Plastic & Reconstructive Surgery
Hand & Upper Extremity Surgery Services in La Crosse
The ability to perform tasks with your hands and upper extremities without discomfort, pain or limitations is important for your independence and quality of life. Our Plastic & Reconstructive Surgery team will work with you and medical providers from other specialties to relieve the pain and return your hands and upper extremities to activity, productivity and maximum function.
In-office hand surgery
In addition to providing traditional surgery in the operating room, the team now offers in-office hand surgery procedures during the clinic visit without the need for traditional anesthesia. This technique is referred to as Wide-awake Local Anesthesia No Tourniquet, or WALANT. Anesthesia risks can be avoided while providing similar treatment and ensuring you are still comfortable.
Surgical procedures available in-office for most patients includes:
- Carpal tunnel release
- De Quervain's release
- Dupuytren's disease
- Ganglion cyst removal
- Mucous cyst removal
- Hand, extremity and face mass removal
- Tendon repair
- Trigger finger injection and release
- Getting the procedure during regular clinic hours.
- Getting in and out quickly, without the presurgical preparation process, wait times or post-anesthesia recovery time.
- Using a local injectable anesthetic so there is no need for general anesthesia or sedation medications and their possible side effects.
- Saving money without operating room and anesthesia fees.
- Attending fewer appointments, as there is no need for a preoperative clearance appointment.
- Eating breakfast and taking medications the morning of the procedure.
- Available to patients who do not meet anesthesia guidelines and are not eligible for surgery in the operating room.
- Asking questions during the procedure.
- Offers family members peace of mind and, if appropriate, they can be in the procedure with you.
- Relief from the underlying condition.
Most patients qualify for in-office surgical procedures, which most insurance plans cover. Those with complex issues may require or benefit from traditional surgery. This approach is a good option for those at risk for anesthesia complications or want to enjoy the noted benefits.
We provide care and treatment for these hand and upper extremity conditions:
- Carpal tunnel revision
- Carpal tunnel syndrome
- Cubital tunnel release
- De Quervain's tenosynovitis
- Dupuytren's contracture
- Extensor tendon rebalancing
- Ganglion cysts
- Radial and ulnar collateral ligament reconstruction
- Tendon and joint injury
- Trigger finger release
Swelling and tenderness of one or more joints are signs of arthritis. Additional symptoms include stiffness, pain, and reduced motion in your hands and wrists. Advanced reconstructive surgery can relieve these symptoms.
Carpal tunnel revision
In a small number of cases, symptoms can persist or recur, or new symptoms can develop after carpal tunnel surgery. This could happen due to an incomplete release during carpal tunnel surgery or a wrong initial diagnosis. In these cases, carpal tunnel revision surgery may be needed.
Carpal tunnel syndrome
Carpal tunnel syndrome occurs when you have a pinched nerve in your wrist. The carpal tunnel is a passageway from the wrist to the hand, and it is made of tendons, ligaments and bones. The median nerve passes through the tunnel and provides sensation to your thumb, index finger, middle finger and the thumb-side of the ring finger. When it is compressed, numbness, tingling and weakness in the hand and arm can result. Nerve-decompressing surgery, often called carpal tunnel release, can provide treatment for carpal tunnel syndrome.
Cubital tunnel release
Cubital tunnel release is a surgical procedure that decompresses the ulnar nerve. An incision is made along the inside of the elbow, and the structures that lie over the nerve are opened to relieve pressure on the nerve.
In this video, orthopedic surgeon Julie Adams, M.D., shows carpal tunnel surgery being performed in a clinic setting, explaining the pros and cons of this setting versus the operating room:
Dupuytren's contracture is a slow-forming hand deformity that affects a layer of tissue that lies under the skin of your palm. Knots of tissue form under the skin, eventually creating a thick cord that can pull one or more fingers into a bent position. This condition mainly affects your ring finger and pinky. Treatment options include injection or surgery.
Extensor tendon rebalancing
Tendons are tissues that lie next to the bone and connect muscles to bone. Extensor tendons are on the back of the hands, wrists and fingers, enabling you to straighten your fingers and thumbs. Extensor tendon rebalancing, or repair, is surgery to fix the torn or damaged extensor tendons on the back of the fingers. This surgery seeks to reestablish the strength of the damaged tendon to renew as much of its previous function as possible.
Ganglion cysts are noncancerous lumps that typically develop along the tendons or joints of the wrist or hands. They usually are round or oval in shape and filled with a jelly-like fluid. Ganglion cysts can be painful if they press on a nearby nerve and, depending where they are located, can interfere with joint movement. Treatment options include draining the cyst or surgery.
Radial and ulnar collateral ligament reconstruction
Radial and ulnar collateral ligaments help stabilize the fingers and thumb at the joint. Injuries to the ligaments generally occur at the metacarpophalangeal joints. The injury can occur in any of the fingers when too much stress is placed in either the radial or ulnar direction at the joint, but it typically occurs in the thumb.
Treatment depends on the severity of the injury. For a mild injury, treatment may begin with conservative measures, such as strict mobilization of the affected finger for a few weeks. If the injury does not improve, surgery may be the next treatment option to consider.
Tendon and joint injury
Tendons are the soft, band-like tissues that connect muscles to bone. When the muscles contract, the tendons pull the bones and cause the joints to move. If tendon damage occurs, movement may become limited, which may require surgery to repair.
Trigger finger release
Trigger finger occurs when a tendon in your finger has become irritated and swollen, preventing it from sliding smoothly under the sheath. When that happens, your finger or thumb can get stuck in a bent or straight position. Over-the-counter anti-inflammatory medication, such as ibuprofen, may help symptoms. More severe cases may require steroid injections, splinting or a minor surgery during which the surgeon probes under the skin to loosen the adhesion.