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Hand

Carpal Tunnel Surgery

Carpal Tunnel Syndrome is very common in the community and symptoms are usually confined to a feeling of intermittent tingling in the palm at the thumb, index to ring finger. Shaking the hand usually heralds relief, though with increasing severity the tingling persists and progresses to numbness. Weakness can also intervene particularly in activities involving the thumb and often patients say that the hand feels clumsy. The condition can be treated with splints, although these are usually unsuccessful.

The surgery is simple and usually takes about 10 minutes. A 3cm incision is made in the heel of the palm and the ligament compressing the nerve (which is the cause of the symptoms) is released.

The hand can be used immediately afterward and bandages removed next day. The sutures should be kept clean and when washed, dried carefully.

Generally the tingling resolves immediately. Numbness can take much longer as it signifies a more severe injury to the nerve. Strength can improve with exercise.


Trigger Finger Release

When a finger 'triggers' it gets stuck, usually in a bent position. It usually hurts, with tenderness felt in the palm. Often a period where it just catches precedes the actual trigger.

The problem is one of swelling of the tendons which bend the finger and inelasticity of the tunnels that the tendons run through, in the palm. The tendons most often swell due to degeneration (sorry folks - age).

The solution is easy and results excellent. The tunnel that the tendons run through in the palm is released, enabling the tendons to run without impediment. The surgery is day surgery and the incision in the palm often less than 15 mm long.

It is rare for the condition to recur in any one finger.


Osteoarthritis At The Base Of The Thumb

Arthritis at the base of the thumb is common and is felt most often when grasping items as one would a key. Lifting oven trays, knitting,tasks of fine digit manipulation can all become quite difficult due to the pain.

Our bodies are remarkable structures and if the stiffness from the arthritis at the base of the thumb is left for long enough, the other thumb joints begin to deform so that the hand can still function to some extent. To avoid the pain, and the compensatory deformities, the problem can be treated fairly simply. Anti-inflammatory tablets, and injections can help. Eventually nothing helps and patients are tired of their symptoms.

The surgery involves excision of a small bone within the wrist (the trapezium) at the base of the thumb and stabilisation of the thumb using a tendon sling.

A splint is worn post operatively for 6 weeks and then exercises commenced to improve the strength and movement of the thumb. Treatment is finished when the thumb can touch the tip of the little finger. Pain relief is the rule and patients may return to the activities they wish.