Hand Surgeon Perth
Common hand and finger conditions:
All your questions answered about hand surgery
Hand Surgeon Perth
When to see a hand surgeon?
Hands are intricate structures made up of various tissues, including bones, muscles, nerves, blood vessels, and specialised skin. Plastic surgeons are highly skilled in managing the complexities of hand trauma, degenerative conditions, and tumours affecting the hand. While conditions such as pain in the hand or wrist may be managed with rest, ice, and pain medication, there are times when surgical intervention may be required.
Hand surgery is a vital component of plastic and reconstructive surgery, addressing issues related to the nerves, tendons, bones, and blood vessels of the hand. Whether caused by injury or inflammation, at Forme Specialist Plastic Surgery, we manage all aspects of hand surgery with a comprehensive, patient-centred approach.
Dr Jeremy Rawlins, Hand Surgeon Perth
Below, we’ll explain some common conditions that can affect your hands or fingers and their different treatment plans.
Carpal Tunnel Syndrome
Carpal tunnel syndrome occurs when the median nerve within the carpal tunnel is compressed, affecting hand function.
What are the symptoms of carpal tunnel syndrome?
Symptoms include tingling, numbness (especially in the thumb, index, middle, and ring fingers), and weakness when gripping objects.
What causes carpal tunnel?
Various factors contribute to carpal tunnel syndrome, including trauma, degenerative diseases like arthritis, and inflammatory conditions such as tenosynovitis.
Who is at risk for carpal tunnel syndrome?
Manual workers, pregnant females, and older individuals are at higher risk of developing carpal tunnel syndrome.
What is the treatment for carpal tunnel syndrome?
Hand therapy exercises are often recommended to reduce swelling and improve hand movement and strength.
When is carpal tunnel bad enough for surgery?
For cases where conservative treatment is ineffective, carpal tunnel decompression surgery provides effective relief by reducing pressure on the median nerve. This procedure is generally performed as a day surgery.
Dupuytren’s disease
Dupuytren’s disease causes abnormal contraction of the tissue in the palm, commonly affecting individuals of Anglo-Saxon descent, particularly those with British or Nordic heritage. If left untreated, the condition may cause the fingers to become permanently bent inward, making it difficult to straighten them.
What are the symptoms of Dupuytren’s disease?
Symptoms typically begin with small, tender lumps on the palm, which can progress to the fingers being pulled inward. A common test for the condition involves the inability to place the hand flat on a table with the palm facing down.
What causes Dupuytren’s disease?
The exact cause of Dupuytren’s disease is not fully understood, but a genetic component is clearly involved. Additionally, the condition may have an inflammatory and autoimmune component, with roots in ancestral heritage.
Who is at risk for Dupuytren’s disease?
Both men and women can be affected by Dupuytren’s disease. Risk factors include alcohol consumption, anti-seizure medications, and trauma. However, trauma is believed to trigger an inflammatory response rather than directly causing the condition.
What is the first-line treatment for Dupuytren’s disease?
For small contractures, observation may be sufficient. However, if the palmar contracture is extensive, preventing the patient from placing their palm flat on a table or affecting any digit, surgical intervention may be required.
What does surgery for Dupuytren’s disease involve?
Surgery for Dupuytren’s disease is typically performed as a day-surgery procedure to excise the affected tissue and release the contracture. After surgery, patients may need to wear a night splint for 6-8 weeks to maintain the proper hand position and will
De Quervain’s tenosynovitis
De Quervain’s tenosynovitis affects the base of the thumb, causing pain, especially when turning the wrist.
What are the symptoms of De Quervain’s tenosynovitis?
What causes De Quervain’s tenosynovitis?
It happens when the tendons under the first dorsal compartment of the wrist become inflamed, affecting the ones controlling thumb movement.
Who is at risk for De Quervain’s tenosynovitis?
Anyone, regardless of age or background, can develop this condition.
What is the first-line treatment for De Quervain’s tenosynovitis?
Splinting and occasionally steroid injections are the initial treatment options.
What surgical procedure is performed if first-line treatment fails?
Surgical treatment involves making an incision over the outer aspect of the base of the thumb to release the compartment, allowing the tendons to move freely. Small compartments within the tendons may also need release for optimal results.
Ganglion cysts
Ganglion cysts are benign lumps that develop near the tendons or joints of the hand or wrist. These cysts are typically round and filled with fluid. If the fluid escapes, it may become trapped under the skin, causing discomfort. While ganglion cysts are most commonly found around the wrist, they can also develop in other areas of the hand, including the palm, fingers, and fingertips.
What are the symptoms of ganglion cysts?
- Swelling
- Pain and limited movement
What are the causes of ganglion cysts?
While the exact cause is unknown, ganglion cysts often develop after some form of trauma.
Who is at risk for ganglion cysts?
Ganglion cysts can affect anyone. However, individuals who have experienced injuries, such as torn ligaments or fractures, may be at an increased risk of developing them.
What is the first-line treatment for ganglion cysts?
