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Schulze offers a helping hand

Lewes surgeon performs wrist replacements
By Nick Roth | Jul 29, 2014
Photo by: Nick Roth Lewes surgeon Dr. Scott Schulze of Delmarva Hand Specialists is one of a few hand specialists who perform wrist joint replacement surgeries in Delaware and in the Mid-Atlantic region.

Lewes — Without the help of Lewes surgeon Dr. Scott Schulze, Mary Jo Calloway may not be working on a special project for this year's Christmas holiday.

Calloway, whose favorite hobby is needlework, developed pain in her wrist caused by a lack of cartilage and shifted bones. She sought out Schulze, who recommended a wrist joint replacement, a procedure not offered by many doctors in Delaware or on the East Coast. She underwent surgery in March, and after extensive physical therapy, Calloway is elated with the results.

“I do a lot of quilting, sewing, needlework and what not,” she said. “I thought if I could do that again, I would be happy. So far I have finished two baby quilts, and I'm back working on a Christmas project.”

She said her hand is not quite where she would like it to be, but she is confident movement will increase as she continues working with a hand specialist at Old Towne Physical Therapy.

“The whole experience for me was just so good,” she said. “Everything went so smoothly.”

Calloway is one of several wrist joint replacement cases Schulze has completed in recent months. The procedure has been in existence since the 1960s, but Schulze said it has only recently has become a viable option for patients.

“One of the big problems early on is they just didn't have a good life expectancy,” he said. “Even when I was training, the ones we did I didn't feel were very good from a biomechanics standpoint or from the standpoint of what the patients gained out of it.”

Recent studies have shown technology is catching up. According to an article in the Journal of Hand Surgery, the Universal 2 implant that Schulze uses has been found to have the highest survival rate at 100 percent three to five years after surgery. Still, he said, studies have shown all manufacturers' implants begin to wear out after eight years.

Wrist joint replacements are not for everyone. He said he works with every patient to determine the most appropriate path forward.

“When it comes to anything we offer, you really want to cater to the patient,” he said. “You need to know what activities in daily living they do, what their job is, what their hobbies are.”

In another recent case, Schulze said, a patient wanted to continue lifting weights and working out. Instead of recommending a wrist joint replacement, he suggested they move forward with a scaphoidectomy and four-corner fusion: removal of a bone in the wrist followed by fusing together of four other wrist bones.

Both the wrist replacement and limited fusion procedures give patients 45 degrees of flexion and 45 degrees of extension, but it's important to work with patients to meet their needs.

Originally from central New Jersey, Schulze did his primary surgery training at Seton Hall University, working at St. Barnabas, St. Francis and St. Joseph's hospitals in the Newark, N.J. area. His initial plan was to enter the field of plastics, but while doing a hand and microvascular fellowship through Southern Illinois University, Schulze's path changed.

“I found that it was something that I was not only good at, but also enjoyed,” he said. “It's a lot of intricacy, a lot of uniqueness, and there is a lot of reward with treating patients with hand [problems]. You can give somebody their life back.”

Schulze also completed a burn fellowship while in Illinois, and he continues to treat burn patients.

After completing back-to-back fellowships, he blanketed the East Coast in search of a permanent home. Beebe Healthcare was one of the first to call, but it was his general surgery background that was most attractive to them.

He told them he wanted to use his hand training, and he thought he would never hear from them again. They called back 72 hours later.

“They did a needs assessment and pretty much all the hand in this area was going out to Philly and Baltimore,” he said. “They felt it would be a nice niche here, and they brought me on for my hand expertise.”

He joined Beebe's staff in 2008. In 2012, he split off on his own and created Delmarva Hand Specialists. He remains in the Beebe network and performs many procedures at Beebe's Lewes campus as well as in his Lewes office.

His workload has been intense since opening his practice. He recently added physician's assistant Laurel Steen to his staff in order to see even more patients.

“Being a solo practitioner, there was certainly a limit to the amount of people I could see on any given day, unless I was seeing patients to midnight or on Saturdays,” he said.

Schulze sees patients with a wide range of conditions, from folks with arthritis to patients with amputated fingers or traumatic injuries. He also speaks nationally about Dupuytren's contracture and reconstruction of soft tissue and nerve pathology. Dupuyten's contracture is a progressive fibromatosis where collagen in the palm causes cord-like structures that draw the finger down to the palm. Until 2010, only surgery would correct the condition, but a nonsurgical treatment has been developed, and it is now used in many practices, including his own.

In addition to hand work, Schulze also works with patients with dermatological and burn-related issues. His office is at 34434 Kings St. Row in the Old Towne Office Park on Kings Highway off Route 1. For more information, call the office at 302-644-0940.

An x-ray shows the implant used for a wrist joint replacement. (Courtesy of: Delmarva Hand Specialists)
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