Jonathan A. Donigan, MD
Dr. Jonathan Donigan is an orthopedic surgeon specializing in surgeries of the hand and upper extremity. He also has trained in the use of minimally-invasive endoscopic surgery, especially for surgery to repair Carpal Tunnel Syndrome.
Dr. Donigan received his medical degree from Johns Hopkins University School of Medicine, a nationally recognized program based in Baltimore, Md. He followed that with a residency in orthopedic surgery at the University of Iowa Hospitals and Clinics. Dr. Donigan continued his training with a fellowship in surgery of the hand and upper extremity, also at the University of Iowa Hospitals and Clinics.
Dr. Donigan, who is a native of Hawaii, moved to Logan, Utah, as a high school student. Following an LDS mission to the Philippines, he completed his undergraduate degree at Brigham Young University. A father of four children, Dr. Donigan spends much of his free time coaching his son’s soccer team. He also enjoys reading, playing and watching sports, camping and snowboarding.
What patients are saying about Dr. Donigan
“Dr. Donigan is amazing! He did my hand surgery in January. I highly recommend him and his skills!” — Terry, Facebook post, July 17, 2014
“After a bad experience with a broken elbow, I was very impressed with all the staff that participated in my recovery. They answered my questions so I could understand. … Dr. Donigan always had a smile and was gentle, and he made me feel like a person, not just some number on a chart.” — Kathryn, in-office comment form, June 20, 2014
“Very honest with course of treatment and possible outcome. Will not tell you something that you want to hear — he will tell you what he thinks is going on and your best options. Has great bedside manners. Both husband and I had surgery with him.” — Comment on ucomparehealthcare.com, Oct. 15, 2013
“Took great concern when I had complications and office staff would follow up with me without me having to call. He is very nice and honest with treatment and outcomes.” —Comment on ucomparehealthcare.com, May 25, 2013
“He is one of the most gifted and talented orthopedic surgeons I have met. He fixed my thumb and shoulder and fixed my husband’s shoulder. He is amazing.” — Gaby on Facebook, July 15, 2013
- Carpal Tunnel Surgery
- Cubital Tunnel Surgery
- Total shoulder replacement
- Reverse total shoulder replacement
- Shoulder arthroscopy
- Rotator cuff repair
- Elbow replacement
- Elbow arthroscopy
- Tennis elbow repair
- Wrist arthritis treatment
- Wrist joint replacement
- Wrist arthroscopy
- Hand injuries
- Treatment of fractures
- “Arthritis of the Elbow, Wrist and Hand,” a chapter in the 2012Musculoskeletal Examination of the Elbow, Wrist and Hand: Making the Complex Simple.Editors: Randall W. Culp and Leonid I. Katolik
- “The Distal Radioulnar Joint,” a chapter in the 2010 “Hand Surgery Worldwide: International Reconstruction of a ‘Beautiful and Ready Instrument of the Mind.’” Editor: James Urbaniak
- “Pre-operative and Intra-operative Factors Related to Shoulder Arthroplasty Outcomes.” Co-author of this 2009 publication of the University of Iowa Hospitals and Clinics
In the Media
Dr. Jonathan Donigan, an orthopedic surgeon who specializes in hand injuries, offers advice on when a hand injury merits an emergency room visit, during an episode of Fox 13’s Healthfix.
Three Simple Tests for Carpal Tunnel Syndrome
Physicians diagnose Carpal Tunnel (CTS) Syndrome using a variety of methods, including electrophysiological testing, a diagnostic tool used by Dr. Jonathan Donigan, Tanner Clinic hand surgeon. The following tests are also commonly used for clinical assessment of possible CTS.
▸ Phalen’s maneuver: This test is performed by pushing the palm areas of the hands together, gently flexing the wrist as far as possible, then holding for 30 to 60 seconds. A positive test for CTS is one that results in numbness in the median nerve area.
The quicker the numbness starts, the more advanced the condition. Phalen’s sign is defined as pain and/or paresthesias (a sensation of tingling, numbness, prickling or burning) in the fingers with one minute of wrist flexing.
▸ Tinel’s sign: This classic test is performed by lightly tapping the skin over the flexor retinaculam (the area on the palm side of the wrist that covers the carpal tunnel) to elicit a sensation of tingling or “pins and needles.” Tinel’s sign is less sensitive, but slightly more specific, than Phalen’s maneuver.
▸ Durkan compression test: In this variation of Tinel’s sign, pressure is applied to the palm over the nerve for up to 30 seconds. Symptoms of tingling and numbness indicate a likelihood of CTS.
— Information from Wikipedia.com and other sources
Sore Wrist May Not Be Carpal Tunnel, but Can Be as Painful
Remember when we all thought that Carpal Tunnel Syndrome was the main hazard of an office job? In fact, this condition of tingly fingers and sore wrists was known as the “white collar epidemic of the 1990s.”
