Carpal tunnel syndrome is a common condition that results from a compression of a major nerve at the base of the hand. Patients typically report numbness and pain, with symptoms often waking them up at night. Patients are typically treated with nocturnal bracing and anti-inflammatories, but for those who do not improve, surgical decompression of the nerve can be beneficial.

The surgery entails decompressing the nerve, either through a small incision in the palm or through the use of endoscopic surgery. Surgery is performed under local anesthesia with minimal to no sedation. The tissue that is compressing the nerve is released, and the nerve is thereby freed up from any adhesions.

Patients are discharged the same day of surgery and can begin moving their fingers right away. Most patients can return to their normal activities within two weeks.

Trigger finger is a condition that can affect the fingers and thumbs. Patients typically report pain involving motion of the finger. It is not uncommon for the patient to report stiffness, locking, or triggering of the finger as it flexes and extends. This is caused by inflammation of the tendon that flexes the finger. Patients are initially treated with a mild steroid anti-inflammatory injection, but for those who do not improve, a small surgical procedure is recommended.

The surgery consists of decompressing the tendon through a small incision in the palm. Surgery is performed under local anesthesia with minimal to no sedation. The inflammatory tissue is then removed from the tendon.

Patients are discharged the same day of surgery and can begin moving their fingers right away. Most patients can return to their normal activities within two weeks.

Dupuytren’s contracture is a disorder of the palmar fascia, the tissue underneath the skin of the palm. In these cases, the fascia becomes nodular and thickened, which can cause contractions of the fingers. Dupuytren’s contracture is a hereditary disorder, though the severity of contracture may vary from one family to another.

Mild contractures may be observed, but for more significant contractures, removing the diseased tissue can improve function of the hand. Surgery is typically done under regional anesthetic. An incision is made in the palm and the affected fingers. The contracted fascia is then removed.

Patients are discharged the same day of surgery. Hand therapy is often prescribed postoperatively to help patients regain their motion.

A ganglion cyst is a benign outpouching of fluid that is typically seen at the wrist joint. These cysts can grow and shrink with time. Some cysts can be treated by aspiration in the office setting. For recurring cysts, however, surgical excision can be performed.

Ganglion cysts are typically removed through a small incision in the skin. After tendons and neurovascular structures have been moved aside, the cyst is dissected and removed.

Surgery is done in an ambulatory center. Patients are typically discharged in a splint. Range of motion exercises are usually initiated at the first postoperative visit.

Distal radius fractures, also known as broken wrists, are common injuries seen after a fall or contusion to the wrist. The distal radius is the largest bone in the wrist and can break if the force is great enough, causing the patient to experience pain and swelling. Some distal radius fractures can be treated with immobilization in a cast. If the fracture is displaced or involves the joint surface, however, the fracture may benefit from surgical fixation.

Surgery is typically performed under a regional anesthetic, which renders the arm numb but negates the need for general anesthesia. One or more incisions are made at the wrist and the broken pieces of the distal radius are placed in the correct position. The pieces are then held together using metal plates and screws. Occasionally bone grafting is required.

This surgery is done at our ambulatory surgery center. Patients go home the same day and usually start range of motion exercises and hand therapy shortly after surgery.