Tennis Elbow

Cause:

Tennis Elbow is painful and is due to an overuse of the muscle on the back of the lower arm (extensor muscles). There is an inflammation of the attachment of those muscles on the outside part of the elbow that causes varying degrees of pain.

Treatment:

Surgery will loosen this inflamed attachment at the elbow through an incision on the outside aspect of the elbow. After the surgery, the elbow will be immobilized in a cast for two weeks.

Hospital Admission:       Outpatient

Recuperation Time:        3 to 5 weeks

Post Surgery:                    Physiotherapy is helpful in severe

 

Trigger Finger

Cause:

Trigger Finger or stenosing tenosynovitis is a painful chronic inflammation of the flexor tendon sheath in the hand. Typically, there is a click or a triggering of the finger while straightening. This is due to a shrinking of the pulley at the base of the finger and can be very painful.

Treatment:

A surgical procedure under local anesthesia will release that tight pulley in the finger through a very small incision. Sutures are removed after 2 weeks.

Hospital Admission:            Outpatient

Recuperation time:             2 – 4 weeks depending on severity

Post Surgery:                        Physiotherapy needed in severe cases

 

Cubital Tunnel

Cause:

This syndrome is caused by the compression of the Ulnar Nerve in the area that is referred to as the “funny bone”. Cubital Tunnel can result in pain, numbness of the littlefinger, weakness of grip and deterioration of the muscles in the hand.

Treatment:

Treatment consists of surgically releasing the structures that cross the nerve in the elbow region. This release can be performed in an open or minimally invasive procedure with suture removal after ten days.

Hospital Admission:             Outpatient

Recuperation Time:              2-4 weeks

Post Surgery:                          Physiotherapy is helpful in severe

 

Golf Arm

Cause:

This condition is due to an over-use of the flexor muscle in the lower arm (wrist benders) and is a chronic inflammation of those muscles where they attach to the inside of the elbow.

Treatment:

The muscles can be released through a small surgical incision. This treatment does not cause any loss of function. The elbow will be immobilized in a cast for two weeks. Dissolvable sutures will be used so suture removal will not be necessary.

Hospital Admission:         Outpatient 

Recuperation Time:          2 weeks Post Surgery: Physiotherapy is helpful in severe cases

 

Tendon Adhesions

Cause:

Tendons very often get fixed in a scar after an injury restricting the range of motion of the respective joint. The release of the tendon may allow the tendon to move freely in their path and thereby restoring the range of motion.

Treatment:

Surgical release of tendons with suture removal after 10 to 14 days

Hospital Admission:      Outpatient

Recuperation Time:      3-4 weeks

Post Surgery:                   Physiotherapy is mandatory to avoid new adhesions

 

Nerve Compressions

Cause:

After trauma or overuse, a nerve might be compressed by a scar or other anatomical structures passing over the nerve in its path along the arm. Depending on the nerve affected and the location, the symptoms may vary however, both numbness and paralysis are possible.

Treatment:

Depending on the nerve that is affected and localization, an open approach to surgically release the nerve from the constricting structure will be taken. Suture removal after 10 days.

Hospital Admission:            Outpatient

Recuperation Time:            2-4 weeks

Post Surgery:                        Physiotherapy is helpful in severe cases

 

Arthrosis

Cause:

Because of age, over-use, or joint fractures, arthrosis (translation: sick joint) can commonly occur in the hand and wrist. Especially common is the degeneration of the base of the thumb called Rhizarthrosis which can be particularly painful and debilitating. The carpal bone that builds the connection of the thumb with the wrist (trapezium) is very often subject to chronic degenerative structural change causing pain and weakness of the hand that in the long run will result in a painful frozen joint.

Treatment:

The treatment of this condition depends on the degree of degeneration and can range from nonsurgical methods to joint prosthesis or fusion of joints. An experienced hand surgeon can remove the affected bone to allow for pain relief, a better range of motion, and a stronger grip. The patient would require six weeks of immobilization in a cast or an orthosis (brace) to fully recover.

Hospital Admission:            Depends on diagnosis

Recuperation Time:             Depends on diagnosis

Post Surgery:                         Physiotherapy is advisable

 

Rheumatism

Cause:

Rheumatic disease is a very common condition where the immune system of a person will attack its own tissue for example joints, ligaments, or tendons.

