Procedures - Hand Surgery
Carpal Tunnel Syndrome
Carpal Tunnel Syndrome (CTS) is an entrapment neuropathy due to compression of the median nerve at the wrist. The main symptoms of CTS are numbness of the thumb, index and middle fingers with a decrease in grip or pinch strength. Often patients will have these symptoms when driving long distances or cause them to be awakened out of sleep at night.
Initial treatment usually involves splints and possible treatment of area with corticosteroid injections. Diagnosis of CTS is confirmed by electrophysiologically testing called EMG’s and NCV’s often by a neurologist. Some patients require surgery. We utilize a technique for Carpal Tunnel Release (CTR) which is open allowing for exposure and identification of all areas of compression of the median nerve through a limited incision in the palm of the hand.
Recover is often quick. Nerve regeneration and return of function can take several months depending upon the extent/duration of compression of a patient’s nerve. The longer you wait the longer the recovery process could take. Failure to treat CTS can and does result in permanent nerve damage.
Patients that have had a CTR but still have signs or symptoms of CTS often require a detailed examination and an extensive work-up to differentiate/determine the etiology. Recurrent CTS can be addressed surgical but, requires a much more extensive procedure to correct the condition with a much longer recovery.
A trigger finger, trigger thumb, or trigger digit is a disorder that is characterized by catching, snapping or locking of the involved flexor tendon and is associated with hand dysfunction and pain. The lay term of trigger finger is utilized because when a patient’s finger unlocks, it often pops back suddenly like a releasing a trigger of a gun.
Initial treatment entails injection of corticosteroids which can be effective in over 50% of patients. Should the shot fail to make the trigger finger resolve a simple surgery that involves the release of a pulley in the hand is very effective to resolve the process. Recovery is often quick once the wound is healed and recurrence is rare.
De Quervain Syndrome
De Quervain Syndrome or Gamers Thumb is a tenosynovitis of the covering, sheath or tunnel of the proximal radial aspect of the forearm that control the movement of the thumb ( extension/abduction ). Symptoms include pain, tenderness and swelling over the thumb side ( radial ) of the wrist with difficulty/pain with gripping.
Initial treatment entails injection of corticosteroids which can be effective in over 70% of patients. Should the shot fail to make the Gamers Thumb resolve a simple surgery that involves the release of the sheath at the distal radius first dorsal compartment is very effective to resolve the process. Recovery is often quick once the wound is healed and recurrence is rare.