There are medical conditions that affect the area of the hand, wrist and fingers that may require orthopedic surgery. Most injuries of the wrist and hands are due to a fall trauma when one supports the fall with the hand; this is associated with sports injury and other types of slip and fall accidents, such as, a sidewalk with ice and inappropriately leveled concrete floors. Injuries may also relate to slicing the skin, tendons, ligaments, nerves and more in the wrist which may affect the hand and fingers. In cases involving the nerves, an orthopedic surgeon and neurosurgeon may have unique approaches to treatment. Thus, it is valuable to prepare for a Q and A session with your doctor aided by research. The following common hand, wrist and finger diseases or injuries may benefit from minimally invasive orthopedic surgery.

Traumatic Injury – Traumatic injury to hand, wrist and/or finger(s) from a slip and fall are usually very painful and may be debilitating with the loss of use or limited use of the hand, wrist and/or fingers. The injury may affect the skin, tendons, ligaments, nerves and other anatomical features.  

Surgical approaches for slip and fall are often highly technique driven procedures that may be very complex, depending upon the nature of the injury. Both orthopedic surgeons and neurosurgeons may develop a unique treatment plan based on the type and level of training, surgical expertise and the number of unique techniques that they have had to apply in their practice for unique injuries.   Traumatic injuries that require surgical intervention are usually best employed within the first week of injury.    

Carpal Tunnel Syndrome – This is a progressively painful hand and arm condition caused by the compressed median nerve in the wrist. The Carpal Tunnel is a narrow passage way of the median nerve along the palms side of the wrist to supply the palms and fingers. Compression symptoms will cause numbness, pain and eventual weakness.

Non-surgical options may be the approach for 6 months, such as, wrist splinting to immobilize, NSAIDs to control the pain and Corticosteroids injections to relieve the swelling.

Surgical approaches are focused on the release of the transverse ligament of the palm to relieve pressure in the carpal tunnel and symptoms through a very small incision made in the hand.

Dupuytren’s Contracture – This is a slowly progressing hand deformity that affects the palm tissues and the underlying skin in the ring and pinky finger, causing it to contract in a bent position.  The contracture may affect certain daily activities like hand shaking, placing hands in the pocket and wearing of gloves.

Enzyme injections may release the fibrous cord and loosen the tissues grip on the contracture.

Minimally invasive techniques are available like needling to destroy the contracture or fibrous cord may be effective.

The surgical approach may involve completely releasing the joint by removing all the dysfunctional tissues including the skin to avoid the recurrence of the contracture. A skin graft may be needed to cover the voided space and extensive physical therapy is imperative for the prompt functionality of the fingers.

• Duypytren’s contracture procedures take months for full recovery and weaning from physical therapy.

Boutonniere Deformity – This a deformity of the tendon that prevents the straightening up of the finger, whereby the resulting injury causes the middle joint of the finger to bend down and the fingertip bends backward. Signs and symptoms of Boutonniere Deformity include: swelling of the middle joint that may progressively develop within a period of 7 to 21 days from the time of injury. If no surgical interventions are performed promptly in this case, deformity may become permanent.

• Protective and corrective splints may be placed to immobilize the joint during healing may be effective.

Surgical options are contemplated if no correction is observed. Surgical alignment of dislodged bones and repair of severed tendon may be performed by an orthopedic surgeon to correct the deformity.

It is important to recognize that medications and medical procedures are associated with benefits and risks that should be discussed with your physician. It is important to recognize that all information contained on this website cannot be considered to be specific medical diagnosis, medical treatment, or medical advice. As always, you should consult with a physician regarding any medical condition. Your Health Access disclaims any liability for the decisions you make based on this information.