Treatment:

Hand surgery offers techniques to restore function and reduce painful limitation in a rheumatic hand or wrist. Options can include reconstruction of tendons or joints or treatment of pain by disconnecting the pain nerves that service the inside of the wrist.  

Hospital Admission:             Depends on treatment

Recuperation Time:              Depends on treatment

Post Surgery:                         Physiotherapy depends on the treatment

 

Fractures

Cause:

Usually a result of blunt or sharp trauma to the hand, fractures cause pain and loss of function. 

Treatment:

Depending on localization and type of fracture different treatment options are available. Some fractures might not have to be surgically treated whereas others have to be reduced and fixed by wires, pins or screws.

Hospital Admission:                Depends on procedure

Recuperation Time:                 Depends on procedure

Post Surgery:                             Physiotherapy is often necessary

 

Reconstruction

Cause:

After hand injuries or as a consequence of disease, many patients are left with loss of function of the hand and wrist. This can be very debilitating and often leads to problems relating to work, independence, and physical activities.

Treatment:

Plastic surgery offers reconstruction techniques that can range from reconstruction of tendons and nerves all the way to the reconstruction of a lost thumb. These surgical procedures can restore full or partial function of the hand, restoring quality of life to many patients.   

Hospital Admission:             Depends on treatment

Recuperation Time:              Depends on treatment

Post Surgery:                          Physiotherapy depends on treatment

 

Microsurgery

Cause:

After hand injuries or as a consequence of disease, many patients are left with loss of function of the hand and wrist. This can be very debilitating and often leads to problems relating to work, independence and physical activities. Severe injuries might involve the destruction of vital structures of the hand or lower arm such as nerves or blood vessels which may need reconnecting to save function or even to avoid amputation. In other cases, amputated body parts can be reconnected and saved.

Treatment:

Microsurgery is a very specialized and complex surgical procedure reconnecting blood vessels and nerves (of 1-3 mm diameter) with microsutures under a microscope.  

Hospital Admission:             Depends on treatment

Recuperation Time:              Depends on treatment

Post Surgery:                          Physiotherapy depends on treatment

 

Wrist arthroscopy

Cause:

The painful wrist is a common problem and very often the cause may be unknown. Wrist arthroscopy offers the possibility to look inside the wrist in a minimally invasive way to detect the cause of pain and repair immediately if possible.

Treatment:

A surgical incision is made that is 1mm long. This minute incision creates minimal wounding and contributes to faster recuperation speeds. No sutures are needed.

Hospital Admission:           Outpatient 

Recuperation Time:            Depends on the diagnosis

Post Surgery:                       Physiotherapy depends on the diagnosis

 

DeQuervan’s Tendinosis

Cause: 

Painful inflammation of the tendons on the side of the wrist along the base of the thumb.

Treatment:

Injection of steroids can in mild cases cure the problem. More severe cases require surgery to release the fibrous roof of the tunnel through which the inflamed tendons pass.

Hospital Admission:          Outpatient

Recuperation Time:           2 – 4 weeks

Post Surgery:                       Physiotherapy is helpful in severe cases

 

Carpal Tunnel Syndrome

Cause:

Carpal Tunnel Syndrome is caused when the Median Nerve, a major hand nerve responsible for sensation in the thumb, index, middle, and parts of the ring finger, is compressed. Swelling causes the fragile nerve’s function to be compromised. Patients affected typically experience pain in their hands and arms more so at night.

Treatment:

Treatment consists of surgically releasing the rigid ligament that compresses the nerve. Surgery is performed under local anesthesia through a small incision. Although sutures are removed after two weeks, patients may require more time to recover full nerve function.

Hospital Admission:          Outpatient

Recuperation Time:           2 – 4 weeks

Post Surgery:                       Physiotherapy is helpful in severe cases

 

Dupuytren’s Contracture

Cause:

Dupuytren’s Contracture or Morbus Dupuytren is a  condition caused when one or more fingers become permanently bent or in a flexed position, hard nodules or strands. This condition does not resolve itself and may require surgical intervention. 

Treatment:

A surgical procedure under local anesthesia will release that tight pulley in the finger through a very small incision. Sutures are removed after 2 weeks.

Hospital Admission:            Outpatient

Recuperation time:             2 – 4 weeks depending on severity

Post Surgery:                        Physiotherapy needed in severe cases