Hand Surgery
The Specialist Plastic Surgeons supported by Adelaide Plastic Surgery, are pleased to offer our patients a comprehensive range of treatments for a variety of hand and wrist conditions. The Specialist Plastic Surgeons are skilled in treating degenerative hand conditions and birth defects that require elective hand surgery, including Carpal Tunnel Syndrome, Ganglion and Dupuytren’s contracture.
The Specialist Plastic Surgeons offer a 24/7 emergency referral service for injuries requiring the skills of a Specialist Plastic Surgeon. As a result, the hand surgery service also largely involves repairing hand trauma and injuries such as:
- Lacerations
- Nerve and tendon damage
- Fractures and crush injuries
- Amputations
- Minor burns
The Specialist Plastic Surgeons operating out of Adelaide Plastic Surgery work closely alongside our onsite occupational hand therapists, and often refer patients who require further rehabilitation therapy post operatively to help facilitate a holistic recovery.
Further Information
Ganglion Surgery
This is a common type of benign tumour, which occurs in the hand or wrist next to a joint or tendon. A ganglion forms as a result of lubrication fluid leaking from a joint capsule or tendon sheath, forming a bubble of jelly-like fluid. Eventually, ganglions interfere with your hand movement and may become painful with prolonged handwork.
Removal of a ganglion is done through
surgical excision. An excision is made to expose the ganglion, and it is
surgically removed along with a small amount of surrounding tissue to help
avoid reoccurrence.
A
dressing is applied and remains for seven to ten days, and sutures are removed
at your post-operative appointment with the surgeon at this time. Localised
swelling and bruising to the area is common, and can persist for up to two
weeks. You may be able to resume light duties after 10 days, but full recovery
may take several weeks. Recovery time is highly individual and your time frame
for recovery will vary depending on your individual surgery details, the
nature of your employment and your overall level of health. Your surgeon
will discuss this with you prior to surgery, and it is important to allow
yourself the recommended recovery time.
Carpal Tunnel Syndrome
Carpal Tunnel Syndrome occurs when the median nerve that passes through the carpal bones in your wrist becomes compressed by fluid retention or continual, repetitive movements.
The first signs of carpal tunnel syndrome are tingling and numbness in your thumb and fingers (usually excluding the little finger). Initially symptoms will be nocturnal but, over time, will gradually persist throughout the day and eventually become permanent. If left untreated it can result in ongoing numbness, discomfort and loss of dexterity.
Prior to surgery, we may arrange for you to visit a Neurologist for nerve conduction studies if you haven’t already done so. Carpal Tunnel Syndrome surgery is achieved by releasing the constrictive tunnel and relieving pressure on the median nerve. It can be performed as either an open or endoscopic carpal tunnel release, and your surgeon will discuss which option is best for you during your initial consultation.
After surgery, a firm dressing is applied to the entire hand and remains until your first post-operative appointment with the surgeon at around week two. Localised swelling and bruising to the area is common, and can persist for up to two weeks. You should be able to resume light use of your hand immediately after surgery, such as eating and dressing. Full recovery and heavy duties may be performed after approximately four to six weeks. Recovery time is highly individual and your time frame for recovery will vary depending on your individual surgery details, the nature of your employment and your overall level of health. Your surgeon will discuss this with you prior to surgery, and it is important to allow yourself the recommended recovery time.
Tenosynovitis/Trigger Finger Surgery
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 friction as the joints move. If the synovium becomes inflamed, the friction increases, which can eventually lead to nodules developing on the tendon or thickening of the tendon sheath.
As a result, when your tendons move these nodules and the thickened tissue can suddenly catch, and prevent your finger from moving smoothly. This is known as Tenosynovitis, or Trigger Finger.
Trigger finger requires surgical release, performed by a small incision in the palm of the hand to allow the tendon to move smoothly again. Tenosynovitis may also affect the wrist tendons, resulting in pain when you move your wrist. These conditions may respond to conservative management such as rest, splints, anti-inflammatory medication and injections of steroids. If this fails, then surgical release is indicated for this condition as well.
Post-surgery a dressing is applied and remains for seven to ten days. Sutures are removed at your post-operative appointment with the surgeon at this time. You should have full range of motion after surgery and be able to perform light duties within a few days. Strenuous activity should be avoided for the first two-three weeks. Your surgeon may refer you to a occupational hand therapists and be required to perform some specific at home exercises. Recovery time is highly individual and your time frame for recovery will vary depending on your individual surgery details, the nature of your employment and your overall level of health. Your surgeon will discuss this with you prior to surgery, and it is important to allow yourself the recommended recovery time.
Dupuytren’s Contracture
Dupuytren’s Contracture is a fibromatosis (a benign, thickened, scar-like growth) that affects your palms. This thickened tissue eventually tightens, pulling your fingers towards your palm and restricts normal extension. Currently there is no known cause for this condition, however it tends to run in families. During surgery, your surgeon will separate and remove the bands of fibrous tissue, releasing tendons and allowing for freer movement.
Post-surgery, a dressing is applied and remains until your two-week post-operative appointment with your surgeon, when your sutures will also be removed. You should be able to perform light duties within a few days. Strenuous activity should be avoided for the first two-three weeks. Your surgeon may refer you to one of our occupational hand therapists, and you may be required to perform some specific at home exercises. Recovery time is highly individual and your time frame for recovery will vary depending on your individual surgery details, the nature of your employment and your overall level of health. Your surgeon will discuss this with you prior to surgery, and it is important to allow yourself the recommended recovery time.
Hospital Stay + Anaesthesia
Depending on individual circumstances, your hand surgery can be safely performed either under a general anaesthetic with an anaesthetist present, or, in our rooms in our accredited theatre with local anaesthetic. Your plastic surgeon will discuss your choices in your initial consultation and determine which option is best for you.
Your Consultation
In order to keep your consultation as smooth and efficient as possible, we ask that you please bring all relevant documentation with you on the day. This includes your referral letter, Medicare card, private health insurance details, any third party or return to work insurance information, and any relevant scans or i.e. x-ray or ultrasounds.
During your initial consultation with your Specialist Plastic Surgeon, you will have an extended opportunity to discuss expectations and desired outcomes, along with any questions you may have about the procedure. We highly recommend preparing a list of questions for your surgeon prior to your appointment, and remember, there’s no such thing as a silly question!
You will then meet with your surgeon’s personal assistant. You will be given an in-depth quote, outlining the surgeon, hospital and anaesthetist fees, along with some take home information about your procedure.
We recommend that you allow around half an hour for this consultation. Please keep this in mind when organising parking so that you don’t feel the need to rush.
Ready to book an initial consultation?
If you are ready to book your initial consultation, please book online or call us to book with one of our helpful team members. We’ll be pleased to help you start your journey.
Not quite ready or have a question to ask?
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