Hand Surgery

Dramatic advances have been made in recent years in hand surgery to correct imperfections caused by injury or birth defects. At the forefront of these advances have been plastic surgeon-specialists improving both function and appearance. Hand surgery is often covered by insurance.

Hand surgery techniques vary, depending upon the reason for the procedure. The most common reasons are:

Carpal tunnel syndrome, in which pressure builds up in the passageway through the wrist carrying tendons and one of the hand's major nerves. This can happen as a result of arthritis, injury, fluid retention during pregnancy, overuse, or repetitive motions. Surgery involves cutting the tissue that presses on the nerve to release the pressure.

Endoscopic Surgery is done by Dr. Edstrom for carpal tunnel syndrome when quick return to work and activities is desired. The ligament is released by introducing a scope through tiny incisions in the wrist and hand. Recovery is quick – usually back to full activities in 10 days to 2 weeks.

Congenital Defects that interfere with proper hand growth in children, such as the fusing together of two fingers (known as syndactyly). Surgery involves cutting the tissue that connects the fingers, then grafting skin from another part of the body. Other common defects include short, missing or deformed fingers, immobile tendons and abnormal nerves or blood vessels.

Dupuytren's Contracture, a disorder of the tissue just under the skin in which thick, scar-like bands form under the skin of the palm and fingers, restricting motion. Surgery is a precise procedure that involves carefully removing the bands of thickened tissue, freeing the joints and allowing the fingers to move more normally. Recovery can take several weeks, and often requires some time in hand therapy.

Injury to the tendons, nerves, blood vessels, and joints; fractured bones; and burns, cuts and other injuries to the skin. In cases of injury, a variety of innovative techniques can be used, including grafting, flap surgery, and replantation. Rhode Island Hospital is a major trauma center, and a large amount of trauma is treated each year.

Rheumatoid Arthritis, an inflammation of the joints that can deform finger joints and force them into a bent position that impedes movement. Surgeons can repair or reconstruct almost any area of the hand or wrist by removing tissue from inflamed joints, repositioning tendons, or implanting artificial joints.

Hand surgery is usually performed in our Dudley Street Operatory, using local anesthesia with sedation. Patients return home with dressings that must be kept elevated above the heart, and often have to spend some time working with our hand therapist.