We know that some conditions if left untreated will deteriorate and lead to permanent poor function and pain in the hand.
Currently, we treat the following conditions:
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Carpal Tunnel Release
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Dupuytren’s Contracture
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Ganglion excision
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Release of trigger finger
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Treatment of paronychia
Included in your treatment is an appointment with a Consultant Plastic and Hand Surgeon, physiotherapy if required and a follow-up appointment. Additional charges may be required for tests including, blood tests, collagenase injections, x rays, splints, nerve conduction studies, additional physiotherapy appointments, and consultant review appointments.
Carpal Tunnel Release
When the nerves to the hand pass from the wrist into the palm they travel through a tunnel made up of bones and a strong ligament. In some people this tunnel gets tight and it can affect the function of the nerves. Initially, this results in pain and tingling in the hand, characteristically improving by wringing the hands. Eventually, if left untreated this can permanently affect the nerves and the muscles they supply resulting in permanent weakness and numbness in the hands.
Investigation of this condition relies on the clinical judgment of the Surgeon and sometimes the need for nerve conduction studies. This will demonstrate the cause of the constriction and in most cases confirm the tight ligament at the wrist should be released.
The procedure to release the nerve takes 30 minutes and leaves a scar at the wrist/palm. Relief from the constriction can be instantaneous but if the nerve is already permanently damaged full recovery may not occur.
Dupuytren’s Contracture
Dupuytren’s contracture results from a thickening of the tissues in the hand, resulting in nodules, indentations, and eventually permanent bending of the fingers, affecting the function of the hand. Left untreated this can affect the skin of the palm and fingers and cause issues with the blood and nerve supply to the fingers.
Dupuytren’s contracture has an inherited link but also can be brought about by other conditions. It tends to get worse with time. The longer left before treatment the more difficult is the surgery and the more likely is that permanent numbness of the fingers, disfiguring surgery, or even losing fingers may occur.
Either single or multiple fingers can be treated at the same operation. Operations differ in length and severity depending on the condition of the disease.
In most cases, the release will require a splint afterward and then input from a physiotherapist to improve function
Ganglion excision
Ganglions are fluid-filled cysts that appear near joints in the hands and fingers. They are benign lumps that tend to increase in size gradually and can cause discomfort and affect the function of the hand.
Treatment of ganglions may involve draining the cyst or operating to remove it. The operation to remove the lesion is quick and straightforward in most cases.
Trigger Finger
Trigger fingers are thickenings of the sheath surrounding tendons in the hand. It is the tendons that normally move the fingers and to do this they travel through little tunnels in the palms and fingers. When these thickened areas can to a large enough size they can get blocked in the tunnel, stopping the finger from moving. Characteristically you may need to force your finger straight.
Rather than remove the lump on the tendon, in most cases, the easiest way to improve the condition is by releasing the tunnel so the tendon can move freely again.
