Hand Surgery

Hand and wrist surgery is an orthopedic subspecialty involved in treating all pains, trauma, disease, congenital defects, and functional impairment associated with the fingers, hands, and wrists.

Orthopedic surgeons at Bone and Joints offer specialized surgical plans to patients with degenerative disorders of the hand, overuse injuries, or hand trauma to help relieve symptoms and restore function. Experts at Bone and Joints are skilled at assessing, identifying, and treating both mild and severe hand illnesses and injuries.

Dr. Niva Chitrakar

Functioning of Hands and Wrists

The functioning of our hands and wrists (movement and power) are controlled by the muscles and tendons around them. Usually, any damage to these muscles and tendons leads to problems related to hands and wrists. The functioning of hands and wrists are:

Our fingers and wrist may bend thanks to the flexor group, which is located on the inside or front of the forearm. The flexor retinaculum, also known as the carpal tunnel ligament, is a powerful fibrous band that passes over the front of the wrist and holds the flexors in place.
Our hand can open up due to the extensor muscles on the back or outside of the forearm.
Our hand's lumbrical and interossei, two little muscles, enable precise motion.
The same tissue that coats our joints, synovium, covers the tendons in our hands. A tendon sheath, which resembles the protective coating on a bicycle's brake cable, protects the tendon and synovium.

Common Conditions Related to Hands and Wrists

Injuries or the normal aging process can result in pain, stiffness deformities of the fingers, hands, or wrists. The symptoms of hands and wrists-related problems can sometimes be brought on by normal wear and tear or excessive use.

Your wrists and hands might sting, burn, or pain. Or they could feel hot, chilly, numb, tingling, stiff, fatigued, hurting, or exhausted. They may be bloated or you may not be able to move them normally. It's possible that your hands have changed color and are now red, pale, or blue. You could have noticed a bulge or protrusion on your wrist, palm, or fingers. Often, home therapy is sufficient to alleviate your problems. However, not all problems can be treated with home therapy and some will require a doctor’s consultation and perhaps even surgery in order to alleviate the pain or to solve the problem.

Some common Hands and Wrists Conditions

Hands and Wrist conditions can be quite different from one another. Some conditions arise due to trauma sustained in the past while others are caused by illnesses or diseases. Whatever the cause may be, most of these conditions are treatable either surgically or non-surgically.

Some common conditions treated by orthopedic specialists at Bone and Joints are:

Arthritis:

Arthritis is one of the most common issues related to hands and wrists conditions. The wrists and hands are susceptible to arthritis, especially around the base of the thumb joint.

Arthritis usually arises when the cartilage that protects the joints begins to deteriorate, forcing the bones to grind against one another. As a result, there is pain and decreased mobility. While any joint can be afflicted, wrist and thumb arthritis is more frequent as we age.

Rheumatoid arthritis, a condition that affects the entire body, is one of the most typical causes of wrist arthritis. It produces joint inflammation, which can get destroy joint cartilage and the adjacent bones.

Another common arthritis affecting the hands and wrists is thumb arthritis. The carpometacarpal joint, where the metacarpal bone connects to the trapezium (carpal) bone of the wrist, is often affected by thumb arthritis. It is frequently age-related but can also be due to obesity.

Carpel Tunnel Syndrome

When the nerve that supplies the majority of your hands and fingers passes via the carpal tunnel, a small tunnel inside your wrist becomes compressed, it can lead to carpal tunnel syndrome, which manifests as tingling, numbness, and other symptoms in the hand and fingers. Women experience the disease a little more frequently than men.

De Quervain’s Syndrome

The tendons on the thumb side of the wrist are affected by De Quervain's syndrome, sometimes referred to as De Quervain's tenosynovitis. Making a fist, turning your wrist, or grasping objects becomes painful. Repetitive motions like playing table tennis or racquet sports can make the pain worse.

Trigger Finger

A trigger finger happens when one of your fingers becomes trapped in a bent position. Trigger finger is also known as stenosing tenosynovitis. It is brought on by inflammation, which reduces the amount of room within the sheath that covers the tendon on the palmar side of the finger. Your finger may snap into a bent or straight posture, or it may just lock entirely into place. Women and those whose occupations or hobbies demand them to grasp repeatedly are more likely to suffer from the illness. A trigger finger can affect any finger on a hand including the thumb.

Ulnar Nerve Entrapment

The ulnar nerve is the other important nerve of the hand. It is responsible for the agonizing pain we get when hitting the funny bone in the elbow. It can get entrapped usually in two locations:

Cubital Tunnel Syndrome: Cubital tunnel syndrome develops inside the elbow where the funny bone is located. The funny bone (medial epicondyle) is the most common space for ulnar nerve entrapment.

