The beauty of hand surgery is that it is a combination of bone work (like fractures of bones) and reconstruction of soft tissues (skin, tendons, nerve and muscle and blood vessels).
Any injury from the elbow to the hand. This includes the spectrum from open injuries like lacerations to fractures and dislocations. Repair of any fractures from the elbow to the hand. Management of complex fractures and fracture-dislocations of the wrist. Management of any fractures or dislocations of the hand and fingers.
Management of any lacerations of the hand from destructive grinder injuries to kitchen lacerations. Any soft tissue injuries that require soft tissue reconstruction (plastic reconstructive surgery) like skin grafts or local flaps. All tendon injuries.All acute hand infections like cellulitis, flexor sheath infections (tenosynovitis) or any hand abscesses. All sport injuries with advice and facilitation of rehabilitation.All work related injuries.
1. Trauma Hand Surgery
Trauma hand surgery usually refers to any acute injury that requires urgent treatment.
2. Planned Surgery
This group of procedures is usually scheduled and aims to address a certain problem. A good example for this would be to address carpal tunnel syndrome (when someone presents with numbness and pins and needles in the hand) by doing a carpal tunnel release. These procedures are always well thought through and performed when conservative or non-surgical treatment has failed to cure a problem.
3. Nerve Related Problems
- Carpal tunnel release for median nerve compression.
- Cubital or Guyon’s canal release for ulnar nerve compression.
- Radial tunnel decompression for posterior interosseous syndrome and radial tunnel syndrome.
- Brachial plexus reconstruction. Late exploration of nerve injuries with repair with nerve grafts if required.
- Tendon transfers for management of nerve injuries.
4. Osteoarthritis Related Problems
Thumb first CMC (carpo-metacarpal) arthritis is a very common disabling condition of the base of the thumb. The most common procedure for this condition is a trapeziectomy (excision of trapezium bone) with ligament reconstruction.
Multiple procedures are performed for wrist arthritis from excision of arthritic joints/bones to joint replacements.
Arthritis of the last joint of the finger is commonly associated with small cysts or bumps on the nail side of the finger.
5. Common Overuse Syndromes or Tendon Conditions
- Trigger finger
- Tennis elbow (lateral epicondylitis)
- Golfer’s elbow (medial epicondylitis)
- De Quervain’s tenosynovitis
6. Rheumatoid Arthritis, Gout and Other Inflammatory Arthropathies
These conditions are usually managed with the guidance of the rheumatologist and in selected cases require surgical management. All procedures of the upper limb are performed in this practice and are done with a multidisciplinary approach to ensure the best outcome for the patient.