PROCEDURES

 
HAND SURGERY

With 27 bones, three main nerves, 15 muscles, 18 tendons and 2 blood vessels in the hand, there are a variety of conditions that can affect the structures in the hand, leaving someone with severe pain and loss of function of one or both hands. In cases where these conditions are severe and non-surgical treatment has failed, Dr Nhlapo may suggest hand surgery to restore the essential function that the hand is responsible for.

What conditions may affect the hand?

The hand can be affected by trauma such as fractures, sprains and strains, nerve damage or ligament and tendon injuries, or by non-trauma conditions such as:

  • Carpal tunnel syndrome – is the numbness and tingling in the hand and forearm due to a pinched nerve in the hand.
  • Cubital tunnel syndrome – although this condition occurs in the elbow, it causes numbness or tingling in the ring and small fingers and a weakness of the hand's gripping ability.
  • Arthritis – causes the cartilage of a joint to wear, and in the hand, it causes severe pain and swelling.
  • Gout – this condition is caused by excess uric acid in the bloodstream, leading to swelling, redness and pain in the joints of the hand such as the knuckles.
 
  • De Quervain's Tenosynovitis – this condition involves inflammation of the synovium that surrounds the two tendons that run between the wrist and the thumb.
  • Cysts – these are non-cancerous fluid-filled lumps that often form on the tendons or joints of the hand.
  • Trigger finger – this usually affects the ring and middle finger, causing pain, stiffness, and a sensation of locking when the finger is bent or straightened.

These issues may cause pain, swelling, stiffness and loss of function of the hand's ability to grip and pinch which may just get worse over time.

What surgeries may be done on the hand?

Dr Nhlapo will be able to advise what treatment is best suited for your specific condition. In cases of traumatic injuries to the hand, surgery and bracing may be needed to ensure that the fractures heal properly and in the correct position. In these cases, your orthopaedic surgeon will prioritise nerve functioning to ensure that your hands can do as much of what they could before your injury. For non-trauma conditions of the hand as mentioned above, non-surgical treatments are explored first. For severe cases where these options fail, certain surgical options can be explored such as fusion, tendon repair and internal fixation.