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Hand & Wrist Problems

Our Hand & Wrist Unit takes a multi-disciplinary collaborative approach to treat and diagnose injuries and conditions affecting the hand and wrist. You’ll have access to world-class Consultant Orthopaedic & MSK Surgeons, a Specialist Hand Therapist, Sports & Exercise Medicine Specialists, Chartered Physiotherapists and onsite diagnostic imaging with reporting from specialist MSK Radiologists. Several Orthopaedic Surgeons also hold sub-specialties specifically for hand conditions and treatments.

We are equipped with two state-of-the-art theatres built with laminar flow systems to specifically accommodate Orthopaedic procedures. Our theatre staff are highly skilled in MSK & Orthopaedic operations, and our nurses are trained to assist with your recovery following Orthopaedic surgery.

Services & Treatments

At the Hand & Wrist Unit, we can treat an array of conditions and injuries of the hand and wrist. Whether you are suffering from a common condition to something more complex, we work with London’s leading Consultants and Specialists to provide you with first-class care.

Hand & Wrist Procedures

Carpal tunnel syndrome

Carpal tunnel syndrome affects your median nerve, which shares a narrow tunnel (carpal tunnel) in your wrist with the tendons that move your fingers. Increased pressure on this nerve can cause numbness and pain in your thumb, index and middle fingers. Wrist support worn at night can help with mild symptoms and steroid injection can also help to reduce pain and numbness. However, if these prove ineffective then a carpal tunnel release procedure should relieve symptoms and prevent any permanent nerve damage.

Treatment

During the 20-minute operation, which is normally performed under local anaesthetic, your surgeon will make a small incision in your palm to access and cut the tight ligament known as the flexor retinaculum, which forms the roof of the carpal tunnel.

Recovery

You’ll normally be able to return home the same day, although your hand should remain bandaged and raised for the next two days. Gently exercising your fingers, elbow and shoulders will prevent stiffness and help you return to your usual activities sooner but do check with your consultant before you begin exercising.

This page provides information about a carpal tunnel release. Please speak to your consultant for further information.

Trapeziectomy (for osteoarthritis)

Your trapezium is a cube-shaped bone at the base of your thumb that joins your wrist to your thumb. Osteoarthritis of the trapezium is a painful and restricting condition where the cover on the cartilage has worn away, exposing the bone and causing pain, immobility and lack of strength.

Treatment

A splint or a steroid injection may help to relieve the pain but a surgical procedure called a trapeziectomy is the most reliable way of treating your condition and giving you back proper use in your hand.

During your operation, which will use one of several anaesthetic options and will take between 60 and 90 minutes, your surgeon will make a small cut in the back of your hand, at the base of the thumb, to remove your trapezium. To fasten your thumb to your wrist, they will usually form a new ligament from the tendon that runs across the trapezium.

Recovery

You will usually return home on the same day, although your hand must be kept raised for two weeks. Your bandage or plaster will be removed four to six weeks later. Gentle thumb and finger exercises will help to ensure a speedy recovery and elbow and shoulder exercises will also help to keep you flexible, although do check with your consultant first.

Excision of a ganglion

Ganglions are lumps under the skin caused by leaking fluid from your joints or tendons. They often occur near your wrist joint, or sometimes on your foot or ankle. Although ganglions are not serious, they can be uncomfortable and it is relatively straightforward to have them removed through surgery.

Treatment

During your operation, which will use one of several possible anaesthetic techniques and takes around 30 minutes, your surgeon will make a cut over the ganglion. They will then separate and remove the ganglion from any tendons, blood vessels and nerves.

Recovery

You’ll normally return home on the same day, although you will probably ache for a few days and experience some stiffness around the site of the ganglion. Frequent and gentle exercise will help you to recover quickly but do check with your doctor. In some cases, ganglions can return.

This page will help you understand what an excision of a ganglion is. If you have any queries, please contact your consultant.

