Hand/Wrist

Hand surgery is a specialized type of procedure that may be performed to correct a wide range of diseases, injuries and defects that may cause symptoms and/or affect the appearance of the hand. Hand surgery can be performed for both medical and cosmetic purposes. Your hand surgery procedure will be customized in order to repair your individual condition and leave your hands looking and feeling their best.

Because of their frequent use, the hands are a common location for injuries and degenerative disorders such as arthritis. Many people are born with birth defects of the hand as well. Hand surgery can restore function, relieve pain and improve the appearance of the hands for patients suffering from cysts, nerve conditions such as carpal tunnel syndrome, arthritis, birth defects and other problems. Hand surgery may also be performed to re-attach or reconstruct severed fingers after trauma.

Effective hand surgery requires the skill and precision of an experienced surgeon, in order to successfully treat the condition and restore full function to the hand. At Dr. Tchejeyan's Orthopaedics & Sports Medicine, our Ventura County surgeons have years of experience performing a full range of hand surgery procedures, and utilize the latest techniques while doing so.

Candidates for Hand Surgery

Hand surgery can be performed on patients of any age to correct conditions and deformities within the hands. The ideal candidates for hand surgery include patients who:

  • Do not smoke
  • Do not have any other serious medical conditions
  • Have made the decision for surgery on their own
  • Have realistic expectations for their surgery

Hand Surgery Procedures

Hand surgery is usually performed under general anesthesia or local anesthesia with sedation, on an outpatient basis. The surgeon will make an incision to access the targeted area. Many hand procedures can be performed laparoscopically, allowing patients to benefit from smaller incisions, less bleeding and shorter recovery times.

The actual procedure will vary depending on the type and severity of each patient's individual condition, but may include:

  • Carpal tunnel surgery - tissue that is causing pressure on the nerve is removed to relieve pressure.
  • Rheumatoid arthritis surgery - damaged tissue is removed from the joint, tendons and ligaments are repositioned, or the entire joint is replaced with a prosthetic.
  • Dupuytren's contracture surgery - thickened, scar-like tissue is separated to improve range of motion and prevent nerve damage.
  • Grafting - transfers bones, nerves or other tissue from healthy areas of the body to the damaged area, commonly performed after trauma.

After the condition is treated, the incision is closed, with or without sutures, depending on each individual patient.

Recovery and Results of Hand Surgery

After hand surgery, patients may experience mild to severe pain. Your doctor will provide you with oral medication to manage pain, if needed. The hands will usually need to be immobilized for a few days as they heal. Patients usually require a course of physical therapy in order to restore full function and range of motion to the hand.

The results of hand surgery usually appear gradually, as swelling and other side effects subside. Most patients notice significant pain relief almost immediately, while cosmetic results may take several months before they are fully visible.

Risks and Complications of Hand Surgery

As with any type of surgical procedure, there are certain risks associated with hand surgery procedures, including:

  • Bleeding
  • Blood clots
  • Infection
  • Scarring
  • Change in skin sensation
  • Discoloration
  • Deep vein thrombosis
  • Nerve damage

These risks are considered rare and will be discussed with your surgeon before the procedure. Patients can reduce theses risks even further by choosing an experienced surgeon to perform their hand surgery procedure.

Total Wrist Replacement

The wrist joint is not a common target of full replacement, but instances of serious degeneration or injury may indicate this course of action. The goal of the procedure is to eliminate the severe pain associated with these problems and restore lost strength and stability to the joint so the patient may perform normal activities free of pain and other symptoms.

The cartilage deteriorating between the carpal bones, radius and ulna is the source of the pain that is to be fixed. The ideal patient for a total wrist replacement has severe arthritis but does not need to use their wrist for demanding tasks. While joint replacement will reduce pain and restore strength, the new joint will not be as strong as a natural joint. In patients with severe arthritis in both wrists, it is usually recommended to replace one wrist and have the other fused, so that one has good range of motion while the other is strong for stressful tasks.

The new joint itself is a ball-and-socket made of metal and plastic. The socket fits into the radial head while the ball is attached to the carpal and metacarpal marrow cavities. This procedure requires that several carpal bones and the radius head be removed from the wrist entirely while the new joint is drilled and fitted.

The replacement joint and the cement used to affix it in place can wear down over time, much like the original joint did, which may require a revision procedure. However, most patients experience long-term pain relief from this procedure and do not require additional treatment.

To learn more about our Orthopedic Services, please contact us at 805-495-3687 today to schedule an appointment.

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