The initial treatment options for ganglion cysts depend on factors such as the location, size, and the level of discomfort caused by the cyst. Not all ganglion cysts require treatment, as they are common and often asymptomatic. However, larger cysts in areas such as the wrist or fingers may require surgical intervention. An ultrasound can help confirm the diagnosis and determine the origin of the cyst.
How is ganglion cyst surgery performed?
Surgery for ganglion cysts is typically performed as a day procedure and can be done under either local or general anaesthesia. During the procedure, a small incision is made over the cyst. The surrounding structures are carefully protected, and the cyst, along with its capsule, is removed. This approach helps minimise the risk of recurrence. With the use of advanced removal techniques, the recurrence rate for ganglion cysts has significantly decreased, now standing at less than 1%.
Trigger finger
Trigger finger is an inflammatory condition that affects the flexor tendons of the finger, causing them to become locked in a bent position.
What are the symptoms of trigger finger?
Symptoms of trigger finger include stiffness, particularly in the morning, a clicking or popping sensation when moving the affected finger, a nodule at the base of the affected finger in the palm, and the finger becoming locked in a bent position.
What causes trigger finger?
Inflammatory tenosynovitis results in the formation of a small nodule on the tendon, which becomes trapped beneath a pulley in the palm, causing the tendon to become locked in place.
Who is at risk for trigger finger?
What is the first-line treatment for trigger finger?
Hand therapy, splinting, and steroid treatment can help alleviate symptoms for 3-6 months. However, if these conservative treatments are not effective, surgery may be necessary.
What is the surgical procedure for trigger finger if first-line treatment fails?
Basal joint arthritis
Basal joint arthritis, a form of hand osteoarthritis, is a degenerative joint disease that affects the joint where the thumb meets the wrist. This joint is known as the carpometacarpal (CMC) joint. In basal joint arthritis, the cartilage in the CMC joint begins to break down and wear away.
What are the symptoms of basal joint arthritis?
Symptoms of basal joint arthritis include swelling, pain, and loss of function in the affected joints, most commonly in the thumb base (CMC joint), as well as in the finger joints (PIP joint or DIP joint).
What causes basal joint arthritis?
Over time, the wear of cartilage leads to structural changes and reduced joint mobility. As cartilage loss progresses, it can result in osteoarthritis.
Who is at risk for basal joint arthritis?
What is the first-line treatment for basal joint arthritis?
Hand therapy, steroid injections, and splinting are commonly used to manage symptoms.
What is the surgical treatment for basal joint arthritis?
Surgery is considered when pain and deformity significantly impair daily function. This day surgery involves the removal of the affected joint and may include soft tissue reconstruction (thumb base) or joint replacement surgery (thumb, digits).
Finger dislocations and fractures
Finger dislocations and fractures are common injuries that often occur during work, sports, or accidents at home.
What is the treatment for finger dislocations and fractures?
After assessing the injury with an x-ray, the initial steps include pain management and stabilising the hand with splints or casts. Treatment options vary depending on the severity and location of the fracture.
Less severe fractures that have not shifted significantly can usually heal on their own with conservative methods. However, if the fracture is more severe or affects the joint, surgery may be necessary. This could involve the use of pins or plates to hold the bones in place. The best treatment plan will be discussed with you during your consultation.
How long does recovery take for fractions and finger dislocations?
Recovery typically involves 6-12 weeks of hand therapy to achieve an optimal outcome.
Fingertip injuries and amputations
Fingertip injuries are common injuries caused by crushing, cutting, or blunt trauma to the fingers.
How can early treatment help?
Early surgical intervention can minimise scarring, maintain finger length, and reduce sensitivity associated with fingertip injuries.
What is the treatment for fingertip injuries?
Simple fingertip injuries can typically be addressed with surgery on the same day, performed as a day procedure. After surgery, a basic cap splint is worn for three weeks to support recovery. Your hand therapist will then guide you through the next steps to aid healing and reduce sensitivity.
When is urgent surgery necessary?
In severe fingertip injuries, urgent surgery may be required to restore blood flow. This procedure, which may last 2-3 hours, could necessitate hospitalisation for 5-7 days.
If the damage is extensive and cannot be repaired surgically, or if attempts to restore blood flow are unsuccessful, fingertip amputation may be necessary.
Forme Specialist Plastic Surgery, Hand Surgeons Perth
Why Forme Specialist Plastic Surgery in Perth?
From your initial contact with us, through to your consultation, surgery, and aftercare, we are dedicated to providing exceptional clinical care and support at every step of the process.
We understand that consulting a specialist can be a significant decision. Our approach is focused on providing clear, supportive, and professional guidance to help you feel confident and well-informed throughout the process.
Dr Jeremy Rawlins, Hand Surgeon Perth
Risks & Complications
All surgical procedures involve potential risks. Learn more about the considerations involved by visiting our Risks & Complications page.
Considering starting this journey with us? Request an appointment to discuss your options and explore the best treatment plan for your needs.
