Carpal Tunnel Syndrome
Carpal tunnel syndrome occurs when a pinched nerve in the wrist causes pain, tingling, numbness and a weak grip throughout the hand. The carpal tunnel is an area of the wrist where nine tendons travel from the forearm into the hand along with the median nerve. Swelling in this tunnel, due to arthritis, fractures, tendon injuries or other factors, causes carpal tunnel syndrome. Over time, this condition may become progressively more painful and may limit the use of the hand.
However, treatment is possible that can help to improve carpal tunnel syndrome and relieve the pressure on your nerve. Carpal tunnel surgery works by dividing the ligament that compresses the nerve.
The experienced hand surgeons at Cold Spring Plastic Surgery can perform a carpal tunnel release. This procedure involves making an incision in the palm of the hand in the area of the carpal tunnel before opening the ligament.
Fractures can occur in the bones of the wrist, hand and fingers for any number of reasons, including crush injuries, auto accidents, sports injuries, falls or other circumstances. When you experience pain, tenderness, an inability to move a part of the hand, a depressed knuckle, swelling or a deformity in the hand after an injury, this can indicate the aftermath of a broken bone in the hand.
At Cold Spring Plastic Surgery, your surgeon will examine your hand to determine the extent and age of the fracture as well as its effects on the feeling in your fingers and your range of motion.
Some hand and wrist fractures, including those that break through the skin or cannot be held in place, require surgery in order to fully heal. Hand surgery for fractures can help the bones of your hand heal and return to function.
Your surgeon will help to move the bone and soft tissue back into place; in some cases, implants may be used in order to ensure that the bone holds its shape throughout the healing process. Pins, plates or screws can help to set the small bone fragments, or a bone graft could be used in the case of severely damaged bones. Following your surgery, hand therapy may be used to help exercise the injured area and increase your strength and range of motion.
Many kinds of complex and detailed work are carried out with the hands. This means that the hands can be at risk for serious injuries and lacerations from the use of tools like saws, drills and knives as well as sports injuries, dog bites, kitchen injuries and other sources of hand trauma. Lacerations to the hand can be extremely painful and may affect your ability to use your hands and fingers normally. They can lead to tendon, ligament, joint, and nerve injuries, or skin and blood vessel damage or loss.
Sharp objects like glass fragments can injure tissues throughout the hand in the case of a penetrating laceration, and injuries caused by bites or other non-sterile objects may cause infection. In the case of a serious hand laceration, our hand surgeons at Cold Spring Plastic Surgery can provide critically important care to minimize the loss of tissue, protect hand function and restore the structures of the hand.
Your surgeon may use an operative microscope to repair nerves and blood vessels in the hand and fingers and will also re-connect any injured tissues. Your surgeon can also advise you about protecting your hand during the healing process and will guide you regarding rehabilitative techniques and exercises that can help you restore the function of your injured hand.
The tendons of the hand are cords of tissue that connect muscles and bones, making it possible to extend and flex the joints. Your hands have both flexor and extensor tendons that allow you to point your fingers, grip objects or form a fist. Because the hands are delicate and flexible, the tendons in each finger can be at risk for injury during sports, work or other physical activities.
Tendon injuries in the hand can become apparent when you lose the ability to move some parts of the hand or find that movement is difficult or causes pain and swelling.
There are several forms of injuries that are frequently suffered in the tendons of the hand, including:
- Mallet finger
- Trigger finger
- Jersey finger
- Boutonniere finger deformity
The hand experts at Cold Spring Plastic Surgery can advise you of the best steps to take to recover from a tendon injury in your hand. Hand surgery can be an important part of tendon repair; when a tendon has been cut or severed, surgery is often necessary to restore its normal anatomy and its function.
Neuropathies & nerve injuries
Neuropathy, or damage or disease of the nerves, can result in tingling, numbness or weakness in the hands. The hands are one of the most common places in the body for people to experience peripheral neuropathy. Neuropathies can develop for a number of reasons, including physical injuries to the hands, repetitive stress injuries, cancer treatment and chemotherapy, autoimmune diseases, infections, diabetes and other illnesses.
Physical injuries like auto accidents, sports injuries and crush injuries can lead to long-lasting pain, numbness, insensitivity to temperature or excessive sensitivity. When a nerve is severed, it can result in a complete loss of sensation, while a crushed nerve may cause pain. Nerve damage can also cause the development of neuromas, or scar tissue on the nerve.
Some types of neuropathies can be treated through hand surgery, especially injuries to a nerve caused by compression or entrapment. Surgery can help to release the nerve.
When a nerve is damaged due to a physical injury, hand surgery can at times be used to repair the severed protective sheath around the nerve, leading the nerve to heal itself and grow back together. A nerve graft can also be used in order to facilitate the healing of an essential, damaged nerve.
Soft tissue masses
Benign soft tissue masses or tumors in the hand can arise from any of the soft tissues in the hand. The most common include:
- Lipomas, or masses composed of fat
- Synovial tumors/ganglion cysts
- Nerve masses
- Blood vessel tumors
All of these are generally benign tumors. The hand is one of the most common places to develop soft tissue masses that are not malignant but can interfere with the function and comfortable use of your hand.
If you have a soft tissue mass on your hand, your hand surgeons at Cold Spring Plastic Surgery will examine the mass and perform tests in order to determine the type of tumor that you have and to verify that it is benign.
Many of these masses can be simply removed with an excisional biopsy performed by your hand surgeon. In the case of tumors that develop on the sheaths of the nerves of the hand, your surgeon can use microscopic surgery to delicately remove the tumor from the surrounding nerves.