Hand

Carpal Tunnel Surgery

Carpal tunnel syndrome is a condition in which the median nerve is compressed as it passes through an opening from the wrist to the hand called the carpal tunnel. The carpal tunnel is formed by the carpal bones on the bottom of the wrist and the transverse carpal ligament across the top of the wrist. Since the median nerve provides sensory and motor functions to the thumb and three middle fingers, many symptoms may result.

Carpal tunnel is diagnosed through:

• x-ray, MRI, CT scan
• physical exam

Symptoms

Symptoms include:

• difficulty making a fist

• difficulty gripping objects with the hand(s)
• pain and/or numbness in the hand(s)
• "pins and needles" feeling in the fingers
• swollen feeling in the fingers
• burning or tingling in the fingers, especially the thumb and the index and middle fingers
• pain and/or numbness that is worse at night, interrupting sleep

Treatment

Treatment may include:

• splinting of the hand (to help prevent wrist movement and decrease the compression of the nerves inside the tunnel)
• oral or injected (into the carpal tunnel space) anti-inflammatory medications (to reduce the swelling)
• changing position of a computer keyboard, or other ergonomic changes
• occupational therapy
• surgery (to relieve compression on the nerves in the carpal tunnel)

Surgery can be performed in the traditional open manner or endoscopically, which is minimally invasive. During both procedures, the transverse carpal ligament is cut. This release the pressure on the median nerve, relieving carpal tunnel symptoms.

In open surgery, the incision is made at the base of the palm, allowing the doctor to see the transverse carpal ligament. After the ligament is cut, the skin is closed with stitches. The gap where the ligament was cut is left alone and eventually fills up with scar tissue.

In endoscopic surgery, a thin, flexible tube with a camera attached (endoscope) is guided through a small incision in the wrist  The endoscope is guided through a small incision in the wrist (single-portal technique) or at the wrist and palm (two-portal technique). The endoscope lets the doctor see structures in the wrist, such as the transverse carpal ligament, without opening the entire area with a large incision.

After Surgery/Recovery

Physical Therapy is a critical part of complete recovery. Our doctors recommend DMC's Rehabilitation Institute of Michigan, with 30 convenient locations across southeastern Michigan. To find one near you, click here.

Carpal Tunnel Surgery

Carpal tunnel syndrome is a condition in which the median nerve is compressed as it passes through an opening from the wrist to the hand called the carpal tunnel. The carpal tunnel is formed by the carpal bones on the bottom of the wrist and the transverse carpal ligament across the top of the wrist. Since the median nerve provides sensory and motor functions to the thumb and three middle fingers, many symptoms may result.

Carpal tunnel is diagnosed through:

• x-ray, MRI, CT scan
• physical exam

Symptoms

Symptoms include:

• difficulty making a fist

• difficulty gripping objects with the hand(s)
• pain and/or numbness in the hand(s)
• "pins and needles" feeling in the fingers
• swollen feeling in the fingers
• burning or tingling in the fingers, especially the thumb and the index and middle fingers
• pain and/or numbness that is worse at night, interrupting sleep

Treatment

Treatment may include:

• splinting of the hand (to help prevent wrist movement and decrease the compression of the nerves inside the tunnel)
• oral or injected (into the carpal tunnel space) anti-inflammatory medications (to reduce the swelling)
• changing position of a computer keyboard, or other ergonomic changes
• occupational therapy
• surgery (to relieve compression on the nerves in the carpal tunnel)

Surgery can be performed in the traditional open manner or endoscopically, which is minimally invasive. During both procedures, the transverse carpal ligament is cut. This release the pressure on the median nerve, relieving carpal tunnel symptoms.

In open surgery, the incision is made at the base of the palm, allowing the doctor to see the transverse carpal ligament. After the ligament is cut, the skin is closed with stitches. The gap where the ligament was cut is left alone and eventually fills up with scar tissue.

In endoscopic surgery, a thin, flexible tube with a camera attached (endoscope) is guided through a small incision in the wrist  The endoscope is guided through a small incision in the wrist (single-portal technique) or at the wrist and palm (two-portal technique). The endoscope lets the doctor see structures in the wrist, such as the transverse carpal ligament, without opening the entire area with a large incision.

After Surgery/Recovery

Physical Therapy is a critical part of complete recovery. Our doctors recommend DMC's Rehabilitation Institute of Michigan, with 30 convenient locations across southeastern Michigan. To find one near you, click here.

Ganglion Cyst Removal

The ganglion cyst is a tumor or swelling on top of a joint of the covering of a tendon. It appears as a fluid-filled lump that changes in size. It may appear after injury to a tendon or joint. Surgery may be required to put certain types of broken bones back into place. Occasionally, internal fixation (metal rods or pins located inside the bone) or external fixation devices (metal rods or pins located outside of the body) are used to hold the bone fragments in place to allow alignment and healing.

Treatment

Treatment includes:

• Splinting of the wrist
• Exercises to strengthen wrist and improve range of motion
• Aspiration
• Surgical removal - recommended when the mass is painful, interferes with daily function, or when numbness or tingling of the hand or fingers occurs 

After Surgery/Recovery

Physical Therapy is a critical part of complete recovery. Our doctors recommend DMC's Rehabilitation Institute of Michigan, with 30 convenient locations across southeastern Michigan. To find one near you, click here.

Wrist Fracture

A fracture is a partial or complete break in the bone. When a fracture occurs, it is classified as either open or closed:

• open fracture - the bone exits and is visible through the skin, or where a deep wound exposes the bone through the skin
• closed fracture - the bone is broken, but the skin is intact

Fractures occur when there is more force applied to the bone than the bone can absorb. Bones are weakest when they are twisted. Breaks in bones can occur from falls, trauma, or as a result of a direct blow or kick to the body.

Diagnostic procedures may include the following:

• x-ray, MRI, CT scan

Symptoms

The following are the most common symptoms of a fracture:

• pain in the injured area
• swelling in the injured area
• obvious deformity in the injured area
• difficulty using or moving the injured area in a normal manner
• warmth, bruising, or redness in the injured area

Treatment

After Surgery/Recovery

Physical Therapy is a critical part of complete recovery. Our doctors recommend DMC's Rehabilitation Institute of Michigan, with 30 convenient locations across southeastern Michigan. To find one near you, click here.