Tag Archive: hand surgeon

Conditions That Affect Hand Function

The hands are vital parts of the human body and without them, very little essential and social activities can be performed such as feeding, being productive to be able to make a living and support dependents, and interactions with others. Losing the ability to use one’s hand can be a very emotional and debilitating problem that can lead to increased stress and anxiety that may result in the development of mental health issues such as depression. Therefore, the proper diagnosis and management of conditions affecting hands is extremely important.

The following are conditions that can result in the hands becoming unable to function properly and how they are managed.

Dupuytren’s contracture Hand SurgeryDupuytren’s contracture

  • Progressive thickening of the tissue in the palm of the hand results in shortening of this tissue and causes flexing contractures of the fingers (makes the fingers close).
  • The most commonly affected fingers are the fourth and fifth digits and this can be quite a disabling condition.
  • Management includes physical and occupational therapy and surgical intervention in severe cases.

Trigger finger

  • Referred to in medicine as stenosing tenosynovitis.
  • Trigger finger causes a similar issue to Dupuytren’s contracture. The difference though is that where the latter involves pathology of the tissue covering the palm of the hand, trigger finger is caused by thickening of the tissue that covers the tendons which allow the fingers to close.
  • The condition is characterized by the affected finger seeming like it is stuck in a trigger-pulling position. Since it is difficult for the finger to be straightened, when it becomes unlocked it resembles the pulling of a trigger.
  • Management includes trigger finger surgery and when the thumb is involved is referred to as trigger thumb surgery.
  • These surgeries may be performed through minimally invasive access or open procedures if the cases are severe.

Carpal tunnel syndrome

  • This condition is associated with compression of the median nerve through the carpal bones in the wrist.
  • Compression of the median nerve results in the decreased sensation of the thumb and first two fingers which can complicate and lead to decreased power in the hand with an inability to use the limb.
  • Management of this condition involves initial conservative therapy with pain relieving measure and the use of splints to help take pressure off the median nerve.
  • If these therapies are ineffective, or the case is severe, then carpal release surgery is performed.

Rheumatoid arthritis

  • An autoimmune condition where antibodies are produced by the immune system that attacks and damages the synovial tissue around joints, especially of the wrists and fingers.
  • This process results in damage to the joints leading to deformities of the fingers making them stiff and difficult to use.
  • Management of this condition includes using medications such as steroids and non-steroidal anti-inflammatories such as ibuprofen or naproxen. Early therapy may also include medications such as disease-modifying anti-rheumatic drugs (DMARDs) like azathioprine, sulfasalazine, and methotrexate to help reduce disease progression as well as induce more remissions.
  • Surgical interventions may be warranted in cases where the medications are not working and the patient’s use of their hands has becomes severely debilitating.

Carpal Tunnel Release Surgery with a Gilbert Hand Surgeon

Carpal tunnel release surgery is only considered for patients who do not get relief of symptoms from nonsurgical measures. This procedure is done on an outpatient basis for most patients.

Why is carpal tunnel release surgery done?

Carpal tunnel syndrome (CTS) occurs when the tissues (synovium) around the flexor tendons and median nerve swell and cause pressure. These synovial tissues lubricate the tendons so the fingers can move easily. Over time, this swelling narrows the small space of the carpal tunnel and crowds the nerve.carpal tunnel horizontal wrist photo

Who is a candidate for carpal tunnel release surgery?

Candidates for carpal tunnel release surgery include those who:

  • Do not respond to conservative treatment (physical therapy and medications).
  • Have constant numbness and wasting of the thumb muscles.

How do I prepare for the surgery?

Before you undergo carpal tunnel release surgery, notify the doctor of all medicines you are taking. Certain blood-thinning agents must be held for 7 days before the scheduled procedure. Arrange for someone to drive you from the hospital, and do not eat or drink for 8 hours before the surgery.

Will I be given anesthesia?

The outpatient procedure only takes around 60 minutes. Before the surgery, you are given general anesthesia (put to sleep), which prevents pain and movement during the surgery.

How is carpal tunnel release performed?

There are two ways to perform the procedure:

  • Open carpal tunnel release – The surgeon will use a needle to administer a local anesthetic. A small cut icarpal tunnel anatomy pictures made in your palm, and the surgeon divides the transverse carpal ligament (roof of the carpal tunnel). A ligament is also cut from inside the carpal tunnel to speed up recovery, and tissue around the nerve is removed.
  • Endoscopic carpal tunnel release – With this procedure, the surgeon makes a small cut in the palm region of the hand, and inserts a small endoscope into the wrist. This tube has an attached camera and light so the surgeon can view images on a monitor. Small tools are inserted so the surgeon can cut the carpal ligament.

