Hand and Wrist Surgical Procedures Performed at Marina del Rey Hospital
The need to opt for surgery depends on how bad the symptoms are, and it also depends on how the patient reacts to non-surgical treatments such as medications, exercises, splinting, and physiotherapy. Early treatment is very important, if not treated at the correct time, the healing of broken bones and alignment of other associated structures will be improper leading to restrictive and awkward movements of your hands while performing everyday activities.
Hand and Wrist Surgeries
The most common hand and wrist surgeries are discussed below:
Carpal Tunnel Surgery: This surgery is performed to treat carpal tunnel syndrome. In this surgical procedure, the carpal tunnel ligament is split to ease the pressure on the median nerve. It is carried out under local anesthesia and the tunnel is enlarged to provide more space to the nerves.
Dupuytren’s Contracture Fasciectomy: In this surgical procedure, the excess tissues on the palms and fingers are removed, enabling proper positioning and finger hand movements.
The release of the trigger finger: In this procedure, the tendon that is stuck in the tunnel is released to enable it to retract to normal position.
Tendon Repair: In this surgical procedure, undamaged tendons from other fingers are partially taken to repair the damaged tendons. The rough edges of the bones are smoothened to avoid further damage. This surgery is more successful when done at the earliest stage of the injury. The healing of repaired tendon can take more than six weeks. The use of the operated hand should be restricted to enable a quicker recovery.
Ganglion surgery: Ganglions are cysts formed when the synovial fluid from the joints of bones, move into the tendon sheath and become thick to form a cyst. They are commonly found on the wrists and fingers. These ganglions can be hard when pressed and do not allow the fingers to move freely, the shape and position of the fingers get abnormally changed. Arthritis is the common cause for this disorder.
In this surgical procedure, needles are used to remove the fluids, or else a minor surgery will be done to remove the thickened fluids. When there is a severe restriction of movement and distortion of fingers, knuckle replacement surgery will have to be done.
Trapeziectomy: Trapezium bone is located at the base of the thumb and arthritis can cause pain and restriction in moving this part. If the pain lasts for a long time and hand movements get severely restricted, the joint and the trapezium bone will be removed surgically. Either tendon is used or scar tissues are allowed to grow in the empty space of the trapezium bone. After surgery to restrict and support thumb movements, splints will be given for six weeks. Specific exercises will have to be done for a few months as suggested by the medical practitioner to strengthen and retain normal movements.
Triangular fibrocartilage repair: Triangular fibrocartilage provides a cushion to the bones of radius and ulna in the hand. It can get damaged due to a fall on an outstretched hand. In this procedure, the surgeon will use an arthroscope inserted through a small incision to view the damaged area. The debris of damaged tissue is removed, the area is cleaned, made smooth and torn cartilage and ligaments are joined by stitches.
Replacement of wrist joints: Wrist joints are more complex than hip or knee joints. Here, the complete joints can be removed and replaced by artificial materials known as prosthesis, thus improving hand movements and relieving pain. Prosthetic materials can be metals, ceramics, or plastics designed to replace the joints. A cast with splint is worn after the surgical procedure for around six weeks.
Repair of wrist fracture: Scaphoid is a cashew nut shaped bone associated with the thumb, forefinger and the large forearm bone in the wrist. There can be small bits of broken bones that will have to be removed surgically. Bigger pieces of bones will have to be aligned and stabilized with the help of pins, screws, and wires. If the stabilizing is done from outside it’s called external fixation, and if done from inside, it is called internal fixation.
Open reduction internal fixation (ORIF): This is a specialized surgery where a large incision is made and with the help of pins, plates, screws and wires the broken bones are stabilized and positioned.
Osteotomy: In this surgical procedure, the size of the bone is changed by cutting to have the bones aligned correctly. This is usually done when the healing of the bone happens abnormally or distorts due to osteoarthritis.
Synovectomy: This is a minimally invasive procedure where the excess synovial membrane grown between the wrist and finger joints is removed. The swelling of the synovial membranes often occurs due to rheumatoid arthritis.
Proximal Row Carpectomy: In this surgical procedure, the carpal bones of the wrist are removed to ease wrist movements. This is done when the patient undergoes severe pain with limited wrist movements.
Bones fusion surgery: This is done when the movement of hands and wrists become very difficult. Here, the carpal bones of the wrist are fused together as a solid single bone. The fusion can be complete or partial depending on the symptoms of the patient. Here, the movements can get limited comparing to normal actions, but the pain can be relieved and partial hand movements can be restored.
Drugs and Other Treatment Needed for Hand and Wrist Disorders
Assistive Devices »
Steroid Injections »
Lifestyle Changes »
Physical Therapy »
Braces or splints »
Other types of therapies include:
Hot and cold therapy: This therapy can be used to relieve pain and increase the mobility of the joints. Most often, this therapy is combined with physical exercise for better results. Gel packs can be used by either keeping it in the freezer or in a microwave oven to cool or heat it.
Hot therapy: Applying bearable heat upon the affected area will increase the blood flow, improve movements, reduce joint pains and relax muscles. This therapy is more often used before exercising.
Cold therapy: Cold therapy after exercise or exertion of the joints will alleviate pain, decrease blood flow, swelling, and inflammation.
Nutritional supplements: Supplements such as chondroitin, glucosamine, Vitamin C, D, and calcium are more popularly used to alleviate the symptoms of joints, strengthen the bones, and growth of tissues.
Aquatic therapy: Swimming is very helpful in solving the problem of the joints; the buoyancy of water avoids impact on the joints and restricts painful movements.
Discuss with your doctor before taking up any of the above therapies.