Hand Surgery

Also called carpal tunnel release or carpal tunnel decompression surgery, this procedure involves severing a ligament on the palm side of the hand near the wrist. Doing so alleviates pressure on the median nerve and can resolve the symptoms of carpal tunnel syndrome.

The two usual methods of performing carpal tunnel surgery are:

• Open Release – The more traditional method, where an incision up to 2 inches in length is made at the base of the palm, which is closed with stitches following the procedure.
• Endoscopic Release – A less invasive method in which a small incision at the wrist allows the use of a tiny, flexible tool with a camera called an endoscope, to perform the cutting of the ligament.

These relatively simple, convenient, and minimally invasive procedures are used to treat patients with Dupuytren’s contracture, in which a patient’s fingers are stuck in the bent position. Both can be performed right here in our offices.

• Needle aponeurotomy (NA) – A needle is used to break up the tissue that is pulling the fingers in toward the palm of the hand. It is done under local anesthetic and is sometimes called percutaneous needle fasciotomy.
• Xiaflex® enzyme injections – Medication is injected directly into the tightened cord of tissue under the skin of the palm that is causing the finger to bend. These ultrasound-guided injections break down the collagen in the cord, softening the tissue, and allowing the fingers to extend properly.

There are three joints associated with each finger of the hand:

• PIP (proximal interphalangeal) – the joint in the middle of the finger
• MCP (metacarpophalangeal) – the joint at the base of the finger
• DIP (distal interphalangeal) – the joint closest to the tip of the finger

In a finger joint replacement surgery, your doctor replaces a damaged finger joint with an artificial one. The PIP and MCP can both be replaced with artificial joints to relieve pain, especially for patients with severe arthritis.

Nerve injuries are typically caused by compression of a nerve but may also result from an accident in which the nerve is severed. Hand nerve injury repair involves repairing the injury.

Common nerve compression injuries that affect the hand and fingers include carpal tunnel syndrome, cubital tunnel syndrome, and radial tunnel syndrome.

When surgery is required to surgically reattach the ends of a nerve cut in two, you’ll want to select an orthopedic surgeon specifically trained and experienced in hand surgery, which is why you’ll want to choose The Bone & Joint Center.

Hand therapy and splinting is typically required during recovery from surgery to repair a hand nerve injury.

Tendon transfers are a type of hand surgery that replaces a nonfunctioning tendon by surgically attaching a working tendon, allowing that tendon to take its place and restore muscle function.

The two main types of tendons in the hand are flexor and extensor. Flexor tendons run along the palm side of your hand and fingers and allow the fingers to bend inward. Extensor tendons run along the back side of your hand and fingers and allow the fingers to straighten.

This procedure is used to treat arthritis of the joint at the base of the thumb, called the carpometacarpal (CMC) joint or basal joint.

Basal joint reconstruction involves making an incision at the base of the thumb and surgically replacing damaged portions of the joint’s bone and cartilage with artificial components.

It can help restore the thumb’s range of motion, especially for patients with disabling basal joint arthritis.

Wrist surgery may be performed to treat a wide number of medical issues that affect the hand and wrist. These surgeries include joint replacement, ligament reconstruction, tendon transfer, nerve decompression, and surgical fusion.

In most cases, a minimally invasive arthroscopic method is available to allow a smaller point-of-entry incision and the use of specialized tools that minimize trauma to surrounding tissue, helping reduce postsurgical pain, scarring, and recovery time.

This is the case for fusion procedures (arthrodesis), in which adjacent bones are surgically joined together to immobilize an unstable area. In the wrist, this typically occurs after a fracture.

The number of bones joined together during a fusion surgery will depend on the severity of a patient’s condition. For example, a four-corner fusion, in which the corners of four carpal bones in the wrist are surgically attached to a plate, is considered a partial fusion.

If significant bone fusion is required, an open surgery may be required.