Hand & Upper Extremity Division Procedures

Arthroscopic Procedures

The use of the arthroscope is rapidly changing many procedures in hand surgery. Procedures that used to require large incisions can often be performed through very small portals with the use of an arthroscope or endoscope.

Both carpal tunnel release and trigger finger releases can currently be performed with the use of an endoscope. Patients enjoy the fact that no sutures are used. They often return to work the following day and may enjoy full function in 10 to 14 days following surgery.

The arthroscope can be utilized for reduction of intraarticular fractures of the distal radius. This magnified view provides for more accurate reduction compared to fluoroscopic assisted reduction and obviates the need for a large incision.

Many scapholunate ligament tears and other ligamentous tears in the wrist can now be treated with the use of the arthroscope. This obviates the need for the large incisions that has been required in the past.

Small joint arthroscopy has allowed reductions of Stener's lesions in patients who have ulnar collateral ligament tears of the thumb. This obviates the need for the large incisions that has been required in the past.

Small joint arthroscopy has allowed reductions of Stener's lesions in patients who have ulnar collateral ligament tears of the thumb. Reduction of the ulnar collateral ligament with repair through the scope as opposed to large incisions provide for faster recovery and negligible scars. A multitude of other intraarticular problems are also being treated via arthroscopic procedures in the small joints of the hand.

New techniques including cubital tunnel release with the use of the endoscope are currently being developed.

Total Elbow Replacement

Painful, stiff elbows resulting from rheumatoid arthritis or osteoarthritis or posttraumatic stiffness and pain can now be restored with successful elbow joint replacement. Total elbow arthroplasty has made substantial advancements in the recent years.

In previous years the response, "Nothing else can be done," was common following severe injuries of the elbows. While this is still frequently told to patients in some circles, it is possible to restore the motion and relieve the pain with total elbow arthroplasty.

Total Wrist Replacement

Joint replacement surgery of the wrist has not been a very functional and accepted treatment in the past. Now we have better implants and improved surgical techniques allowing for better results.

Both rheumatoid arthritis and osteoarthritis may result in joint destruction requiring total wrist arthroplasty. The old treatment option of wrist fusion is no longer the gold standard because of the functional limitation of a stiff wrist and the high complication rate associated with wrist fusion. Patients can now enjoy a pain free wrist and preserve normal, or near normal, motion.

New Advancements in the Treatment of Carpal Tunnel Syndrome

Carpal tunnel syndrome is a condition brought on by elevated pressure on the median nerve where the nerve runs through the carpal tunnel. Symptoms may include pain and numbness and tingling in the hand and fingers. The patient often awakens at night with symptoms. Carpal tunnel syndrome which does not respond to conservative treatment often requires carpal tunnel release surgery. New endoscopic techniques allow the release to be performed through very small incisions with the aid of an endoscope. An endoscope is a very small video camera that allows the surgeon to see without the need for a large incision. The incisions are so small, in fact, that no stitches are used. Most patients can return to work the day after surgery. Normal use can begin at 10 to 14 days after surgery.