Hand Surgery

pain-management-surgery-la-peerThe hand is one of the most delicate parts of the human body and, as such, is highly sensitive to injury. The human hand is composed of 27 bones, 27 joints, 34 muscles, and over 100 ligaments and tendons. In order to preserve the long-term function of the hand in the event of an injury, it is important to consult an experienced hand surgeon or orthopedic surgeon.

The hand surgeons at La Peer Health Systems are renowned orthopedic experts that routinely perform advanced surgical procedures at our state-of-the-art outpatient center in Beverly Hills. To schedule a consultation with one of our hand specialists, contact us at (855) 360-9119.

Carpal Tunnel

The carpal tunnel is an arrangement of bones and ligaments surrounding the median nerve at the base of the hand. The median nerve runs through the carpal tunnel and gives sensation to the thumb, index, middle, and ring fingers. Carpal tunnel syndrome occurs when the median nerve is compressed or irritated. This often causes pain, numbness, or tingling in the hand and fingers.

Any structural defect in the hand or inflammatory condition that puts pressure on the median nerve may cause carpal tunnel syndrome. The most common causes of carpal tunnel include:

  • Repetitive motions of the fingers or wrist
  • Cyst or tumor in the hand
  • Hand Fracture

Many cases of carpal tunnel syndrome can be treated conservatively (non-surgically) to relieve painful symptoms. Non-surgical treatment may include activity modification, temporary splinting to immobilize the hand and wrist, or steroidal injections designed to reduce inflammation.

For more severe cases, surgery may be necessary to preserve long-term strength and function in the hand. Our Los Angeles hand surgeons are expertly trained in minimal incision carpal tunnel release surgery. This outpatient procedure involves cutting a ligament in the carpal tunnel to relieve pressure on the median nerve. Most patients experience immediate relief of carpal tunnel symptoms and recover full hand strength within months.

Trigger Finger

Trigger finger is a condition in which it becomes difficult or painful to extend the finger or thumb from a bent position. Trigger finger develops when the protective, lubricating sheath surrounding a tendon in the finger becomes narrowed or inflamed. Repetitive hand motions, such as gripping, can cause this constriction of the tendon sheath. People with trigger finger often experience the following symptoms:

  • Soreness in the finger or hand
  • Bump (nodule) at the base of the affected finger
  • Popping or catching as the finger straightens
  • Finger becoming locked in a bent position

Trigger finger is often treated through non-surgical methods, such as splinting, anti-inflammatory medication, or steroidal injection. These treatments can help to reduce inflammation and further irritation of the tendon sheath. However, people with more severe symptoms or with pre-existing health conditions, such as gout and diabetes, may require surgery for long-term trigger finger relief.

Trigger finger release surgery is a simple procedure that involves making a small incision in the palm of the hand and cutting the affected tendon sheath. Upon healing, the tendon has more room to slide back and forth. Patients who undergo this outpatient procedure have immediate relief from trigger finger symptoms and generally regain full movement of the hand and finger within several days of surgery.

Tendon Injuries

Tendon injuries in the hand are classified as either flexor or extensor tendon injuries.

Two flexor tendons on the inner surface of each finger allow the finger to bend into the palm. Laceration of a finger is the most common cause of a flexor tendon injury, often resulting in the inability to bend the finger at one or more joint. Timely treatment of flexor tendon injuries is crucial in order to preserve long-term mobility and function of the affected finger. Most cases require surgery, in which the two ends of the injured flexor tendon are sewn back together. Afterward, the finger is immobilized with a splint until physical therapy has restored full use to the hand.

Extensor tendons line the back of the hand and allow for straightening of the fingers and fine motor function. The extensor tendons are very close to the surface of the skin, and therefore are highly susceptible to injury. A laceration or blunt trauma to the back of the hand may tear an extensor tendon. This often causes an immediate loss of mobility in the affected finger. Extensor tendon injuries with a tendon that is mostly in tact can be treated through immobilization of the hand with a splint. For more severe extensor tendon injuries, surgical repair similar to that for a flexor tendon injury may be necessary.

Nerve Injuries

Nerves are very important components of the functionality of the hand, giving sensation to the hand and fingers and relaying these signals back to the brain. Any hand injury which cuts, stretches, or places pressure on a nerve can result in significant pain or a loss of sensation.

Nerve injuries are typically diagnosed through a Nerve Conduction test, which reveals any disruption in the transmission of signals through nerves in the hand. While surgery may not be necessary in minor injuries, completely severed or significantly damaged nerves often require surgical repair. Our orthopedic specialists work closely with each patient to determine the most effective course of treatment for a nerve injury.

Hand Fractures

A hand fracture may include a partial or complete break of one of the bones in the hand or fingers. These injuries are typically caused by a traumatic blow to the hand. Diagnostic imaging, such as X-Ray or MRI scan, is needed to confirm the location of the fracture and the extent of damage to other structures in the hand. Symptoms of a broken hand bone generally include:

  • Pain
  • Swelling
  • Bruising
  • Depressed knuckle
  • Inability to perform certain movements with the hand and fingers

Most hand fractures are treated by stabilizing and realigning the hand. This is accomplished with a splint, which is worn for up to six weeks. Repeat hand fractures or fractures involving multiple bones in the hand can require surgical intervention to ensure bone realignment and to minimize soft tissue or nerve damage. Surgery involves the placement of titanium pins through the injured bones to maintain correct alignment. Recovery from this type of hand surgery involves physical therapy and can take several months to regain full mobility and function of the hand. Surgical treatment for severe broken hands may be particularly useful for athletes or those who wish to maintain an active lifestyle.

Contact a Beverly Hills Surgeon

La Peer Health Systems in Beverly Hills boast some of the country’s finest orthopedic and plastic surgeons specializing in reconstructive hand surgery. We utilize state-of-the-art facilities to perform the latest and most effective procedures. For more information on hand injuries and treatment, or to schedule a consultation with one of our expert hand surgeons, please call (855) 360-9119 or fill out our contact form.

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