Hand & Wrist

Hand & Wrist Treatments

Arthroscopy: Using small incisions and a tiny camera, our wrist surgeons can stabilize a wrist fracture, repair torn ligaments, remove bits of cartilage that may be preventing your wrist from moving freely, or repair torn cartilage. This minimally invasive procedure can shorten your recovery time, putting you back on the field faster than major surgery.

Cyst or Tumor Excision: In this outpatient procedure, the doctor makes an incision and removes the ganglion cyst and its root—a part of the joint capsule or tendon. Your doctor may recommend this surgery if the cyst does not shrink after use of a wrist brace or drainage (aspiration) of the fluid inside of it. In the case of a tumor, the entire mass is removed to guard against any risk of the growth becoming cancerous.

Dupytren's Contracture Release Surgery: A surgeon can divide or remove the bands of thickened tissue to restore some motion in the affected finger. Physical therapy after surgery can help you regain strength in your hand.

Endoscopic Carpal Tunnel Surgery: If you have had nonsurgical treatment and you still have a lot of pain in your hand, your doctor may recommend this surgery. The surgeon makes one or two small incisions and inserts a flexible tube with a camera on the end. He or she uses this camera to see inside the wrist, and inserts tiny tools through the tube to cut the transverse carpal ligament, releasing pressure on the median nerve. This relieves the pain caused by carpal tunnel syndrome. Most patients go home on the same day, and you can begin physical therapy in a day or so. If the surgery is on your dominant hand—the one you use for most tasks—your recovery may take 4 weeks or more.

Fracture Fixation: Using plates, nails, rods, wires, and screws to hold broken bones together and keep them in place, surgeons can help patients return to their normal activities more quickly than they could with a cast or splint. The surgical procedure reduces the risk of infection, allows patients to go home sooner, and reduces the possibility of a break healing improperly.

Joint Alignment: When a break in the bone pushes the wrist out of line with the arm, it may take more than a cast to keep it in the right position for proper healing. A surgeon can insert a plate, screws, wires, nails, or rods to hold the bone in place while it heals. In some cases, a device called an external fixator may be used on the outside of your arm to hold the bone in the correct place.

Microsurgery: Performing surgery under a microscope allows our surgeons to reconnect tiny blood vessels and nerves—skills that are very important when we need to reattach a severed finger or thumb. This special surgery also comes into play in traumatic injuries, when repairing a nerve or blood vessel can help to restore function in a badly injured hand.

Peripheral Nerve Surgery: When trauma damages the nerves in your wrists and hands and nonsurgical treatments have not helped, our surgeons can repair the nerves and give you back the use of your hands. Your surgeon will discuss the specific surgery with you and the chances for success, to help you decide if this procedure is right for you.

Radial Nerve Release Surgeries: When the nerve that allows you to extend your fingers becomes entrapped or injured, surgery may be needed if other kinds of therapy don't correct the problem. Surgery relieves the pressure on the nerve, allowing it to function normally again. You may wear a splint or a brace after the surgery while the nerve heals, and you will see a physical therapist to help you regain the strength and motion in the affected arm.

Tendon Repairs: Depending on the extent of your injury, our surgeons can either use a minimally invasive arthroscopic procedure to repair the damaged tendon in your wrist, or make a larger incision to repair a broader area. After surgery, you will wear a brace or cast for six to twelve weeks.

Tendon Transfer: When any of the three nerves in the hand—radial, median, and ulnar—are damaged or destroyed, you can lose feeling and function in your hand. This can make activities of daily living impossible for you. In some cases, our surgeons can transfer a healthy tendon to the paralyzed area, restoring your hand's ability to perform basic functions—and vastly improving your quality of life.

Tenosynovectomy: Overuse of a joint in the hand or wrist, infection, or injury may case the lining of the tendon sheath—the covering that protects the tendon—to become inflamed and painful. An experienced surgeon can release this tightened sheath and remove this inflamed material, reducing the risk that the tendon could rupture and cause more serious damage.

Trigger Finger Release Surgery: Many cases of trigger finger respond to steroid injections, but some require surgery to release the tendon. This outpatient procedure is performed using a local anesthetic, and the surgeon will wrap the finger in a bandage to allow it to heal before you begin to use it again.

Ulnar Nerve Release Surgery: The nerve that controls the forearm and hand muscles is critical to the sense of touch from our fingertips to just before the elbow. Damage to this sensitive nerve can be very painful, and it can restrict the movement of the thumb and cause weakness in the hand. When all other corrective measures have been tried, surgery can repair damage to the ulnar nerve; if a tumor is pressing on the nerve, removing it can relieve pain and restore feeling.

Wrist Fusion: When treatments for arthritis in your wrist no longer control the pain, your doctor may recommend this procedure. The wrist has as many as 12 joints that allow it to bend and flex, and each of these can become arthritic—so the pain may come from several different bones rubbing against each other. Fusing the bones together—making them grow together into one bone—makes them stop rubbing, so the pain is gone. There are some trade-offs, but you may feel these are worthwhile: Your wrist will no longer bend after the surgery, but you will get your grip back and regain strength in your hand.

Medicine of the Highest Order

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