In this decade, we understand that repetitive motion — constant typing, for instance, or working on an assembly line — won’t cause Carpal Tunnel Syndrome. However, it may aggravate the symptoms, says Dr. Jonathan Donigan, an orthopedic surgeon with the Tanner Clinic Orthopedic Center.
The carpal tunnel is the bony channel in the wrist through which the hand’s nerves and flexor muscles pass. When this passageway, for some reason, crimps the nerves, the result is the numbness and pain common to Carpal Tunnel Syndrome.
But what many people believe to be Carpal Tunnel Syndrome is often something else — tendonitis, bursitis, or possibly simple joint inflammation, says Dr. Donigan, who specializes in surgeries of the hand. Sometimes, he adds, it’s an earlier trauma that has caused “wear-and-tear arthritis.” These conditions can all be caused by repetitive motion on the job or at play — such as pressure on the wrist exerted by the bicycle rider. And, they mimic the symptoms of an impaired carpal tunnel.
But Carpal Tunnel Syndrome itself, says Dr. Donigan, is caused by a combination of genetics and other unknown factors that researchers haven’t yet pegged down.
Dr. Donigan’s experience, as well as scientific studies, indicate that people tend to recover more quickly after endoscopic surgery, in large part due to the smaller incision. The incision, he said, “is not in the palm where people grab things, so they get back to using their hands more quickly.”
“Studies have been done showing that people who work and who don’t work have the same incidence of Carpal Tunnel Syndrome,” he said.
Tingling and numbness
Carpal Tunnel Syndrome, which does worsen with age, is characterized by tingling and numbness specifically in the fingers. Sometimes the pain radiates up the arm, “but usually the numbness and tingling are in the fingers,” said the orthopedic surgeon.
When these symptoms flare up and seem to stick around, Dr. Donigan advises that patients do not put off a visit to the doctor.
Surgery to “release” the nerve that travels through the carpal tunnel, known as the median nerve, is one of the most common surgeries undertaken. The prognosis is excellent, said Dr. Donigan, and recovery is generally complete.
“I usually don’t let people lift more than 5 pounds with their hands for two weeks, but they can start doing light things like typing within a couple of days,” he said. A return to heavier duties will take about a month.
Any long-term pain following surgery can likely be attributed to permanent nerve damage, which occurs when treatment has been postponed. Some patients may develop permanent weakness if the pressure on the nerve is not relieved.
Inside view of the wrist
Technology to repair a damaged carpal tunnel has advanced in recent years, and Dr. Donigan practices one of the newest techniques: endoscopic surgery. Traditional carpal tunnel surgery uses a palm incision, which can be up to 2 inches. Endoscopic surgery, instead, is accomplished by inserting a micro-camera through a half-inch incision in the wrist.
Dr. Donigan’s practice extends well beyond Carpal Tunnel Syndrome. As a surgeon, he specializes in the “upper extremity,” which he describes as “basically, the shoulder to the fingertips.” This includes injuries of the elbow, such as arthritis, ligament tears around the elbow, or “tennis” elbow” (cubital tunnel release). That upper extremity also includes shoulder issues.
A new shoulder surgery
Reverse shoulder replacement is another newer surgical technique that Dr. Donigan practices. This procedure offers help to those patients for whom a traditional shoulder replacement has not worked, he said.
“Reverse” shoulder replacement is exactly that: Instead of conventional shoulder replacement, in which a plastic “cup” is fitted into the shoulder socket and a metal “ball” is attached to the top of the upper arm bone, a reverse total shoulder replacement calls for the socket and metal ball to be switched, with the metal ball attached to the socket and the plastic cup fixed to the upper end of the humerus.
Candidates for reverse total shoulder replacement are those who have:
- A completely torn rotator cuff that cannot be repaired
- Cuff tear arthropathy
- A previous shoulder replacement that was unsuccessful
- Severe shoulder pain and difficulty lifting the arm away from one’s side or over the head
- Tried other treatments, such as rest, medications, cortisone injections and physical therapy, that have not relieved shoulder pain
Only available since 2003, reverse shoulder replacement is an option for “people who prior to this didn’t have any good options,” said Dr. Donigan. “With a reverse shoulder replacement, even those people can regain the ability to lift their arm up and have good pain relief.”
The most common surgery performed by Dr. Donigan is carpal tunnel related, and much of his practice is related to chronic conditions such as arthritis or tendonitis. However, about a third of his patients have suffered some kind of trauma.
Based on that, Dr. Donigan has a word of advice: Keep kids off the local park’s jungle bars. “It’s a real problem, more so than trampolines,” he said. “Monkey bars are the ones that cause the worst injuries.”