Different Types of Hand Surgery (Part 1)

The hand and wrist area is both delicate and durable – comprised of hundreds of bones, ligaments, tendons, muscles and nerves. With so many moving parts, and so much wear and tear, it is not surprising that there are many types of hand and wrist problems that arise.

In many cases physical therapy and other non-surgical treatments can be used to remedy a hand or wrist issue. In more severe cases, surgery may be required. There are many different types of hand and wrist surgeries that can be performed to correct, depending on the underlying cause of the problem.

As the Clarkston area’s leading hand surgeon, Dr. Rehman performs all types of wrist, finger and hand surgeries. In this two part article is a brief overview of some of the more common types of wrist and hand surgery that may be performed.

Carpal Tunnel Surgery

Carpal tunnel syndrome (CTS) is a common condition affecting the hand and wrist, characterized by numbness, tingling, and weakness. It is caused by the compression of the median nerve as it passes through the carpal tunnel, a narrow passage in the wrist. Repetitive hand movements, conditions like diabetes and arthritis, and anatomical factors can contribute to the development of CTS. If other treatments don’t improve your Carpal Tunnel Syndrome symptoms, carpal tunnel release surgery may be required.

Individuals who frequently engage in activities requiring repetitive wrist movements, such as typing or using vibrating tools, are at an increased risk. Symptoms may include pain, numbness, or a burning sensation in the hand, particularly the thumb, index, and middle fingers. When conservative treatments like splinting and physical therapy do not provide relief, carpal tunnel surgery may be recommended. The surgical procedure involves releasing the pressure on the median nerve by cutting the ligament that forms the roof of the carpal tunnel.

During Carpal Tunnel Syndrome surgery the surgeon cuts the ligament around the carpal tunnel to take pressure off the medial nerve – which relieves the symptoms. Post-surgery, the ligament comes back together, but leaving more room for the nerve to pass through.

Rheumatoid Arthritis Wrist & Hand Surgery

Rheumatoid arthritis (RA) is an autoimmune disorder that can affect various joints in the body, including those in the wrist. In the wrist, RA often leads to inflammation, swelling, and pain. The exact cause of RA is unknown, but it is believed to involve a combination of genetic and environmental factors. The immune system mistakenly attacks the synovium, the lining of the membranes that surround the joints, causing inflammation. This chronic inflammation can result in joint damage and deformities. Individuals with a family history of RA, as well as women and those between the ages of 40 and 60, are at a higher risk.

Treatment for RA in the wrist may include medications to reduce inflammation, physical therapy, and in severe cases, surgical interventions to repair or replace damaged joints. In cases of severe joint damage due to Rheumatoid Arthritis, damaged tissue can be surgically removed from the joint, while tendons and ligaments are repositioned. Alternatively, the entire joint can be surgically replaced with a prosthetic.

Dupuytren’s Contracture Hand Surgery

Dupuytren’s contracture is a hand deformity that develops slowly over years. It occurs when the connective tissue under the skin in the palm thickens and tightens, causing the fingers to be pulled inward. The exact cause is unknown, but genetic factors and certain lifestyle elements, such as smoking and heavy alcohol use, are associated with an increased risk.

Dupuytren’s contracture usually affects the ring and little fingers and can make everyday activities challenging. In cases where the condition progresses, and the fingers become significantly bent, surgical intervention may be recommended. The surgical procedure involves releasing the contracted tissue to restore finger movement. Surgery is typically considered when the deformity interferes with daily functioning and conservative measures like hand therapy are insufficient.

Dupuytren’s contracture is a medical condition in which one or more fingers have become permanently bent into a flexed position. It typically begins as small hard bumps (“nodules”) beneath the skin of the palm, then worsens over time until the fingers can no longer be straightened.

Typically non-surgical treatment and/or collagenase injection is recommended for treating Dupuytren’s Contracture. However, severe cases may require hand surgery. Surgery involves making one or more incisions (typically along the creases of the hand) to remove and separate the fibrous, thickened, scar-like tissue to improve range of motion and prevent nerve damage.

De Quervain’s Tendonitis Hand Surgery

De Quervain’s tenosynovitis (also called De Quervain’s tendonitis) is a painful condition affecting the tendons on the thumb side of the wrist, as a result of repetitive activities and overuse of the thumb or wrist. It can usually be treated with splints, ice, anti-inflammatories and therapy.

If these minimally invasive methods fail, surgery may be required, to release the tendon’s tight covering to allow it to move more smoothly. This is typically an outpatient procedure, and the patient can go home the same day.

Basal Joint Arthritis Surgery

Basal joint arthritis, also known as thumb arthritis, is a condition that affects the joint at the base of the thumb, where the thumb meets the wrist. This joint, called the basal joint or carpometacarpal (CMC) joint, is crucial for the thumb’s range of motion and function. The cartilage in this joint can wear down over time due to aging, overuse, or genetic factors, leading to basal joint arthritis. Individuals with a family history of arthritis, women, and those over 40 are at a higher risk. Symptoms of basal joint arthritis include pain, swelling, and weakness at the base of the thumb, which can affect the ability to grip and pinch.

When conservative treatments like splinting, anti-inflammatory medications, or corticosteroid injections do not provide relief, surgery may be considered. One common surgical procedure for basal joint arthritis is arthroplasty, also known as joint reconstruction. During arthroplasty, the damaged joint surfaces are removed and replaced with a graft or implant, alleviating pain and improving function. Another surgical option is joint fusion, where the bones of the joint are fused together to eliminate painful motion. The choice of surgical intervention depends on the severity of the arthritis and the patient’s overall health. Surgery aims to restore thumb function and reduce pain, allowing individuals to regain the ability to perform daily activities without discomfort.

When nonsurgical treatment is no longer effective to treat osteoarthritis of the joints, and the pain is overwhelming, surgery is a viable option. Surgical ligament reconstruction and tendon interposition (LRTI) surgery is often performed for lasting relief.

CLICK HERE for Different Types of Hand Surgery (Part 2)

Best Hand Surgery – Bloomfield Hills, MI

If you are suffering from any pain or limitation in your hand, fingers or wrist, contact Dr. Rehman for a comprehensive evaluation and consultation. As with most medical conditions, early detection, awareness, and a prevention or treatment plan is the most effective way to treat injuries of the hand or wrist.

In many cases we may be able to treat your condition with non-surgical, non-invasive procedures in our Bloomfield Hills office. In more severe cases, where wrist or hand surgery is required, board certified hand surgeon Dr. Rheman offers the highest standard of medical care and the latest techniques in hand surgery.

Bloomfield Hills Hand Surgery Doctor: 248.335.2638