Adelaide Plastic Surgery

Elective Hand Surgery

Elective Hand Surgery

Put your hands in the skilled hands of our plastic surgeons, who offer real hope for people who may be suffering any one of a wide range of problems such as: ganglions, carpal tunnel syndrome, tenosynovitis/trigger finger, Dupuytren’s disease and arthritis.

Elective Hand Surgery

Ganglion

This is the most common type of a benign tumour that can affect how your hands function. What’s happening is a gel-like (myxomatous) degeneration of the joints (ligamentous capsule) and the tendon sheath.

What will I experience?

Initially, you’ll discover painless lumps, often on the back of the wrist and finger joints, but also occasionally on the front. Eventually, ganglions interfere with your hand movement and become painful with prolonged handwork.

What is the treatment?

Surgical excision (removal).

Do ganglions recur?

Unfortunately, there is a significant recurrence of ganglions after treatment. You can minimise this, however, if you are careful to rest your hand post-operatively and only start back into normal use gradually.

Tenosynovitis/Trigger Finger

Your tendons and joints are surrounded by tissue called the synovium. Its job is to produce and distribute a lubricant called synovial fluid that minimises the friction as the joints move. If the synovium becomes inflamed, the friction increases. Eventually, that can lead to nodules developing on the tendon and/or thickening of the tendon sheath.

What will I experience?

When your tendons move, these nodules and the thickened tissue can suddenly catch and may only release when you manipulate the digit. This then results in a sudden release or triggering effect of the finger, which we call tenosynovitis.

What causes the inflammation?

There are many possible causes of this type of tenosynovitis. The most common are inflammatory conditions such as rheumatoid arthritis or prolonged repetitive movements as occur in some occupations.

What is the treatment?

The underlying causes of tenosynovitis need to be addressed, where possible, but once established, trigger finger needs surgical release. This is performed by a small incision in the palm of the hand.

What about tenosynovitis of the wrist?

Tenosynovitis may also affect the wrist tendons (e.g., DeQuervain’s syndrome), resulting in pain when you move your wrist. These conditions may respond to conservative management, for example: rest, splints, anti-inflammatory medication and injections of steroids. If this fails, then surgical release is indicated for this condition, as well.

Osteo-arthritis

This is the most common type of arthritis of the hand, developing with age-related wear and tear of the joint. Treatment is usually conservative. Occasionally, surgery may be performed, especially if advanced destruction of joints causes ongoing pain and significant loss of function. In such cases, the joint may be replaced or fused. But, again, we can help you choose the operation that will suit your exact needs.

Carpal Tunnel Syndrome

This occurs when the median nerve that passes through the carpal bones in your wrist becomes compressed by fluid retention or continual, repetitive movements.

What will I experience?

The first signs of carpal tunnel syndrome are when you suffer nocturnal tingling and numbness in your thumb and fingers (usually excluding the little finger). Gradually, this becomes more common, occurring at any time of the day, and eventually becoming permanent. The result is ongoing numbness, discomfort and loss of dexterity.

How do we confirm our diagnosis?

We’ll arrange for you to visit an expert Neurologist for confirmation of our suspicions through nerve conduction studies.

What is the treatment?

By creating a small incision at the base of the palm, we can release the constrictive tunnel. Generally, this treatment produces very successful outcomes. However, if the condition is neglected, you may experience a permanent loss of feeling. So: do get it checked if you suspect you have carpal tunnel syndrome.

Dupuytren’s Disease

This is a fibromatosis (a benign, scar-like growth) affecting the fascia of your palms. It may also be found on the soles of your feet, and – rarely – the penis.

What will I experience?

You’ll feel thickened cords under the skin of your palms, which may be tender. Eventually, these cords tighten, pulling the fingers towards the palm and restricting normal extension.

Who does it affect?

Dupuytren’s disease usually affects males over 30. That said, women can contract it and it can appear at an earlier age for both genders. You stand a much higher risk if you:

  • are of northern European or Celtic extraction;
  • have diabetes or certain types of liver diseases;
  • take certain long-term medications; or
  • have an occupation which entails repeated percussion to the hands (such as the use of a pneumatic impact-drill).
What is the treatment?

Our treatment involves surgical resection of the cords and it needs to occur as soon as the restricted finger extension sets in. Excessive delay may result in your fingers being permanently bent. Delay also makes the operation technically more difficult and increases the risk of injury to local nerves and vessels, which may become encased in the infiltrative fibrous tissues.

Rheumatoid arthritis

Rheumatoid arthritis is one of the most destructive of joint pathologies for hands. It may also involve your tendons. This complex condition often needs long-term management from a rheumatologist. In the early stages, treatment is medical. When the condition becomes severe and advanced, however, surgical correction may be recommended. There’s a host of possible operations we can offer and your hand surgeon will guide you through it.

Our Surgeons for Elective Hand Surgery