Treatments & Procedures
The physicians specializing in care of the hand and wrist at Placentia-Linda Hospital focus on providing patients with customized treatment plans to get them back into action.
Among the most common treatments for hand and wrist conditions and injuries:
In the case of arthritis in the hands, a physician may use anti-inflammatory or other analgesic medication to treat arthritis pain. In addition to finger or wrist splints and the use of heat and cold to moderate swelling, a physician may also require hand therapy to maintain the strength and mobility of hand muscles.
When non-surgical treatment does not relieve pain, surgeons perform this minimally invasive surgery to reattach the biceps tendon to the upper or lower bicep. Surgery in the shoulder involves two to three small incisions and an arthroscopic camera to navigate and reattach the tendon to the upper arm bone. Similarly, surgery in the elbow uses one to two incisions in the forearm.
CARPAL TUNNEL RELEASE SURGERY
To relieve numbness and tingling in the fingers and hand, surgeons make an incision in the palm to cut the transverse carpal ligament and relieve pressure on the median nerve. After the surgeon closes the incision with sutures, the patient may have to wear a wrist splint while it heals.
CUBITAL TUNNEL RELEASE SURGERY
The surgeon makes a small incision on the inside of the elbow, taking pressure off the ulnar nerve. After surgery, the patient may feel improvement immediately or over time, but it may take several months to regain full strength in the hand and wrist.
DE QUERVAIN’S RELEASE SURGERY
Surgeons perform this outpatient procedure by making a small incision on the wrist near the base of the thumb. Once the inflamed tendon is located, a tiny slit is made in the tendon sheath to relieve pressure and friction.
ELBOW AND WRIST ARTHROSCOPY
Skilled surgeons perform this minimally invasive surgery by using two to three incisions to insert a small camera and miniature instruments into the wrist or elbow joint. While the patient is under anesthesia, the camera projects an image onto a monitor so surgeons can review the damage surrounding cartilage, tendons and ligaments.
Physicians tend to use a sling or cast to allow healing but, depending on the severity of the injury, a surgical procedure might be needed. Elbow-bone fractures, for example, can be realigned or cleansed of bone fragments in the event of through-the-skin fractures to minimize the risk of a deep infection.
GAMEKEEPER THUMB SURGERY – THUMB UCL REPAIR
A surgeon evaluates the patient’s thumb UCL (ulnar collateral ligament) by making a small incision on the back of the thumb. Once the surgeon exposes the joint and locates the damaged soft tissue damage, the surgeon will anchor the ligaments back to the bone with sutures.
GANGLION CYST REMOVAL
This outpatient procedure relies on the surgeon to make a small incision just above the location of the fluid-filled sac. The surgeon will then isolate the cyst from surrounding tissues and remove the stalk of the cyst.
GOLFER’S ELBOW (MEDIAL EPICONDYLITIS) TREATMENT
Most cases of golfer’s elbow are treated with daily ice application, medication and rest. Surgeons treat more serious cases using a compression brace on the forearm for force reduction, as well as an injection into the tendon to reduce pain and inflammation.
The hand surgeon will make an incision along the top of the wrist to remove the arthritic surface, then fuse together each side of the joint and secure the bones with pins, a plate or screws. Once the incision is closed, the joint is placed in a protective splint for healing.
JOINT REPLACEMENT SURGERY
With this procedure, surgeons remove damaged or abnormal bone and replace it with new parts made of special carbon-coated metal or plastic implants. In the case of a finger, the surgeon cuts the back of the finger. The damaged bone is then cut away to make room for the implant.
MICROSURGICAL REPAIR FOR FINGERTIP INJURIES
This type of surgery requires extremely fine precision. The surgeon uses a surgical microscope and precision instruments to preserve or restore functions to such delicate structures and tissues in the fingers as nerves and blood vessels.
MINIMALLY INVASIVE DUPUYTREN’S CONTRACTURE SURGERY
To improve upon severe cases, surgeons perform this outpatient procedure using just two to three incisions. The surgeon locates the contracture and cuts away at the thickened cords of the fascia (the layer just beneath the skin) to help relax the hand and restore proper function.
NERVE DECOMPRESSION SURGERY
In the event of a pinched nerve at the elbow or wrist, the surgeon will treat severe cases of discomfort by making small incisions around the surrounding ligaments that enlarge the tunnel and take pressure off the nerve.
TENDON REPAIR SURGERY
Repairing a ruptured or severed tendon in the hand requires the surgeon to make an incision in the hand or wrist and locate the very end of the tendon. After carefully uniting all parts of the end of the tendon, the surgeon will trim the tendon and reconnect it using sutures and then place the hand or arm in a splint for healing.
TENNIS ELBOW TREATMENT
Ice, pain medication and a break from excessive physical activity can all treat most tennis elbow injuries. Some additional treatments may include wearing a brace to reduce force to the elbow and exercises to build strength.
TOMMY JOHN SURGERY FOR UCL TEAR
Surgeons repair medial ulnar collateral ligaments (UCL) by creating a graft to reconstruct torn UCLs. After drilling holes in the area surrounding the elbow, the orthopedic surgeon harvests part of the patient’s body (typically from a tendon in the forearm) to recreate part of the UCL.
TRIGGER FINGER RELEASE SURGERY
Surgeons perform this operation to release constrictions of the tendon in the hands of patients with trigger finger. This minimally invasive surgery is done with a small incision in the palm of the hand, followed by the use of cutting instruments to divide the tendon and release the constriction.
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