Ulnar Tunnel Syndrome: Ulnar tunnel syndrome, which rarely occurs, happens when the nerve becomes imprisoned in a canal at your wrist.

Wrist Tendonitis

Wrist tendonitis is a condition where the tendons in the wrists get inflamed.
Tendons, which link muscles to bone, are substantial collagen strands. The fingers, hands, and wrists are moved under the control of the wrist tendons, which surround the wrist joint. They may become irritated and rub on the bone as a result of repetitive movements or damage, causing discomfort and swelling.

Treatment For Hands and Wrists Pain

Treatment for hands and wrists condition is carried out by both surgical and nonsurgical methods.

Nonsurgical Methods of Treatments for Hands and Wrists Pain

The following are some nonsurgical treatments for conditions and pain involving the hands and wrists:
Casts, braces, supports, and splints
Lifestyle changes
Physical therapies
Anti-inflammatory medications

Surgical Methods of Treatments for Hands and Wrists Pain

The surgical method of treatment for hand and wrist pain and conditions is offered by orthopedic surgeons once it is deemed absolutely necessary. Surgery may be your best option if your hand or wrist discomfort, numbness, or tingling is brought on by the degenerative effects of arthritis, nerve injury, fracture, dislocation, or other conditions. Orthopedic surgeons at Bone and Joints perform the following surgical procedures to treat hand and wrist pain and conditions.

Joint Surgery for Arthritis:

Joint Surgery may be beneficial when arthritic or injured joint inflammation results in persistent discomfort, a loss of function in the hands or wrist, or both. Orthopedic surgeons may use plastic or metal components to replac or stabilize damaged joints. As a consequence, there is less discomfort, more function, and an improvement in the look of malformed joints.

Nerve Decompression Surgery:

In the hands and wrists, nerves can get squeezed between ligaments, tendons, and bones, causing excruciating pain. Compression on the nerve that is causing pain, numbness, or tingling can be surgically released by a surgeon.

Hands and Wrists Fracture or Dislocation Repair:

Surgery is usually necessary for severe fractures of the hands or wrists. To secure and hold bone fragments in place so they can heal well, surgeons implant wires, screws, or plates to stabilize the fractures or dislocations.

Carpal Tunnel Release:

The symptoms of carpal tunnel syndrome include discomfort, numbness, weakness, or tingling in the hands or fingers. When the median nerve in the wrist is under pressure, the symptoms of carpal tunnel syndrome can be felt. During a carpal tunnel release, the carpal ligament is cut to make greater room for the median nerve and adjacent tendons.

Trigger finger release:

A trigger finger is a condition where the fingers are bent and looks like you are holding the trigger of a gun. When the disorder affects the thumb, it is known as a trigger thumb. In extreme circumstances, the thumb or fingers may lock. The compressed tendons that are the cause of the ailment can be released by surgeons, relieving the patient’s symptoms.

Dupuytren's Contracture Surgery:

Dupuytren's contracture is a disorder in which scar tissue develops beneath the skin of the palm and fingers. The fingers gradually start to tighten and draw inward due to the scar tissue. This can occasionally prevent the fingers from fully straightening, preventing correct hand movement. In order to allow tendons to move correctly, the offending scar tissue is removed during surgery.

Wrist Fusion:

Wrist Fusion is a type of surgery deemed best in case of serious damage or serious deformity of the wrist. The technique entails removing the wrist joint and using a metal plate to fuse the little bones in the wrist (carpal bones) with the large bone in the forearm (radius). Although it restricts wrist movement, it effectively relieves pain.

Recovery From Hands and Wrists Surgery

Recovering from hands and wrists surgery or treatment will depend on the patient's general health and the type of operation. The recovery time will depend on the type of surgery you had, and can range from a few weeks to a few months. You should talk with your surgeon about what to anticipate following the procedure. You might need to wear splints to preserve the bone and tissues that are healing.

Looking for Trusted Hands and Wrists Surgeons?

Bone and Joints offers one of the best Hands and Wrists-related orthopedic services in Kathmandu, Nepal. Doctors and orthopedic specialists at Bone and Joints are capable of helping you with the proper evaluation, diagnosis, and treatment of fractures, trauma, and soft tissue injury in your hands and wrists. Services at Bone and Joints are tailored according to our patient's needs with cost-effective and affordable pricing.

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Hand Surgery

Dr. Niva Chitrakar

Subspeciality teams

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