic implant to replace the arthritic thumb/wrist joint that was initially developed and first used in conjunction with hand surgeons at the Mayo Clinic in Rochester, MN. It resurfaces the base of the arthritic thumb metacarpal bone while leaving more of the native trapezium bone in place. The pyrolytic joint replacement implant has been used since the early 2000s. The result of this study found some improved function in patients treated with the pyrocarbon joint replacement, but also a higher risk of need for future surgeries in those treated with the newer joint replacement.

Hand surgeons today debate about what surgical procedures are most appropriate for severely arthritic thumbs. The results of Dr. Vitale’s research will now help guide surgeons around the country to better treat patients.

Dr. Vitale commented, “The ASSH conference was a great success. The ONS Foundation for Clinical Research and Education has provided us with an incredible state of the art research and biomechanics lab from which we continue to drive the field of hand surgery, sports medicine and orthopedic surgery.”

Orthopaedic and Neurosurgery Specialists PC (ONS) is an advanced multi-specialty orthopedic and neurosurgery practice in Greenwich, CT. ONS physicians provide expertise in sports medicine, minimally invasive orthopedic, spine and brain surgery, joint replacement and trauma. For more information, please visit www.onsmd.i9e.co.

ONS Doctors Receive 40 Under 40 Award

Congratulations to Dr. Vitale and Dr. Vadasdi of Orthopaedic and Neurosurgery Specialists, Greenwich, CT, who received the 40 Under 40 award June 19, 2014, at the Palace in Stamford!

Dr. Vitale is  recognized for his career adv40Under40Winnersances, contribution to published research, community involvement and organizing trips to the country of Haiti where he and a group of clinician/physicians provide medical services to those in need.

Dr. Vadasdi was recognized for achievements in her medical career in orthopedics and sports medicine, for her community work and as an athlete.

Each year WAG Magazine and Fairfield County Business Journal recognize 40 professionals under the age of 40 as leaders in the workplace and community. Nominees are submitted and winners are decided by a panel. This year marked the 10th anniversary of this award. We are proud of both our winners, the work they do here at ONS, in the community and abroad.


Orthopedic Surgeon offers “Hands on” advice for common hand and wrist issues at Greenwich Hospital Seminar

On Thursday, November 15th at 6:30 p.m., orthopedic surgeon and hand and wrist specialist Dr. Mark Vitale will present a talk at Greenwich Hospital; “Hands On”, Common hand conditions and their solutions.

A presentation and discussion on conditions of the hand and wrist will include information on carpal tunnel syndrome, arthritis of the fingers and wrist, trigger finger, common forms of tendonitis of the wrist and Dupyutren’s contractures of the fingers. The talk will also offer information on common misconceptions as well as treatments for these maladies which affect millions of people each year in the US.

After graduating Tufts University, Dr. Vitale earned a doctorate in medicine and a master’s in public health from Columbia University. He completed his residency training in orthopedic surgery at Columbia-Presbyterian Medical Center, where also he served as chief resident. He received fellowship training in hand surgery at the Mayo Clinic and was recognized as the Alice D. Jensen fellow in hand surgery.

Dr. Vitale has been a leader in orthopedic and hand surgery research over his career having published more than 20 peer-reviewed scientific papers, and authored book chapters and invited articles. He has given numerous scientific presentations at national and international conferences. For more information about Dr. Vitale and a list of published research, click here. For appointments, call ONS at 203-869-1145.