Hand & Upper Extremity Surgery

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.

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 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 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.

De Quervain's tenosynovitis is a condition that affects the tendons on the thumb side of your wrist. Pain results when turning your wrist, grasping anything or making a fist. Activity that involves repetitive hand or wrist movement can worsen the pain. Reconstructive surgery, along with physical or occupational therapy, is a treatment option.

 

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.

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 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.

Tendons are the soft, bandlike 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.