Hi Michael,


I posted your question to a friend of mine who is a physician. He is a U.S. 
board certified orthopedic surgeon who has kept up to date with the latest 
techniques. He has also performed successful surgeries on me. I thought you 
might be interested in his response:



"Please tell him to see a hand surgeon who is more up-to-date. Silicone and/or 
Silastic implants have problems with breakage and synovitis.

Check out this web site: http://www.eatonhand.com/img/img00092.htm "



Incidentally, I also have a vintage Kruspe - a New Symphony model which I 
purchased as a used instrument about 1940 and is the only horn I've ever owned. 
Although I've recently had the original mouthpipe replaced with a new one by 
Dennis Houghton - it's made a tremendous difference in its playing qualities - 
I would also feel reluctant to make changes on it such as installing a 
mechanical linkage.



I thought you might be interested to know that, because I am in the beginning 
stages of Carpal Tunnel Syndrome, I have also recently bought and installed a 
Clebsch strap and had the finger hook removed from my Kruspe. I find it so much 
easier on my hand and also easier to play third finger notes and notes that use 
the third finger along with other keys. I wish I had had the Clebsch strap 
installed earlier.



I hope you'll find some of this information useful.



Ed Glick



-----Original Message-----
From: [email protected] [mailto:[email protected]] On Behalf Of 
Michael Cox
Sent: Monday, January 31, 2011 7:45 AM
To: [email protected]
Subject: [Hornlist] Osteoarthritis and horn-playing



Hi folks,



Medical advice time...again.

I have advanced osteoarthritis in the middle finger of my right hand, so much 
so that the finger is now 'frozen' at the first knuckle out from the hand 
(between the metacarpal bone and the proximal phalanges) and it can no longer 
be bent.  X-rays show that there is no cartilage at all between the bones.  I 
have adapted my horn playing with a Clebsch strap for support and by using the 
fleshy padding under the metacarpals to depress the keys.  It looks cumbersome 
but the adaptation seems to work, although rapid fingerings just can't happen.



My hand surgeon has given me three options:  do nothing since there is no pain, 
do a silicon implant between the bones, or do a knuckle replacement.  The old 
school of thought is to live with the arthritis and stiffness since there is so 
much packed in the small space around the knuckle that surgery is risky and 
gives only a small chance of permanent help.



Question one:  Is there anyone out there (or who knows of someone) who has had 
either the silicon implant or the knuckle replacement done?  Has it helped on a 
long-term basis?  Has someone in the horn community encountered an alternative 
solution?



Question two:  My horn is an early- to mid-1930s Kruspe in superb condition.  I 
can minimize the throw of the keys and make the playing easier (and faster) by 
installing mechanical linkages (and probably in doing so postpone the need for 
surgery)...but would it be a travesty to adapt such a beautiful and historic 
instrument?



Many, many thanks in advance for whatever help and advice can be sent my way.





Michael David Cox

Senior Chemistry Lecturer

Singapore American School

40 Woodlands St. 41

Singapore 738547

Republic of Singapore

Tel:  (65) 6363-3404

email:  [email protected]

email:  [email protected]



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