Surgery for De Quervain’s Disease (BlackBerry thumb)

A tender swelling at the base of your thumb and pain or stiffness when you move your wrist and thumb can all be symptoms of De Quervain’s disease – a condition often referred to as ‘washerwoman strain’, ‘BlackBerry thumb’ or ‘gamer’s thumb’. The pain you feel is due to a thickening of the fibrous roof of the narrow tunnel that your two thumb tendons glide through, at the base of your thumb.

Treatment

If your symptoms are mild then rest, anti-inflammatory painkillers, physiotherapy and a night splint may help, and steroid injections can relieve the pain for many people. If these methods have been unsuccessful then surgery should help alleviate the pain.

During your operation, which is likely to use a local anaesthetic and takes around half an hour, your surgeon will make a small incision at the base of your thumb and then cut open the roof of the tunnel. This will allow your thumb tendons to glide freely through the tunnel.

Recovery

You will usually be able to go home on the same day, although your hand should remain bandaged and raised for the next few days. Gentle exercise of your fingers, elbow and shoulders will help prevent stiffness and promote a speedy recovery but do check with your consultant. Most people find their symptoms improve quickly following their surgery.

This page provides information about surgery for De Quervain’s disease. Please contact your consultant for further information.

Dupuytren’s fasciectomy

Dupuytren’s disease is a condition that often causes scarring of the skin on the palm of your hand and fingers. The scar tissue contracts as the condition develops, forcing your fingers to curl towards your palm. This is known as Dupuytren’s contracture. Surgery is currently the most effective way to correct the curl of the fingers, returning the mobility and use of your hand.

Treatment

During the procedure, which uses an anaesthetic technique to suit your treatment, your surgeon will either cut the scarred tissue on the skin of your palm or remove the tissue and make the area good again with skin grafts.

Recovery

You can usually return home on the same day, although your hand may take a little time to settle after the operation. Gently exercise your fingers and hand every day to encourage a swift recovery, but do check with your consultant beforehand.

Trigger finger release

Trigger finger is a common condition where your finger or thumb catches or locks as it bends towards your palm. You may experience discomfort, clicking and stiffness, and small lumps often appear at the base of your finger or thumb.

The causes are still generally unknown, but certain conditions such as gout, rheumatoid arthritis and diabetes can be a contributing factor. Women and those over 40 are also more likely to develop the condition.

Treatment

You may find that your trigger finger heals without intervention. But if not, then medication, injections or splinting (attaching the affected finger to a splint) can all help. If the condition persists, you may require surgery.

There are two types of trigger finger release surgery. The type of surgery you need will depend on your condition, and your consultant will discuss this with you.

Open trigger finger release surgery

During open surgery, your consultant will make a small incision into your palm to reach your tendon. They will cut the ligament where the tendon is catching, which will release the tendon.

Percutaneous trigger finger surgery

During percutaneous surgery, your consultant will insert a needle into the base of your affected thumb or finger to slice the ligament. This type of surgery doesn’t require any incisions, leaving no scarring or wounds behind.

Both procedures take around 20 minutes and normally use a local anaesthetic.

Recovery

You should be able to move your finger immediately after surgery, but it may be sore or tender. Dressings can be removed after a few days, and full movement will return within a fortnight.

References:

EIDO Healthcare Limited – The operation and treatment information on this website is produced using information from EIDO Healthcare Ltd and is licensed by Aspen Healthcare.

The information should not replace advice that your relevant health professional would give you.

Consultants & Specialists

By taking a collaborative approach to your diagnosis and treatment, the Consultants and Specialists as part of the Hand & Wrist Unit are there to support you every step of the way – from diagnosis through treatment.

Hand & Wrist Problems Consultants

Are you insured?

We welcome patients with private medical insurance and are approved by all major insurers, including Bupa and AXA PPP.

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Not insured?

We offer a variety of fixed price Self-Pay Packages for those considering paying for their own treatment.

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For assistance call us on: 020 8341 4182 Email us

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