Surgery of The Hand

Dramatic advances have been made in recent years in treating patients with hand injuries, degenerative disorders, and birth defects of the hand.  At the forefront of these advances have been plastic surgeons - specialists whose major interest is improving both function and appearance.  Dr. Dreyer has extensive training in hand surgery, and treats patients with a wide range of hand problems.

The most common procedures in hand surgery are those done to repair injured hands, including tendons, nerves, blood vessels, and joints; fractured bones; and burns, cuts, and other injuries to the skin.  Dr. Dreyer also treats carpal tunnel syndrome, rheumatoid arthritis of the hand, Dupuytren's contracture, trigger fingers/thumb, and congenital defects.
Carpal Tunnel Syndrome
Carpal tunnel syndrome is a condition brought on by increased pressure or a pinched nerve at the wrist.  Symptoms may include numbness, tingling, and pain in the arm, hand, and fingers, or a combination of all three.  A detailed history including medical conditions, how the hands have been used, and whether there were any prior injuries is important.  Nerve conduction studies may be done to check for other sites of nerve problems as well as to evaluate the carpal tunnel.  Occasionally, symptoms can be relieved without surgery.  Changing the patterns of hand use or keeping the wrist splinted in a straight position may help reduce pressure on the nerve.  When symptoms are severe or do not improve, surgery may be needed to release pressure on the nerve.
Ganglion Cysts
Ganglion cysts are very common masses that can grow in the hand or wrist.  These cysts are generally found on the top of the wrist, on the palm side of the wrist, the end joint of a finger, and at the base of a finger.  Cysts usually come from nearby joints or tendon sheaths.  There is no specific cause and these cysts are not malignant (cancerous).  Ganglions often change in size and may disappear completely.  If the cyst is painful, limits activity, or its appearance is unacceptable to the patient, surgical removal may be recommended. 
Trigger Finger
Tenosynovitis, commonly known as trigger finger or trigger thumb, involves the pulleys and tendons in the hand that bend the fingers.  In the finger, the pulleys form a tunnel under which the tendons must glide.  The tendons and the tunnel have a slick lining that allows easy gliding inside the pulleys.  Trigger finger/thumb happens when the tendon develops a nodule or swelling of its lining.  When the tendon swells, it must squeeze through the opening of the tunnel (flexor sheath), which causes pain, popping, or a catching feeling in the finger or thumb.  Sometimes the finger becomes locked and is hard to straighten or bend.  If nonsurgical forms of treatment do not improve symptoms, surgery may be recommended. 
The contents of this site is for informational purposes only.  The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment.  Always seek the advice of a physician regarding a medical condition. 
Dupuytren's Disease
Dupuytren's disease is an abnormal thickening of the fascia tissue between the skin and the tendons that may limit movement of one or more fingers.  In some patients, a cord forms beneath the skin that stretches from the palm into the fingers.  The cord can cause the fingers to bend into the palm so they cannot be fully straightened.  It can also occur in areas other than the hand.  The cause of Dupuytren's is unknown and there is no permanent cure.  This is a non-cancerous, usually painless condition that occurs more often in men than women.  The disease progresses slowly over years and often develops in the palm of the hand at the base of the ring or little fingers.  Surgery can relieve the bending of the fingers into the palm, but it is important to remember that the condition can return with time.  The main goal of the surgery is to restore use of the fingers.