Hand Surgery

The following information is provided as a guide, every patient is different and treatment can be tailored to suit each patient and their individual needs. If you are after a particular type of treatment, please discuss this with your surgeon at the time of your appointment. Please click on the links below to go direct to the information of interest.

Trigger Finger

The tendons of the thumb and each of the fingers pass through a sheath on the palm side of the hand. Certain diseases and overuse activities can cause a thickening of this sheath. As the tendon passes through a thickened sheath, the tendon eventually becomes irritated and swells. Pain, catching and eventually locking of the finger will occur. Early treatment consists of anti-inflammatory medication or Cortisone injection. If these fail to provide relief, the sheath is opened surgically through a small incision at the base of the finger.

Dupuytren's Contracture

This disorder is a thickening of a ligament in the palm, resulting in nodules on the ligament which, if severe enough, can cause an inability to fully straighten the fingers. The ring and small fingers are the fingers most commonly involved.

The cause of this disorder is unknown. It is seen more commonly in men and is usually found in individuals of northern European extraction.

If deformity is mild and there is no functional loss, no surgery is needed. If, however, there is significant contracture that interferes with full use of the hand, surgical removal of a portion of the ligament is the treatment of choice to improve function and to prevent further deformity.

De Quervain's Tenosynovitis

Tendonitis on the thumb side of the wrist can be a very painful and disabling condition. Simple pinching and twisting activities can be almost impossible. The tendons to the thumb become inflamed as they pass under a ligament and the slightest motion of the wrist can cause pain.

Treatment consists of rest, medication and occasionally the use of a steroid injection. If these treatments do not provide relief over time, the tendons can be surgically released.

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome is a common, painful, progressive condition that is caused by compression of the median nerve at the wrist area. Common symptoms of carpal tunnel syndrome include numbness and tingling sensation in all the fingers except little finger; pain and burning sensation in hand and wrist that may radiate up the arm and elbow; and weakness in hand with diminished grip strength Exact causes of the condition are not known. However certain factors increase the risk of developing carpal tunnel syndrome and they include congenital abnormalities, repetitive motion of hand and wrists, fractures and sprains, hormonal imbalance, and other medical conditions such as hypothyroidism, rheumatoid arthritis, diabetes, obesity, gout, overactive pituitary gland, or the presence of a cyst or tumor in the canal.

Carpal tunnel syndrome may be treated using conservative approaches or surgery. The conservative treatments include:
  • Treating underlying medical conditions
  • Immobilization of the hand and wrist with a splint or wrist brace for 4-6 weeks
  • Rest the hand for 2 weeks or more
  • Ice packs to avoid swelling
  • Avoid activities that tend to worsen the symptoms
  • Medications such as nonsteroidal anti-inflammatory drugs, diuretics, and steroid injections.
  • Strengthening and stretching exercises once symptoms diminish
If conservative treatment options fail to resolve the condition your surgeon may recommend surgical procedure.

Carpal Tunnel Release Surgery

Carpal tunnel syndrome can be treated with carpal tunnel release Surgery Traditional surgery involves up to a 2- inch incision in the palm and wrist area, whereas endoscopic surgery involves one or two half-an-inch incisions and the use of an endoscope. During the surgery, the transverse carpal ligament will be dissected to release the pressure on the median nerve and enlarge the carpal tunnel. Your surgeon will decide which options are best for you based on your general and medical conditions.

Your surgeon may suggest you to practice certain post-operative procedures for better recovery and to avoid further complications.
  • Elevate the hand above heart level to reduce swelling.
  • A splint may be worn
  • Ice packs to the surgical area to reduce swelling.
  • Keep the surgical incision clean and dry. Cover the area with plastic wrap when bathing or showering.
  • Physical therapy may be ordered to restore wrist strength.
  • Eating a healthy diet and not smoking will promote healing
The majority of patients suffer no complications following carpal tunnel release surgery. However some patients may suffer from pain, infections, scarring, and nerve damage causing weakness, paralysis, or loss of sensation and stiffness in the hand and wrist area.

Arthroscopic Wrist Surgery

Wrist is also called as carpus, a complex joint comprised of bones and joints, ligaments and tendons, nerves, blood vessels, and muscles that hold the bones together. A fibrous cartilage present between the radius and ulna (forearm bones of the hand) separates the radioulnar joint from the rest of the wrist. Wrist connects the forearm to the hand and allows it to move. Carpal tunnel is an opening in the wrist through which the nerves and blood vessels pass.

Some of the common problems of the wrist which can be treated by arthroscopy include carpal tunnel syndrome (the nerves in the carpal tunnel are compressed), arthritis, bone fractures, dislocations, inflamed tendons and ligaments, ganglion cysts, chronic wrist pain

Arthroscopy is a minimally invasive procedure that allows your surgeon to look inside the wrist joint using small incisions (portals) and instruments. Wrist arthroscopy allows the surgeon to diagnose and treat the disorders of the wrist. Your surgeon makes several incisions near your wrist joint. Through one of the incision, an arthroscope, having a small camera fixed to the end of a narrow fiber-optic tube which is inserted. The camera magnifies and projects images of the wrist on a large screen monitor which helps in diagnosing the condition. Through the other incisions surgical instruments are inserted to treat the problem of the wrist. A sterile solution is injected into the wrist to expand the joint that allows clear view of the joint and provides extra room for the procedure. After the surgery the stitches are closed and dressing is applied.

After the surgery, your surgeon will place a cast or a splint that immobilizes that will prevent the movement of the wrist until it is healed completely. The operated wrist should be elevated to prevent excessive swelling and pain. Ice (wrapped over a cloth) can be applied over the operated area which helps to reduce swelling and medications are taken to reduce pain. Always remember to keep the operated area clean and dry to prevent infection and pus formation.

Some of the advantages of arthroscopy are smaller incisions, minimal soft tissue trauma, less pain, faster recovery time, low infection rate, less scarring, earlier mobilization, and allows patient to go home the same day.

Some of the risks observed after wrist arthroscopy include infection, damage to the nearby nerves or tissues during surgery, and stiffness which can be treated through post-operative rehabilitation. Exercises are performed to strengthen the wrist and rebuild your strength.
Share by: