An amputation may be recommended to revise a badly injured body part that is still attached, but not functional or not healing well. It may also be a planned operation to prevent the spread of the disease in an infected finger or hand. In many cases, it is possible to close the amputation site, but sometimes skin must be rearranged (flap) or transferred from another body part (graft) in order to close your wound.
Arthrodesis (joint fusion) is a procedure for the treatment of a painful joint condition of the hand, wrist or elbow caused by arthritis or injury. This procedure may be needed to decrease pain and improve function when conservative measures have failed, and when there are no other reconstructive surgical options available. Your doctor will determine which procedure is best for you based on a thorough evaluation of your condition.
Arthroplasty (joint modification or joint replacement) is a procedure for the treatment of painful joint conditions of the hand, wrist or elbow caused by arthritis or injury. This procedure may be needed to decrease pain and improve function when non-operative measures have failed. Your doctor will determine which procedure is best for you based on a thorough evaluation of your condition.
Arthroscopy is a minimally invasive procedure that allows doctors to diagnose and treat joint injuries and disease through small incisions in the skin. During an arthroscopic procedure, a small camera is inserted into the problem area, allowing your doctor to examine the joint in great detail. It is then possible to treat the problem using this approach or with a combination of arthroscopic and “open” surgery. Potentially treatable injuries include torn cartilage or ligaments, inflamed joint lining (synovitis), carpal tunnel syndrome, rotator cuff tears, and loose bone or cartilage.
Joint aspiration, also known as arthrocentesis, is a minor procedure that involves draining fluid from a joint with a sterile needle and syringe. This may be performed for either diagnostic or treatment purposes in patients with swelling, inflammation and pain within the hand and wrist. Aspiration of joints can usually be performed under local anesthesia and involves inserting a needle with a syringe attached to it into the affected area. Fluid within the joint is withdrawn (aspirated) into the syringe and then sent to a laboratory for complete testing.
Dupuytren’s disease affects the fascia in the palm, causing finger contractures. It can be treated surgically with removal of the diseased tissue. A joint release may also be necessary (See Joint release.) The use of Xiaflex for treatment of Dupuytren’s contracture is a relatively new procedure, and can be extremely effective when properly administered, without the trauma associated with surgery when used in appropriately selected patients.
From the youngest to the oldest of patients, upper extremity fractures are a common part of our everyday practice at the Hand Center. A fracture is a broken bone. Fractures can be very simple or very complex in appearance as well as treatment. Each fracture is individually evaluated and treated by the doctor, taking into consideration the specific needs of each patient.
Splints/Orthoses and Casts
Many fractures in the fingers, hands, wrists and elbows can be treated without surgery. Most require some amount of immobilization to allow the fracture to heal. Depending on specific patient and fracture characteristics, this can be achieved with custom orthoses (splints) made on site by our therapy staff or by casts that are applied by our physicians/physician assistants.
When a fracture results in bone ends that are not appropriately aligned, you may need more than a cast or splint. You may require a procedure, either in the office under local anesthesia (numbing medicine) or in the operating room under general anesthesia, to reset your broken bones. Often, this type of procedure has been done in an Emergency Room prior to your arrival at The Hand Center. When done in the operating room, metal pins may be added to hold unstable fractures in place.
If a fracture has substantially shifted out of position or is unstable in a cast or splint, it may not be possible to treat it appropriately without an open surgery. This type of surgery is called an open reduction internal fixation (ORIF). It allows your surgeon to piece together your broken bone through one or more skin incisions, and fix the pieces together with metal implants such as pins, wires, plates or screws. Your doctor will discuss the specifics of surgery with you at your pre-operative visit.