A joint release is a surgical procedure involving removal of soft tissue that prevents full motion. This may be needed after an injury that damages a joint, or a crush or other traumatic injury that causes significant swelling (edema) in the hand. Surgery is indicated only if conservative treatment methods have been unsuccessful in regaining functional mobility.
There are many conditions that can cause lumps or bumps (masses) to develop in the upper extremities. Most of these conditions are benign (non-cancerous), but the mass may be causing pain or dysfunction in the arm. To treat the mass, your doctor may recommend having it removed (excised). Excision of a mass can not only treat your symptoms, but also make a definitive diagnosis by sending the removed tissue to the laboratory and allowing specialized Pathology doctors to analyze it microscopically. (See Hand Masses.)
When a nerve becomes entrapped within tight spaces or scarred tissue, it can cause symptoms of pain, numbness, tingling and weakness (see Carpal Tunnel Syndrome and Cubital Tunnel Syndrome). Your surgeon may recommend surgical release of the nerve if non-operative measures fail. This type of surgery involves releasing any tight structures that are putting pressure on the nerve, to allow the nerve to have more room and better blood supply. The nerve may also have to be moved out of a bed of scar tissue into a more protected location (transposition). The goals of a nerve release are to improve the health of the nerve, decrease your symptoms and increase your ability to function.
Nerves carry messages to and from the brain to give you sensation (feeling) and the ability to move. If a nerve is completely cut, surgery will be necessary to restore sensation and motor function. Depending on the nature of the injury, your surgeon may recommend a direct repair or graft. A nerve conduit or tube may also be used to help guide the recovering nerve. It is important after surgery to protect the repair and to follow your doctor and therapist’s instructions.
In cases of finger or hand amputation, your surgeon may be able to reattach (replant) your injured part. In many circumstances, this is not possible for a variety of patient and injury related reasons. If performed, replantation surgery is a highly specialized skill that requires microscopic instrumentation and a dedicated team approach, both within the hospital and upon your discharge (usually several days after injury). The Hand Center staff is dedicated to the care of these complex injuries and we put forth a team effort to help your hand to function as well as possible after injury. When replantation is not possible, there are a variety of prosthetic options that may improve the appearance and/or function of your hand.
Surgery may be performed on the hand to enhance its appearance in patients after the treatment of skin cancer or a hand injury that has left the hand in a less-than-ideal aesthetic and/or functional condition. A personalized surgical plan will be determined for each patient to most effectively treat the individual condition. Our doctors utilize the most advanced surgical techniques to restore function and appearance to the affected hand, which may involve the use of tissue and skin grafts.
A steroid injection is a procedure that can be done in the office to treat the pain and swelling associated with many common upper extremity conditions, including arthritis and tendinitis. Your doctor will determine if you are an appropriate candidate for receiving a steroid injection. If so, the injection given is a combination of a short acting local anesthetic (numbing medicine) and a longer acting anti-inflammatory medication (corticosteroid). Cortisone injections may provide long term or temporary relief depending on the condition being treated.
In rheumatoid arthritis or other conditions causing inflammation, your body may attack the cells in the tissue that lines the joint (synovium). Surgical removal of inflamed tissue can help prevent further damage to the joints or surrounding tissues.