Hand & Wrist Surgery

Common sites for hand arthritis include the base of your thumb, your knuckles, and the top and second joint of your fingers. From osteoarthritis to psoriatic arthritis and rheumatoid arthritis, the expert plastic surgeons at Rochester Regional Health are here to help.

Arthritis is a disease that attacks the tissues of your joints, which is where two bones meet. Common symptoms in your hands and wrists include:

• Morning pain and stiffness in your joints
• Swollen joints
• Burning or dull joint pain

Arthritis in the hands and wrists is diagnosed by examining your hands and with X-rays. The X-ray will show any loss of bone cartilage and if any bone spurs have formed. Your physician may also recommend a blood test to help determine if rheumatoid arthritis is the cause.

Our plastic and reconstructive surgeons treat arthritis non-invasively when possible, using splints and joint injections to help ease your symptoms. We often also remove the tissue from your inflamed joints, rebalance damaged joints, or implant artificial joints. When necessary, we also use joint fusion to relieve pain and stabilize your joints from degenerative changes.

Carpal tunnel syndrome is a condition in which your median nerve is compressed as it passes through the carpal tunnel, a narrow, confined space in your wrist. The median nerve provides sensory and motor functions to your thumb and three middle fingers, and pressure can cause symptoms including pain, tingling, and other hand issues.

Carpal tunnel syndrome symptoms tend to be different for everyone, but the most common symptoms include:

• Burning or tingling in the fingers
• Difficulty gripping objects
• Difficulty making a fist
• Fingers that feel swollen
• Pain and/or numbness in the hands
• Pins and needles in your fingers

Your carpal tunnel treatment may include:

• Splinting of the hand to prevent wrist movement and decompress the nerves inside your tunnel
• Anti-inflammatory medications are taken orally or injected into the carpal tunnel space to reduce swelling
• Changing the position of your keyboard or mouse
• Surgery to relieve compression in the nerves of your carpal tunnel

Surgery for carpal tunnel is typically performed as an outpatient procedure under local anesthesia and/or sedation. An incision will be made in your hand or wrist area, and the tissue that is pressing on your nerves will be cut out to decrease the pressure. This can be done using an endoscope or via an open technique.

Present at birth, congenital hand deformities may become a challenge for children as they continue to grow, learn, and interact with their environment through the use of their hands. The degree of deformity can vary from something minor to a more severe deformity, and seeking a consultation with a hand surgeon as early as possible is an important part of the treatment process.

Common deformities we treat include:

• Failure of the parts of the hand to separate
• Contractures of the hand
• Duplications of digits
• Congenital constriction band syndrome

The expert Plastic & Reconstructive Surgery providers will choose the right treatment for your child based on several criteria, including your child’s age, health, and medical history, the extent of their condition, the cause of their condition, their tolerance for medications, procedures, or therapies, and your preferences, opinions, and goals.

Any number of treatments may work for your child, from limb manipulation to prosthetics. After a full physical exam and talking through expectations with the family, treatments may include:

• Correction of contractures
• Physical therapy
• Skin grafts
• Splinting

Also called Dupuytren’s contracture, this disease is characterized by a gradual thickening and tightening of the skin in your hand. As the disease progresses, you may develop a hard lump or a thick band which may cause your finger to curl or pull in or sideways toward your palm.

We treat Dupuytren’s contracture by surgically removing the abnormal tissues and soft-tissue reconstructions with grafts and tissue transfers.

Our hands and wrists are made up of 27 different bones, as well as many ligaments, muscles, tendons, and tissues that provide us with the ability to make a variety of movements and actions. These activities require hand coordination and specific movements within our hands and wrists–a constant interaction between everything beneath your skin. Because of the important role our hands play, it’s imperative you seek treatment from hand and wrist experts when pain and injuries slow you down.

Our plastic surgeons are specially trained to treat soft tissue injuries to your upper extremities.

Hand and wrist fractures (or breaks) can prevent us from using our hands, wrists, and fingers. Symptoms of a fracture include:

• Deformities, like a crooked finger
• Difficulty moving your hand, fingers, or wrist
• Pain and stiffness

Both a medical evaluation and an X-ray are needed for your doctor to diagnose your fracture and determine the best treatment for your break.

Trigger finger is a condition caused when the tendon in the affected finger becomes inflamed and is characterized by one of your fingers getting stuck in a bent position. It is most commonly found in women, those with arthritis or diabetes, and people who regularly strain their hands during activities.

Symptoms of trigger finger include:

• Stiffness
• Clicking or popping sensation
• Tenderness in the affected finger 

For many, their trigger finger symptoms are worse in the morning. Treatment options include splinting, medications, and trigger finger surgery.

Treatments for arthritis typically vary based on the severity of your symptoms. If you have lost the ability to grip, grasp, and pinch, your provider may recommend surgery to help you perform activities of daily living.

There are a wide variety of problems that can be treated via hand and wrist surgery. Endoscopic surgery is minimally invasive and is performed through a small incision in your hand or wrist. Your plastic surgeon will look inside your body using a camera inserted through a tube (called an endoscope).

Endoscopic surgery has many benefits, including:

• Faster recovery time
• Fewer complications
• Less blood loss
• Minimal scarring
• Shorter and/or no hospital stay
• Smaller incisions

Our plastic surgeons regularly use endoscopic surgery to treat carpal tunnel syndrome, ligament tears, and tendon injuries.

Our peripheral nerves originate and branch out from our spinal cord, reaching to our arms, fingers, legs, and extremities. There are hundreds of conditions that are labeled as peripheral neuropathy, meaning you’re experiencing problems with your peripheral nerves.

Symptoms of peripheral neuropathy include:

• Changes in temperature sensation
• Excessive sweating
• Muscle atrophy
• Muscle weakness
• Numbness or loss of sensation
• Pain
• Tingling sensation

Our plastic surgeons have special training in performing peripheral nerve surgeries, from decompression surgeries to surgically removing damaged tissue or performing nerve transfers. They will assess your peripheral neuropathy and craft a treatment plan individualized to your needs.