Many tissues including bones, muscles, tendons, nerves and ligaments make up your hands, wrist and elbow. All of these elements can be subjected to stress and problems in this area of the body are commonplace. Hand, wrist and elbow conditions can have a great impact on your everyday ability to function and even simple activities such as getting dressed and putting shoes on can become challenging.
Here at New Hall Hospital our highly regarded orthopaedic surgeons who have a special interest in hands, wrist and elbow offer the very best care to manage hand, wrist and elbow conditions, restore function and reduce pain.
We diagnose and treat many injuries and disorders of the hand, wrist and elbow including: carpal tunnel syndrome, Dupuytren’s contracture, wrist sprains and fractures and tennis elbow due to sports injuries and thumb arthirits.
We offer both surgical and non-surgical options and your hand, wrist and elbow surgeon will discuss the best option for you based on your individual needs, condition and symptoms.
The range of hand, wrist and elbow surgeries we offer
Carpal tunnel release surgery
The carpal tunnel is a narrow passageway made of ligaments and bones at the base of your hand. It contains your median nerve which runs from your forearm into the palm of your hand and tendons. Carpal tunnel syndrome (CTS) occurs when the median nerve becomes pressed or squeezed at the wrist. If you have CTS you’ll feel pain, numbness and tingling in your hand.
Your consultant may suggest wearing a wrist support or having a steroid injection near the carpal tunnel if your symptoms are mild. If these are not successful in alleviating your pain or the symptoms are acute then carpal tunnel release surgery, otherwise known as carpal tunnel decompression, will be recommended. This is a common surgical procedure that cuts your carpal ligament to reduce the pressure on your median nerve in the wrist.
Dupuytren's disease or Dupuytren’s contracture can cause the tissues in your palm to thicken. As the disease progresses one or more of your fingers may develop a contracture or bend. A contracture does not always happen and if it does it can take a long time to do so, often starting in the ring finger first.
If a contracture doesn’t occur, and your Dupuytren’s disease isn’t stopping you from actively using your hand for many daily activities, then you may not need treatment. If you do develop a contracture and you find it difficult to flatten your hand on a table top, or if your hand function is significantly affected, then treatment may be advised.
Radiation is often used to soften the abnormal tissue and can slow down or stop the disease.
The most frequently used treatment is Dupuytren’s fasciectomy. This surgical option removes the abnormal thickened tissue in the palm of your hand and therefore is the best long term option.
Tennis elbow surgery
Tennis elbow, medically known by the Latin name of lateral epicondylitis, is a condition where you experience pain on the outer side (called the lateral epicondyle) of your elbow. It can occur in tennis players but not exclusively. Exactly what causes tennis elbow is unknown, but it’s thought to be due to small tears of the tendons that attach forearm muscles to the arm bone at the elbow joint, that results from an overuse strain.
Often just stopping the activity that’s causing strain on the affected tendon will help. Other non-surgical options include: painkillers and non-steroidal anti-inflammatory drugs (NSAIDs), physiotherapy, corticosteroid injections and shock wave therapy.
If your tennis elbow pain is severe surgery might be the best treatment for you to relieve your pain. Surgical treatment will involve removing the damaged part of the tendon.
Thumb arthritis surgery
Thumb arthritis causes inflammation and cartilage loss within the thumb joint. Osteoarthritis, or wear and tear arthritis, commonly occurs in the joint at the base of your thumb. Your cartilage on the bone ends of your thumb joint wear away and this causes pain, swelling, joint immobility, lack of strength and difficulty gripping and pinching.
Early stage treatments include: splints, medication and injections. Surgery is often required and offers the most successful pain relief as well as the full return of your hand function. There are a number of surgical options and these include:
- joint fusion or arthrodesis (permanent fusion of the affected bones in your thumb joint)
- osteotomy (repositioning your thumb joint bones)
- trapeziectomy (removal of a bone called the trapezium in your thumb joint)
- joint replacement or arthroplasty (replacing all or part of the affected thumb joint with a graft).
The following consultants specialise in hand, wrist and elbow surgery at New Hall hospital