Hand surgery2020-08-11T17:18:30+02:00

Hand surgery

Diseases and different treatment methods.

Lock finger

Lock finger — is a disease connected with the disorder of the finger bending tendon. It has a hereditary character and appears because of the big difference between the bending and tendon and annular ligaments of fingers. During the physical loading or because of the degenerative changes the tendon gets thicker which may lead to difficulties while the finger is bent and be accompanied with pain and the ‘click’ sound.

Symptoms

The most obvious symptoms include difficult and limited finger extension and palpable thickening of the tendon. However, before that, there is undetectable pain and swelling in the area of the main joints of the fingers. Most often, this disease affects the thumb, but it is possible that several fingers are affected at the same time.

Diagnostics

As a specialist, I make a diagnosis. At the initial stage of the disease, this can be determined by palpation of the nodular thickening of the tendon and by the feeling of numbness or the short-term immobility of the finger. At a later stage of the disease progress, a typical ‘click’ is observed.  

Therapy

The conservative treatment may be applied up till the stage, when the bending and extension of the finger are not accompanied with a ‘click’. This means that the affected finger may be treated with ointments and injections. However, if this does not help or the ‘click’ sound already appears the surgery is required. Unlike breast augmentation, which is a part of the aesthetic medicine, this operation belongs to the field of reconstructive plastic surgery. The operation takes place under a local anesthesia. The annular ligament is cut through a small incision. Then the incision is sutured, and a compression bandage is applied.

Carpal tunnel syndrome

When the median nerve is squeezed in the wrist, it is referred to as carpal tunnel syndrome. It is the most common pinched nerve syndrome and is abbreviated as CTS. The consequences of the nerve compression are impaired sensation of the thumb, index and middle fingers, as well as the inner part of the ring finger. If the squeezing is not urgently removed, this can lead to irrecoverable consequences.

Symptoms

As mentioned above, the main symptom – response disorders which include numbness, tingling and ‘sleeping’. Besides there are present painful feelings at night, which disappear after hand shaking, as well as more and more clear adynamia in the area of the affected finger. If the treatment is not started in the nearest time, this may lead to the prolonged ‘sleep’ of the finger.

Diagnostics

In case there is a suspicion of a disease, the electrophysiological examination may be conducted. This usually takes place with the experts in the sphere of neurology or the physical medicine and includes control via measurement of the nerve signals conductivity speed. If the suspicions confirm the surgery may be conducted at my facility.

Therapy

This disease requires surgery. A small incision is made in the wall of the cavity through which the roof of the carpal tunnel is split lengthwise to relieve pressure on the underlying nerve. After the surgery, a thin protective bandage is applied to preserve the fingers’ mobility. The pain will go away immediately, but the numbness may continue for several weeks. 

Tendinitis

Unusual and extreme loading onto the hand may lead to narrowing of the optical pocket on the wrist or the thumb. The wrist is most affected. The tissue in the tendon part creates the thin liquid layer. Because of the extreme tension this coat cannot be produced, and the tendon may get to the tendon compartment. As a result the person gets tendinitis.

Symptoms

The symptoms mostly include the strong nagging pain in the wrist and forearm tendons, which appears while moving. Limited mobility is not rare. In case the inflammation is not treated, it becomes chronic, and in the area of tendons swellings and redness may appear.

Diagnostics

The doctor can make a diagnosis on the basis of the characteristic symptoms. However, in case there is some uncertainty ultrasound examination may be used in order to exclude other diseases.

Therapy

Acute tendinitis may be treated by immobilization and cooling of the wrist and the thumb during several weeks. Yet in case the of relapse or the chronic disease develops again and again, the surgery is recommended.

In such a surgical treatment, an incision is made under the skin under the tendon compartment using the local anesthesia, and then it is cut lengthwise to loosen the narrowed area and bring relief.

Ganglion

Benign tumors are known as ganglions or the nerve-knots. It usually takes place in a capsule or the wrist tendons. Yet it may appear anywhere, where there are articular capsule or tendons. It is a visible and noticeable swelling which is often filled with liquid. Very often women from 20 to 40 suffer from it, but men and children are not kept out. The reasons for this remain unknown, yet it is considered that there is a relation between the intensive usage and ganglions formation.

Symptoms

Pain which often increases with stress or because of the distortion of the neighboring nerves. As a result, limitations in movements may appear. As in most cases they are visible a lot of patients consider ganglions as an aesthetic problem. 

Diagnostics

Diagnosis can be usually made at a first glance due to the typical abnormalities. If ganglions remain open in the articular capsules or penetrate into bones they may be diagnosed with the help of X-ray.  

Therapy

Ganglions usually do not require surgical removal, as in most cases they are harmless. However, in case the constant strong pain is present the surgery is recommended during which the ganglion is removed via the cut and the relief is achieved. It is worth stating that very often the tumor relapses.

Nerve reconstruction

Whether for eating, drinking painting or playing music – due to the cooperation of nerves and muscles we can use our hands for many types of activities. Muscles and nerves may be damaged as a result of accidents, complications after surgeries or even because of tumors. Functional limitations such as sensitivity disorders, numbness or paralysis appear.

In case such a nerve damage is fresh the torn nerves may be sewn together as a part of a surgery. And if the surgery is successful the growth into the peripheral nerve system becomes renewed and the sensation recovers.

A clear diagnosis is essential to be able to carry out the correct treatment. It is usually made by a neurologist. The subsequent precise planning and execution of the surgery is also of paramount importance, which I, as a specialist in plastic, reconstructive and aesthetic surgery, am very good at. 

  • Local anesthesia (with sedation on request)
  • Duration of the procedure: 30-60 minutes
  • Day clinic
  • Pain: moderate

Dupuytren’s contracture

Dupuytren’s contracture — is a benign disease of the connective tissue which usually appears on the palm. Connective tissue changes, becomes thicker than filamentous form knots and gets shorter. With time it leads to fingers bending. This disease is slow in progress, which may be characterized both by the still phases and phases of accelerated development. Its reasons, however, are unknown, yet this disease may be inherited. Men are specifically vulnerable.  

Symptoms

Initially there are no clear symptoms pointing at the disease. Later the typical signs such as bent fingers appear. Pain is rare, and if it appears, this happens on the later phases because of the limited movements. Most often ring finger and small finger are affected. The thumb and index fingers – much less.

Diagnostics

Considering that there are no typical signs on the initial stages, other hand disease, such as carpal tunnel syndrome, may be diagnosed. However, in the later phases the diagnosis is pretty clear due to the distinct symptoms.

Therapy

The surgery is recommended only in the cases when the patient’s progress is quick and the hands movements are limited.  Unfortunately, this is cureless and, correspondingly, the frequency of relapses is very high. The surgical treatment foresees the small cut on the palm which allows access to the palm. Then the pathologically changed tissue there is removed. The particular attention is paid not to damage the neighboring nerves or the blood vessels.

  • Anesthesia
  • Treatment duration: depending on the stage
  • 1 night
  • Suture release: in 2 weeks
  • Pain: insignificant

Contact

Contact

You can reach us on the phone number +43 676 563 62 63 or via the following contact form.