What is involved in the recovery process?

Immediately after surgery, you must frequently elevate your hand on pillows to reduce swelling and prevent stiffness. Some pain, stiffness, and swelling can be expected after the procedure. You are required to wear a wrist brace for 2-3 weeks, and you can use your hand normally.

Expect some soreness of the palm for several weeks, as well as pinching and griping weakness (will last for around 6 months). In addition, light gripping and lifting, self-care activities, and driving are permitted soon after the procedure.

What are the long-term outcomes of the procedure?

The majority of people’s symptoms improve after carpal tunnel release surgery. However, recovery is gradual. On the average, pinch and grip strength returns by the second month following the procedure. For optional recovery, physical therapy is prescribed.

What are the home care instructions?

It will take around 4 weeks to fully recover. For a full recovery, the patient should:

  • Take medications as prescribed.
  • Apply ice packs to the wrist and hand every few hours.
  • Avoid lifting heavy objects.
  • Elevate the hand and wrist frequently.

What are the risks and complications of the carpal tunnel release procedure?

All surgeries carry some risks. With carpal tunnel release surgery, risks include infection, nerve damage, bleeding, and allergic reaction to solutions and medications. Be sure to notify the Gilbert orthopedic doctor if you experience intense pain, fever, chills, unusual redness or swelling, chest pain, and/or shortness of breath.

At OSPI, top hand surgeons offer carpal tunnel release procedures for the entire East Valley including Chandler, Gilbert, Mesa and surrounding areas. Most insurance is accepted, and appointments are readily available. Call today for the top hand surgeons Arizona trusts!

All about Hand Fractures – Info from a Gilbert AZ Hand Surgeon

Anatomy of the Hand


A number of bones join together to make up the human hand. These bones also form and act as the appendage’s supporting framework which attaches the muscles together at the wrists and shoulder and enables the fingers and arm to move.

A considerable amount of pressure directly to a bone is needed to break it, i.e. a hand fracture hand wrist carpal tunnel pain photooccurs due to direct force to the hand. What usually comes next, is pain, swelling, and a decrease in usage of the injured hand.

Kinds of Hand Fractures

While some fractures may be considered as simple, with bone pieces being perfectly aligned and stable, there are other kinds of fractures that are just the opposite, where bone fragments tend to shift or lose their place. There are also some fractures that happen in the main body of the bone, while there are others that only break the surface of the joint.

Comminuted Fractures: These are fractures where the bone is broken into many pieces and is often highly unstable.

Open Fracture: Also known as the compound fracture, it usually happens when a bone fragment tears through the skin. There is a level of risk associated with this type of fracture.

Signs and Symptoms of a Hand Fracture

If you have a hand fracture, you will experience;

  • Pain
  • Stiffness
  • Loss of movement

To help determine the exact plan of action to take in the case of a hand fracture, your orthopedic hand surgeon in Gilbert or Chandler will first undertake a medical evaluation and x-rays. A number of treatment options will be made available to you, depending on what type of fracture you are suffering from.

Treatment Options for Hand Fractures

In order to treat a fracture that isn’t displaced, a splint or cast is usually recommended. Your orthopedic hand specialist may also prescribe one to protect a fracture that has been set.

There are some fractures that need to be held in place with the help of wires or pins. This is known as a closed reduction and internal fixation, because no incision is made to carry out the procedure. On the other hand, some fractures require surgery known as open reduction.

Articular fractures or those that disrupt the joint surface require a precise setting of bone fragments to smoothly restore the joint.

In some cases, a bone graft might be necessary, especially when the bone is severely broken. In this procedure, your orthopedic surgeon will take bone fragments from another part of the body or from a cadaver and attach it to the area to be repaired, which provides stability to it. Depending on the case, substitutes for bone graft are also used at times, instead of taking it from the body part of the patient.

Once the fracture has been set and gains enough stability, your orthopedic surgeon will lead you through a range of motion exercises aimed at reducing stiffness and improving mobility with physical therapy.    

The top hand specialists in Gilbert, Chandler, Mesa and Queen Creek are at OSPI. All types of nonoperative and operative treatment are offered at Orthopedic and Sports Performance Institute for hand injuries. Most insurance is accepted. Call OSPI today at (480) 899-4333!